The impact of the environment on health by country: a meta-synthesis.
The impact of the environment on health by country: a meta-synthesis.
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环境对国家对健康的影响：元合成。
DOI：
10.1186/1476-069x-7-7
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发表时间：
2008-02-25
影响因子：
6
通讯作者：
Corvalan, Carlos
中科院分区：
文献类型：
--
作者：
Pruess-Uestuen, Annette;Bonjour, Sophie;Corvalan, Carlos
在选择环境卫生行动以预防疾病时，环境干预可以实现的健康收益是主要问题。世界卫生组织最近公布了192个国家的疾病环境负担概况。这些国家概况提供了对三个主要风险因素“不安全的水、环境卫生和个人卫生”、“固体燃料使用造成的室内空气污染”和“室外空气污染”对健康影响的估计。这些概况还提供了对整个环境可预防的健康影响的估计。虽然三个风险因素的估计数是根据国家接触情况得出的，但总体环境改善的健康收益估计数是根据对文献的审查得出的，并辅以专家意见，同时结合国家健康统计数据。这些国家13%至37%的疾病负担可以通过改善环境来预防，导致全球每年约1300万人死亡。据估计，仅通过改善水、环境卫生和个人卫生以及室内和室外空气，就可以预防其中约400万人。每年每1 000人中的环境保护专家人数依国家而定，从14人到316人不等。按疾病类别进行的分析指出了每个国家的主要预防机会。尽管计算中存在不确定性，但这些估计数提供了通过更健康的环境进行预防的机会的概览。估计数表明，对于类似的国民收入，疾病的环境负担通常可以相差五倍。这项分析还表明，更安全的水、环境卫生和个人卫生以及更安全的烹饪燃料可以显著降低儿童死亡率，即在20个最低收入国家降低25%以上。
Health gains that environmental interventions could achieve are main questions when choosing environmental health action to prevent disease. The World Health Organization has recently released profiles of environmental burden of disease for 192 countries. These country profiles provide an estimate of the health impacts from the three major risk factors 'unsafe water, sanitation & hygiene', 'indoor air pollution from solid fuel use' and 'outdoor air pollution'. The profiles also provide an estimate of preventable health impacts by the environment as a whole. While the estimates for the three risk factors are based on country exposures, the estimates of health gains for total environmental improvements are based on a review of the literature supplemented by expert opinion and combined with country health statistics. Between 13% and 37% of the countries' disease burden could be prevented by environmental improvements, resulting globally in about 13 million deaths per year. It is estimated that about four million of these could be prevented by improving water, sanitation and hygiene, and indoor and outdoor air alone. The number of environmental DALYs per 1000 capita per year ranges between 14 and 316 according to the country. An analysis by disease group points to main preventions opportunities for each country. Notwithstanding the uncertainties in their calculation, these estimates provide an overview of opportunities for prevention through healthier environments. The estimates show that for similar national incomes, the environmental burden of disease can typically vary by a factor five. This analysis also shows that safer water, sanitation and hygiene, and safer fuels for cooking could significantly reduce child mortality, namely by more than 25% in 20 of the lowest income countries.