Y HOC VIET NAM THAHG 9 - S d 2 f 2 0 1 4
MOI LIEN QUAN GIO'A TAI NAN THlTaNG TICH v A TU" VONG TRONG CONG DONG VOI DIEN BIEN KHI HAU BAT THUONG TAI TINH NAM D|NH VA T H A I BINH GIAI DOAN 2 0 0 7 - 2 0 1 1
T6M TAT
Ket qua nghien culi cho thay trong 5 nam, cac tinh hirtig chiu H-17 cdn bao, 4 dot nSng nong vdi
^ng^so ngay t y 9 -11 ng^y, 22-24 ddt ret dam, ret hai vdi tong so ngay ret la 127-135 ngay. Hoi cCftj cac s5 li|u tai n?n thudng tich va t y vong trong 5 nam cho thSy s5 tai n?n thuWng tich va ty I? t y vong do tat ca dc nguyen nhan du'dc ghi nh^n trong nhutig ngay co bao va ret d|m, ret hai trong 5 n3m co xu hu'dng tang ISn ciJng vdi tong so ngay co bio va ret dSm, ret hai trong nSm. Tai tinh Nam Djnh: Trong nhuTig ngay co bSo va r^t dam, ret hai tai nan giao thong la nguyen ntiSn h^ng dau gay tai nan thu'dng tich (35,7 % va 63,4%), xay ra chu y^u vdi nam gidi (69,2% va 75,6%); d n6ng dan thd thu c6ng (53,8% va 46,3%) va d lya tuoi ngu'di lao dong 15-60 tuoi (61,5% va 75,6%). Ty l | t y vong do tat ca cac nguyen nhan co xu hudng t5ng len t y 2-7,7% va t y 1-25,5% vdi tong so ngay c6 bSo t y 0-18 ngay v^ ret dam, ret hai t y 12- 51 iw^y. Tai tinh Thai Binh: Trong nhUng ngay co bao vk ret dim, ret h^i, ngS 1^ nguyen nhan hang dau gay tai nan thu'dng tich (33,3% va 32,1%), xay ra chii yeu vdi nam gidi (60% v& 82,1%); d nong dan thd thii c6ng (66,7% va 53,6%) va d lira tuoi lao dong i5-60 tuoi (60% va 67,8%). Ty l§ t y vong do tiit ca cac nguyen nhan co^xu hu'dng tSng len t y 0,6-3,8% va 2j4-16,8% vdi tong so ngay co bio t y 6-13 ngay va ret d§m, ret hai t y 13-46 ngay
T k gia de xuat mpt s5 qiai phap iitig pho vdi khi h|u bE^ tiiu'dng ket hdp vdi cac giai phip phdng chong tai n^n thi/dng tich t^i cpng dong.
SUMMARY
R E L A n O N S H I P BETWEEN C O M M U N I T Y ' S I N J U R I E S AND DEATHS W I T H C U M A T E CHANGE I N T H A I B I N H AND NAM D I N H
PROVINCES D U R I N G 2 0 0 7 - 2 0 1 1 The study results showed that during 5 years, there were 11-17 storms, 4 heat-waves v/ith in total of 9 -11 days, 22-24 cold-v/aves with in total of 127-135 days happening in two provinces. The injury and deatti data collected from the studied Commune Health Stations during 5 years Indicated that the number of injury and death due to all causes recorded during the storm, damaging and very cold days tended to be increased with the total storm, damaging and very cold
* Vi?n syc khoe nghe nghiep va Moi tru'dng Chiu b-ach nhi?m chfnh: N g u y e n B i c h D i e p Email: fti?pyhld<givahoo.com Dt: 0904.155.008 Phan bi?n khoa hpc: PGS.TS Nguyen Duy Bao Ngay nhan ban 22.7.2014
Nguyen Bfch Diep*
days. At Nam Dinh province, during the storm, damaging and very cold days, the traffic injuries was the leading cause (35.7 % and 63.4%, respectively), happened mostly in males (69.2% and 75.6%), in farmers (53.8% and 46.3%), at working age from 15- 60 years old (61.5% and 75.6%). The rate of deaths due to all causes tended to be increased from 2-7.7%
and from 1-25.5%, respectively with total storm days from 0-18 days and damaging and very cold days from 12-51 days. At Thai Binh province: during the storm, damaging and very cold days, the fall was the leading cause of injuries (33.3% and 32.1%, respectively), happened mostly in males (60% and 82.1%), in farmers (66.7% and 53.6%), at working age from 15- 60 years old (60% and 67.8%). The rate of deaths due to all causes tended to be increased from 0,6- 3.8% and 2.4-16.8%, respectively with total storm days from 6-13 days and damaging and very cold days from 13-46 days.
