Burkle Frederick M, Dallas Cham E
1Harvard Humanitarian Initiative,Harvard School of Public Health,Cambridge, Massachusetts, and Woodrow Wilson International Center for Scholars,Washington,DC.
2Institute for Disaster Management,Department of Health Policy & Management,College of Public Health,University of Georgia,Athens,Georgia, andDepartment of Emergency Medicine,Medical College of Georgia,Georgia Regents University,Augusta,Georgia.
Disaster Med Public Health Prep. 2016 Feb;10(1):129-44. doi: 10.1017/dmp.2015.125. Epub 2015 Nov 3.
This study argues that any nuclear weapon exchange or major nuclear plant meltdown, in the categories of human systems failure and conflict-based crises, will immediately provoke an unprecedented public health emergency of international concern. Notwithstanding nuclear triage and management plans and technical monitoring standards within the International Atomic Energy Agency and the World Health Organization (WHO), the capacity to rapidly deploy a robust professional workforce with the internal coordination and collaboration capabilities required for large-scale nuclear crises is profoundly lacking. A similar dilemma, evident in the early stages of the Ebola epidemic, was eventually managed by using worldwide infectious disease experts from the Global Outbreak Alert and Response Network and multiple multidisciplinary WHO-supported foreign medical teams. This success has led the WHO to propose the development of a Global Health Workforce. A strategic format is proposed for nuclear preparedness and response that builds and expands on the current model for infectious disease outbreak currently under consideration. This study proposes the inclusion of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and WHO's Radiation Emergency Medical Preparedness and Assistance Network leadership and supported by the International Health Regulations Treaty. Rationales are set forth for the development, structure, and function of a nuclear workforce based on health outcomes research that define the unique health, health systems, and public health challenges of a nuclear crisis. Recent research supports that life-saving opportunities are possible, but only if a rapidly deployed and robust multidisciplinary response component exists.
本研究认为,在人类系统故障和基于冲突的危机类别中,任何核武器交换或大型核电站熔毁都将立即引发一场前所未有的国际关注的突发公共卫生事件。尽管国际原子能机构和世界卫生组织(WHO)制定了核事故伤员分类和管理计划以及技术监测标准,但在大规模核危机中,仍严重缺乏迅速部署具备内部协调与协作能力的强大专业人员队伍的能力。在埃博拉疫情早期也出现了类似的困境,最终通过启用全球疫情警报和反应网络的全球传染病专家以及世卫组织支持的多个多学科外国医疗队得以解决。这一成功促使世卫组织提议发展全球卫生人力队伍。本文提出了一种核应急准备与响应的战略模式,该模式在当前正在考虑的传染病爆发应对模式基础上进行构建和扩展。本研究提议在国际原子能机构的技术专长以及世卫组织辐射应急医疗准备和援助网络的领导下,纳入一支核全球卫生人力队伍,并由《国际卫生条例》条约提供支持。基于健康结果研究阐述了核人力队伍的发展、结构和职能的基本原理,这些研究界定了核危机所特有的健康、卫生系统和公共卫生挑战。近期研究表明,拯救生命的机会是存在的,但前提是要有一支迅速部署且强大的多学科应对力量。