The journal of climate change and health最新文献_第7页

Too hot and too humid in the Caribbean: Impacts of extreme heat events and non-accidental mortality in the tropical island of Puerto Rico (2015-2020) 加勒比地区太热太湿：极端高温事件对热带岛屿波多黎各的影响和非意外死亡率（2015-2020）

IF 3.6

The journal of climate change and health

Pub Date : 2025-08-05 DOI: 10.1016/j.joclim.2025.100484

Pablo A. Méndez-Lázaro , Claudia Di Napoli , Sona Rivas-Tumanyan , Naydi Pérez-Ríos , Lorena González Sepúlveda , Ernesto Rodríguez , Ernesto Morales , Odalys Martínez , Laura T. Cabrera-Rivera , Mónica V. Sánchez-Sepúlveda , Liza Milán

Background

The complex interactions between heat and public health in tropical environments are not well understood, limiting the integrated understanding of heat-related impacts on the sustainability and resilience of the affected populations.

Objectives

To provide evidence on the impact of heat stress on mortality in Puerto Rico by means of indices that are based on physiologically relevant environmental factors.

Methods

Daily data on non-accidental mortality for the period of 2015-2020 were obtained from the Puerto Rico Department of Health. We obtained 2 meter ambient air temperature data across the whole geographical extent of Puerto Rico and for the 2015-2020 period at an hourly step from the ERA5 climate reanalysis dataset. We employed two indices derived from thermo-physiological models: the Universal Thermal Climate Index (UTCI) and the Heat Index (HI). Poisson regression models were fitted to explain the total number of deaths as a function of UTCI and HI while adjusting for sex and age.

Results

We observed an increase in overall non-accidental mortality in the days categorized as the highest tertile of both HI (IRR: 1.23, 95% CI: 1.21; 1.25) and UTCI (IRR:1.47, 95% CI: 1.44; 1.49) in the adjusted model. Myocardial infarction, ischemic heart disease, heart failure, and cerebrovascular disease were some of the primary causes of death.

Conclusion

Results will provide local decision-makers with sufficient evidence on heat stress impacts and valuable information on vulnerability that can be translated into heat adaptation strategies in Puerto Rico.

热带环境中热与公共卫生之间的复杂相互作用尚未得到很好的理解，这限制了对受影响人群可持续性和恢复力的热相关影响的综合理解。目的通过基于生理相关环境因素的指数，为热应激对波多黎各死亡率的影响提供证据。方法从波多黎各卫生部获取2015-2020年非意外死亡率的每日数据。我们从ERA5气候再分析数据集中获得了波多黎各整个地理范围和2015-2020年期间每小时2米的环境空气温度数据。我们采用了两个来自热生理模型的指数：通用热气候指数（UTCI）和热指数（HI）。在对性别和年龄进行调整的同时，拟合泊松回归模型来解释死亡总人数作为UTCI和HI的函数。结果：我们观察到，在两种HI的最高分位数分类的天数中，总体非意外死亡率增加(IRR: 1.23, 95% CI: 1.21；1.25)和UTCI (IRR:1.47, 95% CI: 1.44；1.49)。心肌梗死、缺血性心脏病、心力衰竭和脑血管疾病是一些主要的死亡原因。结论研究结果将为波多黎各当地决策者提供足够的热应激影响证据和有价值的脆弱性信息，这些信息可转化为热适应策略。

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引用次数: 0

Medical education competency frameworks for climate and planetary health: A scoping review 气候和地球健康的医学教育能力框架：范围审查

IF 3.6

The journal of climate change and health

Pub Date : 2025-08-02 DOI: 10.1016/j.joclim.2025.100488

Elizabeth Cerceo , Hannah N.W. Weinstein , Stefan Wheat , James Sullivan , James Bevan , Cecilia Sorensen

Introduction

Climate change threatens human health by exacerbating existing health inequities, increasing climate-related illnesses, and disrupting healthcare systems. Preparing future physicians to address these challenges is essential for resilient healthcare systems. While climate health education in medical schools is gaining traction globally, its integration remains inconsistent, with limited consensus on core competencies.

