A pandemia de COVID-19 e o seu impacto à saúde planetária / The COVID-19 pandemic and its impact on planetary health

A pandemia de COVID-19 deu ao mundo uma imagem clara do que é uma crise multidimensional em escala planetária, revelando o papel central que ocupa o setor de saúde e as profundas desigualdades no acesso aos cuidados em saúde que existem entre os diferentes países, e dentro de cada um deles. Melhorar os efeitos ambientais do setor e reduzir as emissões de gases de efeito estufa pode não apenas melhorar a saúde de todos, mas também reduzir os custos com os cuidados em saúde. O setor de saúde de cada país libera direta e indiretamente gases de efeito estufa ao fornecer seus serviços e ao comprar produtos, serviços e tecnologias em uma cadeia de fornecimento de carbono intensivo. Educar os profissionais de saúde mais profundamente sobre os efeitos das mudanças climáticas pode levar a práticas clínicas mais sustentáveis, melhorando os resultados para os pacientes e fornecendo um impulso substancial para aumentar os esforços para reduzir as emissões de carbono. O setor da saúde deve assumir a responsabilidade por sua pegada climática respondendo à crescente emergência climática, não apenas prestando assistência aos doentes, feridos ou moribundos como resultado da crise climática e suas causas, mas também fazendo a prevenção primária e reduzindo drasticamente suas próprias emissões.

The COVID-19 pandemic has painted a clear picture of what a multidimensional planetary crisis is, revealing the central role played by the health sector and the deep inequalities in access to health care that exist between and within each country. Decreasing the environmental effects of the health sector and reducing greenhouse gas emission may not only improve people's health, but also reduce health care costs. The health care sectors around the world directly and indirectly release greenhouse gases by providing their services and purchasing products, services, and technologies within a carbon-intensive supply chain. Further educating health care professionals about the effects of climate change may lead to more sustainable clinical practices, improving patient outcomes and providing substantial impetus to increased efforts to reduce carbon emission. The health sector must take responsibility for its climate footprint by responding to the growing climate emergency not only by assisting the sick, injured, or dying from the climate crisis, but also by doing primary prevention and drastically reducing its own carbon emission.

Psicologia ambiental e recursos em sustentabilidade: revisão integrativa / Environmental psychology and sustainability resources: integrative review / Psicología ambiental y recursos de sostenibilidad: revisión integradora

O objetivo deste estudo foi examinar, por meio de revisão integrativa de artigos empíricos, a produção científica relacionando a Psicologia Ambiental (variáveis de comportamento/cognição) e sustentabilidade, considerando diferentes recursos. Para efeitos deste estudo, foram analisados os artigos que abordam um recurso único. A busca foi realizada nos periódicos Environment and Behavior, Journal of Environmental Psychology e Psyecology, reconhecidos pela relevância internacional em produção científica no campo da Psicologia Ambiental. Foram selecionados 24 artigos, publicados entre os anos de 2012 e 2016, a partir dos critérios de inclusão pré-estabelecidos. Os anos com maior número de publicação foram 2014 (n = 8) e 2015 (n = 8). A maioria dos artigos se refere a estudos realizados na Europa, apenas um trata de pesquisa no Brasil. Os recursos abordados nos estudos abrangeram transporte, produtos, água, energia elétrica, sacola plástica e pastagem natural. Os resultados revisados demonstram que há uma diversidade de conceitos na mediação entre comportamentos/cognições e diferentes recursos, indicando a relevância destas abordagens para a promoção de sustentabilidade. Sugere-se caminhos para pesquisa e intervenção nas relações sustentáveis entre pessoas e recursos disponíveis em seus meios.(AU)

