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The big lie: discursive risk analysis and wildland firefighter safety in the Western United States 大谎言:美国西部话语风险分析与野地消防员安全
Pub Date : 2023-10-06 DOI: 10.1088/2752-5309/ad00d5
Trevor Durbin, Casper G Bendixsen, Amber A Neely, Sarah Strauss
Abstract While increased length and intensity of wildfire seasons have led to more concern about wildland firefighter safety, we believe ethnography has been underutilized within wildfire health and safety. In response, we begin building a shared idiom for ethnographic engagement with wildland firefighter safety and similar occupational domains. We draw on ethnographic approaches to late industrialism to develop a method called Discursive Risk Analysis (DRA) as an initial stage in a broader collaborative and generative research practice. By collaborative, we mean cooperation among stakeholder, disciplinary, professional, and other groups. We use DRA to analyze ethnographic data and documentary sources relevant to discussions of “the Big Lie” among firefighters and agency leadership. The Big Lie is a term that both firefighters and agency leaders used to suggest that wildland firefighters are being harmed by agency discourse that says firefighters will be kept safe despite the unavoidable danger of the job. It is important to the Big Lie discussion that this harm is conceptualized by firefighters as discursively driven, necessitating a method attentive to discourse. Discursive Risk Analysis of the Big Lie discussion suggests two discursive gaps that may result in two discursive risks. The first gap, found in agency discourse, is that “everyone knows the job is dangerous” but “zero fatalities is a reasonable goal.” This gap is associated with a discursive risk, a possible decrease in trust among wildland firefighters in agency leadership. The second gap, observed in firefighter discourse, is that “the job is dangerous” but “no one will get hurt today.” This gap is associated with another discursive risk, the possibility of decreased situational awareness. Finally, we clarify each of these gaps and risks through two anthropological concepts (the Sapir-Whorf hypothesis and the public secret) that can bring new perspectives to discussions about institutional cultures of health and safety.
虽然野火季节的长度和强度的增加引起了人们对野火消防员安全的更多关注,但我们认为民族志在野火健康和安全方面的利用不足。作为回应,我们开始建立一个共享的习语,用于与野外消防员安全和类似职业领域的民族志接触。我们利用民族志方法来研究晚期工业主义,开发了一种称为话语风险分析(DRA)的方法,作为更广泛的协作和生成研究实践的初始阶段。通过协作,我们指的是利益相关者、学科、专业和其他团体之间的合作。我们使用DRA来分析与消防员和机构领导层之间“大谎言”讨论相关的人种学数据和文献来源。“弥天大谎”是消防队员和消防机构领导人都使用的一个术语,用来暗示,尽管消防人员的工作存在不可避免的危险,但他们仍将保持安全,这一说法损害了野外消防员的利益。重要的是,这种伤害被消防员概念化为话语驱动,需要一种关注话语的方法。对大谎言讨论的话语风险分析表明,两个话语缺口可能导致两种话语风险。第一个差距是,在机构的话语中发现,“每个人都知道这份工作很危险”,但“零死亡是一个合理的目标”。这一差距与话语风险有关,可能会导致野火消防员对机构领导层的信任下降。在消防员话语中观察到的第二个差距是,“这份工作很危险”,但“今天没有人会受伤”。这种差距与另一种话语风险有关,即情境意识下降的可能性。最后,我们通过两个人类学概念(Sapir-Whorf假说和公共秘密)澄清了这些差距和风险,这可以为讨论健康和安全的制度文化带来新的视角。
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引用次数: 0
Air quality and health effects of a transition to ammonia-fueled shipping in Singapore 新加坡向氨燃料航运过渡对空气质量和健康的影响
Pub Date : 2023-09-19 DOI: 10.1088/2752-5309/acfb2e
Sagar Rathod, Morgan R Edwards, Chaitri Roy, Laura Warnecke, Peter Rafaj, Gregor Kiesewetter, Zbigniew Klimont
Abstract Ammonia has been proposed to replace heavy fuel oil in the shipping industry by 2050. When produced with low-carbon electricity, ammonia can reduce greenhouse gas emissions. However, ammonia emissions also contribute to local air pollution via the formation of secondary particulate matter. We estimate the potential ammonia emissions from storage and bunkering operations for shipping in Singapore, a port that accounts for 20% of global bunker fuel sales, and their impacts on air quality and health. Fuel storage and bunkering can increase total gaseous ammonia emissions in Singapore by up to a factor of four and contribute to a 25-50% increase in ambient PM2.5 concentration compared to a baseline scenario with heavy fuel oil, leading to an estimated 210-460 premature mortalities in Singapore (30-70% higher than the baseline). Proper abatement on storage and bunkering can reduce these emissions and even improve ambient PM2.5 concentrations compared to the baseline. Overall, while an energy transition from heavy fuel oil to ammonia in the shipping industry could reduce global greenhouse gas and air pollutant burdens, local policies will be important to avoid negative impacts on the communities living near its supply chain.
