October 23, 2018 05:19 pm Scott Wilson – Whatever human activity has contributed to Earth's warming, it's now evident that only human intervention can slow it. And that intervention, according to a blistering report(www.ipcc.ch) by the United Nations' Intergovernmental Panel on Climate Change (IPCC), must be swift and profound if it is to avert global catastrophe.
Among those in concurrence with the report's findings -- and in broad support of energy reform to curb greenhouse-gas emissions -- are the health care organizations in the Medical Society Consortium on Climate and Health (MSCCH). The AAFP is a founding member of the consortium, which also includes the American College of Physicians, the American Academy of Pediatrics and the Society of General Internal Medicine, among nearly two dozen others.
"The prognosis is very bad," said Mona Sarfaty, M.D., M.P.H., the MSCCH's director, in a statement responding to the IPCC report, which warns that the planet's temperature is rising faster than previously thought, and that only unprecedented action among governments and industry over the next decade can prevent a deadly rise of 1.5 degrees Celsius.
Sarfaty, a family physician in Chevy Chase, Md., went on: "As a physician, I know that climate change is already harming the health of Americans. Doctors and medical professionals see it daily in our offices, including the effects of extreme weather events like Hurricane Florence to droughts, smoke from large wildfires, spreading Lyme disease and worsened asthma.
"In the face of this terrible news, we see a truly extraordinary opportunity. Our patients -- and all people -- can have cleaner air to breathe and cleaner water to drink, and can live longer and healthier lives, if we're willing to work together to fully embrace the clean energy revolution."
Checks on fossil-fuel extraction, particularly coal mining, have been repealed or weakened. And in August, the administration announced plans to replace the 2015 Clean Power Plan with the Affordable Clean Energy (ACE) proposal -- which, according to government calculations, could lead to thousands more deaths a year than under today's rules.
In the MSCCH's response to the ACE, Sarfaty said, "As doctors, we can only treat a patient if we take full measure of a problem, rely on evidence and identify the best possible treatment. The EPA must do the same and propose national standards that strongly support and accelerate the inevitable transition to clean energy.
"The cost of failing to act is enormous -- from increases in lung disease and heavy metal poisoning to the many health harms from climate change that doctors are already seeing among their patients."
Claire Gervais, M.D., a Madison, Wis., family physician, testified in Chicago Oct. 1, at what is likely to be the only public hearing on the proposed rule change before the comment period ends Oct. 31.
"ACE is projected to cause an estimated 4,500 premature deaths annually by 2030, up to 15,000 new cases of respiratory problems, while also increasing heart attacks, strokes, cancer, developmental and neurological problems," Gervais said at the hearing.
She added, "The impact of ACE would be felt in states where the development of sustainable energy has been thwarted in favor of coal-fired power plants. .... These states and the dirtiest coal plants would no longer have the incentive to change."
In one of those states, family physicians are already seeing fallout from policy changes.
Just four years beyond her residency, Joanna Bailey, M.D., of Pineville, W.Va., didn't expect to treat an illness she'd been taught was in decline. But black lung disease -- which is preventable but cannot be cured -- is increasing. At the rural clinic where Bailey works, it's showing up in younger miners and, she says, in a truck driver who has never worked underground.
"We do a black lung clinic two or three days a week, with its own part-time physician, and (patient) volume has increased," Bailey tells AAFP News. "And we have a lot of chronic lung disease. A lot of times they don't have just black lung but COPD, too."
Matthew Burke, M.D., a family physician in Seattle and past MSCCH member who has spoken about climate change to AFP chapters, tells AAFP News that physicians are well placed to prompt legislators to act on climate change.
"I try to get physicians to think about their advocacy days at the state level," Burke said. "If you go to a state lawmaker who is different-minded from you, and you say that this is science and this is bad for my patients, you can affect legislation from a position of scientific and moral authority. In the absence of federal change, state-level advocacy is going to be what moves the needle. States are the crucibles."
Related AAFP News Coverage
Preserve Clean Power Plan to Protect Health, AAFP Urges
More From AAFP
In the Trenches blog: Protecting the Environment, Our Health
Patient Care: Environmental Health and Climate Change
Familydoctor.org: Occupational Respiratory Disease(familydoctor.org)