Methods

A systematic search of peer-reviewed and gray literature was conducted across databases including PubMed, ERIC, EMBASE, and CINAHL. Inclusion criteria required frameworks to address climate or planetary health in medical education and to reflect consensus-level guidance from national or regional bodies. Each framework was thematically assessed for competencies and domains.

Results

12 frameworks met inclusion criteria. Key competencies identified varied among the frameworks and included medical knowledge of climate change’s health impacts, skills in climate-informed clinical practice, advocacy for sustainable healthcare, and addressing health equity. Unique aspects of climate health, such as Indigenous knowledge and environmental justice, appeared in a few frameworks. While foundational knowledge was universally emphasized, domains such as health system sustainability and interprofessional skills were less consistently integrated.

Conclusion

Our findings underscore the paucity of globally aligned, evidence-based competency frameworks, especially in the Global South, needed to equip future physicians with the skills to address the health impacts of climate change. Establishing standardized competencies will support consistent education and preparedness among future physicians worldwide. This review reveals a need for standardized frameworks to ensure comprehensive climate-health education across diverse medical education systems. Current frameworks demonstrate progress, yet gaps remain, especially in practical, action-oriented skills and specific competencies for vulnerable populations.

气候变化通过加剧现有的卫生不平等、增加与气候有关的疾病和破坏卫生保健系统来威胁人类健康。培养未来的医生应对这些挑战对有弹性的医疗保健系统至关重要。虽然医学院的气候健康教育在全球范围内越来越受欢迎，但其整合仍然不一致，对核心能力的共识有限。方法系统检索PubMed、ERIC、EMBASE、CINAHL等数据库的同行评议文献和灰色文献。纳入标准需要在医学教育中处理气候或地球健康问题的框架，并反映国家或区域机构的共识级指导。对每个框架的能力和领域进行了主题评估。结果12个框架符合纳入标准。所确定的关键能力因框架而异，包括气候变化对健康影响的医学知识、了解气候的临床实践技能、倡导可持续医疗保健以及解决卫生公平问题。气候健康的独特方面，如土著知识和环境正义，出现在一些框架中。虽然普遍强调基础知识，但卫生系统可持续性和跨专业技能等领域的整合不太一致。结论：我们的研究结果强调了全球一致的、基于证据的能力框架的缺乏，特别是在全球南方，需要为未来的医生提供应对气候变化对健康影响的技能。建立标准化的能力将支持全球未来医生的一致教育和准备。这一综述表明，需要标准化框架，以确保在不同的医学教育系统中进行全面的气候健康教育。目前的框架取得了进展，但差距仍然存在，特别是在面向行动的实际技能和弱势群体的具体能力方面。

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引用次数: 0

Understanding environmental decision making: The association between stages of decision making and decisional conflict 理解环境决策：决策阶段与决策冲突之间的关系

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100467

Letizia Richelli , Eline L.F.M.G. Vissers , Alessandra Gorini , Marijn H.C. Meijers , Eline S. Smit , Thomas Gültzow

Introduction: As research highlights how climate change impacts individual and planetary health, people might consider reducing their ecological footprint by acting pro-environmentally. However, their choice might depend on how far along they are in the process of deciding to act pro-environmentally (i.e., different stages of decision making) and on their experienced difficulty in deciding in favour of the environment and which behaviour to conduct (i.e., decisional conflict).

Methods: To explore in which stage participants find themselves (i.e., not yet thinking about choices, showing interest in doing so, actively considering options, approaching a decision, having already decided but remaining open to reconsideration, or being firmly committed to a decision with little chance of change) and whether their respective stages are correlated with their experienced decisional conflict, an online, cross-sectional questionnaire was distributed among a convenience sample of 418 English-, Dutch-, and Italian-speaking adults to measure participants’ demographics, stages, and extent to which they experience decisional conflict.

Results: Based on regression analyses, we observed that participants who were further along in the stages experienced less decisional conflict.

Conclusion: Therefore, we suggest that interventions (e.g., decision aids) take stages into account to better meet users’ needs and assist people in making environmental decisions.

