摘要:

全球氣候變化已經(jīng)并將持續(xù)對人類健康造成廣泛而嚴(yán)重的影響。世界衛(wèi)生組織呼吁，醫(yī)療衛(wèi)生專業(yè)人員須在應(yīng)對氣候變化和保護(hù)公眾健康方面發(fā)揮重要作用，尤其應(yīng)當(dāng)在氣候敏感性疾病監(jiān)測、脆弱人群識別與照護(hù)、健康共益效應(yīng)促進(jìn)、風(fēng)險溝通和環(huán)保倡導(dǎo)等方面采取積極行動。本研究系統(tǒng)回顧了國內(nèi)外醫(yī)療衛(wèi)生人員對氣候變化的健康風(fēng)險認(rèn)知和適應(yīng)策略研究進(jìn)展，發(fā)現(xiàn)大多數(shù)人員基本認(rèn)識到氣候變化的健康威脅，并采取了高溫?zé)崂撕蜌夂蛎舾行詡魅静≡缙陬A(yù)警等有限的應(yīng)對措施，但仍面臨突出的挑戰(zhàn)和障礙，需要更多的健康風(fēng)險評估信息、風(fēng)險管理專業(yè)知識以及充足的專業(yè)技術(shù)人員和資金支持。未來研究應(yīng)加強(qiáng)評估氣候變化健康風(fēng)險認(rèn)知程度與實(shí)際適應(yīng)行動的關(guān)聯(lián)性，并開展優(yōu)先適應(yīng)策略甄別、干預(yù)措施效果和成本效益的分析，以幫助政府決策部門和醫(yī)療衛(wèi)生人員積極應(yīng)對。

Abstract:

Global climate change has widespread and serious impacts on human health and is expected to be worse in the future. The World Health Organization has called for health professionals to play an important role in addressing climate change and protecting public health, especially in climate-sensitive disease surveillance, vulnerable population identification and care, health co-benefit promotion, risk communication, and environmental advocacy. We systematically reviewed international research advances of health care professionals' perceptions and adaptation strategies on climate change-related health risks. We found that most health professionals basically recognized the health threats of climate change and adopted a few early warning strategies in coping with heat waves and climate-sensitive infectious diseases. However, they still faced significant challenges and obstacles, and needed more health risk assessment information, risk management expertise, and adequate health workforce and financial support. Future research should strengthen the assessment on the relationship between climate changerelated health risk perceptions and actual adaptation actions, and the evaluation on priority adaptation strategies, and the effectiveness and cost-benefit analysis of interventions, aiming to help government decision-making departments and health professionals respond to climate change positively.

[1]

EBI K L, OGDEN N H, SEMENZA J C, et al. Detecting and attributing health burdens to climate change[J]. Environ Health Perspect, 2017, 125(8):85004. doi: 10.1289/EHP1509

[2] 童世廬.氣候變化與人群健康[J].中華預(yù)防醫(yī)學(xué)雜志, 2018, 52(4):344-347. doi: 10.3760/cma.j.issn.0253-9624.2018.04.003 [3]

WATTS N, AMANN M, AYEB-KARLSSON S, et al. The Lancet Countdown on health and climate change:from 25 years of inaction to a global transformation for public health[J]. Lancet, 2018, 391(10120):581-630. doi: 10.1016/S0140-6736(17)32464-9

[4]

WOODWARD A, SMITH K R, CAMPBELL-LENDRUM D, et al. Climate change and health:on the latest IPCC report[J]. Lancet, 2014, 383(9924):1185-1189. doi: 10.1016/S0140-6736(14)60576-6

[5] 鐘爽, 黃存瑞.氣候變化的健康風(fēng)險與衛(wèi)生應(yīng)對[J].科學(xué)通報, 2019, 64(19):2002-2010. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFD&filename=KXTB201919005 [6]

MAIBACH EW, SARFATY M, MITCHELL M, et al. Limiting global warming to 1.5 to 2.0℃-a unique and necessary role for health professionals[J]. PLoS Med, 2019, 16(5):e1002804. doi: 10.1371/journal.pmed.1002804

[7]

RAMANATHAN V, HAINES A. Healthcare professionals must lead on climate change[J]. BMJ, 2016, 355:i5245. http://cn.bing.com/academic/profile?id=7d4c9fcd6b5d39ae1af8f7ec17a18b84&encoded=0&v=paper_preview&mkt=zh-cn

[8]

World Health Organization. Climate change and health conference document[R]. Geneva: WHO, 2016.

