居民对热浪健康防护相关措施的支付意愿调查研究

目的了解公众对热浪健康防护相关措施的实际需求,分析居民对不同类型防护措施的偏好程度及相关原因,为我国开展热浪健康防护相关措施的工作提供必要的科学依据。方法于2013年在北京市城区A和郊区B开展基于条件价值法的居民对热浪健康防护措施的支付意愿问卷调查,采用多阶段分层抽样、入户调查形式,调查措施提供方为政府或市场时,居民对预警、市政、宣传、应急四项措施的支付意愿。结果共调查1 227人,其中城区A 636人,郊区B 591人;当防护措施的提供方为政府时,城区A和郊区B居民的支付率分别为31.6%和51.6%;当防护措施的提供方为市场时,城区A和郊区B居民的支付率分别为32.0%和47.4%。无论是政府还是市场提供热浪健康防护相关措施,两区居民的支付金额集中于40元/(人·年)。综合支付率与支付金额结果,两区居民对政府提供措施的支付意愿大于市场;居民对应急措施的支付意愿较高,对宣传措施的支付意愿较低。当措施的提供方为政府时,居民不愿意支付费用的原因选择最多的是"政府的责任,费用应该由政府承担";当措施的提供方为市场时,居民不愿意支付费用的原因选择最多的为"市场应该免费为公众提供此项措施";原因选择率位居第二的均为"收入问题"。结论社会亟需向公众提供热浪健康影响的防护相关措施。虽然优先考虑由政府提供相关措施,但也可吸纳市场上的机构来提供相似的服务。社会在向公众提供热浪健康防护相关措施时,应优先考虑提供加强市政工程和建设城市热浪应急场所等措施。     

城镇化过程的交通噪声污染与健康问题

交通噪声污染对人群健康的影响是城镇化过程中应关注的重要环境与健康问题。目前,研究结果显示交通噪声暴露可对神经系统、心理健康和心血管系统等方面产生影响,已经成为影响公众身心健康的重要环境危险因素之一。在将来的研究中,亟待对不同类型交通噪声的健康影响差异开展进一步分析,并探索交通噪声与空气污染、绿地等其它相关环境因素的综合效应,为城镇化过程中交通噪声污染控制和人群健康防护提供科学依据。     

空气污染对人群认知功能和神经行为影响的研究进展

认知功能和神经行为的发育、发展受多种内外因素的综合影响。近年来,许多研究表明空气污染物暴露会对人群认知功能和神经行为产生不良影响。该文综述了空气污染的概念与分类、空气污染物暴露对人群认知功能和神经行为影响的可能机制及相关研究,为深入探讨空气污染对认知功能和神经行为的影响及公众健康防护提供科学依据。     

某医院放疗中心建设项目职业病危害放射防护控制效果评价

目的 对某医院放疗中心进行职业病危害控制效果放射防护评价,以保障放射工作人员和周围公众的健康与安全。方法 采用放射卫生检测、放射卫生调查,检查表分析等方法按照国家相关法律、法规对机房屏蔽设施防护效果、设备安全装置和机房防护设施、辐射监测及健康管理等方面进行评价。结果 该院放射治疗中心职业病危害防护设施和健康管理措施基本符合国家相关标准要求。结论 该院放疗中心按要求整改后正常运行时,能够保障放射工作人员和周围公众的健康与安全。     

公众自我防护意识、行为对传染病传播速度与广度的影响

目的 从公众性别、年龄、现居住地三个维度出发,探讨公众自我防护意识、健康或非健康行为对传染病流行速度与广度的影响程度,为公众未来提升呼吸系统传染病自我防护意识、开展健康教育与健康促进提供借鉴和帮助。方法 利用问卷星App发布线上调查问卷,分别对中国城市、农村、海外华人进行呼吸道传染病自我防护意识调查。结果 此次调查共收回675份问卷,其中有效问卷667份。不同年龄段、不同学历人群的自我防护意识均高于80.00%。其中,初中及以下学历人群自我防护意识最高。中国城市、农村、海外华人面对传染病时均能自主地采取健康行为,差别不大。结论 随着我国爱国卫生运动等活动的开展,公众对传染病的自我防护意识逐渐增强,健康素养水平不断提高,健康行为习惯逐渐养成,有效地减缓了呼吸道传染病传播的速度与广度。     

某医院放射治疗中心职业病危害控制效果评价

目的对某医院放射治疗中心进行职业病危害控制效果放射防护评价,以保障放射工作人员和周围公众的健康与安全。方法按国家《建设项目职业病危害放射防护评价报告编制规范》GBZ/T 181-2000进行评价。结果该院放射治疗中心的屏蔽和安全防护措施符合国家相关标准要求。结论该院放射治疗中心在正常运行时,能够保障放射工作人员和周围公众的健康与安全。     

