Climate Change and Health
The Earth’s climate is changing and already our health is threatened. This article offers a basic explanation of climate change, how climate threatens our health, and what those of us who work in healthcare can do about it.
Carbon dioxide and other greenhouse gases have increased in the atmosphere over the past 150 years to levels of these gases not seen in 650,000 years. These gases trap the sun’s heat to gradually warm the planet and leading to extreme weather patterns.
The burning of fossil fuels such as coal, natural gas and petroleum are the principal human causes of greenhouse gas accumulation. Other important causes are forest fires, deforestation, methane from domestic animals, and pollution by industrial fluorocarbon chemicals. The United Nations, US Environmental Protections Agency, the five recent U.S. Presidents, and the consensus of the world’s climate scientists have all declared that human activity is responsible primarily for today’s climate change.
We are seeing signs of the Earth warming almost everywhere. Climate change is responsible for excessive amounts of rainfall, rising sea levels, heat waves, droughts, and extreme weather events. Storms are increasing in strength, ice glaciers are melting, and summers are becoming excessively hot.
Some health effects of climate change are:
- Increased rates of asthma, particularly for children & elderly adults
- Cardiovascular deaths during heat waves
- Cancer, especially melanoma
- Mental health effects caused by stress
- Weather-related injuries: hurricanes, tornadoes, flooding, & fires
- Vector-borne and zoonotic diseases, such as malaria, Dengue, Zika virus, Lyme disease, West Nile & others
- Malnutrition and famine due to prolonged drought and sea level rise, now occurring across Africa & in parts of Asia
- Health risks to migrants who are forced to relocate due to rising sea levels & other disasters caused by climate change
What We Can Do
Those of us working in healthcare can help slow climate change and to help protect our patients from the effects of climate change. We have a responsibility to do this because we care about our patients; our influence can be significant because we are role models in our communities.
As a first step, you can become part of the solution by acknowledging that climate change is real and by encouraging others to do so as well. The more we discuss this openly, the better prepared our societies will be to respond to this threat.
Second, make choices in your life and in your office that help prevent climate change. Here are a few options that will help save your family money and help the environment:
Appliances:
- Purchase only home and office appliances with the Energy Star rating from the United States Department of Energy, or a rating system offered in your country. Look for these ratings when you shop for large or small kitchen appliances, clothes washers and dryers, televisions and telephones, computers and data storage devices, ceiling fans, light bulbs, vacuums, and pool pumps.
Home heating & air conditioning:
- Change your home air filters and office according to the manufacturer’s recommendations, use programmable thermostats, and perform regular maintenance on these machines. A programmable thermostat lets you set the temperature and to change the temperature depending on the time of the day. You can program your thermostat to cool or heat your home less when you are away from home. This saves energy, which is good for the planet and lowers your costs. You can purchase a programmable thermostat at a hardware store or home improvement store. Be sure machines are properly maintained so that they function at peak efficiency.
- Buy Energy Star-rated machines
Reduce/Reuse/Recycle
My Green Doctor’s seven workbooks offer dozens of ways to reduce your family’s and office’s use of resources, and how to reuse and recycle.
- “Reduce” your use of chemicals, paper products, office supplies, & medical supplies. Consider carefully before buying. Try to avoid buying environmentally- costly plastic and Styrofoam products.
- “Reduce” your water use, both at home and for landscaping. My Green Doctor offers dozens of ways to save water.
- “Reduce” home and office use of electricity by turning lights off when leaving a room, installing motion detectors to turn the lights off (this is almost always cost-effective), and turning off electrical items or putting them in “sleep mode” when not in use.
- “Reuse” sheets of paper when possible; avoid buying “disposable supplies for your home and office.
- “Recycle” whenever possible. If recycling is not available for commercial buildings in your city, you can still recycle by taking home your office recyclables. Begin composting your food and garden wastes if this is available in your community. Ask your city leaders to require recycling and composting by offices.
Other tips to consider:
- Consider climate change in your personal transportation choices. Why not walk, bicycle or carpool whenever you can? Choose an energy efficient or smaller vehicle as your next purchase. Why not a hybrid or an electric car?
- “Go meatless” twice a week.
- Use solar panels for the hot water needs of your home and office.
- Plant trees and vegetation.
Laurie Kirkland, University of North Florida, MPH candidate, February 2016
Extreme Heat: A Guide for Health Professionals and Patients
Heat kills more Americans than floods, hurricanes, tornadoes, and earthquakes combined. This is why health professionals and their patients should know the dangers of heat and know the signs of heat exhaustion. Doctors and nurses can advise patients on how to be protected from heat’s dangers. This short essay explains this and includes links to free waiting room brochures, posters, free CME opportunities, and PowerPoint slide sets from My Green Doctor.