摘要到2050年,氨气将取代航运业的重质燃料油。当用低碳电力生产氨时,可以减少温室气体的排放。然而,氨的排放也通过形成二次颗粒物而造成当地空气污染。我们估计了新加坡这个占全球船用燃料销售20%的港口的船舶储存和加油作业可能产生的氨排放,以及它们对空气质量和健康的影响。与使用重燃料油的基准情景相比,燃料储存和加油可使新加坡的气态氨排放总量增加四倍,并导致环境PM2.5浓度增加25-50%,导致新加坡估计有210-460人过早死亡(比基准高出30-70%)。适当减少储存和加油可以减少这些排放,甚至可以改善环境PM2.5浓度。总体而言,虽然航运业从重质燃料油向氨的能源转型可以减少全球温室气体和空气污染物的负担,但地方政策对于避免对其供应链附近的社区产生负面影响至关重要。
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引用次数: 0
Human milk EV-miRNAs: a novel biomarker for air pollution exposure during pregnancy. 母乳EV miRNAs:妊娠期空气污染暴露的新生物标志物。
Pub Date : 2023-09-01 Epub Date: 2023-06-30 DOI: 10.1088/2752-5309/ace075
Elizabeth A Holzhausen, Allison Kupsco, Bridget N Chalifour, William B Patterson, Kelsey A Schmidt, Pari Mokhtari, Fredrick Lurmann, Andrea A Baccarelli, Michael I Goran, Tanya L Alderete

Exposure to ambient and near-roadway air pollution during pregnancy has been linked with several adverse health outcomes for pregnant women and their babies. Emerging research indicates that microRNA (miRNA) expression can be altered by exposure to air pollutants in a variety of tissues. Additionally, miRNAs from breast tissue and circulating miRNAs have previously been proposed as a biomarker for breast cancer diagnosis and prognosis. Therefore, this study sought to evaluate the associations between pregnancy exposures to ambient (PM10, PM2.5, NO2, O3) and near-roadway air pollution (total NOx, freeway NOx, non-freeway NOx) with breast milk extracellular vesicle miRNA (EV-miRNA), measured at 1-month postpartum, in a cohort of 108 Latina women living in Southern California. We found that PM10 exposure during pregnancy was positively associated with hsa-miR-200c-3p, hsa-miR-200b-3p, and hsa-let-7c-5p, and was negatively associated with hsa-miR-378d. We also found that pregnancy PM2.5 exposure was positively associated with hsa-miR-200c-3p and hsa-miR-200b-3p. First and second trimester exposure to PM10 and PM2.5 was associated with several EV-miRNAs with putative messenger RNA targets related to cancer. This study provides preliminary evidence that air pollution exposure during pregnancy is associated with human milk EV-miRNA expression.

