Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599-7431, USA.
Environ Health Perspect. 2012 May;120(5):681-6. doi: 10.1289/ehp.1104064. Epub 2012 Feb 22.
Environmental risks to health in the United Arab Emirates (UAE) have shifted rapidly from infectious to noninfectious diseases as the nation has developed at an unprecedented rate. In response to public concerns over newly emerging environmental risks, the Environment Agency-Abu Dhabi commissioned a multidisciplinary environmental health strategic planning project.
In order to develop the environmental health strategic plan, we sought to quantify the illnesses and premature deaths in the UAE attributable to 14 environmental pollutant categories, prioritize these 14 risk factors, and identify interventions.
We estimated the disease burden imposed by each risk factor using an attributable fraction approach, and we prioritized the risks using an empirically tested stakeholder engagement process. We then engaged government personnel, scientists, and other stakeholders to identify interventions.
The UAE's environmental disease burden is low by global standards. Ambient air pollution is the leading contributor to premature mortality [~ 650 annual deaths; 95% confidence interval (CI): 140, 1,400]. Risk factors leading to > 10,000 annual health care facility visits included occupational exposures, indoor air pollution, drinking water contamination, seafood contamination, and ambient air pollution. Among the 14 risks considered, on average, outdoor air pollution was ranked by the stakeholders as the highest priority (mean rank, 1.4; interquartile range, 1-2) and indoor air pollution as the second-highest priority (mean rank 3.3; interquartile range, 2-4). The resulting strategic plan identified 216 potential interventions for reducing environmental risks to health.
The strategic planning exercise described here provides a framework for systematically deciding how to invest public funds to maximize expected returns in environmental health, where returns are measured in terms of reductions in a population's environmental burden of disease.
随着阿联酋以空前的速度发展，其健康面临的环境风险已迅速从传染病转变为非传染病。针对公众对新出现的环境风险的担忧，环境署-阿布扎比委托进行了一项多学科环境健康战略规划项目。
为了制定环境健康战略计划，我们试图量化阿联酋 14 种环境污染物类别所导致的疾病和过早死亡，对这 14 个危险因素进行优先排序，并确定干预措施。
我们使用归因分数法估计每个危险因素造成的疾病负担，并使用经过实证检验的利益相关者参与过程对风险进行优先排序。然后，我们让政府人员、科学家和其他利益相关者参与确定干预措施。
按全球标准衡量，阿联酋的环境疾病负担较低。环境空气污染是导致过早死亡的主要因素[约 650 例死亡；95%置信区间（CI）：140，1400]。导致每年超过 10,000 次医疗保健机构就诊的危险因素包括职业暴露、室内空气污染、饮用水污染、海鲜污染和环境空气污染。在所考虑的 14 个风险因素中，户外空气污染平均被利益相关者列为最高优先级（平均排名 1.4；四分位距 1-2），室内空气污染列为第二优先级（平均排名 3.3；四分位距 2-4）。由此产生的战略计划确定了 216 项减少环境健康风险的潜在干预措施。
此处描述的战略规划工作为系统地决定如何投资公共资金以最大限度地提高环境健康方面的预期回报提供了框架，其中回报是根据降低人群的环境疾病负担来衡量的。
