背景:儿童比成年人更容易受到与气候相关的健康威胁,但是研究气候变化如何影响人类健康的评论主要是描述性的,缺乏对儿童面临的健康影响程度的评估。这是第一次系统评价和荟萃分析,确定哪些气候-健康关系对儿童构成最大威胁。
目的:我们回顾了流行病学研究,以分析气候变化导致的各种儿童健康结果,并确定与最大效应大小的关系。我们确定了特定人群的风险,并为未来的研究提供了建议。
方法:我们搜索了四个大型在线数据库,以根据PRISMA(系统评价)指南在2023年1月5日之前发表的观察性研究。我们分别评估了每个纳入的研究,并汇总了相关的定量数据。我们在荟萃分析中使用了定量数据,我们标准化了效应大小,并在气候变量和健康结果的不同分组之间进行了比较。
结果:在我们确定的1301篇文章中,163项研究符合分析条件。我们确定了气候变化与儿童健康之间的许多关系,其中最强的是暴露于极端温度的早产风险增加(平均60%)。呼吸系统疾病,死亡率,和发病率,其中,也受到气候变化的影响。与温度影响相比,不同空气污染物对健康结果的影响要小得多,但大多数(16/20=80%)污染物研究表明至少有微弱的影响。大多数研究发生在高收入地区,但是我们没有根据健康结果发现地理聚类,气候变量,或风险的大小。以下因素是保护与气候有关的儿童健康威胁:(i)经济稳定和实力,(ii)获得高质量的医疗保健,(iii)适当的基础设施,(四)粮食安全。对这些服务的威胁因当地地理而异,气候,和社会经济条件。由于人为气候变化,儿童的疾病患病率将增加,我们对气候变化各方面对儿童健康的影响进行量化,可以有助于规划将改善今世后代健康的缓解措施。
BACKGROUND: Children are more vulnerable than adults to climate-related health threats, but reviews examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. This is the first systematic review and meta-analysis that identifies which climate-health relationships pose the greatest threats to children.
OBJECTIVE: We reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. We identify population-specific risks and provide recommendations for future research.
METHODS: We searched four large online databases for observational studies published up to 5 January 2023 following PRISMA (systematic review) guidelines. We evaluated each included study individually and aggregated relevant quantitative data. We used quantitative data in our meta-analysis, where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes.
RESULTS: Of 1301 articles we identified, 163 studies were eligible for analysis. We identified many relationships between climate change and child health, the strongest of which was increasing risk (60 % on average) of preterm birth from exposure to temperature extremes. Respiratory disease, mortality, and morbidity, among others, were also influenced by climate changes. The effects of different air pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20 = 80 %) pollutant studies indicating at least a weak effect. Most studies occurred in high-income regions, but we found no geographical clustering according to health outcome, climate variable, or magnitude of risk. The following factors were protective of climate-related child-health threats: (i) economic stability and strength, (ii) access to quality healthcare, (iii) adequate infrastructure, and (iv) food security. Threats to these services vary by local geographical, climate, and socio-economic conditions. Children will have increased prevalence of disease due to anthropogenic climate change, and our quantification of the impact of various aspects of climate change on child health can contribute to the planning of mitigation that will improve the health of current and future generations.