怀孕期间暴露于环境和道路附近的空气污染与孕妇及其婴儿的几种不良健康后果有关。新兴的研究表明,暴露于各种组织中的空气污染物可以改变微小RNA(miRNA)的表达。此外,来自乳腺组织和循环miRNA的miRNA先前已被提议作为乳腺癌症诊断和预后的生物标志物。因此,本研究试图评估妊娠期暴露于环境(PM10、PM2.5、NO2、O3)和近道路空气污染(总氮氧化物、高速公路氮氧化物、非高速公路氮氧化物)与母乳细胞外小泡miRNA(EV-miRNA)之间的关系,该研究在产后1个月对居住在南加州的108名拉丁裔女性进行了测量。我们发现,妊娠期PM10暴露与hsa-miR-200c-3p、hsa-miR-200 b-3p和hsa-let-7c-5p呈正相关,与hsa-iR-378d呈负相关。我们还发现,妊娠期PM2.5暴露与hsa-miR-200c-3p和hsa-miR-200 b-3p呈正相关。妊娠早期和中期暴露于PM10和PM2.5与几种EV-mRNA相关,这些EV-mRNA具有与癌症相关的假定信使RNA靶点。这项研究提供了初步证据,证明怀孕期间暴露于空气污染与母乳EV miRNA表达有关。
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引用次数: 0
Inclusion of child-relevant data in the development and validation of heat vulnerability indices: a commentary. 在热脆弱性指数的制定和验证中纳入儿童相关数据:评论。
Pub Date : 2023-09-01 Epub Date: 2023-06-22 DOI: 10.1088/2752-5309/acdd8a
Kate R Weinberger, Blean Girma, Jane E Clougherty, Perry E Sheffield
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引用次数: 0
High ambient temperatures associations with children and young adult injury emergency department visits in NYC. 高环境温度与纽约市儿童和青少年伤害急诊就诊的关系
Pub Date : 2023-09-01 Epub Date: 2023-07-12 DOI: 10.1088/2752-5309/ace27b
Blean Girma, Bian Liu, Leah H Schinasi, Jane E Clougherty, Perry E Sheffield

Injury is a significant health burden for children and young adult and may be an increasing concern in a warming climate. Research reveals many impacts to children's health associated with hot weather and heatwave events, including a growing literature on the association between high ambient temperature and injury, which may vary by intent such as injury resulting from violence. However, little is known about how this association varies across different types of injury and subgroups of young people. We examined relationships between warm season ambient temperature and intentional and unintentional injury among children and young adults in New York City (NYC). Within a case-crossover design, our study observed injury-related emergency department (ED) visits from the New York Statewide Planning and Research Cooperative System administrative dataset. Injuries were categorized as unintentional or intentional injuries during the warm season (May through September) in NYC from 2005 to 2011 among patients (0, 1-4, 5-9, 10-14, 15-19, 20-25 years old (y.o.)). Conditional logistic regression models with distributed lag non-linear functions were used to model the cumulative odds ratio (OR) injury-related ED visit over 0-5 lag days. Analyses were stratified by age group and sex to understand how associations vary across young people of different age and sex. There were a total of 572 535 injury-related ED visits. The largest effect of elevated temperature (daily minimum 77°F vs 48°F) was for unintentional injury among 5-9 y.o. (OR 1.32, 95% CI 1.23, 1.42) and for intentional injury among 20-25 y.o. (OR 1.54, 95% CI 1.28, 1.85). Further stratified analyses revealed that the highest risk of unintentional injury was among 5-9 y.o. males and 20-25 y.o. males for intentional injury. Our results suggest that high ambient temperatures are associated with higher odds of unintentional and intentional injuries among children. This work adds to a growing body of literature demonstrating the adverse impacts of heat on children, and suggests the need for messaging to parents and children about adopting adaptive strategies to prevent injuries when it is hot outside.

