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[热浪:对健康的影响]

[Heat waves: health impacts].

作者信息

Marto Natália

机构信息

Serviço de Medicina Interna, Hospital de São José, Centro Hospitalar de Lisboa.

出版信息

Acta Med Port. 2005 Nov-Dec;18(6):467-74. Epub 2006 Mar 6.

Abstract

During the summer of 2003, record high temperatures were reported across Europe, causing thousands of casualties. Heat waves are sporadic recurrent events, characterised by intense and prolonged heat, associated with excess mortality and morbidity. The most frequent cause of death directly attributable to heat is heat stroke but heat waves are known to cause increases in all-cause mortality, specially circulatory and respiratory mortality. Epidemiological studies demonstrate excess casualties cluster in specific risk groups. The elderly, those with chronic medical conditions and the socially isolated are particularly vulnerable. Air conditioning is the strongest protective factor against heat-related disorders. Heat waves cause disease indirectly, by aggravating chronic disorders, and directly, by causing heat-related illnesses (HRI). Classic HRI include skin eruptions, heat cramps, heat syncope, heat exhaustion and heat stroke. Heat stroke is a medical emergency characterised by hyperthermia and central nervous system dysfunction. Treatment includes immediate cooling and support of organ-system function. Despite aggressive treatment, heat stroke is often fatal and permanent neurological damage is frequent in those who survive. Heat related illness and death are preventable through behavioural adaptations, such as use of air conditioning and increased fluid intake. Other adaptation measures include heat emergency warning systems and intervention plans and environmental heat stress reduction. Heat related mortality is expected to rise as a consequence of the increasing proportion of elderly persons, the growing urban population, and the anticipated increase in number and intensity of heat waves associated with global warming. Improvements in surveillance and response capability may limit the adverse health conditions of future heat waves. It is crucial that health professionals are prepared to recognise, prevent and treat HRI and learn to cooperate with local health agencies.

摘要

2003年夏天,欧洲各地均报告出现了创纪录的高温,造成数千人伤亡。热浪是偶发的反复出现的事件,其特点是酷热且持续时间长,会导致超额死亡率和发病率上升。直接归因于高温的最常见死亡原因是中暑,但众所周知,热浪会导致全因死亡率上升,尤其是循环系统和呼吸系统死亡率上升。流行病学研究表明,超额伤亡集中在特定风险群体中。老年人、患有慢性疾病的人和社会孤立者尤其脆弱。空调是预防与高温相关疾病的最有力保护因素。热浪通过加重慢性疾病间接导致疾病,也通过引发与高温相关的疾病(HRI)直接导致疾病。典型的HRI包括皮疹、热痉挛、热昏厥、热衰竭和中暑。中暑是一种以体温过高和中枢神经系统功能障碍为特征的医疗急症。治疗包括立即降温并支持器官系统功能。尽管进行了积极治疗,中暑往往是致命的,幸存者中经常会出现永久性神经损伤。通过行为调整,如使用空调和增加液体摄入量,可以预防与高温相关的疾病和死亡。其他调整措施包括高温紧急预警系统和干预计划以及降低环境热应激。由于老年人比例增加、城市人口增长以及预计与全球变暖相关的热浪数量和强度增加,与高温相关的死亡率预计将会上升。监测和应对能力的提高可能会限制未来热浪对健康造成的不利影响。卫生专业人员做好识别、预防和治疗HRI的准备并学会与当地卫生机构合作至关重要。

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