导言：由于研究强调了气候变化如何影响个人和地球健康，人们可能会考虑通过采取环保行动来减少他们的生态足迹。然而，他们的选择可能取决于他们在决定采取有利于环境的行动的过程中走了多远（即决策的不同阶段），以及他们在决定有利于环境和采取何种行为方面所经历的困难（即决策冲突）。方法:为了探索参与者发现自己处于哪个阶段（即尚未考虑选择，表现出兴趣，积极考虑选项，接近决定，已经决定但仍然可以重新考虑，或者坚定地致力于一个几乎没有改变机会的决定），以及他们各自的阶段是否与他们经历的决策冲突相关，在线，横断面调查问卷在418名讲英语、荷兰语和意大利语的成年人中分发，以衡量参与者的人口统计学特征、阶段和他们经历决策冲突的程度。结果：在回归分析的基础上，我们观察到，在阶段越深入的参与者经历的决策冲突越少。结论：因此，我们建议干预措施（例如决策辅助）考虑到阶段，以更好地满足用户需求并帮助人们做出环境决策。

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引用次数: 0

Temperature extremes, climate change and multimorbidity: A rapid scoping review 极端温度，气候变化和多病：快速范围审查

IF 3.6

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100452

Hajira Dambha-Miller, Uzayr Nagdi, Lucy Smith, Glenn Simpson

Introduction

Exposure to extreme temperatures disproportionally impacts vulnerable populations, including those with multimorbidity (i.e., people living with two or more long-term health conditions). A greater frequency of temperature extremes such as heatwaves driven by climate change will likely increase adverse health outcomes in vulnerable populations. Therefore, it is important to understand the potential effects of temperature extremes on the health outcomes of multimorbidity populations to aid the planning of healthcare systems and preventive interventions. In this review, evidence was collated and summarised, describing the health outcomes of extreme temperatures amongst people with multimorbidity.

Methods

A rapid scoping review with searches on temperature extremes and outcomes in multimorbidity populations was conducted using Medline, CINAHL, Scopus and Wiley Library. These searches were supplemented with manual citation and Google Scholar searches. There were 1,225 titles screened, with data extracted by two independent reviewers. Eight papers were included in the final analysis.

Results

Relatively few studies were identified, indicating limited evidence on this topic. Existing evidence focused on the increased risk of mortality in the multimorbidity population from extreme heat. No studies were identified examining the impact of cold extremes on the health outcomes of those with multimorbidity.

Conclusion

There is a need for significant further research, including systematic review and/or empirical investigation, on a range of issues that can further understanding of the effects of temperature extremes on health outcomes of multimorbidity populations.

暴露于极端温度对脆弱人群，包括多病人群（即患有两种或两种以上长期健康状况的人）的影响不成比例。由气候变化引起的热浪等极端温度的频率增加，可能会增加脆弱人群的不良健康后果。因此，了解极端温度对多病人群健康结果的潜在影响，以帮助规划卫生保健系统和预防性干预措施是很重要的。在这篇综述中，对证据进行了整理和总结，描述了极端温度对多重疾病患者的健康影响。方法使用Medline、CINAHL、Scopus和Wiley Library对多发病人群的极端温度和结果进行快速检索。这些搜索还补充了人工引文和谷歌学者搜索。筛选了1225个标题，数据由两位独立审稿人提取。8篇论文被纳入最终分析。结果相对较少的研究被确定，表明该主题的证据有限。现有证据集中于极端高温导致多病人群死亡风险增加。没有研究证实极端寒冷对多病患者健康结果的影响。结论有必要对一系列问题进行进一步的研究，包括系统综述和/或实证调查，以进一步了解极端温度对多病人群健康结果的影响。

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引用次数: 0

Prioritizing evidence for action from the 2024 small island developing states report of the Lancet Countdown on health and climate change 优先考虑《柳叶刀》健康与气候变化倒计时2024年小岛屿发展中国家报告提供的行动证据

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100482

Stephanie Y Parker , Kimalie F Parchment , Maria Walawender , Georgiana Gordon-Strachan

Introduction

Small island developing states (SIDS) are vulnerable to the ill-health effects associated with unabated atmospheric warming driven by larger, more developed countries. Hence, the health-centered focus of the Lancet Countdown on Health and Climate Change has immense value for SIDS.

