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气候变化背景下疾病模式和药物使用的潜在变化。

Potential changes in disease patterns and pharmaceutical use in response to climate change.

机构信息

European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom.

出版信息

J Toxicol Environ Health B Crit Rev. 2013;16(5):285-320. doi: 10.1080/10937404.2013.802265.

Abstract

As climate change alters environmental conditions, the incidence and global patterns of human diseases are changing. These modifications to disease profiles and the effects upon human pharmaceutical usage are discussed. Climate-related environmental changes are associated with a rise in the incidence of chronic diseases already prevalent in the Northern Hemisphere, for example, cardiovascular disease and mental illness, leading to greater use of associated heavily used Western medications. Sufferers of respiratory diseases may exhibit exacerbated symptoms due to altered environmental conditions (e.g., pollen). Respiratory, water-borne, and food-borne toxicants and infections, including those that are vector borne, may become more common in Western countries, central and eastern Asia, and across North America. As new disease threats emerge, substantially higher pharmaceutical use appears inevitable, especially of pharmaceuticals not commonly employed at present (e.g., antiprotozoals). The use of medications for the treatment of general symptoms (e.g., analgesics) will also rise. These developments need to be viewed in the context of other major environmental changes (e.g., industrial chemical pollution, biodiversity loss, reduced water and food security) as well as marked shifts in human demographics, including aging of the population. To identify, prevent, mitigate, and adapt to potential threats, one needs to be aware of the major factors underlying changes in the use of pharmaceuticals and their subsequent release, deliberately or unintentionally, into the environment. This review explores the likely consequences of climate change upon the use of medical pharmaceuticals in the Northern Hemisphere.

摘要

随着气候变化改变了环境条件,人类疾病的发病率和全球模式也在发生变化。本文讨论了这些疾病谱的变化以及对人类药物使用的影响。与气候相关的环境变化与在北半球已经流行的慢性疾病(如心血管疾病和精神疾病)的发病率上升有关,这导致了与这些疾病相关的西药的使用量增加。由于环境条件的改变(例如花粉),患有呼吸道疾病的患者可能会出现症状加重。在西方国家、中亚和北美,呼吸道、水传播和食源性毒素和感染(包括那些由媒介传播的感染)可能会变得更加常见。随着新的疾病威胁的出现,药物的使用量似乎不可避免地会大幅增加,尤其是目前不常用的药物(如抗寄生虫药物)。用于治疗一般症状的药物(如止痛药)的使用也将增加。这些发展需要结合其他重大环境变化(例如工业化学污染、生物多样性丧失、水和粮食安全减少)以及人口结构的显著变化(包括人口老龄化)来看待。为了识别、预防、减轻和适应潜在威胁,人们需要了解导致药物使用变化及其随后有意或无意地释放到环境中的主要因素。本综述探讨了气候变化对北半球医疗药物使用的可能影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6909/3756629/484ee186e4bf/uteb16_285_f1.jpg

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