社會的發(fā)展和科技的進(jìn)步一方面給人們的生活帶來便利，另一方面也帶來越來越多潛在的健康風(fēng)險(xiǎn)。為了更好地進(jìn)行風(fēng)險(xiǎn)管理，公眾感知因素逐漸被納入管理的決策過程中。本文通過文獻(xiàn)綜述，闡述了健康風(fēng)險(xiǎn)感知研究方法的發(fā)展歷程，重點(diǎn)分析疾病、科技、生活習(xí)慣以及環(huán)境這四個(gè)領(lǐng)域健康風(fēng)險(xiǎn)感知的研究特點(diǎn)、熱點(diǎn)和趨勢。最后，基于目前研究的不足，對今后的研究進(jìn)行了展望，以期為促進(jìn)健康風(fēng)險(xiǎn)感知研究的深入發(fā)展提供科學(xué)參考。

關(guān)鍵詞: 健康  /  風(fēng)險(xiǎn)感知  /  風(fēng)險(xiǎn)交流  /  發(fā)展  

The development of society and the progress of technology had brought convenience to our life, on the other hand, more potential health risks had come out. In order to better carry out risk management, public perceptions had been incorporated into the process of decision-making. This paper provided an overview on the development of research method for health risk perception, and summarized the research characteristics, hot spots and trends of health risk perception in four fields:disease, science and technology, life style and environment. Finally, based on current researches, comments and prospects were made to provide scientific references for the further development of researches on health risk perception.

表  1   疾病健康風(fēng)險(xiǎn)感知(以艾滋病為例)文獻(xiàn)內(nèi)容歸納

文獻(xiàn) 研究地區(qū) 研究對象 影響因素 Woldeyohannes等，2017[11] 埃塞俄比亞 大學(xué)生 專業(yè)(是否是健康相關(guān)專業(yè)) Clifton等，2016[12] 英國 居民 危險(xiǎn)性性行為、HIV測試 DE等，2016[13] 南佛羅里達(dá) 變性婦女 年齡、教育程度、住處、婚姻狀況、HIV檢測結(jié)果、工作狀態(tài) Tafazolim等，2016[14] 伊朗 女犯人 知識、酒精消費(fèi)、成癮史、避孕頻率 Buzi等，2015[15] 美國西南部 非裔美國年輕女性 強(qiáng)迫性行為 Fan等，2014[16] 中國，北京 男同性戀 少數(shù)民族、性傳播疾病史、自上次HIV檢測以來的時(shí)間、工作性質(zhì)(是否全職)、使用非法藥物 Stevens等，2013[17] 美國 居民 HIV檢測結(jié)果 Essien等，2008[18] 美國，里奧格蘭德谷 墨西哥裔美國人 性別、收入、毒品使用 Adedimeji等，2007[19] 尼日利亞，伊巴丹 年輕貧民窟居民 婚姻狀況、收入 Essien等，2007[20] 尼日利亞 軍人 教育程度、酒精和大麻使用情況 Kabbash等，2007[21] 尼日利亞 醫(yī)護(hù)人員 工作培訓(xùn) Jovicvranes等，2006[22] 塞爾維亞 醫(yī)護(hù)人員 職業(yè) Helleringer和kohler，2005[23] 馬拉維 居民 社交 Sarker等，2005[24] 布基納法索 農(nóng)村年輕女性 艾滋病感染無癥狀知識的了解程度 Macintyre等，2004[25] 南非 青少年 與家長和社區(qū)男女性的聯(lián)系、男性中避孕效能感、是否與有慢性病的女性一起生活

