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Sisodiya SM, Gulcebi MI, Fortunato F, Mills JD, Haynes E, Bramon E, Chadwick P, Ciccarelli O, David AS, De Meyer K, Fox NC, Davan Wetton J, Koltzenburg M, Kullmann DM, Kurian MA, Manji H, Maslin MA, Matharu M, Montgomery H, Romanello M, Werring DJ, Zhang L, Friston KJ, Hanna MG. Climate change and disorders of the nervous system. Lancet Neurol 2024; 23:636-648. [PMID: 38760101 DOI: 10.1016/s1474-4422(24)00087-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 05/19/2024]
Abstract
Anthropogenic climate change is affecting people's health, including those with neurological and psychiatric diseases. Currently, making inferences about the effect of climate change on neurological and psychiatric diseases is challenging because of an overall sparsity of data, differing study methods, paucity of detail regarding disease subtypes, little consideration of the effect of individual and population genetics, and widely differing geographical locations with the potential for regional influences. However, evidence suggests that the incidence, prevalence, and severity of many nervous system conditions (eg, stroke, neurological infections, and some mental health disorders) can be affected by climate change. The data show broad and complex adverse effects, especially of temperature extremes to which people are unaccustomed and wide diurnal temperature fluctuations. Protective measures might be possible through local forecasting. Few studies project the future effects of climate change on brain health, hindering policy developments. Robust studies on the threats from changing climate for people who have, or are at risk of developing, disorders of the nervous system are urgently needed.
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Affiliation(s)
- Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK.
| | - Medine I Gulcebi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Francesco Fortunato
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - James D Mills
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Ethan Haynes
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Elvira Bramon
- Division of Psychiatry, University College London, London, UK
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Olga Ciccarelli
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK; National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK
| | - Anthony S David
- Division of Psychiatry, University College London, London, UK
| | - Kris De Meyer
- UCL Climate Action Unit, University College London, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of the UK Dementia Research Institute, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Martin Koltzenburg
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Dimitri M Kullmann
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Manju A Kurian
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Hadi Manji
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Mark A Maslin
- Department of Geography, University College London, London, UK; Natural History Museum of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Manjit Matharu
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology, UCL and the National Hospital for Neurology and Neurosurgery, London, UK
| | - Hugh Montgomery
- Department of Medicine, University College London, London, UK
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Lisa Zhang
- Centre for Behaviour Change, University College London, London, UK
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Michael G Hanna
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK; MRC International Centre for Genomic Medicine in Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK
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Gunasekaran S, Szava-Kovats A, Battey T, Gross J, Picano E, Raman SV, Lee E, Bissell MM, Alasnag M, Campbell-Washburn AE, Hanneman K. Cardiovascular Imaging, Climate Change, and Environmental Sustainability. Radiol Cardiothorac Imaging 2024; 6:e240135. [PMID: 38900024 PMCID: PMC11211952 DOI: 10.1148/ryct.240135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/03/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
Environmental exposures including poor air quality and extreme temperatures are exacerbated by climate change and are associated with adverse cardiovascular outcomes. Concomitantly, the delivery of health care generates substantial atmospheric greenhouse gas (GHG) emissions contributing to the climate crisis. Therefore, cardiac imaging teams must be aware not only of the adverse cardiovascular health effects of climate change, but also the downstream environmental ramifications of cardiovascular imaging. The purpose of this review is to highlight the impact of climate change on cardiovascular health, discuss the environmental impact of cardiovascular imaging, and describe opportunities to improve environmental sustainability of cardiac MRI, cardiac CT, echocardiography, cardiac nuclear imaging, and invasive cardiovascular imaging. Overarching strategies to improve environmental sustainability in cardiovascular imaging include prioritizing imaging tests with lower GHG emissions when more than one test is appropriate, reducing low-value imaging, and turning equipment off when not in use. Modality-specific opportunities include focused MRI protocols and low-field-strength applications, iodine contrast media recycling programs in cardiac CT, judicious use of US-enhancing agents in echocardiography, improved radiopharmaceutical procurement and waste management in nuclear cardiology, and use of reusable supplies in interventional suites. Finally, future directions and research are highlighted, including life cycle assessments over the lifespan of cardiac imaging equipment and the impact of artificial intelligence tools. Keywords: Heart, Safety, Sustainability, Cardiovascular Imaging Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Suvai Gunasekaran
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Andrew Szava-Kovats
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Thomas Battey
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Jonathan Gross
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Eugenio Picano
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Subha V. Raman
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Emil Lee
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Malenka M. Bissell
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Mirvat Alasnag
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Adrienne E. Campbell-Washburn
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Kate Hanneman
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
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53
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Beggs PJ, Oliveira C, Giudice C. The United Nations Framework Convention on Climate Change (UNFCCC) 28th Conference of the Parties, Dubai (COP28): Implications for lung disease. Respirology 2024; 29:449-451. [PMID: 38499332 DOI: 10.1111/resp.14705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/10/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Paul J Beggs
- School of Natural Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Camile Oliveira
- Institute for Global Health, Faculty of Population Health Sciences, School of Life and Medical Sciences, University College London, London, United Kingdom
| | - Catharina Giudice
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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54
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Ojong SA, Temmerman M, Khosla R, Bustreo F. Women's health and rights in the twenty-first century. Nat Med 2024; 30:1547-1555. [PMID: 38886622 DOI: 10.1038/s41591-024-03036-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/30/2024] [Indexed: 06/20/2024]
Abstract
In the twenty-first century, the complex relationship between women's health and rights has been influenced by a range of interconnected challenges, including gender inequity, reproductive health disparities, maternal mortality and morbidity, and women's inability to access life-saving, high-quality healthcare services including family planning. Going forward, the world needs to find ways to implement the unfinished agenda of the International Conference on Population and Development (ICPD) 1994 and the Sustainable Development Goals (SDGs), thus prioritizing health and rights for women and girls as essential not only to their survival but also to their progress, agency and empowerment. It is also important to consider the interconnection between women's health and rights and climate change, with its disproportionate impact on the well-being of girls and women, and to address the impact and opportunities afforded by digital technologies. By embracing a holistic approach, societies might be able to advance the cause of women's health and rights in a more inclusive and sustainable manner.
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Affiliation(s)
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, East Africa, Aga Khan University, Nairobi, Kenya.