Methods

Given resource constraints and data limitations across the SIDS region, the inaugural 2024 SIDS report of the Lancet Countdown required a method of singling out the most regionally relevant indicators from 47 Lancet Countdown global indicators. A two-stage semi-qualitative method was designed for this purpose.

Results

The evaluation stage involved identifying two indicator sets from stakeholder consultation (n = 32) and a multi-criteria assessment (n = 11). Using both sets of indicators, only 11 met the criteria of being regionally representative and relevant, further confirming data limitations. To adjust for this challenge, 14 indicators were added to the final list based on relevance. Therefore, 25 Lancet Countdown indicators were selected for the 2024 SIDS report of the Lancet Countdown on Health and Climate Change. To further prioritize the wide range of evidence from these indicators, a qualitative multiplication matrix was used to define relationships between regional data coverage and differences from global benchmarks. Six indicators marked successes in adaptation, and 14 evidenced negative implications compared to global benchmarks.

Conclusion

The impact of heat on physical activity, food security, and economic development was of critical regional importance, as was the need for more research. The study identified critical areas where urgent climate action is needed, emphasizing the need for increased research and data collection in SIDS.

由更大、更发达的国家推动的大气变暖有增无减，使小岛屿发展中国家容易受到与之相关的不良健康影响。因此，《柳叶刀》健康与气候变化倒计时以健康为中心的重点对小岛屿发展中国家具有巨大价值。考虑到整个小岛屿发展中国家区域的资源限制和数据限制，《柳叶刀》倒计时2024年首份小岛屿发展中国家报告需要一种方法，从47个《柳叶刀》倒计时全球指标中挑出最具区域相关性的指标。为此设计了两阶段半定性方法。结果评估阶段包括从利益相关者咨询中确定两个指标集（n = 32）和多标准评估（n = 11）。使用两套指标，只有11个符合区域代表性和相关性的标准，进一步证实了数据的局限性。为了应对这一挑战，根据相关性在最终清单中增加了14个指标。因此，《柳叶刀》健康与气候变化倒计时报告2024年小岛屿发展中国家报告选择了25个《柳叶刀》倒计时指标。为了进一步优先考虑来自这些指标的广泛证据，使用了一个定性乘法矩阵来定义区域数据覆盖范围与全球基准差异之间的关系。6项指标标志着适应取得了成功，与全球基准相比，14项指标显示出负面影响。结论热量对身体活动、粮食安全和经济发展的影响具有重要的区域意义，需要进行更多的研究。该研究确定了需要采取紧急气候行动的关键领域，强调需要增加小岛屿发展中国家的研究和数据收集。

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引用次数: 0

Building resiliency and mitigating climate change – The case of the Unjani Clinic network 建立复原力和减缓气候变化——以Unjani诊所网络为例

IF 3.6

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100454

Harsha Davé

Introduction

This case study explores the innovative strategies employed by the Unjani Clinic in South Africa to address climate change within the primary healthcare system. By integrating renewable energy and water conservation practices, it highlights the dual role of healthcare providers in climate change mitigation and adaptation, especially in resource-limited settings.

Case Presentation

Operational data from annual reports and supplier quotes were analysed to evaluate Unjani Clinic's practices. Currently, 19 % of clinics operate with hybrid or off-grid solar energy systems, reducing utility costs by as much as ZAR 164,512 ($ 9139) and 23, 000 kg carbon emissions. Climate-related disruptions, including flooding and a tornado, significantly impacted clinic operations, underlining the importance of emergency preparedness and network support.

Discussion

The Unjani model demonstrates the viability of sustainability efforts to enhance healthcare delivery and environmental resilience. Flexible implementation and leadership support were key enablers. This approach emphasizes the need for aligning investment and policy support to scale such initiatives.

Conclusion

The Unjani Clinics (https://www.unjaniclinic.co.za/) provide a replicable model of integrating climate resilience into primary healthcare. This study underscores the critical role of healthcare providers in advancing environmental sustainability and addressing health inequities in vulnerable communities.