The objective of this study was to examine, through an integrative review of empirical articles, the scientific production on the relation between Environmental Psychology (behavior/cognition variables) and sustainability considering different resources. For that purpose, this analysis considered articles approaching a unique resource. Search was conducted in three journals with international relevance in the scientific production of Environmental Psychology: Environment and Behavior, Journal of Environmental Psychology and Psyecology. Following pre-established inclusion criteria, results included 24 articles published from 2012 and 2016. Years with higher number of publications were 2014 (n = 8) and 2015 (n = 8). The articles found refer mostly to studies conducted in Europe; only one article is a research from Brazil. Resources included transportation, products, water, energy, plastic bag, and natural grassland. Results indicate that there is a diversity of concepts mediating behaviors/cognitions and different resources, which reveals the relevance of these approaches to the promotion of sustainability. Research and intervention paths are suggested to sustainable relations between people and resources available in their surroundings.(AU)

El objetivo de este estudio fue examinar, por medio de una revisión integradora de artículos empíricos, la producción científica que relaciona la Psicología Ambiental (variables de comportamiento/cognición) y la sostenibilidad, considerando diferentes recursos. Para los propósitos de este estudio, se analizaron artículos que abordan un solo recurso. La búsqueda fue realizada en los periódicos Environment and Behavior, Journal of Environmental Psychology y Psyecology, reconocidos por la relevancia internacional en producción científica en el campo de la Psicología Ambiental. Se seleccionaron 24 artículos, publicados entre los años 2012 y 2016, basados en criterios de inclusión preestablecidos. Los años con el mayor número de publicaciones fueron 2014 (n = 8) y 2015 (n = 8). La mayoría de los artículos se refiere a estudios realizados en Europa, sólo uno trata de investigación en Brasil. Los recursos abordados en los estudios incluyeron transporte, productos, agua, energía eléctrica, bolsas de plástico y pastoreo natural. Los resultados revisados demuestran que hay una diversidad de conceptos en la mediación entre comportamientos/cogniciones y diferentes recursos, indicando la relevancia de estos enfoques para la promoción de la sostenibilidad. Se sugieren caminos para la investigación e intervención en las relaciones sostenibles entre personas y recursos disponibles en sus medios.(AU)

Health in the latest assessment report of the Intergovernmental Panel on Climate Change (IPCC): a discussion on findings for the European Environment and Health Process: report of a meeting in Bonn, Germany, 27–28 May 2014

In May 2014, the WHO Regional Office for Europe organized a technical meeting to discuss Fifth Assessment Report of the Intergovernmental Panel on Climate Change, and its implications for population health in the WHO European Region. Participants agreed that the time for action is now and that delayed action in reducing greenhouse gas emissions will increase costs and its impact, including on human health. Four single overarching communication outcomes (SOCO) were identified to be developed into a communication strategy to feed back to the European Environment and Health Process.

Salud, cambio climático y contaminación: actualización acercade las fuentes alternativas de energía en Chile / Health, climate change and environmental pollution: present status

Son indiscutibles los daños y los peligros inminentes que resultan del uso de los hidrocarburos fósiles como fuentes de electricidad y de energía para el trasporte y la industria. Sin embargo, en muchos países se proyecta una dependencia sostenida o aún creciente respecto a esas fuentes, que no sonrenovables. Los proyectos son cuantiosos en Chile. El argumento para seguir usándolas se basa en una necesidad pretendidamente insoslayable por parte de la economía. Esa no esuna verdad absoluta y su validez depende de lo que la sociedad decida.Desde siempre se han usado otras fuentes, además de la fuerza humana y animal: el calor del sol, el viento, la leña, las corrientes fl uviales y marinas, las termas. Hoy se sabe cómo adaptarlas para su empleo como alternativas suficientes para las fuentesnocivas. Los argumentos a favor de estas fuentes alternativas “de primer tipo “son: limpieza, seguridad, y que están disponibles sin costo y sin límites al interior de los países. También esta demostrada, para varias de ellas, la factibilidad tecnológica y económica, a corto plazo, de las instalaciones necesarias. Hay que tener presente que se ofrecen alternativas “de segundo tipo”, las cuales presentan serios problemas. Algunas son insegurasy generan contaminación radioactiva: las centrales nucleares. Otras destruyen permanentemente el entorno, generan gases de invernadero y presentan el peligro de catástrofes: son los grandes embalses. Y otras aún compiten por suelos necesarios para la alimentación y para la regulación ecológica, además de producir gases de invernadero, como los biocombustibles. No son alternativas convenientes, y las de gran envergadura llegarán tarde para aportar significativamente a las necesidades de la economía, en la competencia con las alternativas de “primer tipo”, particularmente si éstas son apoyadas por los gobiernos y si se cuida la efi ciencia energética...