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland.
| | - Rajat Khosla
- International Institute on Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Flavia Bustreo
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
- Fondation Botnar Board, Basel, Switzerland
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55
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Bryant AK, Lewy JR, Bressler RD, Chopra Z, Gyori DJ, Bazzell BG, Moeller JA, Jacobson SI, Fendrick AM, Kerr EA, Ramnath N, Green MD, Hofer TP, Vaishnav P, Strohbehn GW. Projected environmental and public health benefits of extended-interval dosing: an analysis of pembrolizumab use in a US national health system. Lancet Oncol 2024; 25:802-810. [PMID: 38821085 PMCID: PMC11177338 DOI: 10.1016/s1470-2045(24)00200-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Health care is a major source of greenhouse gas emissions, leading to climate change and public health harms. Changes are needed to improve the environmental sustainability of health-care practices, but such changes should not sacrifice patient outcomes or financial sustainability. Alternative dosing strategies that reduce the frequency with which specialty drugs are administered, without sacrificing patient outcomes, are an attractive possibility for improving environmental sustainability. We sought to inform environmentally sustainable cancer care by estimating and comparing the environmental and financial effects of alternative, clinically equivalent strategies for pembrolizumab administration. METHODS We conducted a retrospective analysis using a cohort of patients from the Veterans Health Administration (VHA) in the USA who received one or more pembrolizumab doses between May 1, 2020, and Sept 30, 2022. Using baseline, real-world administration of pembrolizumab, we generated simulated pembrolizumab use data under three near-equivalent counterfactual pembrolizumab administration strategies defined by combinations of weight-based dosing, pharmacy-level vial sharing and dose rounding, and extended-interval dosing (ie, every 6 weeks). For each counterfactual dosing strategy, we estimated greenhouse gas emissions related to pembrolizumab use across the VHA cohort using a deterministic environmental impact model that estimated greenhouse gas emissions due to patient travel, drug manufacture, and medical waste as the primary outcome measure. FINDINGS We identified 7813 veterans who received at least one dose of pembrolizumab-containing therapy in the VHA during the study period. 59 140 pembrolizumab administrations occurred in the study period, of which 46 255 (78·2%) were dosed at 200 mg every 3 weeks, 12 885 (21·8%) at 400 mg every 6 weeks, and 14 955 (25·3%) were coadministered with infusional chemotherapies. Adoption of weight-based, extended-interval pembrolizumab dosing (4 mg/kg every 6 weeks) and pharmacy-level stewardship strategies (ie, dose rounding and vial sharing) for all pembrolizumab infusions would have resulted in 24·7% fewer administration events than baseline dosing (44 533 events vs 59 140 events) and an estimated 200 metric tons less CO2 emitted per year as a result of pembrolizumab use within the VHA (650 tons vs 850 tons of CO2, a relative reduction of 24%), largely due to reductions in distance travelled by patients to receive treatment. Similar results were observed when weight-based and extended-interval dosing were applied only to pembrolizumab monotherapy and pembrolizumab in combination with oral therapies. INTERPRETATION Alternative pembrolizumab administration strategies might have environmental advantages over the current dosing and compounding paradigms. Specialty medication dosing can be optimised for health-care spending and environmental sustainability without sacrificing clinical outcomes. FUNDING None.
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Affiliation(s)
- Alex K Bryant
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Department of Radiation Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Lung Precision Oncology Program, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Jacqueline R Lewy
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - R Daniel Bressler
- School of International and Public Affairs, Columbia Climate School, and Center for Environmental Economics and Policy, Columbia University, New York, NY, USA
| | - Zoey Chopra
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Economics, University of Michigan, Ann Arbor, MI, USA
| | - Derek J Gyori
- Division of Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA
| | - Brian G Bazzell
- Division of Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA
| | - Julie A Moeller
- Division of Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA
| | | | - A Mark Fendrick
- Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Center for Value-Based Insurance Design, University of Michigan, Ann Arbor, MI, USA
| | - Eve A Kerr
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Nithya Ramnath
- Lung Precision Oncology Program, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Division of Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Michael D Green
- Department of Radiation Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Lung Precision Oncology Program, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Timothy P Hofer
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
| | - Parth Vaishnav
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Garth W Strohbehn
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA; Lung Precision Oncology Program, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Division of Oncology, Charles S Kettles VA Medical Center, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA.
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Hough E, Cohen Tanugi-Carresse A. Supporting Decarbonization of Health Systems-A Review of International Policy and Practice on Health Care and Climate Change. Curr Environ Health Rep 2024; 11:266-278. [PMID: 38358612 PMCID: PMC11082023 DOI: 10.1007/s40572-024-00434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE OF REVIEW Healthcare is a significant contributor of carbon emissions, which contribute to climate change. There has been an increased focus on the role healthcare should play in reducing emissions in recent years. This review, completed in September and October 2022, explored national commitments among 73 countries to reduce emissions from healthcare and the policies and delivery plans that exist to support their implementation. RECENT FINDINGS Whilst some countries such as Norway, Columbia, and Australia are working to understand current emissions and develop plans to reduce them, few have published delivery plans for meeting national targets. Broader policies and reports published to date provide a clear set of actions that healthcare can take to reduce emissions. However, more research, innovation, and service redesign will be needed to close the gap to net zero healthcare. Some health systems are already taking action to reduce their emissions. However, national incentives, including standardized metrics and reporting, can help drive broader action and pace of delivery.
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Affiliation(s)
- Emily Hough
- NHS Mid and South Essex Integrated Care Board, Essex, UK.
- Brown University, Providence, RI, USA.
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57
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Kalmar AF, Mulier H, Rex S. Volatile anaesthetics and net zero: a quantitative approach for spending money effectively. Anaesthesia 2024; 79:665-666. [PMID: 38462792 DOI: 10.1111/anae.16278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Affiliation(s)
- A F Kalmar
- IBiTech, Ghent University, Gent, Belgium
| | - H Mulier
- University Hospitals Leuven, Leuven, Belgium
| | - S Rex
- University Hospitals Leuven, Leuven, Belgium
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58
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Etzel RA, Weimann E, Homer C, Arora NK, Maimela G, Prats EV, Banerjee A. Climate change impacts on health across the life course. J Glob Health 2024; 14:03018. [PMID: 38781571 PMCID: PMC11115476 DOI: 10.7189/jogh.14.03018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Affiliation(s)
- Ruth A Etzel
- George Washington University, Milken Institute School of Public Health, Washington, D. C., USA
| | | | | | | | - Gloria Maimela
- Wits Reproductive Health and HIV Institute, Johannesburg, South Africa
| | | | - Anshu Banerjee
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
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Washington AE, Mallon WT, Spisso J. Accelerating Climate Action Through Academic Health Systems: Leadership's Call to Duty. JAMA 2024; 331:1617-1618. [PMID: 38630484 DOI: 10.1001/jama.2024.4967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
This Viewpoint makes the case for academic health systems to lead the way on climate change action in the US, including planning to reduce greenhouse gas emissions, educating current and future clinicians, and communicating with their patients and communities.