[9]

World Health Organization. Operational framework for building climate resilient health systems[R]. Geneva: WHO, 2015.

[10]

SYAL S S, WILSON R S, CRAWFORD J M, et al. Climate change and human health-what influences the adoption of adaptation programming in the United States public health system?[J]. Mitig Adapt Strateg Glob Chang, 2011, 16(8):911-924. doi: 10.1007/s11027-011-9302-1

[11]

MAIBACH E W, CHADWICK A, MCBRIDE D, et al. Climate change and local public health in the United States:preparedness, programs and perceptions of local public health department directors[J]. PLoS One, 2008, 3(7):e2838. doi: 10.1371/journal.pone.0002838

[12]

ROSER-RENOUF C, MAIBACH E W, LI J. Adapting to the changing climate:an assessment of local health department preparations for climate change-related health threats, 2008-2012[J]. PLoS One, 2016, 11(3):e0151558. doi: 10.1371/journal.pone.0151558

[13]

BEDSWORTH L. Preparing for climate change:a perspective from local public health officers in California[J]. Environ Health Perspect, 2009, 117(4):617-623. doi: 10.1289/ehp.0800114

[14]

CARR J L, SHEFFIELD P E, KINNEY P L. Preparedness for climate change among local health department officials in New York state:a comparison with national survey results[J]. J Public Health Manag Pract, 2012, 18(2):E24-E32. doi: 10.1097/PHH.0b013e31823dea74

[15]

SARFATY M, MITCHELL M, BLOODHART B, et al. A survey of African American physicians on the health effects of climate change[J]. Int J Environ Res Public Health, 2014, 11(12):12473-12485. doi: 10.3390/ijerph111212473

[16]

SARFATY M, BLOODHART B, EWART G, et al. American Thoracic Society member survey on climate change and health[J]. Ann Am Thorac Soc, 2015, 12(2):274-278. doi: 10.1513/AnnalsATS.201410-460BC

[17]

SARFATY M, KRESLAKE J M, CASALE T B, et al. Views of AAAAI members on climate change and health[J]. J Allergy Clin Immunol Pract, 2016, 4(2):333-335.e26. doi: 10.1016/j.jaip.2015.09.018

[18]

POLIVKA B J, CHAUDRY R V, MAC CRAWFORD J. Public health nurses' knowledge and attitudes regarding climate change[J]. Environ Health Perspect, 2012, 120(3):321-325. doi: 10.1289/ehp.1104025

[19]

PATERSON J A, FORD J D, FORD L B, et al. Adaptation to climate change in the Ontario public health sector[J]. BMC Public Health, 2012, 12:452. doi: 10.1186/1471-2458-12-452

[20]

SEMENZA J C, SUK J E, ESTEVEZ V, et al. Mapping climate change vulnerabilities to infectious diseases in Europe[J]. Environ Health Perspect, 2012, 120(3):385-392. doi: 10.1289/ehp.1103805

[21]

MCIVER L J, CHAN V S, BOWEN K J, et al. Review of climate change and water-related diseases in Cambodia and findings from stakeholder knowledge assessments[J]. Asia Pac J Public Health, 2016, 28(S2):49S-58S. http://cn.bing.com/academic/profile?id=59c33f66102f4ed7af76878d9d46263a&encoded=0&v=paper_preview&mkt=zh-cn

[22]

NIGATU A S, ASAMOAH B O, KLOOS H. Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia:a crosssectional study[J]. BMC Public Health, 2014, 14:587. doi: 10.1186/1471-2458-14-587

[23]