The authors proposed some measures for mitigating communit/s injuries and deaths affected by changeable dimate and to integrate into existing measures for coping with dimate change at these localities.
Keywords: Community's injuries and deaths, climate change, changeable weather
I. DAT V A N OE
Bien doi khi hau (BDKH) da va dang gay ra nhQ'ng anh hu'dng tieu cyc den cuoc song eua con ngu'di tren mot ITnh vi/c, ca ve m6i tru'dng va kinh te - xa hpi. Bien doi khi hau, keo theo la thien tai va hien tu'dng thdi tiet cyc doan nhu' lam tang tan suat va cu'dng do bao, nhiet do trai dat am dan len va nu'dc bien dang, ngap lut, han han, mula idn va sat Id dat..., dang t r d thanh moi de doa toan cau trong the lc/ 21 va tac dpng tdi tat ca mpi khia canh eua cupc song. Hang nSm tren the gidi, thien tai da Iam khoang 3 trieu ngi/di^chet va 200 trieu ngu'di bj anh hydng. 0 chau Au, xap xi 22,00() den 45.000 ngu'di chet do nong trong hai tuan vao thang 8 nam 2003 [ 3 ] . Cdn bao Katrina da lam thiet mang 1850 ngu'di d My, con cdn bao Nargis da lay di sinh mang ciia gan 150.000 ngu'di d Birma. Tran dong dat va sdng than nam 2011 tai Nhat Ban da lam hdn 15,534 ngu'di dan bi chet va 7,092 ngu'di bj mat tich 6 cae tinh Dong Bae Nhat Ban [5]. So ngu'di CO nguy cd bi lut loi do nhutig cdn sdng than 6 bd bien du'dc dir doan se tang t y 75 tri$u ngydi hien nay den den 200 trieu ngu'di trong tu'dng lai
Y HOC VIET NAM THANG 9 - S6' 2/2014 do Sii bien doi ktif Inau, va mu'c nt/dc bien se tang
lOcm vao nam 2080 [7],
La mpt trong 1 trong 5 niT^c tren ttie gidi di/dc dir bao la ciiju anil tii/dng nhieu niiat cua tiilSn tai, Viet Nam cung trai qua ntiCfng tran tham hoa thiSn nhien l<inh hoang gay ra thiet hai rat idn ve ngu'di va ciia. Trang hdn 50 nam (1951-2006), Viet Nam da phai ganh chiu 380 tran bao va ap_tiiap nhiet ddi. TCr 1989 den 2011, triing binh moi nam d Viet Nam co 567 ngu'di chet do tham hoa thien nhien. Trung binh moi nSm Viet Nam tliiet hai khoang 1,9 ti USD tong san pham quoc noi theo su'c mua GDP (PPP) (hay 1,3 % GDP) [1]. Tlial Binh va Nam Djnh la hai tinh Idn thuoc dong bang Song Hong va nam trong viing chiu nhieu anh hu'dng cua bao, ID do BOKH. Theo kich ban BDKH B2 (kich ban phat thai trung binh) - du'dc khuyen nghi sir dung trong thdi diem hien nay thi vao thdi ky 2040- 2059, dong chay trung binh mua lu tang khoang 2,0-4,0% d hai he thong song Hong - Thai Binh va song Ca [2]. Nhu' vay, hai tinh nay cung se chiu anh hu'dng nhieu du'di tac dong cua BOKH, dac biSt la cac tCT vong va tai nan thu'dng tich cd llln qiian den bao, ID va BDKH. Tai nan thu'dng tich (TNTT) cd lien quan den thien tai cd xu hu'dng ngay cang tang, nhulig chuS cd nhieu cac nghien cuU ve ITnh vu'c nay va thieu cac bang chLfng CO tinh chat thuyet phuc. Vi vjy, nghien cihj nay du'dc tien hanh nham tim hieu moi lien quan glD^ dien bien ve khi hau bat thu'dng vdi tai nan thu'dng tich va tir vong trong cong Mng tai b'nh Thai Binh va Nam Dinh trong vong 5 nam (2007-2011).