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Affiliation(s)
- A Eugene Washington
- Office of the Chancellor Emeritus, Duke University
- Duke University Health System, Durham, North Carolina
| | | | - Johnese Spisso
- Office of the President and CEO, UCLA Health and UCLA Hospital System, Los Angeles, California
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60
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Zhu Q, Ye P, Wang Y, Duan L, He G, Er Y, Jin Y, Ji C, Hu J, Deng X, Ma W, Liu T. Heatwaves increase road traffic injury morbidity risk and burden in China and its provinces. ENVIRONMENT INTERNATIONAL 2024; 188:108760. [PMID: 38788419 DOI: 10.1016/j.envint.2024.108760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/08/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
Previous studies have demonstrated health impacts of climate change, but evidence on heatwaves' associations with road traffic injury (RTI) is limited. In this study, individual information of RTI cases in May-September during 2006-2021 in China were obtained from the National Injury Surveillance System. Daily maximum temperatures (TMmax) during 2006-2021 were collected from the ERA-5 reanalysis, and the projected daily TMmax during 2020-2099 were obtained from the latest Coupled Model Intercomparison Project Phase 6 Shared Socioeconomic Pathways scenarios (SSPs). We used a time-stratified case-crossover analysis to investigate the association between short-term exposure (lag01 days) to heatwaves (exceeding the 92.5th percentile of daily TMmax for ≥ three consecutive days) and RTI, and to project heatwave-related RTI until 2099 across China. Finally, a total of 1 031 082 RTI cases were included in the analyses. Compared with non-heatwaves, the risks of RTI increased by 3.61 % during heatwaves. Greater associations were found in people aged 15-64 years, in people with transportation occupation, for non-motor traffic vehicle injuries, for severe RTI cases, and in Western China particularly in Qinghai province. We projected substantial increases in attributable fraction (AF) of heatwave-related RTI in the future, particularly in Western and Southwest China. The national average increase in AF (per decade) during 2020s-2090s was 0.036 % for SSP1-2.6 scenario, and 0.267 % for SSP5-8.5 scenario. This study provided evidence on the associations of heatwaves with RTI, and the heatwave-related RTI will substantially increase in the future.
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Affiliation(s)
- Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yuan Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yuliang Er
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Ye Jin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cuirong Ji
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Xiao Deng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
| | - Tao Liu
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China.
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61
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Zhou M, Shen H. Forecasting the global burden of disease to 2050. Lancet 2024; 403:1961-1963. [PMID: 38762312 DOI: 10.1016/s0140-6736(24)00932-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Hongbing Shen
- Chinese Center for Disease Control and Prevention, Beijing, China
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Brauer M, Roth GA, Aravkin AY, Zheng P, Abate KH, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasi MA, Abbasian M, Abbasifard M, Abbasi-Kangevari M, Abd ElHafeez S, Abd-Elsalam S, Abdi P, Abdollahi M, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abedi A, Abedi A, Abegaz TM, Abeldaño Zuñiga RA, Abiodun O, Abiso TL, Aboagye RG, Abolhassani H, Abouzid M, Aboye GB, Abreu LG, Abualruz H, Abubakar B, Abu-Gharbieh E, Abukhadijah HJJ, Aburuz S, Abu-Zaid A, Adane MM, Addo IY, Addolorato G, Adedoyin RA, Adekanmbi V, Aden B, Adetunji JB, Adeyeoluwa TE, Adha R, Adibi A, Adnani QES, Adzigbli LA, Afolabi AA, Afolabi RF, Afshin A, Afyouni S, Afzal MS, Afzal S, Agampodi SB, Agbozo F, Aghamiri S, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad N, Ahmad S, Ahmad T, Ahmed A, Ahmed A, Ahmed A, Ahmed LA, Ahmed MB, Ahmed S, Ahmed SA, Ajami M, Akalu GT, Akara EM, Akbarialiabad H, Akhlaghi S, Akinosoglou K, Akinyemiju T, Akkaif MA, Akkala S, Akombi-Inyang B, Al Awaidy S, Al Hasan SM, Alahdab F, AL-Ahdal TMA, Alalalmeh SO, Alalwan TA, Al-Aly Z, Alam K, Alam N, Alanezi FM, Alanzi TM, Albakri A, AlBataineh MT, Aldhaleei WA, Aldridge RW, Alemayohu MA, Alemu YM, Al-Fatly B, Al-Gheethi AAS, Al-Habbal K, Alhabib KF, Alhassan RK, Ali A, Ali A, Ali BA, Ali I, Ali L, Ali MU, Ali R, Ali SSS, Ali W, Alicandro G, Alif SM, Aljunid SM, Alla F, Al-Marwani S, Al-Mekhlafi HM, Almustanyir S, Alomari MA, Alonso J, Alqahtani JS, Alqutaibi AY, Al-Raddadi RM, Alrawashdeh A, Al-Rifai RH, Alrousan SM, Al-Sabah SK, Alshahrani NZ, Altaany Z, Altaf A, Al-Tawfiq JA, Altirkawi KA, Aluh DO, Alvis-Guzman N, Alvis-Zakzuk NJ, Alwafi H, Al-Wardat MS, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Al-Zyoud W, Amaechi UA, Aman Mohammadi M, Amani R, Amiri S, Amirzade-Iranaq MH, Ammirati E, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Anderson JA, Andrade PP, Andrei CL, Andrei T, Anenberg SC, Angappan D, Angus C, Anil A, Anil S, Anjum A, Anoushiravani A, Antonazzo IC, Antony CM, Antriyandarti E, Anuoluwa BS, Anvari D, Anvari S, Anwar S, Anwar SL, Anwer R, Anyabolo EE, Anyasodor AE, Apostol GLC, Arabloo