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[热浪期间的健康防护:欧洲建议及黑森州的经验]

[Health protection during heat waves: European recommendations and experience in Hesse].

作者信息

Grewe H A, Heckenhahn S, Blättner B

机构信息

Public Health Institute Fulda, Hochschule Fulda, Marquardstr. 35, 36039, Fulda, Deutschland,

出版信息

Z Gerontol Geriatr. 2014 Aug;47(6):483-9. doi: 10.1007/s00391-014-0676-z.

DOI:10.1007/s00391-014-0676-z
PMID:25119705
Abstract

BACKGROUND

In the course of climate change periods of extreme heat will probably happen more frequently. The aim of heat health action plans is to prevent the health consequences of heat.

OBJECTIVES

The purpose of the present work is to develop a proposal for a heat health action plan for Hesse, Germany.

MATERIALS AND METHODS

In 34 interviews with experts the existing heat health warning system was evaluated. Heat health action plans of 8 European countries were analysed. On this basis a concept for a heat health action plan for Hesse was developed.

RESULTS

In Hesse only nursing homes take preventative measures reliably, other health care sectors act along varying individual criteria. Heat health action plans include a heat health warning system and measures. They arrange competences and risk communication. Local authorities are responsible for implementation. Some plans include a surveillance system of mortality or morbidity. In a heat health action plan for Hesse measures should be specified and adapted to specific needs on the local level. Physicians in outpatient clinics are in a key position having contact with the vulnerable group of the elderly.

CONCLUSION

A heat health action plan offers opportunities for effective prevention if responsibilities are defined and evaluated, and monitoring of mortality and morbidity is integrated. In the structures of the German health care system efforts to prevent heat-related illness cannot succeed without reliable participation of the outpatient medical system.

摘要

背景

在气候变化过程中,极端炎热天气可能会更频繁地出现。热健康行动计划的目的是预防炎热天气对健康造成的影响。

目标

本研究的目的是为德国黑森州制定一份热健康行动计划提案。

材料与方法

通过对34位专家进行访谈,对现有的热健康预警系统进行了评估。分析了8个欧洲国家的热健康行动计划。在此基础上,制定了黑森州热健康行动计划的概念。

结果

在黑森州,只有养老院能可靠地采取预防措施,其他医疗保健部门则根据不同的个人标准行事。热健康行动计划包括热健康预警系统和措施。它们安排了职责和风险沟通。地方当局负责实施。一些计划包括死亡率或发病率监测系统。在黑森州的热健康行动计划中,应明确措施并使其适应当地的具体需求。门诊诊所的医生在接触老年弱势群体方面处于关键地位。

结论

如果明确并评估了职责,并将死亡率和发病率监测纳入其中,热健康行动计划将为有效预防提供机会。在德国医疗保健系统的架构中,如果没有门诊医疗系统的可靠参与,预防与热相关疾病的努力将无法成功。

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本文引用的文献

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Changes in the effects of heat on mortality among the elderly from 1998-2010: results from a multicenter time series study in Italy.1998-2010 年老年人热死亡率影响变化:意大利多中心时间序列研究结果。
Environ Health. 2012 Sep 3;11:58. doi: 10.1186/1476-069X-11-58.
2
Surveillance of summer mortality and preparedness to reduce the health impact of heat waves in Italy.意大利夏季死亡率监测及防范热浪对健康影响的准备工作。
Int J Environ Res Public Health. 2010 May;7(5):2256-73. doi: 10.3390/ijerph7052256. Epub 2010 May 6.
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Estimating the impact of the 2009 influenza A(H1N1) pandemic on mortality in the elderly in Navarre, Spain.
评估2009年甲型H1N1流感大流行对西班牙纳瓦拉地区老年人死亡率的影响。
Euro Surveill. 2010 Mar 4;15(9):pii/19501; author reply pii/19502. doi: 10.2807/ese.15.09.19501-en.
4
[Identifying residential areas with heat-related health risks. Sociodemographic and climate data mapping as a planning tool for targeted prevention strategies].[识别存在与热相关健康风险的居民区。社会人口统计学和气候数据绘图作为制定针对性预防策略的规划工具]
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010 Jan;53(1):75-81. doi: 10.1007/s00103-009-0995-1.
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Has the impact of heat waves on mortality changed in France since the European heat wave of summer 2003? A study of the 2006 heat wave.自2003年夏季欧洲热浪以来,热浪对法国死亡率的影响有变化吗?一项关于2006年热浪的研究。
Int J Epidemiol. 2008 Apr;37(2):309-17. doi: 10.1093/ije/dym253. Epub 2008 Jan 13.
6
Prognostic factors in heat wave related deaths: a meta-analysis.热浪相关死亡的预后因素:一项荟萃分析。
Arch Intern Med. 2007 Nov 12;167(20):2170-6. doi: 10.1001/archinte.167.20.ira70009. Epub 2007 Aug 13.
7
August 2003 heat wave in France: risk factors for death of elderly people living at home.2003年8月法国热浪:居家老年人死亡的风险因素。
Eur J Public Health. 2006 Dec;16(6):583-91. doi: 10.1093/eurpub/ckl063. Epub 2006 Oct 6.
8
[Health effects of extreme heat--an example of the heat wave and mortality in Frankfurt am Main in August 2003].[极端高温对健康的影响——以2003年8月美因河畔法兰克福的热浪与死亡率为例]
Gesundheitswesen. 2005 May;67(5):369-74. doi: 10.1055/s-2004-813924.