本案例研究探讨了南非Unjani诊所在初级卫生保健系统中应对气候变化所采用的创新策略。通过整合可再生能源和节水做法，它突出了医疗保健提供者在减缓和适应气候变化方面的双重作用，特别是在资源有限的情况下。案例介绍分析了年度报告和供应商报价中的运营数据，以评估Unjani诊所的做法。目前，19%的诊所使用混合或离网太阳能系统，减少了高达164,512兰特（9139美元）的公用事业成本和23,000公斤的碳排放。与气候有关的破坏，包括洪水和龙卷风，严重影响了诊所的业务，突出了应急准备和网络支持的重要性。Unjani模式证明了可持续发展努力在提高医疗服务和环境复原力方面的可行性。灵活的实施和领导支持是关键的促成因素。这种方法强调需要协调投资和政策支持，以扩大此类举措的规模。Unjani诊所（https://www.unjaniclinic.co.za/）提供了将气候适应能力纳入初级卫生保健的可复制模式。这项研究强调了医疗保健提供者在促进环境可持续性和解决弱势社区卫生不平等方面的关键作用。

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引用次数: 0

Climate-sensitive maternal and child health outcomes: A scoping review and policy implications for Kiribati 对气候敏感的妇幼保健成果：范围审查和对基里巴斯的政策影响

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100479

Teanibuaka Tabunga , Sarah Medcalf , Annabelle Workman

Background

Kiribati is situated in the central Pacific Ocean with a population of over 119,000 people. It is facing numerous health and other challenges from climate change, with adverse impacts on priority populations including women and children. Limited capacity and data gaps create challenges for responsive approaches to protect the health of priority populations. This scoping review surveys the peer-reviewed literature on several climate-sensitive maternal and child health outcomes, and considers this evidence in the context of Kiribati’s current climate and health policy landscape.

Methods

A search of PubMed, Web of Science and Scopus was conducted in August 2024 to identify peer-reviewed articles published in English between 2000 and 2024 examining climate-sensitive child and maternal health outcomes in the Pacific and developing countries. The search returned 463 results. Following abstract and full text screening, 34 articles were included in the review. Kiribati’s climate- and health-related policies were also identified and examined.

Results

Most (91 %) eligible articles have been published since 2010. Diarrheal disease and malnutrition are the commonest outcomes studied, with temperature and rainfall being key climatic factors affecting disease prevalence. Both outcomes are highly relevant for Kiribati. The limited evidence on climate-related maternal and adverse pregnancy outcomes also suggests temperature and rainfall are influential climatic factors.

Conclusion

There is increasing evidence across developing contexts that climate change adversely impacts maternal and child health outcomes. An opportunity exists to proactively identify and implement targeted interventions for women and children to reduce the prevalence of climate-sensitive maternal and child health outcomes.

基里巴斯位于太平洋中部，人口超过11.9万。它正面临气候变化带来的许多健康和其他挑战，对包括妇女和儿童在内的重点人群产生不利影响。有限的能力和数据缺口为保护重点人群健康的反应性办法带来挑战。这次范围审查调查了同行评议的关于若干对气候敏感的孕产妇和儿童健康结果的文献，并在基里巴斯当前气候和卫生政策格局的背景下审议了这些证据。方法于2024年8月对PubMed、Web of Science和Scopus进行了检索，以确定2000年至2024年间发表的同行评议的英文文章，这些文章研究了太平洋和发展中国家对气候敏感的儿童和孕产妇健康结果。搜索返回了463个结果。摘要和全文筛选后，共纳入34篇文献。还确定和审查了基里巴斯的气候和健康相关政策。大多数（91%）符合条件的文章发表于2010年以后。腹泻病和营养不良是研究中最常见的结果，温度和降雨是影响疾病流行的关键气候因素。这两项结果都与基里巴斯高度相关。与气候有关的孕产妇和不良妊娠结局的有限证据也表明，温度和降雨是有影响的气候因素。越来越多的证据表明，在发展中国家，气候变化对孕产妇和儿童健康结果产生不利影响。现在有机会主动确定和实施针对妇女和儿童的有针对性的干预措施，以减少对气候敏感的妇幼保健结果的流行。

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引用次数: 0

Implementation of a heat alert system for clinical staff in an ambulatory setting: A pilot project 在门诊环境中为临床工作人员实施热警报系统：试验项目

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100478

Paul F Dellaripa , Candace Feldman , Lydia Gedmintas , Susan Ritter , Caleb Dresser

Introduction

Climate change leads to an increasing risk of heat exposure and pre-emptive alerting to patients may be an important intervention to limit health risks related to heat. The process of providing counseling and resources related to impending dangerous heat in an ambulatory clinic setting has not been described. In this pilot project utilizing an electronic heat alert system, we describe the implementation of a clinic-level protocol for providing alert-based heat health information and proactively educating rheumatology patients in an ambulatory setting on dangerous heat conditions.