某医院X射线影像诊断职业病危害控制效果评价

目的对某医院新建建设项目进行职业病危害控制效果放射防护评价,以保障放射工作人员和周围公众的健康与安全。方法按国家《建设项目职业病危害放射防护评价报告编制规范》GBZ/T181-2006进行评价。结果该院新建建设项目的屏蔽和安全防护措施符合国家相关标准要求。结论该院新建建设项目在正常运行时,能够保障放射工作人员和周围公众的健康与安全。     

核电站事故的公众防护行动

随着核能发展不断推进,居住在核电站周围的公众数量越来越多,但是他们普遍缺乏对核辐射的基础知识,对核事故的防护行动也知之甚少。而及时、正确的防护行动可以将核电站事故对公众的健康危害降到最低。本文介绍了核电站事故后,公众的防护行动：隐蔽、体表污染去污、撤离、服用稳定性碘、食品和饮用水控制、个人防护措施、宠物照料、心理援助等,以指导公众在事故后开展正确的自救与互救,提高公众对核电站事故的应急响应能力。     

某新建CT机房放射性职业病危害因素控制效果评价

目的 对新建CT机房现场进行辐射检测和对放射防护设施及措施进行核查,从而保护从业人员及公众的健康安全。方法 依据国家相关法规、标准并采用现场调查法和检查表法等进行综合分析,做出评价。结果 CT机房的选址与总体布局、设备安装、放射防护设施设计、辅助用室设置等职业病危害因素,经现场检测符合国家放射防护有关规定。结论 该建设项目放射防护设施的防护效果良好,各项安全防护措施有效,达到了国家放射防护标准。     

某水池贮源γ射线辐照建设项目职业病危害放射防护预评价

目的对某水池贮源γ射线辐照装置职业病危害进行放射防护预评价，从源头控制或消除职业病危害，防治职业病，保护放射工作人员和公众健康。方法根据国家相关的法律法规及放射卫生标准，采用理论估算、现场调查以及检查表分析等方法进行综合评价。结果该项目的辐照装置设计、工作场所布置基本合理；辐射安全符合国家相关标准要求；放射人员和相关公众接受的最大剂量估算值小于建设单位有效剂量管理目标值要求。结论该建设项目的放射防护设施设计基本符合国家规定。     

Operationalizing Iterative Risk Management under Limited Information:Fiscal and Economic Risks Due to Natural Disasters in Cambodia

Iterative risk management and risk-sensitive public investment planning are increasingly seen as essential elements of natural disaster resilience. This article assesses the disaster risk facing the hazard-prone Southeast Asian country of Cambodia and discusses its fiscal preparedness and need for proactive disaster risk management.The study provides a bottom-up assessment of flood and cyclone risks to public and private buildings including educational structures, health facilities, and housing and estimates the total direct economic damage to range from approximately USD 304 million for a 5-year return period event to USD 2.26 billion for a 1000-year return period event. These estimates were further analyzed using the fiscal risk due to disasters, which indicates that Cambodia will likely face a resource gap whenever a hazard as large as that of a 28-year return period event strikes. Given the frequent occurrence of disasters and rapid accumulation of capital assets taking place, proactive risk reduction is highly advisable. But interviews with national policymakers also revealed that there are a number of barriers to effective risk reduction and management in Cambodia. The general lack of awareness regarding risk-based concepts and the limited availability of local risk information necessitate a continued and sustained effort to build iterative risk management in Cambodia.     

Impact of public health emergencies on modern disaster taxonomy, planning, and response

Current disaster taxonomy describes diversity, distinguishing characteristics, and common relations in disaster event classifications. The impact of compromised public health infrastructure and systems on health consequences defines and greatly influences the manner in which disasters are observed, planned for, and managed, especially those that are geographically widespread, population dense, and prolonged. What may first result in direct injuries and death may rapidly change to excess indirect illness and subsequent death as essential public health resources are destroyed, deteriorate, or are systematically denied to vulnerable populations. Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict. We posit here that disaster frameworks be reformed to emphasize and clarify the relation of public health emergencies and modern disasters.     

Strong communities for children: a community-wide approach to prevention of child abuse and neglect

In 1990, the US Advisory Board declared a national emergency in the child protection system, which was nothing short of a disaster. In calling for a new approach to child protection, the Board argued that only a universal system of family support, grounded in the creation of caring communities, could provide an effective foundation for ensuring children's safety. Strong Communities for Children is the first initiative to attempt a comprehensive, large-scale implementation of the Board's proposed strategy. Using a public health approach, Strong Communities blends research about the causes and correlates of child abuse and neglect with public health concepts of community-wide prevention and intervention. Strong Families, the direct service component of Strong Communities, relies heavily on the health sector for the engagement of families.     