J, Arabzadeh Bahri R, Arafat M, Areda D, Aregawi BB, Aremu A, Armocida B, Arndt MB, Ärnlöv J, Arooj M, Artamonov AA, Artanti KD, Aruleba IT, Arumugam A, Asbeutah AM, Asgary S, Asgedom AA, Ashbaugh C, Ashemo MY, Ashraf T, Askarinejad A, Assmus M, Astell-Burt T, Athar M, Athari SS, Atorkey P, Atreya A, Aujayeb A, Ausloos M, Avila-Burgos L, Awoke AA, Ayala Quintanilla BP, Ayatollahi H, Ayestas Portugal C, Ayuso-Mateos JL, Azadnajafabad S, Azevedo RMS, Azhar GS, Azizi H, Azzam AY, Backhaus IL, Badar M, Badiye AD, Bagga A, Baghdadi S, Bagheri N, Bagherieh S, Bahrami Taghanaki P, Bai R, Baig AA, Baker JL, Bakkannavar SM, Balasubramanian M, Baltatu OC, Bam K, Bandyopadhyay S, Banik B, Banik PC, Banke-Thomas A, Bansal H, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Bärnighausen TW, Barone-Adesi F, Barqawi HJ, Barrero LH, Barrow A, Barteit S, Basharat Z, Basiru A, Basso JD, Bastan MM, Basu S, Batchu S, Batra K, Batra R, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Behnoush AH, Beiranvand M, Béjot Y, Bekele A, Belgaumi UI, Bell AW, Bell ML, Bello MB, Bello OO, Belo L, Beloukas A, Bendak S, Bennett DA, Bennitt FB, Bensenor IM, Benzian H, Beran A, Berezvai Z, Bernabe E, Bernstein RS, Bettencourt PJG, Bhagavathula AS, Bhala N, Bhandari D, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhuiyan MA, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Biswas A, Biswas B, Biswas RK, Bjørge T, Boachie MK, Boakye H, Bockarie MJ, Bodolica V, Bodunrin AO, Bogale EK, Bolla SR, Boloor A, Bonakdar Hashemi M, Boppana SH, Bora Basara B, Borhany H, Botero Carvajal A, Bouaoud S, Boufous S, Bourne R, Boxe C, Braithwaite D, Brant LC, Brar A, Breitborde NJK, Breitner S, Brenner H, Briko AN, Britton G, Brown CS, Browne AJ, Brunoni AR, Bryazka D, Bulamu NB, Bulto LN, Buonsenso D, Burkart K, Burns RA, Busse R, Bustanji Y, Butt NS, Butt ZA, Caetano dos Santos FL, Cagney J, Cahuana-Hurtado L, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cao F, Cao Y, Capodici A, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalho F, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Catapano AL, Cattaruzza MS, Caye A, Cederroth CR, Cegolon L, Cenderadewi M, Cercy KM, Cerin E, Chadwick J, Chakraborty C, Chakraborty PA, Chakraborty S, Chan JSK, Chan RNC, Chandan JS, Chandika RM, Chaturvedi P, Chen AT, Chen CS, Chen H, Chen MX, Chen M, Chen S, Cheng CY, Cheng ETW, Cherbuin N, Chi G, Chichagi F, Chimed-Ochir O, Chimoriya R, Ching PR, Chirinos-Caceres JL, Chitheer A, Cho WCS, Chong B, Chopra H, Chowdhury R, Christopher DJ, Chu DT, Chukwu IS, Chung E, Chung SC, Chutiyami M, Cioffi I, Cogen RM, Cohen AJ, Columbus A, Conde J, Corlateanu A, Cortese S, Cortesi PA, Costa VM, Costanzo S, Criqui MH, Cruz JA, Cruz-Martins N, Culbreth GT, da Silva AG, Dadras O, Dai X, Dai Z, Daikwo PU, Dalli LL, Damiani G, D'Amico E, D'Anna L, Darwesh AM, Das JK, Das S, Dash NR, Dashti M, Dávila-Cervantes CA, Davis Weaver N, Davitoiu DV, De la Hoz FP, de la Torre-Luque A, De Leo D, Debopadhaya S, Degenhardt L, Del Bo' C, Delgado-Enciso I, Delgado-Saborit JM, Demoze CK, Denova-Gutiérrez E, Dervenis N, Dervišević E, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhane AS, Dhimal ML, Dhimal M, Dhingra S, Dhulipala VR, Dhungana RR, Dias da Silva D, Diaz D, Diaz LA, Diaz MJ, Dima A, Ding DD, Dinu M, Djalalinia S, Do TC, Do THP, do Prado CB, Dodangeh M, Dohare S, Dokova KG, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza AC, Dsouza HL, Dumith SC, Duncan BB, Duraes AR, Duraisamy S, Dushpanova A, Dzianach PA, Dziedzic AM, Ebrahimi A, Echieh CP, Ed-Dra A, Edinur HA, Edvardsson D, Edvardsson K, Efendi F, Eftekharimehrabad A, Eini E, Ekholuenetale M, Ekundayo TC, El Arab RA, El Sayed Zaki M, El-Dahiyat F, Elemam NM, Elgar FJ, ElGohary GMT, Elhabashy HR, Elhadi M, Elmehrath AO, Elmeligy OAA, Elshaer M, Elsohaby I, Emeto TI, Esfandiari N, Eshrati B, Eslami M, Esmaeili SV, Estep K, Etaee F, Fabin N, Fagbamigbe AF, Fagbule OF, Fahimi S, Falzone L, Fareed M, Farinha CSES, Faris MEM, Faris PS, Faro A, Fasina FO, Fatehizadeh A, Fauk NK, Fazylov T, Feigin VL, Feng X, Fereshtehnejad SM, Feroze AH, Ferrara P, Ferrari AJ, Ferreira N, Fetensa G, Feyisa BR, Filip I, Fischer F, Fitriana I, Flavel J, Flohr C, Flood D, Flor LS, Foigt NA, Folayan MO, Force LM, Fortuna D, Foschi M, Franklin RC, Freitas A, Friedman SD, Fux B, G S, Gaal PA, Gaihre S, Gajdács M, Galali Y, Gallus S, Gandhi AP, Ganesan B, Ganiyani MA, Garcia V, Gardner WM, Garg RK, Gautam RK, Gebi TG, Gebregergis MW, Gebrehiwot M, Gebremariam TBB, Gebremeskel TG, Gerema U, Getacher L, Getahun GKA, Getie M, Ghadirian F, Ghafarian S, Ghaffari Jolfayi A, Ghailan KY, Ghajar A, Ghasemi M, Ghasempour Dabaghi G, Ghasemzadeh A, Ghassemi F, Ghazy RM, Gholami A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Gil AU, Gil GF, Gilbertson NM, Gill PS, Gill TK, Gindaba EZ, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golechha M, Goleij P, Golinelli D, Gomes NGM, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Gouravani M, Goyal A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Guha A, Guicciardi S, Gulati S, Gulisashvili D, Gunawardane DA, Guo C, Gupta AK, Gupta B, Gupta M, Gupta R, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Habibzadeh F, Habibzadeh P, Hadaro TS, Hadian Z, Haep N, Haghi-Aminjan H, Haghmorad D, Hagins H, Haile D, Hailu A, Hajj Ali A, Halboub ES, Halimi A, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hamdy NM, Hameed S, Hamidi S, Hammoud A, Hanif A, Hanifi N, Haq ZA, Haque MR, Harapan