表  2   科技健康風(fēng)險(xiǎn)感知結(jié)論歸納

文獻(xiàn) 科技項(xiàng)目 與健康有關(guān)的主要結(jié)論 Zeng等, 2016[33] 轉(zhuǎn)基因食品 轉(zhuǎn)基因食品帶來的風(fēng)險(xiǎn)包括健康風(fēng)險(xiǎn)、功能風(fēng)險(xiǎn)、社會心理風(fēng)險(xiǎn)、經(jīng)濟(jì)風(fēng)險(xiǎn)以及時(shí)間風(fēng)險(xiǎn)。其中健康風(fēng)險(xiǎn)和經(jīng)濟(jì)投入風(fēng)險(xiǎn)是民眾考慮最多的因素。 Dong等, 2014[34] 轉(zhuǎn)基因食品 消費(fèi)者對轉(zhuǎn)基因食品的潛在風(fēng)險(xiǎn)感知主要是身體風(fēng)險(xiǎn)，社會經(jīng)濟(jì)風(fēng)險(xiǎn)，生態(tài)環(huán)境風(fēng)險(xiǎn)和功能風(fēng)險(xiǎn)，其中前三種風(fēng)險(xiǎn)顯著影響購買意愿。 Savas等, 2013[35] 轉(zhuǎn)基因食品 醫(yī)生對轉(zhuǎn)基因食品的健康風(fēng)險(xiǎn)感知度很高，而知識水平卻很低。 Zhou等, 2012[36] 轉(zhuǎn)基因食品 大多數(shù)消費(fèi)者對GMF健康風(fēng)險(xiǎn)感知處于中等水平；教育程度、是否從事生物技術(shù)工作、對GMF的理解、信息來源、關(guān)注食品標(biāo)簽和GMF信任度對健康風(fēng)險(xiǎn)感知有顯著影響。 Vyncke等, 2015[37] 核電站 媒體是核事故健康風(fēng)險(xiǎn)感知的重要預(yù)測因子。對核電態(tài)度越樂觀，越長時(shí)間信息的覆蓋，對提供的信息滿意度越高，風(fēng)險(xiǎn)感知越低。 Morioka, 2014[38] 核電站 由于父親將輻射風(fēng)險(xiǎn)視為一種經(jīng)濟(jì)穩(wěn)定和男性社會地位的威脅，因此，母親的健康關(guān)心被反駁，并阻止她們采取預(yù)防措施。 Zakaria等, 2014[39] 核電站 所有受訪者認(rèn)為核電是某種風(fēng)險(xiǎn)的來源，但他們的風(fēng)險(xiǎn)感知程度有所不同。女性認(rèn)為核對人類健康的威脅很高。 Kowall等, 2012[40] 移動(dòng)基站 焦慮、抑郁、壓力大的個(gè)體對移動(dòng)基站的關(guān)注度更高，也更抵抗移動(dòng)基站的健康風(fēng)險(xiǎn)。 1. Beckhoff等, 2009[41] 移動(dòng)基站 將不利的健康影響歸因于手機(jī)基站的人有更多的睡眠障礙和健康問題，但是他們沒有更多的頭痛或者更差的身心健康狀態(tài)。 2. Blettner等, 2009[42] 移動(dòng)基站 18.7%的參與者擔(dān)心手機(jī)基站對健康帶來不良影響，另有10.3%的參與者將其個(gè)人不良健康影響歸因于手機(jī)基站。 Siegrist等, 2005[43] 手機(jī)、移動(dòng)
基站 60%的參與者同意兒童和青少年應(yīng)限制使用手機(jī)因?yàn)榭赡艽嬖诮】碉L(fēng)險(xiǎn)。66%的參與者贊成需要監(jiān)測靠近基地的人的健康狀況。36%的受訪者認(rèn)為手機(jī)基站發(fā)射的電磁場導(dǎo)致癌癥。 Wallquist等, 2010[44] CO2捕獲和
封存技術(shù) 大部分非專業(yè)人士認(rèn)為CCS有不良影響，會毒害有機(jī)體，改變有機(jī)體的基因結(jié)構(gòu)。

表  3   生活習(xí)慣健康風(fēng)險(xiǎn)感知文獻(xiàn)分析

不良生活習(xí)慣 研究內(nèi)容 文獻(xiàn)數(shù)量/篇 行為習(xí)慣 吸煙、酗酒 81 飲食習(xí)慣 零食、快餐、食品質(zhì)量 45 作息習(xí)慣 - 0 注：“-”目前還沒有相關(guān)研究內(nèi)容

表  4   環(huán)境健康風(fēng)險(xiǎn)感知研究分類

分類 具體項(xiàng)目 研究年份氣 室內(nèi)空氣 2002 室外空氣 2003—2017水 飲用水 2000—2014 沐浴用水 2000 泳池水 2004—2005氣候 極端天氣 2009—2017化學(xué)物質(zhì) 工作性質(zhì)誘導(dǎo) 農(nóng)藥 2009—2016 有毒氣體 2002—2014 垃圾焚燒廠 2009 社區(qū)環(huán)境誘導(dǎo) 采礦場 2011, 2016 其他 2016 [1] 張成福, 謝一帆.風(fēng)險(xiǎn)社會及其有效治理的戰(zhàn)略[J].中國人民大學(xué)學(xué)報(bào), 2009, 23(5):25-32. https://wenku.baidu.com/view/1f375158fe4733687e21aa45.html [2] 杜艷君, 班婕, 孫慶華, et al.環(huán)境健康風(fēng)險(xiǎn)的研究前沿及展望[J].現(xiàn)代預(yù)防醫(yī)學(xué), 2016, 43(24): http://mall.cnki.net/magazine/Article/XDYF201624006.htm [3]

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