11.06l TinjING VA PHU'CrNG PHAP NGHIEN Ctjll 2.1. Do! tu'dng nghien cu'u
Cac so lieu thu' cap hien co ve khi hau, cac so lieu lien quan den bao, ID va cac ddt thdi tiet bat thi/dng khac va cac so lieu thir cap hien cd ve TNTT va tir vong trong 5 nam (2007-2011) cua hai tinh Thai Binh va Nam Ojnh
2.2. Phu'dng phap nghien cij'u Sir dung phu'dng phap nghien ciru hoi ciru toan bg cac so lieu thit cap hien cd lien quan den - Dien bien khi hau, cac so lieu ve cac ddt thdi tiSt bat thu'dng trong 5 nam: ddt bao lut...tan xuat, mii'c do, thdi gian ciia moi ddt, w . Cac so lieu diTcJc hSi citu theo tirng thang, tirng nam.
Cap gid, cap dp mua, cap do bao du'dc phan ioai theo Quyet djnh so 17/20li/QDTTG ngay 14-3- 2011 ciia Thil tu'dng chinh phii ban hanh Quy che bao ap thap nhiet ddi, bao, ID; Cap dp kho nong, ret dam, ret hai,... theo quyet dinh so 17/2008/QO-BTNI^ ngay 31-12-2008 cua Bo tai
nguyen va moi tru'dng ban hanh Quy chuan ky thuat quoc gia ve khi tu'dng thuy van - TNTT va tiJ vong trong 5 nam (200.7-2011) ciia 8 tram y te xa cua 4 huyen ven bien tai hai tinh Thai' Binh va Nam Binh trong thdi gian xay ra thdi tiet bat thu'dng (bao, ret dam, ret hai, kho nong keo dal, w ) thong qua So kham benh (Al/YTCS) va So theo doi nguyen nhan til vong (A6/YTCS) va Bao cao thong ke TNTT cua Tram Y te xa.
III. KET aUA NGHIEN CLTU
3.1. Ket qua hoi cihi so li$u ve dien bien khi hau bat thu'dng trong 5 nSm tai 2 tinh
Hoi ciiu cac so lieu ve diln bien khi hau tai 2 tinh nghien ciru trong 5 nam cho thSy dien bien khi hau khong theo quy luat nhat djnh. Nam 2011 cd nhiet dp trung binh thap nhSt (22,6°C) va cd tong lu'dng mua va tong so ngay mu^ Idn nhat d ca 2 tinh, nhulig khong gay ung lut.
Trong 5 nam tai tinh i^am Djnh cd 11 cdn bao do bp vao tinh, trong dd 1 cdn bao cap 5, 4 cdn bao cap 6 va 7, va 2 cdn bao cap 8 vdi tong so ngay cd bao la 57 ngay va lu'dng nUdc miia trong bao tir 146-307 mm (chiem 10-23% tong iu'dng mus chung) va khong gay iing lut. Tinh Thai Binh co 17 cdn bao da do bp vao trong 5 nam va hau het la ap thap nhiet ddi. Tong so ngay cd bao la 45 ngay vdi lu'dng nu'dc tniia tii 197-289 mm (8-24% tong lu'dng mua chung). Hau het cac cdn bao khong gay ling lut cho tinh Ttiai Binh, ngoai trir nam 2009 gay iing lut 8,000 ha.
Tai Nam Djnh, trong 5 nam cd 4 ddt nang nong vdi tong so ngay nang ndng la 9 ngay va co 17 ddt ret dgm, ret hai va vdi tong so ngay ret dam, ret hai la 127 ngay. Tai Thai Binh, trong 5 nam cd 4 ddt nang ndng vdi tong sd ngay nang ndng la 11 ngay) va cd 24 ddt ret dam, ret hai va vdi tong so ngay ret dam, ret hai la 135 ngay.
3.2. Ket qua hoi cuti so lieu ve TN'R va moi lien quan vdi s6i ngay dien ra khi hau b^t thu'dng trong 5 nam (2007-2011) tai 2 tinh
3.2.1. Tai tinh Nam Binh
Tai Nam Djnh, trong 5 nam, so TNTT xay ra trong nhOUg ngay cd bao la 13 tru'dng hdp, trong nhu'ng ngay ret dam, j e t hai la 41 tru'dng hdp va trong nhu'ng ngay nang ndng bat thuidng la 2 tru'dng hdp. Tai nan giao thong (TNGT) la nguyen nlian hang dau gay TNTT trong nhffng ngay cd bao va ret. TNTT xay ra chu yeu vdi nam gldl (69,2% va 75,6%), d nong dan thd thu cong (53,8% va 46,3%); va chu yeu d lua tuoi ngu«l lao dong 15-60 tuoi (61,5% va 75,6%).