Methods

Physicians, nurses and medical assistants received electronic notifications of dangerous heat forecasts via a external heat alert system (Realtime Climate Heat Risk). Participating staff completed surveys at the midpoint and end of the heat season. The primary endpoint was a self-reported estimate of the percentage of patients engaged regarding heat safety on days where heat alerts were issued.

Results

There were 4 heat alert days during the study period. Half of participating staff members reported they had engaged 50 % or more of their patients on this topic. Self-reported levels of engagement by medical assistants were significantly higher than those of physicians and nurses, (W = 4.5, p-value = 0.036).

Conclusions

Heat and other environmental exposures present risks to patients as the effects of climate change worsen. Heat alerts may help staff address health risks with their patients. This pilot study demonstrates that an external heat alert system can be implemented utilizing providers of different skill levels and at all points of patient interaction in an ambulatory clinic setting.

气候变化导致热暴露风险增加，对患者进行先发制人的警告可能是限制与热有关的健康风险的重要干预措施。提供咨询的过程和资源有关迫在眉睫的危险热在门诊设置没有被描述。在这个利用电子热警报系统的试点项目中，我们描述了一个临床级协议的实施，该协议提供基于警报的热健康信息，并在门诊环境中主动教育风湿病患者危险的热状况。方法通过外部热警报系统（Realtime Climate heat Risk），医生、护士和医疗助理收到危险热预报的电子通知。参与调查的工作人员在炎热季节的中点和结束时完成了调查。主要终点是自我报告的估计患者在发布热警报的日子里参与热安全的百分比。结果研究期间共出现4个热警报日。半数参与调查的医务人员报告说，他们有50%或更多的病人参与了这个话题。医疗助理自我报告的敬业度水平显著高于医生和护士（W = 4.5， p值= 0.036）。结论随着气候变化影响的加剧，空气和其他环境暴露对患者存在风险。高温警报可以帮助工作人员解决病人的健康风险。这项试点研究表明，外部热警报系统可以在门诊设置中利用不同技能水平的提供者和患者互动的所有点来实施。

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引用次数: 0

Role of medicines dispensation data in city-based air-health surveillance and health preparedness 药物分配数据在城市空气卫生监测和卫生准备中的作用

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100483

Ritu Parchure , Santu Ghosh , Santosh Satam , Aparna Gokhale , Balasaheb Pawar , Vinay Kulkarni

Introduction

Air pollution in India is a significant public health issue. Air-health surveillance has been recently introduced in heavily polluted Indian cities, to inform relevant mitigation and health preparedness actions. The air-health surveillance tracks emergency room visits (ERV) for acute respiratory illnesses in select sentinel hospitals. Reporting from multiple facilities is necessary to get a representative picture, but expanding coverage poses challenges. In this context, pharmaceutical data can serve as an alternative data source to aid surveillance efforts.

Methods

We examined the potential role of data on sales of respules (a combination of corticosteroid and bronchodilator medicines, used in nebulizers) as an indicator in air-health surveillance. The association between daily respules sold at a trust-based hospital in Pune, India, and daily concentration of local ambient particulate matter (PM_2.5) was assessed using a time-stratified case-crossover design.

Results

A positive correlation, with a lag effect, was observed. A 10 µg/m³ increase in PM_2.5 level led to an 8 % and 6 % increase in respules sales after a lag of 3 and 4 days, respectively. The number of respules sold correlated well with ERV.

Discussion

The findings indicate that respules sold could serve as a reliable proxy for tracking health impacts from air pollution.

Conclusion

Our study provides a proof-of-concept analysis showing that pharmaceutical data can be used as a proxy measure to assess the short-term health impacts of air pollution. Further exploration is needed to evaluate its utility for air-health surveillance efforts in India.