伤害是儿童和年轻人的一个重大健康负担,在气候变暖的情况下可能日益受到关注。研究揭示了与炎热天气和热浪事件相关的许多对儿童健康的影响,包括越来越多的关于高环境温度与伤害之间关系的文献,这种关系可能因意图而异,例如暴力造成的伤害。然而,对于这种关联在不同类型的损伤和年轻人亚群中是如何变化的,我们知之甚少。我们研究了温暖季节环境温度与纽约市儿童和年轻人有意和无意伤害之间的关系。在病例交叉设计中,我们的研究观察了来自纽约州规划和研究合作系统管理数据集的与伤害相关的急诊室(ED)就诊情况。在2005年至2011年纽约市温暖季节(5月至9月)的患者(0,1 - 4,5 - 9,10 - 14,15 - 19,20 -25岁)中,伤害被分类为无意或故意伤害。采用具有分布滞后非线性函数的条件logistic回归模型对0-5滞后天的累积优势比(OR)损伤相关急诊科就诊进行建模。分析按年龄组和性别分层,以了解不同年龄和性别的年轻人之间的关联是如何变化的。共有572 535次与伤害有关的急诊科就诊。升高温度(每日最低77°F vs 48°F)对5-9岁的意外伤害(OR 1.32, 95% CI 1.23, 1.42)和20-25岁的故意伤害(OR 1.54, 95% CI 1.28, 1.85)的影响最大。进一步的分层分析显示,意外伤害的最高风险是5-9岁的男性和20-25岁的男性故意伤害。我们的研究结果表明,高环境温度与儿童意外伤害和故意伤害的几率较高有关。这项工作增加了越来越多的文献,证明了高温对儿童的不利影响,并建议有必要向父母和孩子传达在室外炎热时采取适应性策略以防止受伤的信息。
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引用次数: 0
Associations between long-term exposure to fine particulate matter and osteoporotic fracture risks in South Korea 韩国长期接触细颗粒物与骨质疏松性骨折风险的关系
Pub Date : 2023-08-17 DOI: 10.1088/2752-5309/acf14e
Seulkee Heo, G. Byun, Sera Kim, Whanhee Lee, Jong-Tae Lee, Morag Bell
The prevalence of osteoporotic fracture is increasing globally due to rapid population growth and aging. Current evidence suggests adverse impacts of air pollution on bone mineral density loss and osteoporosis, but population-based evidence for the associations between fine particulate matter (particulate matter no larger than 2.5 μm in diameter [PM2.5]) and osteoporotic fracture is limited due to the small number of studies. This longitudinal study assessed the associations between long-term exposure to PM2.5 and osteoporotic fracture incidence in adults aged ⩾40 years, who enrolled in the National Health Insurance Service-National Sample Cohort data in 2002–2019 in South Korea. A time-varying moving window of past exposures of PM2.5 up to ten past years was estimated for participants’ residential addresses using modeled PM2.5. We used Cox proportional hazard models to estimate hazard ratios (HRs) of time-variant moving concentrations of PM2.5 exposure and osteoporotic fracture. The Cox models calculated HRs for an interquartile range (IQR) increase in PM2.5 exposure, adjusting for age, sex, body mass index, health behaviors, medications, disease history, income, and urbanicity. We assessed 161 831 participants over 993 104 person-year of follow-up. Results suggested linear and positive exposure-response associations for past PM2.5 exposure in the prior four years or more. The IQR increase in 5-year moving average PM2.5 was significantly associated with increased osteoporotic risk (HR = 1.079, 95% CI: 1.001, 1.164). The HRs were significant in women (1.102, 95% CI: 1.011, 1.200) and the subset of women aged 50–74 years (1.105, 95% CI: 1.005, 1.214) but not in men overall or by age groups. The association was not significantly different by income, physical activities, urbanicity, or diet. Overall, long-term PM2.5 exposure was associated with increased osteoporotic fracture risks in Korean adults, especially women.
