氣候變遷對台灣生態系之衝擊及脆弱度評估與因應策略---子計畫五：氣候變遷對台灣公共衛生的衝擊及脆弱度評估與因應策略(I)

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Title:	氣候變遷對台灣生態系之衝擊及脆弱度評估與因應策略---子計畫五：氣候變遷對台灣公共衛生的衝擊及脆弱度評估與因應策略(I) Public Health Impact, Vulnerability Assessment and Strategies for Response to Climate Change in Taiwan (I)
Authors:	宋鴻樟;柳中明;吳聰能
Contributors:	中國醫藥大學環境醫學研究所
Keywords:	氣候變遷;族群健康;脆弱度;台灣;Climate change;Population health;Vulnerability;Taiwan
Date:	2007-09
Issue Date:	2010-07-16 10:29:35 (UTC+8)
Abstract:	聯合國緊急災害資料庫(EM-DAT) 統計資料顯示，自1963 年以來，世界天然災害發生頻率激增。本計畫之重點即考量台灣地域特性，量化過去氣象事件對台灣族群健康的衝擊，並建立族群健康脆弱度指標，進而建立氣候變遷所產生的健康衝擊評估模組，並套用未來氣候模擬結果，推測台灣可能的健康損失，最終將提出建議以供決策參考。研究範圍為1980-2004年死亡資料、 1996-2004 就醫資料。地區分為台灣本島、都會區（台北地區、台中地區、高雄地區）及次都會區（桃園縣市、彰化縣市、台南縣市）來做初步研究。自然災害包含水災、旱災、颱風、熱浪及寒潮。健康損失以氣候敏感性疾病死亡及就醫為主。並考量地域性社會經濟因子對暖化衝擊的修飾性，人類發展指標為國際廣用評估地區貧窮度之參數，公共衛生指標主要用於評比地區醫療服務及對健康事務的重視，環境衛生指標則用來代表地區性環境衛生狀態（空氣品質、飲水安全、廢棄物管理）。其他指標如：公共建設普及率及功能性、有無地區性防災組織或是地區政府對天災反應計畫等。第一年研究結果發現：界定台灣氣候敏感性族群特徵並量化 1980-2004年氣象事件（水災、旱災、颱風、熱浪及寒害）造成的健康損失（死亡、就醫）。極低溫和極高溫均可增加心血管疾病的死亡危險，但未必都顯著，以中風和肺炎╱流感有較高危險傾向。颱風期間腸胃炎急診╱住院危險有增加的傾向，但腸胃病門診就醫反而較少，皮膚感染、感染性眼疾及精神疾病急診╱住院也有增加的傾向。與風災期間就醫情況不同，腸胃炎、感染性皮膚病、感染性眼疾及精神疾病門診就醫於水災結束10日內的就醫量增加的情形較明顯。停水期間就醫率的部分則顯示，腸胃炎、感染性皮膚病、感染性眼疾及精神疾病門診就醫量增加發生於停水結束後10日內。第二年：建立本土自然災害衝擊指標（人類發展指標、公共衛生指標、環境衛生指標），並評估地區性社會經濟因子在氣候對健康衝擊上的影響，再進一步建立氣象事件對健康損失的預測模組。第三年：套用 2010-2020、2040-2050、2090-2100 之氣象預測資料，預估未來氣象事件發生時台灣地區可能的健康損失。整合評析，提供資訊以供決策參考。 The aim of this proposed study is to assess the health vulnerability for population exposed to extreme weather events (storm, flood, drought, cold spell and heat wave, etc.) in Taiwan based on meteorological data, vital statistics, and health care data available from a National Health Insurance cohort of 200,000 persons. Adopting meteorological data of 2010-2020, 2040-2050 and 2090-2100 simulated by National Taiwan University Global Change Research Center, we'll also forecast the spatial and temporal patterns of climate-associated health events and propose the strategy of tragedy prevention in the future weather episodes. This study emphasized the health impacts of climate-sensitive diseases, such as cardiovascular diseases (ICD9 410-414, 430-438 and 440-459), respiratory diseases (ICD9 460-519), gastrointestinal infectious diseases (ICD9 002-004, 009, 535, 555 and 558), diabetes mellitus (ICD 9 250), renal disease (ICD 9 580-589), mental disorder (ICD 9 580-589), skin disease (ICD9 173), and accident╱suicide (ICD9 E800-E959). Regional environment has been considered as an important modifier, events vulnerable to weather in urban (Taipei, Taichung and Kaohsiung) and sub-urban areas (Taoyun, Changhwa, Tainan) were analyzed separately. Human Development Indexes were used as the measure of poverty level and Public Health Indexes were used as the indicator of health care and disease prevention activities available in the areas. We also included regional Environmental Health Indexes such as air quality, drinking water quality, and management of waste as covariates to evaluate the potential impacts on human health. By the end of this proposed project, we'll be able to: 1. Identify the climate-sensitive population and quantifying the potential health loss in extreme weather events in 1980-2004 in Taiwan; 2. establish the model of population health vulnerability to extreme weather events containing modifiers such as Human Development Index, Public Health Index and Environmental Health Index in Taiwan; 3. forecast the health impacts using simulated weather data of 2010-2020, 2040-2050 and 2090-2100. Evaluation and compiled information will be proposed for decision making.
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