H, Hargono A, Haro JM, Hasaballah AI, Hasan I, Hasan MJ, Hasan SMM, Hasani H, Hasanian M, Hashmeh N, Hasnain MS, Hassan A, Hassan I, Hassan Zadeh Tabatabaei MS, Hassani S, Hassanipour S, Hassankhani H, Haubold J, Havmoeller RJ, Hay SI, Hebert JJ, Hegazi OE, Hegena TY, Heidari G, Heidari M, Helfer B, Hemmati M, Henson CA, Herbert ME, Herteliu C, Heuer A, Hezam K, Hinneh TK, Hiraike Y, Hoan NQ, Holla R, Hon J, Hoque ME, Horita N, Hossain S, Hosseini SE, Hosseinzadeh H, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hoven H, Hsairi M, Hsu JM, Hu C, Huang J, Huda MN, Hulland EN, Hultström M, Hushmandi K, Hussain J, Hussein NR, Huynh CK, Huynh HH, Ibitoye SE, Idowu OO, Ihler AL, Ikeda N, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Inbaraj LR, Irham LM, Isa MA, Islam MR, Ismail F, Ismail NE, Iso H, Isola G, Iwagami M, Iwu CCD, Iwu-Jaja CJ, J V, Jaafari J, Jacob L, Jacobsen KH, Jadidi-Niaragh F, Jahankhani K, Jahanmehr N, Jahrami H, Jain A, Jain N, Jairoun AA, Jaiswal A, Jakovljevic M, Jalilzadeh Yengejeh R, Jamora RDG, Jatau AI, Javadov S, Javaheri T, Jayaram S, Jeganathan J, Jeswani BM, Jiang H, Johnson CO, Jokar M, Jomehzadeh N, Jonas JB, Joo T, Joseph A, Joseph N, Joshi V, Joshua CE, Jozwiak JJ, Jürisson M, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kahn EM, Kalani R, Kaliyadan F, Kalra S, Kamath R, Kanagasabai T, Kanchan T, Kandel H, Kanmiki EW, Kanmodi KK, Kansal SK, Kapner DJ, Kapoor N, Karagiannidis E, Karajizadeh M, Karakasis P, Karanth SD, Karaye IM, Karch A, Karim A, Karimi H, Karmakar S, Kashoo FZ, Kasraei H, Kassahun WD, Kassebaum NJ, Kassel MB, Katikireddi SV, Kauppila JH, Kawakami N, Kaydi N, Kayode GA, Kazemi F, Keiyoro PN, Kemmer L, Kempen JH, Kerr JA, Kesse-Guyot E, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khalil M, Khalilian A, Khamesipour F, Khan A, Khan MN, Khan M, Khan MJ, Khan MAB, Khanmohammadi S, Khatab K, Khatatbeh H, Khatatbeh MM, Khatib MN, Khavandegar A, Khayat Kashani HR, Khidri FF, Khodadoust E, Khormali M, Khorrami Z, Khosla AA, Khosrowjerdi M, Khreis H, Khusun H, Kifle ZD, Kim K, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Knibbs LD, Knudsen AKS, Koh DSQ, Kolahi AA, Kompani F, Kong J, Koren G, Korja M, Korshunov VA, 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Rodriguez JAB, Roever L, Romadlon DS, Ronfani L, Rosauer JJ, Roshandel G, Rostamian M, Rotimi K, Rout HS, Roy B, Roy N, Rubagotti E, Ruela GDA, Rumisha SF, Runghien T, Russo M, Ruzzante SW, S N C, Saad AMA, Saber K, Saber-Ayad MM, Sabour S, Sacco S, Sachdev PS, Sachdeva R, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi M, Sadeghi Majd E, Saeb MR, Saeed U, Safari M, Safi S, Safi SZ, Sagar R, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahu M, Saif Z, Sajid MR, Sakshaug JW, Salam N, Salamati P, Salami AA, Salaroli LB, Salehi L, Salehi S, Salem MR, Salem MZY, Salihu D, Salimi S, Salum GA, Samadi Kafil H, Samadzadeh S, Samodra YL, Samuel VP, Samy AM, Sanabria J, Sanjeev RK, Sanna F, Santomauro DF, Santric-Milicevic MM, Sarasmita MA, Saraswathy SYI, Saravanan A, Saravi B, Sarikhani Y, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sartorius B, Sarveazad A, Sathian B, Sattin D, Sawhney M, Saya GK, Sayeed A, Sayeed MA, Sayyah M, Schinckus C, Schmidt MI, Schuermans A, Schumacher AE, Schutte AE, Schwarzinger M, Schwebel DC, Schwendicke F, Selvaraj S, Semreen MH, Senthilkumaran S, Serban D, Serre ML, Sethi Y, Shafie M, Shah H, Shah NS, Shah PA, Shah SM, Shahbandi A, Shaheen AA, Shahid S, Shahid W, Shahsavari HR, Shahwan MJ, Shaikh MA, Shaikh SZ, Shalash AS, Sham S, Shamim MA, Shams-Beyranvand M, Shamshirgaran MA, Shamsi MA, Shanawaz M, Shankar A, Sharfaei S, Sharifan A, Sharifi-Rad J, Sharma M, Sharma U, Sharma V, Shastry RP, Shavandi A, Shehabeldine AME, Shehzadi S, Sheikh A, Shen J, Shetty A, Shetty BSK, Shetty PH, Shiani A, Shiferaw D, Shigematsu M, Shin MJ, Shiri R, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shool S, Shorofi SA, Shrestha R, Shrestha S, Shuja KH, Shuval K, Si Y, Siddig EE, Silva DAS, Silva LMLR, Silva S, Silva TPR, Simpson CR, Singh A, Singh BB, Singh B, Singh G, Singh H, Singh JA, Singh M, Singh NP, Singh P, Singh S, Sinto R, Sivakumar S, Siwal SS, Skhvitaridze N, Skou ST, Sleet DA, Sobia F, Soboka M, Socea B, Solaimanian S, Solanki R, Solanki S, Soliman SSM, Somayaji R, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Spearman S, Spencer CN, Sreeramareddy CT, Stachteas P, Stafford LK, Stanaway JD, Stanikzai MH, Stein C, Stein DJ, Steinbeis F, Steiner C, Steinke S, Steiropoulos P, Stockfelt L, Stokes MA, Straif K, Stranges S, Subedi N, Subramaniyan V, Suleman M, Suliankatchi Abdulkader R, Sundström J, Sunkersing D, Sunnerhagen KS, Suresh V, Swain CK, Szarpak L, Szeto MD, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Takahashi K, Talaat IM, Tamuzi JL, Tan KK, Tang H, Tat NY, Taveira N, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Terefa DR, Teye-Kwadjo E, Thakur R, Thangaraju P, Thankappan KR, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas N, Thomas NK, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tobe-Gai R, Tolani MA, Tolossa T, Tonelli M, Topor-Madry R, Topouzis F, Touvier M, Tovani-Palone MR, Trabelsi K, Tran JT, Tran MTN, Tran NM, Trico D, Trihandini I, Troeger CE, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsermpini EE, Tumurkhuu M, Udoakang AJ, Udoh A, Ullah A, Ullah S, Ullah S, Umair M, Umakanthan S, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Usman JS, Vaithinathan AG, Vakili O, Valenti M, Valizadeh