Y HQC VigT NAM THANG 9 - SO 2f2014
Hinh 1. SS ngay co bao va so TNTT trong nhffng ngay co bao tai tinh Nam Djnh
12
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2007
^^^ . — ^^
2008 2009 2010• • S6 ngay CO bao • So TNTT
2011 Nim
Hinh 2. So ngay ret dam, ret hai va so TNTT trong nhutig ngay ret tai tinh Nam Dinh
^ TNTT dudc ghi nhan tCt nam 2007-2011 tai mgt so huyen ven bien cua tinh Nam Dinh co xu hudng tSng Iin cung vdi so ngay co bao va cd ret dam, ret hai (Hinh 1 va2).
3.2.2. T^itinh Thai Binh
Hinh 3. So ngay co bao va so TmT trong bao ty 2007-2011 tai tinh Thai Binh
•
^ J l
- • ^ •^ -•
H Wt
— ^ 3 6 ng^y co bao • • • " S d TNTT
Tai Thai Binh, trong 5 nam, so TNTT xay ra trong (66,7% va 53,6%) va chii yeu d ]ila tuoi lao nhifng ngay cd bao la 15. tru'dng hdp, trong dpng 15-60 tuoi (60% va 67,8%). TNGT la nhuhg ngay ret dam, ret hai la 28 trudiig hdp va nguyen nhan thir 2 gay JHTT, iac biet trong trong nhffhg ngay nang ndng bat thu'dng la 5 nhii'ng ngay ret dam, ret hai. So TNTT du'dc ghi tru'dng hdp. Nga la nguyen nhan hang dau gay nhan tir nam 2007-2011 tai mpt Sd huyen ven TWrr trong nhuhg ngay cd bap (33,3%) va ret bien ciia tinh Thai Binh cd xu hu'dng tang len (32,1%). TNTT xay ra chii yeu vdi nam gidi ciing vdi so ngay cd bao va cd ret dam, ret hai (60% va 82,1%); d nong dan thd thu cong (Hinh 3 va 4).
Hinh 4. So ngay ret va so TNTT trong ngay ret tir 2007-2011 tai tinh Thai Binh
ii
1 ^ - j ^ ""
• So ng&y ret
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-•-S6TNTT
Y HOC VIET NAM THANG 9 - SO 2/2014
3.3. Ket qua hoi cthi so lieu ve tu* vong va mcfi lien quan vdi so ngay dien ra khi hau bat tiiu'dng tai tinh Nam Djnh va Thai Binh 2007-2011
3.3.1. Tai tinh Nam Dmh TT
1
2
3
Sang 1. Dien bien khi hau bat thudnq va Khi h a u v a TV Tonq so nqay bao
So tu' vonq tronq nhilnq ngay bao Ty le tir vonq tronq nh^nq nqay bao Tonq sd nqay ret
So tir vonq tronq nhu'nq nqay ret Tv le tir vonq tronq nhu'nq nqay ret Tonq so tu' vong
t u vonq dl 2 0 0 7
13 3 2,9
9 1 1,0 102
tat ca cac nguyen n 2 0 0 8
0 0 0 41 12 11,2 107
2 0 0 9 18 8 7,7
12 7 6,7 104
i a n tai 2 0 1 0
11 2 2,0
14 S 4,9 101
^am Dmn 2 0 1 1
15 3 2,9 51 26 25,5
102 Hinh 5. Sd ngay cd bao va ty IS tir vong trong ngay bao tir 2007-2011 tai tinh Nam Ojnh
20 1 15 10 S 0
J^>4£. ^ ,p '
^^J3 ^ " * " A l l ~ " ^ ^
•!2>^ v^^-J'^'^^Ji ,J
2007 2008 2009 2010 2011
• S6 ngay c6 bao • Ty 1^ ti> vong
Ket qua tai tinh Nam Ojnh eho thay ty le tii vong chung trong nhOtig ngay co bao va ret dam, ret hai CO xu hu'dng tang len vdi so ngay co bao va
\kt dam, ret hai. Nam gidi tir vong nhieu hdn {ehiem 62,5%) trong nhtj'ng ngay co bao. LiJa tuoi tu" vong chu yeu tren 50 tuoi (68,7% va 76,5%). Trong nhOtig ngay ret dam, ret hai, nguyen nhan hang dau gay tu' vong la tai bien
mach mau nao (29,4%), nguyen nhan thiJ 2 la do ung thu" (25,5%) va nguyen nh3n thti* 3 la tuoi gia (21,5%). Trong nhQ'ng ngay co bao, nguyen nhan hang dau g§y tu" vong la cae benh du'dng ho hap (25%), nguyen nhan thiT 2 la iing thu'va tai bien mach mau nao (18,7%) (Bang 1, Hinh 5 va 6).
