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Thursday Jun 01, 2017

A Changing Climate Threatens Our Health

Climate change is happening now, and this has profound implications not just for the planet, but for our health.

As the continued burning of fossil fuels releases gases into our atmosphere, the planet continues to warm. By trapping solar radiation and preventing it from being reflected back into deep space, these gases function like a greenhouse to warm the planet. Many of these gases comprise just a small fraction of the atmosphere, so even a small change in their concentration has a relatively large impact on the overall climate. For example, carbon dioxide (CO2) accounts for just 0.04 percent of our atmosphere, but that is a 45 percent increase from preindustrial levels(climate.nasa.gov) and represents a concentration not seen on Earth for the past 800,000 years(news.bbc.co.uk)

The rapid increase in CO2 levels during the past 200 years is being driven by human burning of fossil fuels. After decades of work, 97 percent of the world's climate scientists now agree on this point(climate.nasa.gov). Last year was the hottest ever recorded, breaking the record set just one year before. The consequences of this warming are already appearing in the form of more violent storms, droughts, coastal flooding and loss of biodiversity all around the globe.

Until now, these changes (warming, weather variability, severe storms) have largely been viewed through the lens of climate and habitat loss for other species. However, attention is now starting to shift to the human health harms that global warming poses. There are numerous reasons to be concerned about the impact this may have on our well-being and that of our patients. The health threats posed by a changing climate span a variety of illnesses -- some mild, and some severe. Given the scope of the problem, everyone could potentially be affected -- and likely, many of us will be.

These harms include (but are not limited to):

  • Increase in allergens -- Higher atmospheric CO2 and warmer winters are directly associated with an expansion of the allergy season. Ragweed, tree pollen and grass pollen are among the common allergens that will prosper in a warmer climate, both lengthening and exacerbating the allergy season. Patients who suffer from allergic rhinitis or asthma will have to initiate medication sooner and stay on it longer. Patients with asthma will be more prone to exacerbations requiring home medication use and both inpatient and outpatient care.
  • Worsening of heat waves -- Increased frequency and intensity of heat waves may lead to heat stroke, dehydration and even death. Elderly people, outdoor athletes and our pediatric patients will be most susceptible.
  • Rise in vector-borne diseases -- Even as a warming climate threatens the habitat of many creatures (such as polar bears and many amphibians), it also will lead to expanded ranges for many carriers of human disease, chiefly mosquitoes and ticks. West Nile virus infection, Rocky Mountain spotted fever and Lyme disease may become more prevalent and afflict patients for a greater part of the year. The Southern United States may also see a rise in diseases traditionally confined to tropical areas, such as Zika virus infection, yellow fever and malaria.
  • Expansion and exacerbation of lung disease -- Although CO2 is not necessarily directly dangerous to human health, many airborne particulates that are byproducts of burning fossil fuels are. Particulates such as ozone and nitrous oxides are byproducts of industrial processes and are more prevalent in the atmosphere during sunny and warm days. Ozone and nitrous oxides are direct lung irritants and contribute to poor pulmonary health. Patients with asthma or chronic obstructive pulmonary disease are especially vulnerable to these gases, which can cause illness and hospitalization.
  • Hazards to food supply -- The burning of coal results in emission of toxic metals such as lead, mercury and cadmium. These metals contaminate waterways, fish, oysters and other consumables that work their way through our food chain.

What is perhaps most concerning is that these are not hypothetical or future concerns. Climate change is happening now and is already starting to harm us. Increasingly, studies are revealing the numerous ways in which we are all negatively affected by these changes. Therefore, it is important for family physicians to speak out and be active on this issue in the same way we are on a host of other public health concerns, such as access to care, illness prevention and reducing health disparities.

There are already groups that are working to promote awareness and action around climate and human health, including the Medical Society Consortium on Climate and Health(medsocietiesforclimatehealth.org), for which I am the director of state programs. The consortium, which was launched March 15 in Washington, D.C., is composed of 12 medical membership societies that represent more than 450,000 clinicians nationwide -- more than half the physicians in the United States. Its mission is to promote awareness among the physician community at both the national and state levels regarding the negative impacts of climate change on human health.

The AAFP, which is a member of the consortium, acknowledges the potential harms a changing planet poses for public health. An article by environmental health expert Cindy Parker, M.D., M.P.H., was published to this effect in American Family Physician in 2011, and AAFP policy (adopted in 1969 and reaffirmed in 2017) recognizes the adverse consequences of air pollution, including greenhouse gases.

Climate change represents a clear and present danger to public health, but it also presents a great opportunity for physicians to advocate for patient health. I encourage you to get involved and lend your voice to this discussion. By making the case for patient welfare and by advocating to accelerate the transition to clean renewable energy, we help our patients, uphold the high standards of our profession, and become champions for cleaner air and water.

Matthew Burke, M.D., is the new physician member of the AAFP Board of Directors.

Posted at 12:36PM Jun 01, 2017 by Matthew Burke, M.D.

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