Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France.
Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France.
Lancet Planet Health. 2024 Jun;8(6):e353-e364. doi: 10.1016/S2542-5196(24)00099-8.
Faced with climate change, hospitals are confronted with a dual challenge. On one hand, they need to embark on a far-reaching ecological transformation to reduce their contribution to greenhouse gas emissions and other environmental impacts; on the other hand, they need to limit the effects of climate change on their activities. We aimed to evaluate the knowledge, behaviours, practices, and expectations of health workers in French hospitals regarding climate change and environmental sustainability.
This multicentre, cross-sectional study was carried out in six French hospitals from June 1, 2021 to Dec 31, 2022. All health workers at the hospitals were eligible to participate and were recruited through internal publicity. We designed a structured questionnaire consisting of five parts: participant characteristics, knowledge and perceptions of climate change, pro-environmental behaviours, practices concerning environmental sustainability actions, and expectations. A multilevel logistic regression model was used to evaluate associations between the knowledge, behaviours, and practices of health workers and the characteristics of the health workers and hospitals.
Of 57 034 health workers across the six hospitals, 4552 (8·0%) participated in the study. Of those for whom gender data were available, 3518 (78·2%) participants were women and 979 (21·8%) were men. Participants considered energy consumption (71·0%) and waste and discharges related to medical activities (55·6%) and non-medical activities (50·2%) to be the three activities with the greatest environmental impact. On a scale of 1 (not a priority) to 10 (high priority), the median rating attributed by the participants to the commitment of their hospitals to ecological transformation was 5·0 (IQR 3·0-6·0). 1079 (23·7%) of 4552 participants had already initiated at least one environmental sustainability action in their hospital. Barriers reported by participants to the implementation of environmental sustainability-related projects were the lack of dedicated time (40·4%), hierarchical support (32·5%), methodological support (28·9%), and access to training (23·7%). The presence of a sustainable development steering committee, especially one with more than 5 years of activity, was positively associated with health workers feeling better informed about the ecological transformation of their hospital (adjusted odds ratio 1·78 [95% CI 1·29-2·45]), having better knowledge of the environmental impacts of their hospital (1·83 [1·32-2·53]), and initiating a larger number of environmental sustainability actions (1·74 [1·33-2·29]).
We showed that health workers in French hospitals seem to be committed to the ecological transformation of their workplaces, and identified some drivers and barriers to further support these essential transformations. There is an urgent need to bolster training for all health workers, enhance structural frameworks within hospitals, and encourage future interdisciplinary research on the vulnerability of health-care facilities to climate change.
The University Hospital of Poitiers.
面对气候变化，医院面临着双重挑战。一方面，他们需要进行深远的生态转型，以减少对温室气体排放和其他环境影响的贡献；另一方面，他们需要限制气候变化对其活动的影响。我们旨在评估法国医院卫生工作者对气候变化和环境可持续性的知识、行为、实践和期望。
这是一项多中心、横断面研究，于 2021 年 6 月 1 日至 2022 年 12 月 31 日在法国的六家医院进行。所有医院的卫生工作者都有资格参加，并通过内部宣传招募。我们设计了一个由五个部分组成的结构化问卷：参与者特征、对气候变化的知识和看法、亲环境行为、环境可持续性行动实践以及期望。使用多水平逻辑回归模型评估卫生工作者的知识、行为和实践与卫生工作者和医院特征之间的关联。
在六家医院的 57034 名卫生工作者中，有 4552 人（8.0%）参加了研究。在提供性别数据的参与者中，3518 名（78.2%）为女性，979 名（21.8%）为男性。参与者认为能源消耗（71.0%）以及与医疗活动（55.6%）和非医疗活动（50.2%）相关的废物和排放是三个对环境影响最大的活动。参与者对其所在医院生态转型承诺的评分中位数为 5.0（IQR 3.0-6.0）。在 4552 名参与者中，有 1079 名（23.7%）已经在其所在医院发起了至少一项环境可持续性行动。参与者报告实施环境可持续性相关项目的障碍包括缺乏专门时间（40.4%）、层级支持（32.5%）、方法支持（28.9%）和培训机会（23.7%）。可持续发展指导委员会的存在，特别是活动时间超过 5 年的指导委员会，与卫生工作者对医院生态转型的了解程度（调整后的优势比 1.78[95%CI 1.29-2.45]）、对医院环境影响的了解程度（1.83[1.32-2.53]）以及发起更多环境可持续性行动的意愿（1.74[1.33-2.29]）呈正相关。
我们表明，法国医院的卫生工作者似乎致力于工作场所的生态转型，并确定了进一步支持这些重要转型的一些驱动因素和障碍。迫切需要加强对所有卫生工作者的培训，加强医院内部的结构框架，并鼓励未来对卫生保健设施应对气候变化的脆弱性进行跨学科研究。
普瓦提埃大学医院。