Hinh 6. So ngay ret va ty le tu" vong trong ngay ret ti^ 2007-20U tai tinh Nam Ojnh 60
40.
20 0
J > 5 1
^ ^ ^ ^ y ^ m 26.5
2007
, — - ^ ~ • 'H BTo
2008 2009 2010
• S6 ngay ret • TJ 1? tl> vong 2011
Bang 2. Dien bien VHi hau khi hau va tiT vonq do tat T T
1
2
3
D i e n b i e n K h i h a u va tur v o n q Tonq so nqay bao
So tii vong trong nhu'ng ngay bao Ty le tir vonq tronq nhii'nq nqay bao Tong so ngay ret
So tir vong trong nhtiYig ngay ret T"/ le tir vong tronq nhiitiq nqay ret Tir vonq chunq
2 0 0 7 13
5 3,8
12 9 6,9 130
c a c a c 2 0 0 8 9 2 1,3 43 25 16,3 155
iquyen nhan tai tinh Thai 2 0 0 9
6 1 0,6
17 4 2,4 163
2 0 1 0 6 4 3,0 17 9 6,8 132
2 0 1 1 11
3 1,9 46 13 8,3 157
Y HOC VIET NAM THANG 9 - SO 2/2014
Hinh 7. So ngay co bao va ty le tu* vong trong ngay bao tiJ" 2007-2011 tai tinh Thai Binh
~Sd ngay CO bao " T j I9 tu' vong trong ngay bao
Hinh 8. So ngay ret va ty le tu* vong chung trong ngay ret tu* 2007-2011 tai tinh Tiiai Binh
it
30 20 ID 0
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J Ifjl ^ - ^ 1 — — ^ K 17
20DS IDOS 2090
A S6 ngSy ret • Ty 1$ tiJ vong
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Tai ti'nh Thai Binh, ty le tir vong trong nhifng ngay cd bao va ret dam, ret hai cung cd xu huflng tSng len vdi so ngay cd bad va ret. Khong cd 51/ V.hac biet ve ty le tir vong glDS nam va nif trong nhifng ngay cd bao va ret dam, ret hai.
Trong nhifng ngay ret dam, ret hai 76,7% ngu'di tren 60 tuoi bj tsi vong. Trong nhifng^ ngay cd bao lir^ tuoi tu^ vong chii yeu tir 15 tuoi ttH len.
Nguyen nhan tiJ vong trong nhifng ngay ret la do mac cac benh ho hap (28,3%), tupi gia (25%), tai bien mach mau nap (18,3%). Trpng nhifng ngay cd bao, 1 tru'dng hdp dudi nUdc bj tir vong, 40% tii vong dp tupi gia va mac cac benh du'dng hp hap (Bang 2, Hinh 7 va 8).
IV. BAN LUAN
Thep icet qua nghien cuU, tai tinh Nam Djnh va Thai Binh, hang nam phai hifng chju tir 0-4 cdn bad. Thai Binh chju anh hu'dng ciia bac nhieu hdn sp vdi Nam Djnh (17 sp vdi 11 cdn bap trong 5 nSm). Tuy nhien, sp ngay cd bap tai Nam Dinh nhieu hdn sp vdi Thai Binh (68 sp vdi 45 ngay) vS tpng lu'dng mu'a trpng bap cung Idn hdn d Nam Ojnh. Nang ncng xay ra tai Nam Ojnh va Thai Binh l<hpng nhieu: trpng 5 nam. Nam Ojnh cd tong SP 4 ddt nang ndng vdi tpng sp ngay nang ndng ta 9 ngay va Thai Binh cd 4 ddt nang ndng vdi tong so ngay nang ndng la 11 ngay.
