Mashallahi Alireza, Ardalan Ali, Nejati Amir, Ostadtaghizadeh Abbas
Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Ghods Ave, Tehran, Iran.
Institute for Environmental Health Research, Tehran University of Medical Sciences, Tehran, Iran.
J Environ Health Sci Eng. 2022 Jun 9;20(2):983-1013. doi: 10.1007/s40201-022-00810-5. eCollection 2022 Dec.
Climate change is among the most renowned concerns of the current century, endangering the lives of millions of people worldwide. To comply with the United Nations Climate Change Conference (COP21), hospitals should be on track to reduce greenhouse gas emissions. Although hospitals contribute to climate change by emitting greenhouse gases, they are also affected by the health consequences of climate change. Despite all the guidance provided, hospitals need more radical measures to confront climate change. The current study was carried out to examine the components of hospitals' adaptation to climate change and to review measures to confront climate change in hospitals.
This systematic review was designed and carried out in 2020. The required information was collected from international electronic databases including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar. Moreover, Iranian datasets such as Scientific Database (SID), Irandoc, Magiran, and IranMedex were reviewed. No restriction was considered in the methodology of the study. For the relevant thesis, the ProQuest database was also explored. The related sources were examined and the Snowball method was applied to find additional related studies. The research team also reviewed other accessible electronic resources, such as international guidelines and academic websites. The checklist of the Joanna Briggs Institute (JBI, 2017) was employed in order to evaluate the quality of the included papers. The studies published until June1, 2020, were included in the study.
Of 11,680 published documents in the initial search, the full-texts of 140 were read after evaluating the titles and abstracts, of which 114 were excluded due to lack of sufficient information related to countermeasures in hospitals. Finally, the full-texts of 26 studies were reviewed to extract the required components. Two strategies were found, including climate change mitigation and climate change adaptation, with 13 components including water, wastewater, energy, waste, green buildings, food, transportation, green purchasing policy, medicines, chemicals and toxins, technology, sustainable care models, and leadership in hospitals were identified as affecting these measures and strategies.
Considering the significance of climate change and strategies to confront it as one of the current challenges and priorities in the world, it is necessary to develop a framework and model to reduce the effects of climate change and adapt to climate changes in hospitals and other health centers. The identification and classification of the measures and components, influencing hospital adaptability and solutions for reducing the climate change impacts could be the first stage in developing this strategy. This is because it is impossible to create this framework without identifying these factors and their mutual impacts at the first. In the present study, through a systematic review using a comprehensive approach, the related components were explored and divided into two categories, including measures to reduce the effects and measures to adapt to climate change. The results of this study can be useful in developing a comprehensive action model to reduce greenhouse gas emissions and adapt hospitals to climate change.
气候变化是本世纪最受关注的问题之一，危及全球数百万人的生命。为了遵守联合国气候变化大会（COP21）的要求，医院应努力减少温室气体排放。尽管医院通过排放温室气体对气候变化有影响，但它们也受到气候变化对健康影响的波及。尽管有各种指导意见，但医院仍需要采取更激进的措施来应对气候变化。本研究旨在探讨医院适应气候变化的组成部分，并审视应对医院气候变化的措施。
本系统评价于2020年设计并开展。所需信息从国际电子数据库收集，包括Scopus、PubMed、科学网、EMBASE和谷歌学术。此外，还查阅了伊朗的数据集，如科学数据库（SID）、伊朗文献数据库、Magiran和伊朗医学数据库。本研究方法没有限制。对于相关论文，还检索了ProQuest数据库。对相关来源进行了审查，并应用滚雪球法查找其他相关研究。研究团队还查阅了其他可获取的电子资源，如国际指南和学术网站。采用乔安娜·布里格斯研究所（JBI，2017年）的核对清单来评估纳入论文的质量。纳入研究的是截至2020年6月1日发表的研究。
在初步检索的11680篇已发表文献中，在评估标题和摘要后阅读了140篇全文，其中114篇因缺乏与医院应对措施相关的充分信息而被排除。最后审查了26项研究的全文以提取所需的组成部分。发现了两种策略, 包括减缓气候变化和适应气候变化，确定了13个组成部分，包括水、废水、能源、废物、绿色建筑、食品、交通、绿色采购政策、药品, 化学品和毒素、技术、可持续护理模式以及医院领导力，这些被认为会影响这些措施和策略。
鉴于气候变化的重要性以及应对气候变化的策略是当今世界的挑战和优先事项之一，有必要制定一个框架和模型，以减少气候变化的影响，并使医院和其他医疗中心适应气候变化。识别和分类影响医院适应性的措施和组成部分以及减少气候变化影响的解决方案可能是制定该战略的第一阶段。这是因为如果一开始不识别这些因素及其相互影响，就不可能创建这个框架。在本研究中，通过采用综合方法进行系统评价，探索了相关组成部分，并将其分为两类，包括减少影响的措施和适应气候变化的措施。本研究结果有助于制定一个全面的行动模型，以减少温室气体排放，并使医院适应气候变化。