MAJRA J P, ACHARYA D. Protecting health from climate change:preparedness of medical interns[J]. Indian J Community Med, 2009, 34(4):317-320. doi: 10.4103/0970-0218.58390

[24]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Health professionals' perceptions of hemorrhagic fever with renal syndrome and climate change in China[J]. Glob Planet Change, 2017, 152:12-18. doi: 10.1016/j.gloplacha.2017.02.007

[25] 高菡璐, 楊超, 蘭莉, 等.哈爾濱市衛(wèi)生專業(yè)人員應(yīng)對氣候變化風(fēng)險的認(rèn)知調(diào)查[J].環(huán)境與職業(yè)醫(yī)學(xué), 2017, 34(12):1067-1071. doi: 10.13213/j.cnki.jeom.2017.17562 [26]

TONG M X, HANSEN A, HANSON-EASEY S, et al. China's capacity of hospitals to deal with infectious diseases in the context of climate change[J]. Soc Sci Med, 2018, 206:60-66. doi: 10.1016/j.socscimed.2018.04.021

[27]

WEI J, HANSEN A, ZHANG Y, et al. Perception, attitude and behavior in relation to climate change:a survey among CDC health professionals in Shanxi province, China[J]. Environ Res, 2014, 134:301-308. doi: 10.1016/j.envres.2014.08.006

[28]

WEI J, HANSEN A, ZHANG Y, et al. The impact of climate change on infectious disease transmission:perceptions of CDC health professionals in Shanxi Province, China[J]. PLoS One, 2014, 9(10):e109476. doi: 10.1371/journal.pone.0109476

[29] 汪慶慶, 陳曉東, 周連, 等.醫(yī)療衛(wèi)生人員對氣候變化的關(guān)注、認(rèn)知及其影響因素調(diào)查[J].江蘇預(yù)防醫(yī)學(xué), 2012, 23(4):26-28. doi: 10.3969/j.issn.1006-9070.2012.04.010 [30]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Perceptions of capacity for infectious disease control and prevention to meet the challenges of dengue fever in the face of climate change:a survey among CDC staff in Guangdong Province, China[J]. Environ Res, 2016, 148:295-302. doi: 10.1016/j.envres.2016.03.043

[31] 蘇麗琴, 程義斌, 辛鵬舉, 等.三城市公共衛(wèi)生人員對氣候變化健康影響的知識、態(tài)度、行為調(diào)查[J].環(huán)境衛(wèi)生學(xué)雜志, 2013, 3(6):507-509, 514. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=gwyx-wsx201306007 [32]

XIAO J, FAN W, DENG Y, et al. Nurses' knowledge and attitudes regarding potential impacts of climate change on public health in central of China[J]. Int J Nurs Sci, 2016, 3(2):158-161. http://cn.bing.com/academic/profile?id=01ce865d39265aaa764fb4c51c532a69&encoded=0&v=paper_preview&mkt=zh-cn

[33]

YANG L, LIAO W, LIU C, et al. Associations between knowledge of the causes and perceived impacts of climate change:a cross-sectional survey of medical, public health and nursing students in universities in China[J]. Int J Environ Res Public Health, 2018, 15(12):2650. doi: 10.3390/ijerph15122650

[34]

LIAO W, YANG L, ZHONG S, et al. Preparing the next generation of health professionals to tackle climate change:are China's medical students ready?[J]. Environ Res, 2019, 168:270-277. doi: 10.1016/j.envres.2018.10.006

[35]

HATHAWAY J, MAIBACH E W. Health implications of climate change:a review of the literature about the perception of the public and health professionals[J]. Curr Environ Health Rep, 2018, 5(1):197-204. doi: 10.1007/s40572-018-0190-3

[36]

GILL M, STOTT R. Health professionals must act to tackle climate change[J]. Lancet, 2009, 374(9706):1953-1955. doi: 10.1016/S0140-6736(09)61830-4

[37]

SHIN G Y, MANUEL R J. Healthcare professionals must "think globally, act locally" on climate change[J]. BMJ, 2016, 355:i5686. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=HighWire000006579479

[38]

