10 Ways Climate Change Affects Patients

Bruce Y. Lee, MD, MBA


April 11, 2019

Have you seen this patient? This individual is rather spherical and older; aged approximately 4.5 billion years; and has been going through some disturbing changes, such as getting warmer, especially in recent decades.

It's not every day that the planet Earth shows up at your clinic, emergency department, hospital, or operating room, but have you been paying attention to what is happening to the Earth? An abundance of scientific data show that the Earth's climate has been changing:

  • The Earth's average surface temperature has risen approximately 1.62 degrees Fahrenheit (0.9°C) since the late 1800s, with most of this rise taking place in the past 35 years.

  • The five warmest years in recorded history have occurred since 2010.

  • Each year from 1993 to 2016, Greenland has been losing an average of 281 billion tons of ice mass and Antarctica an average of 119 billion tons, with Antarctica's loss rate tripling over the last decade.

  • Sea levels rose 8 inches in the past century, with the rise in the past two decades close to twice that of the past century.

  • Intense rainfall events are increasing in number.

  • Surface ocean water acidity has increased 30% since the beginning of the Industrial Revolution.

Climate change is real, and as another NASA webpage states, "97% or more of actively publishing climate scientists agree: climate-warming trends over the past century are extremely likely due to human activities."

Of course, Earth is not actually on your list of patients. However, because climate change is also a human health issue, it can still be considered in your care. Here are 10 ways patients can be affected by climate change and what you can do about it.

1. Increased risk for respiratory problems, such as allergies, asthma, chronic lung diseases, and lung cancer. Changes in carbon dioxide concentrations, air temperatures, and precipitation can lead to more ozone, pollen, mold spores, fine particles, and chemicals in the air that can irritate and damage the lungs and airways.

What to tell patients: Pay attention to air quality measurements and alerts, and stay indoors during bad air-quality days. Tell your doctor about any new respiratory or allergic symptoms and when and where they may occur, because your doctor may want to perform tests, such as allergy testing. Consider moving to another location if bad air quality and symptoms persist.

2. Increased risk for skin cancer and cataracts. Decreasing ozone in the sky allows more ultraviolet radiation to filter through, which can then lead to skin cancer and cataracts.

What to tell patients: Wear adequate sunscreen and eye protection, don't spend too much time in the sun, and remain covered when you can. Get your skin checked periodically.

3. Increased risk for cardiovascular disease and stroke. More extreme temperatures along with poorer air quality and stress from extreme weather events can tax the cardiovascular system. Also, climate change can encourage the spread of some insects that carry diseases that may affect the heart, such as Lyme disease and Chagas disease.

What to tell patients: Make sure that you are aware of the temperature for the day. Protect yourself from extreme temperatures by staying indoors or at least under enough shade or adequate shelter. Get regular checkups to assess your cardiovascular function, and don't ignore such symptoms as chest or arm pain or difficulty moving, speaking, or thinking. Try to manage stress. Protect yourself from insects.

4. Heat exhaustion or heat stroke. Rising temperatures equal more heat.

What to tell patients: Be aware of the weather reports and temperature. Use air conditioning when appropriate, and minimize time outdoors when it is hot. Wear sun-shielding and cooling clothing.

5. Nutrition problems, such as malnourishment or obesity. Climate change can affect food production by adversely affecting both plants and animals, leading to decreased availability of more natural, healthy foods, such as fruits and vegetables.

Climate change can also increase the insect population, prompting the use of more pesticides and chemicals that could then remain on the food. Extreme weather events can lead to contamination of the food supply with toxins, such as lead, mercury, and arsenic. In addition, toxic algal blooms can occur, which can then affect the fish population and, ultimately, you.

All of these may lead to increased reliance on highly processed, unhealthy foods.

What to tell patients: Pay attention to the ingredients in your food. Try to stick with less processed foods that don't have too much added sugar, salt, or artificial ingredients. Discuss your diet with your doctor or a legitimate nutritionist, not someone who advocates for fad diets not supported by scientific evidence. It's better to rely on real food for nutrients, not supplements.

6. Foodborne illnesses. Changes in temperatures, precipitation, and sea levels, as well as extreme weather events, can create conditions ripe for the spread of disease-causing microbes (eg, Vibrio bacteria), which can then contaminate food.