印度的空气污染是一个重大的公共卫生问题。最近在污染严重的印度城市开展了空气健康监测，为相关的缓解和卫生准备行动提供信息。空气健康监测追踪了选定哨点医院急性呼吸道疾病的急诊室就诊情况。为了获得具有代表性的情况，从多个设施进行报道是必要的，但扩大报道范围带来了挑战。在这种情况下，制药数据可以作为辅助监测工作的另一种数据源。方法我们研究了呼吸道（一种用于雾化器的皮质类固醇和支气管扩张药物的组合）销售数据作为空气健康监测指标的潜在作用。使用时间分层病例交叉设计评估了印度浦那一家信托医院每日销售的血液与当地环境颗粒物（PM2.5）每日浓度之间的关系。结果两者呈正相关，且存在滞后效应。PM2.5浓度每增加10微克/立方米，在3天和4天后，汽车销量分别增长8%和6%。售出的汽车数量与ERV有很好的相关性。研究结果表明，所售气体可以作为追踪空气污染对健康影响的可靠指标。结论我们的研究提供了一个概念验证分析，表明药物数据可以作为评估空气污染短期健康影响的代理措施。需要进一步探索以评估其对印度空气健康监测工作的效用。

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引用次数: 0

Planetary health education in Indian medical curricula 印度医学课程中的行星健康教育

The journal of climate change and health

Pub Date : 2025-07-01 DOI: 10.1016/j.joclim.2025.100481

Prasoon Pattanaik , Anandita Pattnaik

Introduction

This study assesses the state of planetary health education in Indian medical schools and proposes actionable recommendations for enhancement.

Materials and Methods

The Planetary Health Report Card (PHRC), an international student-driven metric-based tool, was used to evaluate planetary health content in six report cards from four prominent Indian medical schools. Five key categories were evaluated: planetary health curriculum, interdisciplinary research, community outreach and advocacy, support for student initiatives, and campus sustainability measures.

Results

Disparities were found in integrating planetary health into medical education among surveyed schools. While some topics like "the effect of extreme heat and pollution on health" were commonly integrated, critical topics such as "the carbon footprint of healthcare systems" were often overlooked. Limited interdisciplinary research and community engagement were noted, with insufficient support for student initiatives. However, all schools showed progress in campus sustainability. The National Medical Commission’s curriculum includes only limited content on planetary health. The absence of dedicated coursework and inconsistent implementation has resulted in uneven integration across the country, with much of it depending on individual faculty initiatives.

Conclusion

Recommendations include developing dedicated coursework with clear learning outcomes, promoting planetary health research, organizing outreach activities, making educational materials accessible, supporting student initiatives, and enhancing campus sustainability. These recommendations aim to equip future healthcare professionals with the knowledge and skills to address the relationship between human health and planetary well-being, fostering a sustainable healthcare system in India.

本研究评估了印度医学院的全球健康教育状况，并提出了可行的改进建议。材料和方法行星健康报告卡（PHRC）是一种国际学生驱动的基于度量的工具，用于评估来自印度四所著名医学院的六份报告卡中的行星健康内容。评估了五个关键类别：地球卫生课程、跨学科研究、社区外展和宣传、对学生倡议的支持以及校园可持续性措施。结果被调查学校在将行星健康纳入医学教育方面存在差异。虽然“极端高温和污染对健康的影响”等主题通常被纳入其中，但“医疗系统的碳足迹”等关键主题往往被忽视。注意到跨学科研究和社区参与有限，对学生倡议的支持不足。然而，所有学校在校园可持续性方面都取得了进步。国家医学委员会的课程只包括有限的关于地球健康的内容。缺乏专门的课程和不一致的实施导致了全国范围内整合的不平衡，其中很大程度上取决于个别教师的举措。建议包括开发具有明确学习成果的专门课程，促进地球健康研究，组织外展活动，使教育材料易于获取，支持学生倡议，增强校园可持续性。这些建议旨在为未来的卫生保健专业人员提供知识和技能，以解决人类健康与地球福祉之间的关系，促进印度可持续的卫生保健系统。

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引用次数: 0