R, Van den Eynde J, van Donkelaar A, Varga O, Vart P, Varthya SB, Vasankari TJ, Vasic M, Vaziri S, Venketasubramanian N, Verghese NA, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villalobos-Daniel VE, Villani L, Villanueva GI, Vinayak M, Violante FS, Vlassov V, Vo B, Vollset SE, Volovat SR, Vos T, Vujcic IS, Waheed Y, Wang C, Wang F, Wang S, Wang Y, Wang YP, Wanjau MN, Waqas M, Ward P, Waris A, Wassie EG, Weerakoon KG, Weintraub RG, Weiss DJ, Weiss EJ, Weldetinsaa HLL, Wells KM, Wen YF, Wiangkham T, Wickramasinghe ND, Wilkerson C, Willeit P, Wilson S, Wong YJ, Wongsin U, Wozniak S, Wu C, Wu D, Wu F, Wu Z, Xia J, Xiao H, Xu S, Xu X, Xu YY, Yadav MK, Yaghoubi S, Yamagishi K, Yang L, Yano Y, Yaribeygi H, Yasufuku Y, Ye P, Yesodharan R, Yesuf SA, Yezli S, Yi S, Yiğit A, Yigzaw ZA, Yin D, Yip P, Yismaw MB, Yon DK, Yonemoto N, You Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Zadey S, Zadnik V, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman SB, Zandieh GGZ, Zanghì A, Zar HJ, Zare I, Zarimeidani F, Zastrozhin MS, Zeng Y, Zhai C, Zhang AL, Zhang H, Zhang L, Zhang M, Zhang Y, Zhang Z, Zhang ZJ, Zhao H, Zhao JT, Zhao XJG, Zhao Y, Zhao Y, Zhong C, Zhou J, Zhou J, Zhou S, Zhu B, Zhu L, Zhu Z, Ziaeian B, Ziafati M, Zielińska M, Zimsen SRM, Zoghi G, Zoller T, Zumla A, Zyoud SH, Zyoud SH, Murray CJL, Gakidou E. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2162-2203. [PMID: 38762324 PMCID: PMC11120204 DOI: 10.1016/s0140-6736(24)00933-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. METHODS The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk-outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. FINDINGS Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7-9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4-9·2]), smoking (5·7% [4·7-6·8]), low birthweight and short gestation (5·6% [4·8-6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8-6·0]). For younger demographics (ie, those aged 0-4 years and 5-14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9-27·7]) and environmental and occupational risks (decrease of 22·0% [15·5-28·8]), coupled with a 49·4% (42·3-56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9-21·7] for high BMI and 7·9% [3·3-12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6-1·9) for high BMI and 1·3% (1·1-1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4-78·8) for child growth failure and 66·3% (60·2-72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). INTERPRETATION Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. FUNDING Bill & Melinda Gates Foundation.
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Tourrette C, Tostain JB, Kozub E, Badreddine M, James J, Noraz A, De Choudens C, Moulis L, Duflos C, Carbonnel F. An e-Learning Course to Train General Practitioners in Planetary Health: Pilot Intervention Study. JMIR Form Res 2024; 8:e56138. [PMID: 38743463 PMCID: PMC11134242 DOI: 10.2196/56138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/24/2024] [Accepted: 03/16/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND According to the World Health Organization, climate and ecological emergencies are already major threats to human health. Unabated climate change will cause 3.4 million deaths per year by the end of the century, and health-related deaths in the population aged ≥65 years will increase by 1540%. Planetary health (PH) is based on the understanding that human health and human civilization depend on flourishing natural systems and the wise stewardship of those natural systems. Health care systems collectively produce global emissions equivalent to those of the fifth largest country on earth, and they should take steps to reduce their environmental impact. Primary care in France accounts for 23% of greenhouse gas emissions in the health care sector. General practitioners (GPs) have an important role in PH. The course offers first-year GP residents of the Montpellier-Nîmes Faculty of Medicine a blended-learning course on environmental health. An e-learning module on PH, lasting 30 to 45 minutes, has been introduced in this course. OBJECTIVE The objective of this study was to assess the impact of the e-learning module on participants' knowledge and behavior change. METHODS This was a before-and-after study. The module consisted of 3 parts: introduction, degradation of ecosystems and health (based on the Intergovernmental Panel on Climate Change report and planetary limits), and ecoresponsibility (based on the Shift Project report on the impact of the health care system on the environment). The questionnaire used Likert scales to self-assess 10 points of knowledge and 5 points of PH-related behavior. RESULTS A total of 95 participants completed the pre- and posttest questionnaires (response rate 55%). The mean scores for participants' pretest knowledge and behaviors were 3.88/5 (SD 0.362) and 3.45/5 (SD 0.705), respectively. There was no statistically significant variation in the results according to age or gender. The pretest mean score of participants who had already taken PH training was statistically better than those who had not taken the PH training before this course (mean 4.05, SD 0.16 vs mean 3.71, SD 0.374; P<.001). CONCLUSIONS The PH module of the Primary Care Environment and Health course significantly improved self-assessment knowledge scores and positively modified PH behaviors among GP residents. Further work is needed to study whether these self-declared behaviors are translated into practice.