The risks and damages that arise from the utilization of fossil fuels as sources of electricity and of energy for transport and industrial activities are now undisputable. In spite of this, many countries still have or tolerate plans for the continuing dependence on those non-renewable sources. In Chile there are many such projects. In support of this, it is argued that national economic growth absolutely requires the increased use of coal, petroleum and gas. This is not true; the validity of the argument depends on what society decides. Since time immemorial, man has utilized natural energy sources, besides his own and animal strength: the sun, wind, fi rewood, the movement of river and of sea water, termal spas. Today, we know how to harness them as suffi cient alternatives in respect to the sources that through climate change and pollution are a menace to the health of mankind and to life in general. The arguments in favour of these alternative sources “of a first type” are that they are clean, safe, inexhaustible within the frontiers of all countries. For several of them, their short term technological and economic feasibility is already a fact.At the same time we should bear in mind the availability of “second type alternatives” which present serious problems. Some of them are unsafe and generate radioactive contamination: the atomic plants; in the case of Chile they would perpetuate dependence onforeign sources of fuel. Others bring about permanent environmental destruction, generate greenhouse gases and present a real danger of catastrophic accidents: these are the great barrages for hydroelectric power. Still others compete for the soil requiredto produce food and ecological regulation, besides also producing greenhouse gases: these are the biofuels. The largest of thesefacilities take a long time to plan, fi nance and build and therefore will arrive too late make a signifi cant contribution to the economy, in competition...

A knowledge, attitude and practices study of the issues of climate change/variability impacts and public health in Trinidad and Tobago, and St Kitts and Nevis / Un estudio de conocimientos, actitudes y prácticas (CAP) de los problemas del cambio climático/variabilidad de los impactos y salud pública en Trinidad y Tobago y St Kitts Nevis

OBJECTIVE: To determine the level of understanding of the issues of climate change (CC)/variability (CV) and public health by populations of St Kitts and Nevis (SKN) and Trinidad and Tobago (T&T) and to find whether respondents would be willing to incorporate these values into strategies for dengue fever (DF) prevention. DESIGN AND METHODS: Using a cluster sampling system, representative samples of the communities of SKN (227) and T&T (650) were surveyed for responses to a questionnaire document with questions on the impact of climate variability on health, the physical environment, respondents' willingness to utilize climate issues to predict and adapt to climate variability for DF prevention. Data were analyzed by Epi Info. RESULTS: Sixty-two per cent SKN and 55% T&T of respondents showed some understanding of the concept of climate change (CC) and distinguished this from climate variability (CV). With regard to causes of CC, 48% SKN and 50% T&T attributed CC to all of green houses gases, holes in the ozone layer burning of vegetation and vehicular exhaust gases. However some 39.3% SKN and 31% (T&T) did not answer this question. In response to ranking issues of life affected by CC/CV in both countries, respondents ranked them: health > water resources > agriculture > biodiversity > coastal degradation. The major health issues identified for SKN and T&T respondents were: food-borne diseases > water-borne diseases > heat stresses; vector-borne diseases were only ranked 4th and 5th for SKN and T&T respondents respectively. There was in both countries a significant proportion of respondents (p < 0.001) who reported wet season-related increase of DF cases as a CC/CV link. Respondents identified use of environmental sanitation (ES) at appropriate times as a method of choice of using CC/CV to prevent DF outbreaks. More than 82% in both countries saw the use of the CC/CV information for DF prevention by prediction and control as strategic but only 50-51...