由于人口的快速增长和老龄化,骨质疏松性骨折的患病率在全球范围内呈上升趋势。目前的证据表明,空气污染对骨密度损失和骨质疏松症有不利影响,但由于研究数量较少,基于人群的细颗粒物(直径不大于2.5μm的颗粒物[PM2.5])与骨质疏松性骨折之间关系的证据有限。这项纵向研究评估了40岁成年人长期暴露于PM2.5与骨质疏松性骨折发生率之间的关系,这些人参加了2002年至2019年韩国国家健康保险服务国家样本队列数据。使用建模的PM2.5,为参与者的居住地址估计了过去十年PM2.5暴露量的时变移动窗口。我们使用Cox比例风险模型来估计PM2.5暴露和骨质疏松性骨折的时变移动浓度的风险比(HR)。Cox模型计算了PM2.5暴露量四分位间距(IQR)增加的HR,并根据年龄、性别、体重指数、健康行为、药物、病史、收入和城市化进行了调整。我们评估了161 831名参与者超过993人 104人年随访。结果表明,在过去四年或更长时间内,过去PM2.5暴露与暴露反应呈线性和正相关。5年移动平均PM2.5的IQR增加与骨质疏松风险增加显著相关(HR=1.079,95%CI:1.001,1.164)。HR在女性(1.102,95%CI:1.011,1.200)和50-74岁女性亚组(1.105,95%CI:11.005,1.214)中显著,但在男性整体或按年龄组不显著。在收入、体育活动、城市化或饮食方面,这种关联没有显著差异。总体而言,长期接触PM2.5与韩国成年人,尤其是女性骨质疏松性骨折风险增加有关。
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引用次数: 0
An interrupted time series analysis of the cardiovascular health benefits of a coal coking operation closure 焦化作业关闭对心血管健康益处的间断时间序列分析
Pub Date : 2023-07-31 DOI: 10.1088/2752-5309/ace4ea
Wuyue Yu, G. Thurston
With the widespread implementation of air pollution mitigation strategies for health and climate policy, there is an emerging interest in accountability studies to validate whether a reduction of air pollution exposure, in fact, produces the human health benefits estimated from past air pollution epidemiology. The closure of a coal coking plant provides an ideal ‘natural’ experiment opportunity to rigorously evaluate the health benefits of air pollution emissions reductions. In this study, we applied an interrupted time series model to test the hypothesis that the substantial reduction in air pollution induced by the closure of the Shenango, Inc. coke plant in Pittsburgh, PA during January, 2016 was followed by immediate and/or longer-term cumulative local cardiovascular health benefits. We observed a 90% decrease in nearby SO2 levels, as well as significant reductions in coal-related fine particulate matter constituents (sulfate and arsenic), after the closure. Statistically significant cardiovascular health benefits were documented in the local population, including a 42% immediate drop (95% CI: 33%, 51%) in cardiovascular emergency department (ED) visits from the pre-closure mean. A longer-term downward trend was also observed for overall emergency visits at −0.14 (95% CI: −0.17, −0.11) visits per week rate of decrease after the closure, vs. a rise of 0.17 (95% CI: 0.14, 0.20) visits per week before. Similarly, inpatient cardiovascular hospitalizations per year showed a decrease after closure (−27.97 [95% CI: −46.90, −9.04], as compared with a 5.09 [95% CI: −13.84, 24.02] average increase in cases/year over the prior three years). Our study provides clear evidence that this intervention lowering fossil fuel-associated air pollution benefited public health in both the short and longer term, while also providing validation of the past use of observational air pollution epidemiology effect estimates in policy analyses.