What to tell patients: Keep track of foodborne illness alerts from the Centers for Disease Control and Prevention and the US Food and Drug Administration. Be aware of the safety records for different food production and retail companies. Check to see what food safety regulations are in place and how well they are followed. Regulations are in place to protect the consumer.

Practice good food-safety techniques, such as washing your hands frequently and thoroughly, cleaning utensils and other objects that have touched raw or potentially contaminated food, and properly and thoroughly cooking food.

If you think you may be suffering from a foodborne illness, contact your doctor as soon as possible. Some cases can be dangerous and deadly. Plus, your doctor can notify the authorities if an outbreak is suspected.

7. Mental health and stress-related issues. Extreme weather events, such as flooding, wildfires, and tornadoes, are not fun, unless you are Storm from the X-Men or Red Tornado (whom Supergirl defeated in Season 1). Neither is pollution, unless you are somehow profiting from it. Even small changes in temperature, precipitation, and sea level can affect how you feel.

What to tell patients: Pay attention to your mental health. There should be no shame or stigma in admitting that you don't feel right or are facing mental health challenges. Discuss your mental health with your doctor and other health professionals regularly. Your doctor may want to give you a regular mental health checkup to see how you are doing. Don't be afraid to talk with your doctor or mental health professional about anything.

8. Diseases from insects. Changes in temperature, rainfall, humidity, and other weather patterns can facilitate the spread, persistence, and biting and sucking behavior of mosquitoes, kissing bugs, ticks, and other insects that can then carry such diseases as malaria, dengue, Zika, Chagas disease, West Nile fever, and Lyme disease.

What to tell patients: Be aware of where these insects are regularly found and how this may be changing. Use insect repellant and protective clothing if exposure is possible. Stay indoors during prime biting times. Get rid of anything that might allow insects to breed, such as standing water in buckets, tubs, or tires.

Inform your doctor when traveling or vacationing in a new place that may have a new insect-carried disease risk. Your doctor may want to test you for some insect-carried diseases if you are at higher risk for them, so tell your doctor about your outdoor habits.

9. Extreme weather-related events and disasters causing the four Ds: damage, distress, disease, and death. Even relatively small changes in the temperature, humidity, and other environmental conditions can trigger extreme events, such as wildfires, mudslides, hurricanes, or flooding. For example, you call rake all the leaves that you want but dry conditions will still create prime conditions for a wildfire.

What to tell patients: Be prepared for such extreme events. Make sure your living quarters are stocked with emergency supplies, and know how to handle different types of events. Stay aware of warnings and disaster alerts. Seek medical care if you are harmed by an extreme event. You may be hurt more than you realize.

10. Other metabolic, endocrine, microbiome, and fertility issues. We only know the tip of the iceberg (which may be melting, by the way) of what climate change may be doing to people's bodies. For example, research from UCLA suggests that climate change may be affecting fertility.

What to tell patients: Climate change is a human health issue. More research and science should be encouraged, with less science denial. Do what you can to reduce pollution and carbon emissions. Encourage policies and regulations that will reduce pollution.

So even though the Earth may not technically be on your patient list, it is accompanying each and every one of your patients. Therefore, it makes sense to talk openly with your patients about climate change, how it may affect them, and what they can do about it. Their health and the environments are not separate but integrated in a complex system.

Read up on climate change and its potential effects. Don't think that it's not a medical or health issue. Your patients need to feel that they can discuss anything that may affect their health.

If your patients question climate change, provide them with the scientific facts and reliable sources, such as governmental websites. Make it clear that you don't have an agenda besides wanting to protect the health of people. After all, it's not as if polar bears and sea turtles have that strong of a lobby.

Bruce Y. Lee, MD, MBA, is a digital health expert, writer, executive director of the Global Obesity Prevention Center (GOPC), associate professor of international health at the Johns Hopkins Bloomberg School of Public Health, and associate professor at the Johns Hopkins Carey Business School. He is a regular contributor to Forbes and has written articles for a variety of general media outlets, including Time, The Guardian, STAT, and the MIT Technology Review, as well as three books.

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