Ngoai ra, trong 5 nam Nam Oinh cd 22 ddt ret dam, ret h?l vdi tong so ngay ret la 127 ngay va
tai Thai Binh cd 24 ddt ret dam, ret hai vdi tong SP ngay ret la 135 ngay.
Ket qua nghien cifu nay ve thdi tiet bat thu'dng cung nam trong xu hu'dng nhSn djnh Chung ve thdl.tiet ciia ca nifdc. Theo bao cao tir Trung tam dU bao khi tUdng thu'/ van trung u'dng [1], trong nhifng nam gan day, thUc te tinh hinh khi hau d nu'dc ta cd nhieu thay dpi sp vdi quy luat thdi tiet nhifng nam tru'dc va ngay cang cd chleu hu'dng dien bien phifc tap. Nam 2009 da xay ra rat nhieu hien tu'dng kiii tu'dng thuy van nguy hiem nhif: Bap, lu, ret dam, khp han.... Cu the la: cd 11 cdn bap va 3 ap thap nhiet ddi hpat dpng tren bien Dong; trong do cd 6 cdn bao va 1 ap thap nhiet ddi anh hu'dng triTc tiep nUdc ta.
So ddt khdng khi lanh anh hu'dng den nifdc ta it hdn (28 ddt) trung binh nhieu nam 4 ddt, nhuhg iai xuat hien sdm khoang 1 tuan so vdi trung iDinh nhieu nam va keo dai hdn (xay ra 6 thang 1) vdi nhiet dp trung binh ngay php bien tir 11- 15°C. SP ddt nang ndng cung tang va keo dai thdi gian hdn vdi nhiet dp cap nhUt php bien tif 36 - 39°C. Tuy sp ddt mUa Idn it hdn cac nam tru'dc nhung mifc dp mu:a lai tram trpng hdn gay ra lu quet, lu Idn, lut, sat Id dat nghiem trpng, lam thiet hai nang ne ve ngu'di va tai san d nhifng khu vifc nay.
Tu'dng tu", ket qua nghien ciru cua Vij Thj Mai Trang va Ha Van Nhu (2014) ve met sp die diem
Y HOC VIET HAM THAHG 9 - SO 2«014 dich te hpc tham hpa tU nhien tai Viet Nam trong
giai doan 2002-2011 qua phan ti'ch so lieu ve tham hpa tU nhien (THTN) dudc lifu trif tai Ban chi dao Phdng chong lut bao Trung Udng (BCO PCLBTW) tai Viet Nam tir 2002 den 2011 cung chp thay bio la mpt trpng bon loal tham hpa tu nhien thu'dng gap nhat va chiem 8,3% trcng tpng sd 436 tru'dng hdp TKTN dUdc bao cao tai Viet Nam. Bao xay ra nhieu nhat vao thang 9 (48,6%) [6]
Ket qua hoi ciiu ve TNTT va tir vpng cpng dpng cua chiing tci trpng vdng 5 nam tai 2 tinh Nam Ojnh va Thai Binh trong thdi gian cd thdi tiSt bat thudng nhu bao, ret dam, ret hai cho thSy tai nan giao thong (TNGT) v^ nga la nguyen nhan hang dau gay TNTT trong nhihig ngay co bao va ret tai hai tinh. TNTT xay ra chii yeu vdi nam gidi, nong dan thd thii cong cd ty le TNTT cao trong thdi gian cd bap va ret va chii yeu d lifa tud'i ngudi lao dpng 15-60 tuoi. Mo hinh TNTT trpng thdi Het btt thudng ciia 2 tinh cung rat phii hdp vdi mc hinh Ti^TT chung cua ca hai tinh. Trong nhifng ngay cd bao va ret dam, rit hai tai Nam Djnh ty le TNGT la 35,7-63,5%, trong khi dd TTJGT churig ciia tinh Nam Djnh la 43%. Tu'dng tif, d Thai Binh nga la nguyen nhan hang dau gay TNTT va ty le chung la 33,3% va trong nhifng ngay cd bao va ret dam, ret hai thi nga cung chiem ty le tUdng tiT (32,1-33%) [4]
DP SP lieu tii vong dp tat ca cac nguyen nhan trong nhifng ngay cd bap va ret dam, ret hai rat it, nen trong nghien ciTu nay chi tinh ty le tir vong Chung. So tai nan thudng tich va if/ l l tir vong dp tat ca cac nguyen nhan difdc ghi nhan trang nhifng ngay cd iaap va ret dam, ret hai trpng^S nam tai 2 tinh cd xu hifdng ting len ciing vdi tcng sp ngay cd bap va ret dam, ret hai trpng nim. Cac nghien cu'u ve TNTT trpng cac dieu kien thdi tiet bat thudng hau nhu' khong cd d Viet Nam, nen sd lieu ciia chung toi khd so sanh vdi cac nghien ciru khac. Mat khac, do han che ciia nghien cOru kh&ng the trien khai tai nhieu dia phifdng, nen sp lieu TNTT va tiJ vpng khorig nhiSu, die biet troiig thdi gian cd thdi tiet bat thu'dng vdi ccn so nhd, nen khp tinh tpan du'dc mpi lien quan cd y nghia thong ke.