随着健康和气候政策中空气污染缓解战略的广泛实施,人们对问责制研究越来越感兴趣,以验证减少空气污染暴露是否真的能产生过去空气污染流行病学估计的人类健康益处。焦化厂的关闭为严格评估空气污染减排对健康的益处提供了一个理想的“自然”实验机会。在这项研究中,我们应用了一个中断时间序列模型来检验以下假设:2016年1月,宾夕法尼亚州匹兹堡股份有限公司Shenango焦炭厂关闭,导致空气污染大幅减少,随后立即和/或长期累积局部心血管健康益处。我们观察到,关闭后,附近的SO2水平下降了90%,与煤有关的细颗粒物成分(硫酸盐和砷)也显著减少。在当地人群中记录了具有统计学意义的心血管健康益处,包括心血管急诊科(ED)就诊次数比关闭前平均值立即下降42%(95%CI:33%,51%)。此外,观察到整体急诊就诊的长期下降趋势是,关闭后每周就诊次数减少-0.14次(95%置信区间:-0.17,-0.11),而关闭前每周就诊次数增加0.17次(95%可信区间:0.14,0.20)。同样,每年的心血管住院患者在关闭后也有所下降(−27.97[95%置信区间:−46.90,−9.04],而前三年的病例/年平均增加5.09[95%置信度:−13.84,24.02])。我们的研究提供了明确的证据,表明这种降低化石燃料相关空气污染的干预措施在短期和长期内都有利于公众健康,同时也验证了过去在政策分析中使用观察性空气污染流行病学效应估计的做法。
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引用次数: 1
Unveiling the link between rainfall, temperature, and childhood undernutrition in Bangladesh using spatial analysis 利用空间分析揭示孟加拉国降雨量、气温和儿童营养不良之间的联系
Pub Date : 2023-07-26 DOI: 10.1088/2752-5309/ace2e0
J. R. Khan, K. Bakar, M. S. Hossain
Child undernutrition is still a major public health concern in Bangladesh in spite of significant decline in the last few years. Climate change may impact the prevalence of undernutrition and its geographical variability through food security and recurring outbreaks of disease, as well as impede efforts to reduce the undernutrition burden. This study aims to evaluate rainfall and temperature associated with childhood malnutrition in Bangladesh. A spatial mixed effect logistic regression model was used to estimate the association between undernutrition (measured by the composite index of anthropometric failure) and residential area-level rainfall and temperatures, controlling for covariates and spatial effects of residential locations using national data from the 2017 to 2018 Bangladesh Demographic and Health Survey. Our findings indicate that an increase in rainfall was associated with increased odds of undernutrition [adjusted odds ratio (AOR) 1.15, 95% confidence interval (CI) 1.07–1.24], whereas an increase in temperature was associated with decreased odds of undernutrition (AOR 0.86, 95% CI 0.80–0.93). We also found statistically significant structured and unstructured spatial variations in undernutrition, indicating locational effects. Investing in infrastructure and education could be potential strategies for mitigating the negative effects of climate change. High-risk regions in terms of climatic change and malnutrition could be given priority for intervention implementation.
尽管在过去几年中儿童营养不良现象显著下降,但在孟加拉国,儿童营养不良仍是一个主要的公共卫生问题。气候变化可能通过粮食安全和疾病反复爆发影响营养不良的普遍性及其地理变异性,并阻碍减少营养不良负担的努力。本研究旨在评估孟加拉国儿童营养不良的降雨量和温度。使用空间混合效应逻辑回归模型来估计营养不良(通过人体测量失败的综合指数测量)与居住区水平的降雨量和温度之间的关联,并使用2017年至2018年孟加拉国人口与健康调查的国家数据控制居住区的协变量和空间效应。我们的研究结果表明,降雨量的增加与营养不良的几率增加有关[调整后的比值比(AOR)1.15,95%置信区间(CI)1.07-1.24],而温度升高与营养不良几率降低有关(AOR 0.86,95%CI 0.80–0.93)。我们还发现营养不良的结构和非结构空间变化具有统计学意义,表明位置效应。投资于基础设施和教育可能是减轻气候变化负面影响的潜在战略。气候变化和营养不良方面的高风险地区可以优先实施干预措施。
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引用次数: 0
The association between high ambient temperature and risk of hospitalization: a time-series study in eight ecological regions in Vietnam 高环境温度与住院风险之间的关系:越南八个生态区的时间序列研究
Pub Date : 2023-07-11 DOI: 10.1088/2752-5309/ace646
Nu Quy Linh Tran, Hieu K T Ngo, N. T. Tuong Vy, T. Dang, S. Nghiem, Huu Quyen Nguyen, D. Phung
Viet Nam is among the countries most threatened by and vulnerable to climate change and extreme weather events. However, research on the temperature-morbidity relationship at the national scale has been scarce. This study aimed to assess the impact of high temperatures on the risk of hospital admissions for all causes and heat-sensitive diseases across eight ecological regions in Vietnam. The study utilized a longitudinal dataset that included hospitalization and meteorological data from eight provinces representing eight regions in Vietnam. A time series analysis was applied using the generalized linear and distributed lag models with a quasi-Poisson family to examine the temperature-hospitalization association in each province. A random-effects meta-analysis was used to calculate the pooled estimate of risk for the national scale. The country-level pooled effects (%, [95% CI]) indicated that a 1 °C increase above the threshold temperature (19 °C) increased the hospitalization risk for all causes and infectious diseases by 0.8% [0.4%–1.2%] and 2.4% [1.02%–1.03%], respectively at lag 0–3 d. The effects of heat on respiratory diseases and mental health disorders were not significant. At the regional level, the association varied across eight regions, of which the Northern parts tended to have a higher risk than the Southern. This is among very few national-scale studies assessing hospitalization risk associated with high temperatures across eight ecological regions of Vietnam. These findings would be useful for developing evidence-based heat-health action plans.