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Affiliation(s)
- Cédric Tourrette
- University Department of General Practice, Montpellier University, Montpellier, France
| | - Jean-Baptiste Tostain
- University Department of General Practice, Montpellier University, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, Montpellier University, INSERM, Montpellier, France
| | - Eva Kozub
- University Department of General Practice, University Toulouse III, Toulouse, France
| | - Maha Badreddine
- Department of Pedagogical Engineering and Audiovisual Production, Faculty of Medicine, Montpellier University, Montpellier, France
| | - Julia James
- University Department of General Practice, Montpellier University, Montpellier, France
| | - Aurore Noraz
- University Department of General Practice, Montpellier University, Montpellier, France
| | - Charlotte De Choudens
- Clinical research and Epidemiology Unit, University of Montpellier Hospital Center, Montpellier, France
| | - Lionel Moulis
- Clinical research and Epidemiology Unit, University of Montpellier Hospital Center, Montpellier, France
| | - Claire Duflos
- Clinical research and Epidemiology Unit, University of Montpellier Hospital Center, Montpellier, France
| | - Francois Carbonnel
- University Department of General Practice, Montpellier University, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, Montpellier University, INSERM, Montpellier, France
- Maison de Santé Pluriprofessionnelle Universitaire Avicenne, Cabestany, France
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Khoshakhlagh AH, Mohammadzadeh M, Gruszecka-Kosowska A, Oikonomou E. Burden of cardiovascular disease attributed to air pollution: a systematic review. Global Health 2024; 20:37. [PMID: 38702798 PMCID: PMC11069222 DOI: 10.1186/s12992-024-01040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/19/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics. METHODS A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle-Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study. RESULTS Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016-2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014. CONCLUSION Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahdiyeh Mohammadzadeh
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Climate Change and Health Research Center (CCHRC), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Agnieszka Gruszecka-Kosowska
- AGH University of Krakow, Faculty of Geology, Geophysics and Environmental Protection, Department of Environmental Protection, al. A. Mickiewicza 30, 30-059, Krakow, Poland
| | - Evangelos Oikonomou
- Department of Cardiology, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Hartinger SM, Palmeiro-Silva YK, Llerena-Cayo C, Blanco-Villafuerte L, Escobar LE, Diaz A, Sarmiento JH, Lescano AG, Melo O, Rojas-Rueda D, Takahashi B, Callaghan M, Chesini F, Dasgupta S, Posse CG, Gouveia N, Martins de Carvalho A, Miranda-Chacón Z, Mohajeri N, Pantoja C, Robinson EJ, Salas MF, Santiago R, Sauma E, Santos-Vega M, Scamman D, Sergeeva M, Souza de Camargo T, Sorensen C, Umaña JD, Yglesias-González M, Walawender M, Buss D, Romanello M. The 2023 Latin America report of the Lancet Countdown on health and climate change: the imperative for health-centred climate-resilient development. LANCET REGIONAL HEALTH. AMERICAS 2024; 33:100746. [PMID: 38800647 PMCID: PMC11117061 DOI: 10.1016/j.lana.2024.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 05/29/2024]
Abstract
In 2023, a series of climatological and political events unfolded, partly driving forward the global climate and health agenda while simultaneously exposing important disparities and vulnerabilities to climate-related events. On the policy front, a significant step forward was marked by the inaugural Health Day at COP28, acknowledging the profound impacts of climate change on health. However, the first-ever Global Stocktake showed an important gap between the current progress and the targets outlined in the Paris Agreement, underscoring the urgent need for further and decisive action. From a Latin American perspective, some questions arise: How do we achieve the change that is needed? How to address the vulnerabilities to climate change in a region with long-standing social inequities? How do we promote intersectoral collaboration to face a complex problem such as climate change? The debate is still ongoing, and in many instances, it is just starting. The renamed regional centre Lancet Countdown Latin America (previously named Lancet Countdown South America) expanded its geographical scope adding Mexico and five Central American countries: Costa Rica, El Salvador, Guatemala, Honduras, and Panama, as a response to the need for stronger collaboration in a region with significant social disparities, including research capacities and funding. The centre is an independent and multidisciplinary collaboration that tracks the links between health and climate change in Latin America, following the global Lancet Countdown's methodologies and five domains. The Lancet Countdown Latin America work hinges on the commitment of 23 regional academic institutions, United Nations agencies, and 34 researchers who generously contribute their time and expertise. Building from the first report, the 2023 report of the Lancet Countdown Latin America, presents 34 indicators that track the relationship between health and climate change up to 2022, aiming at providing evidence to public decision-making with the purpose of improving the health and wellbeing of Latin American populations and reducing social inequities through climate actions focusing on health. This report shows that Latin American populations continue to observe a growing exposure to changing climatic conditions. A warming trend has been observed across all countries in Latin America, with severe direct impacts. In 2022, people were exposed to ambient temperatures, on average, 0.38 °C higher than in 1986-2005, with Paraguay experiencing the highest anomaly (+1.9 °C), followed by Argentina (+1.2 °C) and Uruguay (+0.9 °C) (indicator 1.1.1). In 2013-2022, infants were exposed to 248% more heatwave days and people over 65 years old were exposed to 271% more heatwave days than in 1986-2005 (indicator 1.1.2). Also, compared to 1991-2000, in 2013-2022, there were 256 and 189 additional annual hours per person, during which ambient heat posed at least moderate and high risk of heat stress during light outdoor physical activity in Latin America, respectively (indicator 1.1.3). Finally, the region had a 140% increase in heat-related mortality from 2000-2009 to 2013-2022 (indicator 1.1.4). Changes in ecosystems have led to an increased risk of wildfires, exposing individuals to very or extremely high fire danger for more extended periods (indicator 1.2.1). Additionally, the transmission potential for dengue by Aedes aegypti mosquitoes has risen by 54% from 1951-1960 to 2013-2022 (indicator 1.3), which aligns with the recent outbreaks and increasing dengue cases observed across Latin America in recent months. Based on the 2023 report of the Lancet Countdown Latin America, there are three key messages that Latin America needs to further explore and advance for a health-centred climate-resilient development. Latin American countries require intersectoral public policies that simultaneously increase climate resilience, reduce social inequities, improve population health, and reduce greenhouse gas (GHG) emissions. The findings show that adaptation policies in Latin America remain weak, with a pressing need for robust vulnerability and adaptation (V&A) assessments to address climate risks effectively. Unfortunately, such assessments are scarce. Up to 2021, Brazil is the only country that has completed and officially reported a V&A to the 2021 Global Survey conducted by the World Health Organization (WHO). Argentina, Guatemala, and Panama have also conducted them, but they have not been reported (indicator 2.1.1). Similarly, efforts in developing and implementing Health National Adaptation Plans (HNAPs) are varied and limited in scope. Brazil, Chile, and Uruguay are the only countries that have an HNAP (indicator 2.1.2). Moreover, self-reported city-level climate change risk assessments are very limited in the region (indicator 2.1.3). The collaboration between meteorological and health sectors remains insufficient, with only Argentina, Brazil, Colombia, and Guatemala self-reporting some level of integration (indicator 2.2.1), hindering comprehensive responses to climate-related health risks in the region. Additionally, despite the urgent need for action, there has been minimal progress in increasing urban greenspaces across the region since 2015, with only Colombia, Nicaragua, and Venezuela showing slight improvements (indicator 2.2.2). Compounding these challenges is the decrease in funding for climate change adaptation projects in Latin America, as evidenced by the 16% drop in funds allocated by the Green Climate Fund (GCF) in 2022 compared to 2021. Alarmingly, none of the funds approved in 2022 were directed toward climate change and health projects, highlighting a critical gap in addressing health-related climate risks (indicator 2.2.3). From a vulnerability perspective, the Mosquito Risk Index (MoRI) indicates an overall decrease in severe mosquito-borne disease risk in the region due to improvements in water, sanitation, and hygiene (WASH) (indicator 2.3.1). Brazil and Paraguay were the only countries that showed an increase in this indicator. It