OBJETIVO: Determinar los niveles de comprensión de los problemas del cambio climático (CC)/ variabilidad (CV) y salud pública por parte de las poblaciones de St Kitts y Nevis (SKN) y Trinidad y Tobago (T&T), y averiguar si los encuestados estarían dispuestos a incorporar estos valores en las estrategias para la previsión de la fiebre del dengue (FD). DISEÑO Y MÉTODOS: Usando un sistema de muestreo por conglomerados, muestras representativas de las comunidades de SKN (227) y de T&T (650) fueron encuestadas mediante un cuestionario en el que se les pedía responder preguntas sobre el impacto de la variabilidad del clima sobre la salud, el ambiente físico, y la disposición de los encuestados a aprovechar las cuestiones del clima para predecir y adaptarse a la variabilidad climática a fin de prevenir la FD. Los datos fueron analizados mediante Epi Info. RESULTADOS: Sesenta y dos por ciento de los encuestados de SKN y el 55% de los de T&T, mostraron cierta comprensión del concepto de cambio climático (CC) y fueron capaces de diferenciarlo de la variabilidad climática (CV). En relación con las causas del CC, el 48% (SKN) y el 50% (T&T) atribuyó el CC a los gases de efecto invernadero, los agujeros en la capa de ozono, la quema de la vegetación, y los gases de escape de vehículos.

Environment and health risks from climate change and variability in Italy

The World Health Organization (WHO) and the Italian Agency for Environmental Protection and Technical Services (Agenzia per la protezione dell’ambiente e per i servizi technici, APAT) are collaborating in a project on climate change and health. This report is one of the results of that project. Climate change is already having an effect in Italy, as elsewhere. The global effects of an increasing concentration of greenhouse gases in the atmosphere are reflected in the growing number of extreme weather events, such as heat-waves and intense rainfall. These have various consequences for the health of the population, both directly in terms of mortality and morbidity, and indirectly through changes in the ecosystem. As there has been, as yet, no systematic national climate change impact assessment in Italy, this report is a preliminary evaluation of the situation, using international and national literature and with the help of expert advice. The aim is to assess the potential risks of climate change to human health in Italy, to see what adaptive and preventive measures are available and to suggest what may be additionally needed.

A mathematical model for malaria transmission relating global warming and local socioeconomic conditions

OBJETIVO: Aplicar a análise da sensitividade ao controle de transmissão de malária a um modelo, considerando o aquecimento global e as condições socioeconômicas locais. MÉTODOS: O modelo para a transmissão de malária proposto foi obtido em função de vários parâmetros. A prevalência de malária, em uma comunidade, foi caracterizada pelos valores desses parâmetros. Para estudar os efeitos dos mecanismos de controle, os valores dos parâmetros do modelo são variados em grandes intervalos. RESULTADOS: A análise da sensitividade do ponto de equilíbrio, que representa o nível de infecção de malária em uma comunidade, oferece os possíveis cenários resultantes da variação dos parâmetros do modelo. CONCLUSÕES: Dependendo-se do nível de risco de malária, as melhores formas de mecanismos de controle da transmissão de malária são dadas por um subconjunto de parâmetros do modelo

Assessing the effects of global warming and local social and economic conditions on the malaria transmission

Objetivo: Apresenta-se um modelo matemático mostrando como esse instrumento pode ser importante para descrever a transmissäo da malária. Métodos: Baseado no modelo proposto previamente, foram quantificados os efeitos de dois fatores que podem afetar a transmissäo da malária: a temperatura ambiente e as condiçöes socioeconômicas locais. Resultados/Conclusöes: A quantificaçäo foi feita estudando o modelo proposto no estado estacionário e na sua dinâmica. Dependendo do nível de risco de malária, os principais efeitos na transmissäo de malária säo devidos à temperatura ambiente ou às condiçöes socioeconômicas