越南是受气候变化和极端天气事件威胁最大、最易受其影响的国家之一。然而,在全国范围内对温度-发病率关系的研究很少。这项研究旨在评估高温对越南八个生态地区各种原因住院风险和热敏疾病的影响。该研究利用了一个纵向数据集,其中包括来自越南八个地区的八个省的住院和气象数据。使用具有拟泊松族的广义线性和分布滞后模型进行时间序列分析,以检验各省的温度住院关联。随机效应荟萃分析用于计算全国范围内的风险汇总估计。国家一级的综合效应(%,[95%CI])表明,在0–3d滞后时,高于阈值温度(19°C)1°C会使各种原因和传染病的住院风险分别增加0.8%[0.4%-1.2%]和2.4%[0.02%-1.03%]。高温对呼吸系统疾病和精神健康障碍的影响并不显著。在地区层面上,八个地区的关联各不相同,其中北部地区的风险往往高于南部地区。这是为数不多的评估越南八个生态区高温相关住院风险的全国性研究之一。这些发现将有助于制定基于证据的热健康行动计划。
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引用次数: 0
Climate change-related mass migration requires health system resilience 与气候变化相关的大规模移徙需要卫生系统的应变能力
Pub Date : 2023-07-10 DOI: 10.1088/2752-5309/ace5ca
A. Clark-Ginsberg, A. Chandra
Mass migration driven by climate change-related shocks and stresses is already occurring. We argue for a need for resilient health systems to ensure migration is adaptive, not detrimental, to health. We make this argument for two reasons. First, without resilience, large and sudden population increases such as from migration may strain health systems. Second, while health system resilience-building efforts are occurring, these tend to focus on crises that are substantially different from climate change-related mass migration—most notably because migrants are not threats but instead people with resources and capacity as well as needs. Then, articulating a health system as a large and complex sociotechnical infrastructure, we outline three salient features of health systems resilient to climate change-related mass migration: rapid ability to shift and adapt, multi-stakeholder collaboration, and transformation. We conclude by suggesting the resources, which policymakers need for achieving health system resilience from this sociotechnical perspective.
由气候变化相关冲击和压力驱动的大规模移民已经在发生。我们主张需要有复原力的卫生系统,以确保移徙对健康具有适应性,而不是有害的。我们提出这个论点有两个原因。首先,如果没有复原力,移民等人口的突然大量增加可能会给卫生系统带来压力。第二,虽然正在开展卫生系统复原力建设工作,但这些工作往往侧重于与气候变化相关的大规模移徙有很大不同的危机,最明显的原因是移徙者不是威胁,而是拥有资源、能力和需求的人。然后,我们将卫生系统表述为一个庞大而复杂的社会技术基础设施,概述了卫生系统对气候变化相关的大规模移民具有弹性的三个显著特征:快速转移和适应能力、多利益攸关方合作和转型。最后,我们提出了政策制定者从社会技术角度实现卫生系统弹性所需的资源。
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Environmental research, health : ERH
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