Risk assessment of the impact of climate change on human health and well-being

由于病原体数量众多、种类繁多、与气候和生态系统的联系多种多样，而且往往缺乏数据，因此，评估未来气候变化对人类健康和福祉的潜在影响（后者通过对动物健康的影响）受到阻碍。在这里，我们建议利用利物浦大学开发的一个独特的数据库，该数据库将很快包含一组人类和家畜所有已知病原体的记录。我们将利用利物浦大学、国际共同研究者和我们的项目合作伙伴的专业知识，生成清单的一个子集，即在英国、法国和荷兰附近发生或威胁这些国家的所有病原体;就对人类健康或福祉的影响程度和可能性而言，具有重大影响;并与空气或环境中的温度或湿度水平有流行病学联系，因此可能容易受到气候变化的影响。对这类疾病将进行定性或定量风险评估，以估计在今后半个世纪内气候变化的情况下，这些疾病将如何变化（在分布、发病率和严重程度方面）。我们的基本原则是，我们的结论所依据的数据和途径应该被充分记录、引用和透明;随着更好的数据的出现，将有可能更新模型的输出。我们的方法的一个好处是它是“自下而上”的，一开始就对可能受气候变化影响的所有可能的病原体给予同等的重视，然后根据商定的标准减少名单。这种方法是平衡的，可以得出这样的结论，例如，影响最大的病原体对气候变化基本上不敏感。相比之下，以前对气候变化影响的大多数评估都是自上而下的，从（通常是）人类的一些关键病媒传播病原体（疟疾，登革热，黄热病）需要紧急考虑的前提开始（并且通常结束）。在设计风险评估途径时，我们将密切听取利益相关者和最终用户的意见，并希望有效地向他们传达我们的科学方法和研究结果。最后，我们计划在整个项目中采用参与式方法。

Assessment of the potential impact of future climate change on human health and well-being (the latter via effects on animal health) is hindered by the sheer number of pathogens, their diversity, varied linkages to climate and ecosystems and, often, lack of data. Here we propose to exploit a unique database developed at the University of Liverpool which will soon contain a set of records for all known pathogens of humans and domestic animals. We will use expertise present within the University of Liverpool, the international co-investigators and our project partners to generate a subset of the list, namely all those pathogens that occur in proximity to the UK, France and the Netherlands or threaten these countries; are of major impact in terms of the magnitude and likelihood of impact on human health or well-being; and have epidemiological linkages to temperature or moisture levels in air or the environment and, hence, may be expected to be susceptible to the effects of climate change. This subset of diseases will be subjected to qualitative or quantitative risk assessment to estimate how they will change (in terms of distribution, incidence and severity) under scenarios of future climate change within the next half-century. Our underlying principle is that the data and pathways on which our conclusions are based should be fully recorded, referenced and transparent; as better data become available, it will be possible to update the model outputs. A benefit of our approach is that it is 'bottom-up', at the start giving equal weight to all possible pathogens that could be affected by climate change, and then reducing the list according to agreed criteria. This approach is balanced, allowing the conclusion, for example, that the highest-impact pathogens are largely insensitive to climate change. By contrast, most previous assessments of the impacts of climate change are top-down, starting (and often ending) with the premise that a few key vector-borne pathogens of (usually) humans (malaria, dengue, yellow fever) need urgent consideration. We will listen closely to stakeholders and end-users while designing our risk assessment pathways, and wish to communicate our scientific approaches and findings to them effectively. To the end, we plan to adopt participatory methods throughout the project.