V. Kfr LUAN VA KHUYEN NGHJ
- Trong 5 nim (2007-2011), diln bien ve khi hau tai Nam Ojnh va Thai Binh khong theo qui luat nhat djnh, mSi tinh hiing chju tir 11-17 cdn bad, 4 ddt nang ndng vdi tpng sp ngay nang ndng tif 9 -llngay va 22-24 ddt ret dam, ret hai vdi tdng SP ngay la 127-135 ngay
- SO tai nan thUdng tich va ty le tiJ vong do_tat ca cac nguyen nhan dUdc ghi nhan trong nhifng ngay cd bao va ret dam, ret hai trong 5 nam co xu hudng tang len cung vdi tong so ngay cd bao va ret dam, ret hai trong nam. Trong nhifng ngay CO bao va ret dam, ret hai tai nan giao thong va nga la nguyen nhan hang dau gay tai nan thUdng tich tai tinh Nam Ojnh (35,7 % va 63,4%) va tinh Thai Binh (33,3% va 32,1%). Tai nan thUdng tich xay ra chu yeu vdi nam gidi (Nam Ojnh: 69,2%
va 75,6%; Thai Binh: 60% va 82,1%); d ndng dan thd thii cdng (Nam Djnh: 53,8% va 46,3%;
Thai Binh: 66,7% va 53,6%)) va d lira tuoi ngirdl lap dpng 15-60 tupi (Nam Djnh; 61,5% vi 75,6%; Thai Binh: 60% va 67,8%). Ty le tu'vong do tat ca cac nguyen nhan cd xu hu'dng ting len (Nam Ojnh: 2-7,7% va 1-25,5%; Thai Binh: 0,6- 3,8% va 2,4-16,8%) ciing vdi tdng sd ngay c6 bao va ret dam, ret hai (Nam Djnh: 0-18 ngay va 12-51 ngay; Thai Binh: 6-13 ngay va 13-46 ngay) - Can tang cu'dng tuyen truyen cho cpng d3ng ve cac glai phap phdng chpng tai nan giap thdng va nga, die biet trpng thdi tiet bat thifdng; long ghep thifc hien eac bien phap ifng pho vdi khi hau bat thudng ket hdp vdi cac giai phap phpng elicng tai nan thu'dng tfch tai cong d3ng
T A I Llf U THAM KHAO
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2. B$ tai nguygn va mdi tnfdng (2009). Kldl ban bien doi khi hau, nUdc bien dang cho Viet Nam. Ha Noi.
3. Jonathan A. Patz, David Engelberg, John Last (2000). The effect of changing weatiier on Public healUi, Annu. Rev. Public health. 2000.
21:271-307.
4. Nguyen Bich Di$p (2014). Bien dol khi hiu vi tai nan thu'dng tich cong ddng trong 5 nim d mpt sd huyen ven bien tai Unh Nam 0lnh vi Thai Binh.
Tap chi Y hoc thirc lianh sS 7 (925), trang 49-54 5. Robine JM et al. Deatii toll exceeded 70,000 ia
Europe during the summer of 2003. Les Comptes Rendus/Serie Biologies, 2008, 331:171-78. (28) 6. Vu Thj Mai Trang va ttk Vin Nhu- (2014). Mft
so dac tiem dich tehpc tiiim hoa h/nhien tai Vl^
Nam hong glai doan 2002-2011. Tap chi Y tS c6ng cong. So 30, Thang 02/2014
7. vifn Khoa hgc khi lu'dng thuy van va moi tru'dng (2011). Tai lieu hudng dan 'Binh gii tk ding ciia Bien ddi khi hiu va xic dinh cac glal phap thich uhg". Nha xuat ban tai nguyen -moi tnfdng va ban do Viet Nam.