Reducing automobile traffic: an urgent policy for health promotion

In recent decades traffic injuries have become a leading cause of death and disability the world over. In congested urban areas, the noise and emissions from vehicle engines cause discomfort and disease. More than one billion people are exposed daily to harmful levels of atmospheric contamination. Because internal combustion generates carbon dioxide (CO2), the automobile is a principal contributor to the greenhouse effect, which has significantly raised the temperature of the atmosphere. Scientists anticipate that in coming decades the greenhouse effect will produce alterations in climate that are very likely to be harmful and possibly catastrophic. Meanwhile, burgeoning traffic and rural and urban highway infrastructures are already among the principal causes of environmental degradation. Urban development, because it is nearly always "planned" to accommodate automobiles rather than people, reduces the quality of life and tears the social fabric. In contrast to private automobiles, public transportation, bicycles, and walking produce little environmental contamination or injury-related morbidity and mortality. These modes of transport involve more physical activity, with its positive health effects, and avoid contributing to the greenhouse effect. The reduction of automobile traffic and substitution of alternative modes of transport are essential policies for health promotion. They should be incorporated in "healthy cities" programs and general economic policies

La reducción del tráfico de automóviles: una política urgente de promoción de la salud

En las últimas décadas, las lesiones de tráfico se han convertido en una de las primeras causas de muerte y discapacidad en todo el mundo. En las zonas urbanas la congestión, el ruido y las emisiones de los motores de los vehículos causan molestias subjetivas y efectos patológicos detectables. Más de mil millones de personas están expuestas a niveles de contaminación atmosférica nocivos. Por su motor de combustión que genera dióxido de carbono (CO2), el automóvil es una de las fuentes principales de gases inductores del efecto invernadero. Este efecto ha generado ya un incremento de la temperatura media atmosférica y se estima que producirá en los próximos decenios alteraciones climáticas significativas de consecuencias inciertas, pero muy probablemente nocivas y posiblemente catastróficas. Independientemente del efecto invernadero, el crecimiento constante del parque automovilístico, del tráfico y de la infraestructura viaria urbana y rural es hoy una de las causas principales de la degradación del ambiente. El desarrollo urbano, casi siempre "planificado" en función del tráfico y no de las personas, hace que empeore significativamente la calidad de la vida, a la vez que fractura el tejido social. Frente al automóvil privado, el transporte público o en bicicleta y el desplazamiento a pie contribuyen a reducir la contaminación, la congestión y el volumen de tráfico, así como la morbilidad y mortalidad por lesiones y por enfermedades relacionadas con la contaminación. El transporte no automovilístico promueve también la actividad física - con un efecto de mejora general de la salud - y contribuye a aminorar el efecto invernadero. La reducción del volumen de tráfico y el impulso de métodos alternativos de transporte son así una política integral de promoción de la salud que ha de incorporarse en el movimiento de ciudades saludables, así como en las políticas de transporte y en la política económica en general

During the last few decades, traffic injuries have become one of the leading causes of death and disability in the world. In urban areas, traffic congestion, noise, and emissions from motor vehicles produce subjective disturbances and detectable pathological effects. More than one billion people are exposed to harmful levels of environmental pollution. Because its combustion engine generates carbon dioxide (CO2), the automobile is one of the chief sources of the gases that are causing the greenhouse effect. The latter has already caused a rise in the average ambient temperature, and over the next decades it will predictably cause significant climatic changes whose consequences, though uncertain, are likely to be harmful and possibly catastrophic. Aside from the greenhouse effect, the relentless growth of parking zones, traffic, and the roadway infrastructure in urban and rural areas is currently one of the leading causes of environmental degradation. Urban development, which is nearly always "planned" around traffic instead of people, leads to a significant deterioration in the quality of life, while it also destroys the social fabric. Unlike the private automobile, public transportation, bicycles, and walking help reduce pollution, congestion, and traffic volume, as well as the morbidity and mortality resulting from injuries and ailments related to pollution. Non-automobile transportation also encourages physical activity­with its positive effect on general health­and helps reduce the greenhouse effect. The drop in traffic volume and the increased use of alternate means of transportation are thus an integrated health promotion policy which should become an inherent part of the movement for the promotion of healthy cities and of transportation policies and economic policy in general