When thinking about climate change, what comes to mind first is warmer temperatures. The average world temperature has risen about 1.2° F. (0.8° C.) over the past 140 years. That may not sound like much, but the more complete story is that the warmer temperatures are causing greater fluctuations in the weather. There are more extremely hot days in summer and more very cold ones in winter. The warmth causes more evaporation of ocean water into the air and into the clouds so there is higher humidity and greater rainstorms. The heat intensifies wind speeds to produce stronger tornadoes, hurricanes, and cyclones.
Very hot days and high humidity create health risks. People who are unaware of these risks can be overcome by weakness and dehydration, a condition called “heat exhaustion” or “heat stroke”, which is treatable but often fatal. The good news is that it is easy for health professionals to identify their patients who are at risk, make them aware of the dangers, and advise them on how to stay safe.
Who Is At Risk?
The most vulnerable are young children, athletes, people who work outdoors, the elderly, and those with cardiac or respiratory conditions. It is common for tourists to collapse with exhaustion caused by heat when they do not take the appropriate precautions. Certain medications make patients vulnerable, particularly diuretics and anti-hypertensives. Women in late pregnancy must be especially cautious.
The Health Effects
The health effects run a spectrum from muscle cramps (“heat cramps”) and weakness in the early phase of heat illness, to heat exhaustion, collapse, and death in the advanced stages. The early warning signs are muscle cramps, intense sweating, headache, nausea, dizziness, and weakness. Any of these symptoms on a hot day require the person immediately to rest, ingest oral fluids, and seek a cool shelter. If unimproved in thirty minutes, the person should be taken to a clinic or emergency for evaluation, for intravenous fluids, and perhaps for further treatment.
Air pollution is worse on hot days. This is because heat increases the chemical conversion of air pollution to dangerous ozone which is highly stressful on the heart and lungs. In addition, people rely more on their air conditioners to cool buildings when the temperatures rise, and so more fossil fuel must be burned to create the electricity that is needed to power air conditioners. All this means more air pollution, asthma attacks, breathlessness, angina, and heart attacks on hot days.
Taking Precautions
- Be aware of the weather forecast every day.
- Be familiar with the signs and symptoms of heat exhaustion.
- When outdoors, limit physical exertion, take water with you, stay in the shade, and wear a hat & light-colored, loose clothing.
- Drink plenty of non-alcoholic, non-caffeinated fluids; eat lightly.
- When indoors, close the curtains and blinds to keep out sunlight; take cool showers and baths.
- Use air conditioning and fans.
- Have a plan for where your family and you will go for safety if your air conditioner fails on a hot day.
- Establish a “buddy system” so that someone will help you if necessary.
Health professionals can be powerful voices to advocate for effective public health planning by town and city leaders. There is a lot that government should do to protect communities:
- Expand local green spaces and plant more trees to reduce urban heat islands.
- Paint surfaces white, such as roofs, asphalt, and parking lots.
- Establish heat monitoring and public warning systems.
- Create communication systems to reach vulnerable individuals during a heat crisis.
- Set up local cooling centers and provide transportation to these centers.
- Create social support networks of neighbors and relatives to protect vulnerable populations.
Resources on Heat Illness Found at MGD
Posters: We provide seven colorful, one-page posters that you can print on your office printer (8” x 10” or larger) to display in the patient waiting room and in examination rooms. The topics include the symptoms of heat-related illness and tips for staying safe. These are provided in English, Chinese, and Spanish: https://mygreendoctor.org/resources/waiting-room-posters/ .*
Waiting Room Brochure: My Green Doctor offers an excellent, easy-to-read waiting room brochure for patients to help them understand the risks of extreme heat and how to protect themselves: https://mygreendoctor.org/resources/waiting-room-brochures/. This can be printed in color or in black & white.*
Continuing Medical Education: My Green Doctor provides links to free CME lectures on the facts of extreme heat and guidance on how to protect your patients, provided by the Medical Societies Consortium on Climate Change & Health: https://mygreendoctor.org/free-education-credits/.*
PowerPoint Slide Sets: My Green Doctor shares, with permission, the slide sets from two outstanding lectures on extreme heat. These slides will help you prepare your own talks for colleagues, staff, trainees, and patients: https://mygreendoctor.org/powerpoint-slides/. *
Author: Todd L. Sack MD FACP
*Resources Credits:
My Green Doctor thanks the following individuals and organizations for sharing generously:
Posters:
Dr. Robin Cooper
The Climate Psychiatry Alliance
University of California San Francisco
Zuckerberg San Francisco General Hospital
Waiting room brochure:
Health Care Climate Council (www.noharm.org)
Continuing Medical Education:
Mona Sarfaty MD MPH FAAFP
Mary L Williams MD
Rhonda McCarthy MD MPH FACOE
Medical Societies Consortium on Climate Change & Health
PowerPoint Slide Sets:
Rhonda McCarthy MD MPH FACOE
Physicians for Social Responsibility (www.psr.org)