利用遥感技术对洪涝灾区县界定分级的研究

目的 借助遥感技术，对洪涝灾区县界定分级指标和标准进行研究，为洪涝灾害救灾防病提供科学依据。方法 选择洪涝灾区县界定分级指标，依据1998年江西省洪涝灾害3次遥感淹没资料描述性分析的结果，确定洪涝灾区县界定分级标准。结果 依据遥感资料可以将洪涝灾区县划分成3大类：3次遥感资料中有1次遥感淹没面积超过6700hm^2的灾区县属于一类灾区县；3次遥感淹没面积均低于6700hm^2的灾区县属于二类灾区县；3次遥感资料均未显示有淹没存在的其它上报灾区县属于三类灾区县。结论 借助遥感、地理信息系统技术可以实现对洪涝灾区县及时、准确的界定分级，为洪涝灾害救灾防病疫情统计服务。     

走向完善的公共卫生--中国直面SARS触发的公共危机

公共卫生是社会抵御疾病风险，保障公众生命健康的重要组成部分。公共卫生功能弱化则必然成为公共卫生突发性事件和灾难发生的直接原因。当中国直面SARS触发的公共危机时，即充分暴露了我们公共卫生存在的缺陷与危机，又极大地激发、催化公共卫生快速进行一系列的重大改变，促使公共卫生从社会发展的“边缘”转位为“中心”；迅速建立公共卫生突发事件应急处理机制，为公众健康设定了安全警戒线；有效整合了社会公共伦理资源，培育了公众的公共道德和公共观念，重构了中华人民共和国现代公共伦理的强实基础。文章着重分析了我国公共卫生在SARS触发的公共危机中显露出来的缺陷，以及其带来的警示和机遇，提出我国公共卫生逐步走向完善是必然趋势。     

Evaluation of the psychological consequences of environmental catastrophes: a feasibility study based on the 1992 floods in the Vaucluse

Scientific studies of environmental disasters, whether human or natural in origin, have shown that the psychological impact of such events may be considerable and long-lasting. Several natural disasters have occurred in France, but their impact on public psychological health has not been assessed. In September 1992, there was a major flood in southeast France (Vaucluse), which caused 38 deaths. Four years later, we performed a pilot cross-sectional study to assess the feasibility of a larger epidemiological study to assess the psychological impact of this flood. Two affected towns were chosen for this study: Vaison-la-Romaine (VLR), where the flood was very sudden and 29 people were killed, and Bédarrides, where the water level rose more slowly. In Bédarrides, households were randomly selected from a list of victims (n = 100) and in Vaison-la-Romaine, households were randomly selected from the telephone directory (n = 140). Exposure to the flood was assessed by a series of questions, the answers to which were used to calculate an exposure score. The questionnaire also included psychometric scales for post-traumatic stress disorder (QE-PTSD), anxiety (Spielberger State-Trait Anxiety Inventory) and depression (Beck Depression Inventory). In Bédarrides, the participation rate was high: 69% of the selected households were successfully contacted and found to be eligible for inclusion and 74% agreed to a face-to-face interview. In Vaison-la-Romaine, 51% of the selected households were contacted and eligible and 50% agreed to the face-to-face interview. Our survey showed that exposure was multidimensional and that it was possible to calculate an exposure score suitable for the analysis of exposure-effect relationships. The PTSD scale was completed well by the interviewees, several of whom did not fill in the depression and anxiety scales correctly. However, analysis of the responses obtained showed that these tools had a high level of internal consistency. Cross-correlations between the various psychological scales used in this study were highly significant (p < 10-4). There was some degree of association between some psychometric scales and exposure. This pilot study shows that a cross-sectional study of the long-term psychological consequences of an environmental disaster could be carried out several years after the event but that the feasibility of such a study depends ultimately on its acceptance by the public and the relevant authorities. It underlines the need to collect exposure data immediately after the event and enabled us to identify and to adapt the tools required for this kind of evaluation. It should encourage public health decision-makers to support such evaluation and to improve the psychological and social support available to people exposed to floods.     

Disaster Communication,Posttraumatic Stress,and Posttraumatic Growth following Hurricane Matthew

Disaster survivors may experience a range of mental health reactions that can include posttraumatic stress (PTS) and posttraumatic growth (PTG). The current study examines the associations between citizen disaster communication, PTS, and PTG among individuals in North Carolina communities impacted by Hurricane Matthew, approximately six weeks following the event. Participants who communicated more frequently following the hurricane exhibited more PTS and PTG. Communication activities focused on connecting with loved ones and cognitively restructuring the disaster experience were associated with PTS and PTG, whereas communication activities confirming disaster reports and assisting with disaster recovery were associated solely with PTG. Results illustrate the need for robust disaster communication ecologies to facilitate public disaster mental health response and coordination.     

Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza.

Public health professionals are responsible for ensuring the health of the nation, which requires that planners for public health emergencies recognize that not including protection for underserved or marginalized communities poses a risk to the entire population. To assure the protection of these populations in the event of a pandemic outbreak, preparedness planning will benefit from the application of several principles of social justice in assuring the protection of all individuals. This article will review the history between public health and social justice, provide a brief review of pandemic preparedness planning efforts, discuss the importance of and make recommendations for the incorporation of principles of social justice in the development of pandemic preparedness plans, and highlight some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation's health.     

Health facilities safety in natural disasters: experiences and challenges from South East Europe

The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.