MOSER A M, STIGLER F L, HADITSCH B. Physicians' responsibility for planetary health[J]. Lancet Planet Health, 2017, 1(2):e56. doi: 10.1016/S2542-5196(17)30023-2

[39]

JOHNSON G A. Role of GPs in communicating lifestyle messages that are good for health and the climate[J]. BMJ, 2013, 347:f6480. doi: 10.1136/bmj.f6480

[40]

WANG S, JIANG J, ZHOU Y, et al. Climate-change information, health-risk perception and residents' environmental complaint behavior:an empirical study in China[J]. Environ Geochem Health, 2019(1):10.1007/s10653-018-0235-4. http://cn.bing.com/academic/profile?id=fc6d1506a68630df6545bd77abf6a56b&encoded=0&v=paper_preview&mkt=zh-cn

[41]

COSTELLO A, MONTGOMERY H, WATTS N. Climate change:the challenge for healthcare professionals[J]. BMJ, 2013, 347:f6060. doi: 10.1136/bmj.f6060

[42]

XIE E, DE BARROS E F, ABELSOHN A, et al. Challenges and opportunities in planetary health for primary care providers[J]. Lancet Planet Health, 2018, 2(5):e185-e187. doi: 10.1016/S2542-5196(18)30055-X

[43]

BLASHKI G, ABELSOHN A, WOOLLARD R, et al. General Practitioners' responses to global climate change-lessons from clinical experience and the clinical method[J]. Asia Pac Fam Med, 2012, 11(1):6. doi: 10.1186/1447-056X-11-6

[44] BLASHKI G, ABELSOHN A, WOOLLARD R, 等.應(yīng)對全球氣候變化: 全科醫(yī)生的臨床經(jīng)驗(yàn)和方法[J].邵鈞, 譯.中國全科醫(yī)學(xué), 2013, 16(10): 1079-1084. [45]

PURCELL R, MCGIRR J. Preparing rural general practitioners and health services for climate change and extreme weather[J]. Aust J Rural Health, 2014, 22(1):8-14. doi: 10.1111/ajr.12075

[46]

PATRICK R, SMITH J A. Core health promotion competencies in Australia:are they compatible with climate change action?[J]. Health Promot J Austr, 2011, 22(4):28-33. doi: 10.1071/HE11428

[47]

DASGUPTA P, EBI K, SACHDEVA I. Health sector preparedness for adaptation planning in India[J]. Climatic Change, 2016, 138(3/4):551-566. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=7e740c1061e71e74cd1233269ba10125

[48]

LOWE D, EBI K L, FORSBERG B. Heatwave early warning systems and adaptation advice to reduce human health consequences of heatwaves[J]. Int J Environ Res Public Health, 2011, 8(12):4623-4648. doi: 10.3390/ijerph8124623

[49]

NITSCHKE M, TUCKER G, HANSEN A, et al. Evaluation of a heat warning system in Adelaide, South Australia, using case-series analysis[J]. BMJ Open, 2016, 6(7):e12125. http://cn.bing.com/academic/profile?id=6b535865fbc4037f6e3efee4f15eeeb8&encoded=0&v=paper_preview&mkt=zh-cn

[50]

BENMARHNIA T, BAILEY Z, KAISER D, et al. A differencein-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status(Montreal, Quebec)[J]. Environ Health Perspect, 2016, 124(11):1694-1699. doi: 10.1289/EHP203

[51]

BENMARHNIA T, ZHAO X, WANG J, et al. Evaluating the potential public health impacts of the Toronto cold weather program[J]. Environ Int, 2019, 127:381-386. doi: 10.1016/j.envint.2019.03.042

[52] 畢鵬.氣候變化對弱勢群體健康影響的社區(qū)干預(yù)[J].中華預(yù)防醫(yī)學(xué)雜志, 2018, 52(4):348-351. doi: 10.3760/cma.j.issn.0253-9624.2018.04.004 [53]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Perceptions of malaria control and prevention in an era of climate change:a cross-sectional survey among CDC staff in China[J]. Malar J, 2017, 16(1):136. doi: 10.1186/s12936-017-1790-3

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