Azan Alexander, Nyimbili Sulani, Babayode Oyinkansola O, Bershteyn Anna
Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York, USA.
BMJ Paediatr Open. 2025 Jan 21;9(1):e002883. doi: 10.1136/bmjpo-2024-002883.
Greenhouse gas (GHG) emissions are creating unprecedented climate-driven extreme weather, with levels of heat and humidity surpassing human physiological tolerance for heat stress. These conditions create a risk of mass casualties, with some populations particularly vulnerable due to physiological, behavioural and socioeconomic conditions (eg, lack of adequate shelter, limited healthcare infrastructure, sparse air conditioning access and electrical grid vulnerabilities). Children, especially young children, are uniquely vulnerable to extreme heat-related morbidity and mortality due to factors including low body mass, high metabolism, suboptimal thermoregulatory mechanisms and behavioural vulnerabilities. Children are also uniquely vulnerable to non-fatal heat-related morbidities, including malnutrition due to agricultural disruptions and cardiometabolic, respiratory and mental illnesses from heat exposure and/or confinement during heat avoidance. Climate mitigation through GHG reductions is central to reducing harms to children and preventing the loss of a generation to climate change. In regions most predisposed to extreme heat-driven mass casualties under various GHG emission scenarios-particularly South Asian and Southwest Asian and North African regions-adaptation tools specific to children's needs are the most urgently needed. Existing public health interventions (eg, cooling infrastructure and preventative educational campaigns) to reduce acute heat mortality, and medical infrastructure capacity to treat heat-related illnesses are currently inadequate to meet children's growing heat resiliency needs. Paediatricians and other clinical and community child healthcare providers in these regions lack education about children's heat risks and adaptation tools. Paediatricians and other child healthcare providers have a crucial role in research, education, clinical practice and advocacy to protect children during extreme heat events. Paediatricians, other child healthcare providers and stakeholders of children's well-being are urged to act on young children's behalf and to elevate youth leadership in GHG mitigation and extreme heat adaptation policy-making.
温室气体（GHG）排放正在造成前所未有的由气候驱动的极端天气，炎热和潮湿程度超过了人类对热应激的生理耐受能力。这些情况带来了大规模人员伤亡的风险，一些人群由于生理、行为和社会经济状况（例如，缺乏足够的住所、有限的医疗基础设施、空调使用机会少以及电网脆弱性）而特别脆弱。儿童，尤其是幼儿，由于体重低、新陈代谢快、体温调节机制欠佳以及行为上的脆弱性等因素，特别容易受到与极端高温相关的发病和死亡的影响。儿童还特别容易受到与高温相关的非致命疾病的影响，包括农业中断导致的营养不良以及因高温暴露和/或在躲避高温期间被限制活动而引发的心脏代谢、呼吸和精神疾病。通过减少温室气体排放来缓解气候变化对于减少对儿童的伤害以及防止一代人因气候变化而受损至关重要。在各种温室气体排放情景下最容易发生由极端高温导致大规模人员伤亡的地区——特别是南亚、西南亚和北非地区——最迫切需要针对儿童需求的适应工具。目前，现有的减少急性高温死亡的公共卫生干预措施（例如，降温基础设施和预防性教育活动）以及治疗与高温相关疾病的医疗基础设施能力不足以满足儿童日益增长的耐热能力需求。这些地区的儿科医生和其他临床及社区儿童医疗服务提供者缺乏关于儿童高温风险和适应工具的教育。儿科医生和其他儿童医疗服务提供者在研究、教育、临床实践和宣传方面发挥着关键作用，以在极端高温事件期间保护儿童。敦促儿科医生、其他儿童医疗服务提供者以及儿童福祉的利益相关者代表幼儿采取行动，并提升青年在温室气体减排和极端高温适应政策制定方面的领导力。
