Department of Epidemiology, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, UK; Field Epidemiology Training Programme (FETP), Public Health England, UK; European Programme for Intervention Epidemiology Training, ECDC, Stockholm, Sweden.
European Programme for Intervention Epidemiology Training, ECDC, Stockholm, Sweden; Field Epidemiology Services, Public Health England, Victoria, London, UK.
Environ Int. 2014 Nov;72:75-82. doi: 10.1016/j.envint.2014.05.003. Epub 2014 Jun 10.
Large incidents and natural disasters are on the increase globally. They can have a major impact lasting many years or decades; and can affect large groups of people including those that are more susceptible to adverse consequences. Following a major incident, it may be considered necessary to establish a register of those people affected by the incident to provide appropriate advice on relevant immediate and longer-term public health interventions that may be required, provide reassurance to the public that their care is paramount, to reassure the worried well to avoid them inappropriately overwhelming local services, and to facilitate epidemiological investigations. Arrangements for the prompt follow-up of populations after large incidents or disasters have been agreed in England and a protocol for establishing a register of individuals potentially affected by a large incident has been developed. It is important for countries to have a protocol for implementing a health register if the circumstances require one to be in place, and are supported by Public Health Authorities. Health registers facilitate the initial descriptive epidemiology of exposure and provide the opportunity of carrying out long term analytical studies on the affected population. Such epidemiological studies provide a greater understanding of the impact that a large incident can have on health, which in turn helps in the planning of health care provision. Registers can also assist more directly in providing access to individuals in need of physical and mental health interventions. The challenge that still remains is to formally pilot the register in the field and refine it based on that experience.
全球范围内的重大事件和自然灾害呈上升趋势。这些事件可能会产生持续数年甚至数十年的重大影响，并影响到包括那些更容易受到不利后果影响的人群在内的大量人群。在重大事件发生后，可能需要建立一个受事件影响的人员登记册，以提供有关可能需要的相关即时和长期公共卫生干预措施的适当建议，向公众保证他们的护理至关重要，以安抚那些担心自己健康的人，避免他们不恰当地给当地服务带来压力，并为流行病学调查提供便利。英国已经就重大事件或灾难发生后的人群及时跟进做出了安排，并制定了建立潜在受重大事件影响个人登记册的协议。如果情况需要，各国制定实施健康登记册的方案非常重要，而且还需要得到公共卫生当局的支持。健康登记册有助于对接触情况进行初步描述性流行病学研究，并为对受影响人群进行长期分析研究提供机会。此类流行病学研究使人们更加了解重大事件对健康的影响，从而有助于规划医疗保健服务的提供。登记册还可以更直接地帮助那些需要身心健康干预的人获得相关服务。目前仍然存在的挑战是，需要在实地正式试点登记册，并根据试点经验对其进行完善。