is worth noting that significant temporal variation within and between countries still persists, suggesting inadequate preparedness for climate-related changes. Overall, population health is not solely determined by the health sector, nor are climate policies a sole responsibility of the environmental sector. More and stronger intersectoral collaboration is needed to pave development pathways that consider solid adaptation to climate change, greater reductions of GHG emissions, and that increase social equity and population health. These policies involve sectors such as finance, transport, energy, housing, health, and agriculture, requiring institutional structures and policy instruments that allow long-term intersectoral collaboration. Latin American countries need to accelerate an energy transition that prioritises people's health and wellbeing, reduces energy poverty and air pollution, and maximises health and economic gains. In Latin America, there is a notable disparity in energy transition, with electricity generation from coal increasing by an average of 2.6% from 1991-2000 to 2011-2020, posing a challenge to efforts aimed at phasing out coal (indicator 3.1.1). However, this percentage increase is conservative as it may not include all the fossil fuels for thermoelectric electricity generation, especially during climate-related events and when hydropower is affected (Panel 4). Yet, renewable energy sources have been growing, increasing by an average of 5.7% during the same period. Access to clean fuels for cooking remains a concern, with 46.3% of the rural population in Central America and 23.3% in South America lacking access to clean fuels in 2022 (indicator 3.1.2). It is crucial to highlight the concerning overreliance on fossil fuels, particularly liquefied petroleum gas (LPG), as a primary cooking fuel. A significant majority of Latin American populations, approximately 74.6%, rely on LPG for cooking. Transitioning to cleaner heating and cooking alternatives could also have a health benefit by reducing household air pollution-related mortality. Fossil fuels continue to dominate road transport energy in Latin America, accounting for 96%, although some South American countries are increasing the use of biofuels (indicator 3.1.3). Premature mortality attributable to fossil-fuel-derived PM2.5 has shown varied trends across countries, increasing by 3.9% from 2005 to 2020 across Latin America, which corresponds to 123.5 premature deaths per million people (indicator 3.2.1). The Latin American countries with the highest premature mortality rate attributable to PM2.5 in 2020 were Chile, Peru, Brazil, Colombia, Mexico, and Paraguay. Of the total premature deaths attributable to PM2.5 in 2020, 19.1% was from transport, 12.3% from households, 11.6% from industry, and 11% from agriculture. From emission and capture of GHG perspective, commodity-driven deforestation and expansion of agricultural land remain major contributors to tree cover loss in the region, accounting for around 80% of the total loss (indicator 3.3). Additionally, animal-based food production in Latin America contributes 85% to agricultural CO2 equivalent emissions, with Argentina, Brazil, Panama, Paraguay, and Uruguay ranking highest in per capita emissions (indicator 3.4.1). From a health perspective, in 2020, approximately 870,000 deaths were associated with imbalanced diets, of which 155,000 (18%) were linked to high intake of red and processed meat and dairy products (indicator 3.4.2). Energy transition in Latin America is still in its infancy, and as a result, millions of people are currently exposed to dangerous levels of air pollution and energy poverty (i.e., lack of access to essential energy sources or services). As shown in this report, the levels of air pollution, outdoors and indoors, are a significant problem in the whole region, with marked disparities between urban and rural areas. In 2022, Peru, Chile, Mexico, Guatemala, Colombia, El Salvador, Brazil, Uruguay, Honduras, Panama, and Nicaragua were in the top 100 most polluted countries globally. Transitioning to cleaner sources of energy, phasing out fossil fuels, and promoting better energy efficiency in the industrial and housing sectors are not only climate mitigation measures but also huge health and economic opportunities for more prosperous and healthy societies. Latin American countries need to increase climate finance through permanent fiscal commitments and multilateral development banks to pave climate-resilient development pathways. Climate change poses significant economic costs, with investments in mitigation and adaptation measures progressing slowly. In 2022, economic losses due to weather-related extreme events in Latin America were US$15.6 billion -an amount mainly driven by floods and landslides in Brazil-representing 0.28% of Latin America's Gross Domestic Product (GDP) (indicator 4.1.1). In contrast to high-income countries, most of these losses lack insurance coverage, imposing a substantial financial strain on affected families and governments. Heat-related mortality among individuals aged 65 and older in Latin America reached alarming levels, with losses exceeding the equivalent of the average income of 451,000 people annually (indicator 4.1.2). Moreover, the total potential income loss due to heat-related labour capacity reduction amounted to 1.34% of regional GDP, disproportionately affecting the agriculture and construction sectors (indicator 4.1.3). Additionally, the economic toll of premature mortality from air pollution was substantial, equivalent to a significant portion of regional GDP (0.61%) (indicator 4.1.4). On a positive note, clean energy investments in the region increased in 2022, surpassing fossil fuel investments. However, in 2020, all countries reviewed continued to offer net-negative carbon prices, revealing fossil fuel subsidies totalling US$23 billion. Venezuela had the highest net subsidies relative to current health expenditure (123%), followed by Argentina (10.5%), Bolivia (10.3%), Ecuador (8.3%), and Chile (5.6%) (indicator 4.2.1). Fossil fuel-based energy is today more expensive than renewable energy. Fossil fuel burning drives climate change and damages the environment on which people depend, and air pollution derived from the burning of fossil fuels causes seven million premature deaths each year worldwide, along with a substantial burden of disease. Transitioning to sustainable, zero-emission energy sources, fostering healthier food systems, and expediting adaptation efforts promise not only environmental benefits but also significant economic gains. However, to implement mitigation and adaptation policies that also improve social wellbeing and prosperity, stronger and solid financial systems are needed. Climate finance in Latin American countries is scarce and strongly depends on political cycles, which threatens adequate responses to the current and future challenges. Progress on the climate agenda is lagging behind the urgent pace required. While engagement with the intersection of health and climate change is increasing, government involvement remains inadequate. Newspaper coverage of health and climate change has been on the rise, peaking in 2022, yet the proportion of climate change articles discussing health has declined over time (indicator 5.1). Although there has been significant growth in the number of scientific papers focusing on Latin America, it still represents less than 4% of global publications on the subject (indicator 5.3). And, while health was mentioned by most Latin American countries at the UN General Debate in 2022, only a few addressed the intersection of health and climate change, indicating a lack of awareness at the governmental level (indicator 5.4). The 2023 Lancet Countdown Latin America report underscores the cascading and compounding health impacts of anthropogenic climate change, marked by increased exposure to heatwaves, wildfires, and vector-borne diseases. Specifically, for Latin America, the report emphasises three critical messages: the urgent action to implement intersectoral public policies that enhance climate resilience across the region; the pressing need to prioritise an energy transition that focuses on health co-benefits and wellbeing, and lastly, that need for increasing climate finance by committing to sustained fiscal efforts and engaging with multilateral development banks. By understanding the problems, addressing the gaps, and taking decisive action, Latin America can navigate the challenges of climate change, fostering a more sustainable and resilient future for its population. Spanish and Portuguese translated versions of this Summary can be found in Appendix B and C, respectively. The full translated report in Spanish is available in Appendix D.
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Affiliation(s)
- Stella M. Hartinger
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yasna K. Palmeiro-Silva
- Institute for Global Health, University College London, London, UK
- Centro de Políticas Públicas UC, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Llerena-Cayo
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana Blanco-Villafuerte
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis E. Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA
| | - Avriel Diaz
- Columbia University, International Research Institute for Climate and Society New York, USA
| | | | - Andres G. Lescano
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Oscar Melo
- Centro Interdisciplinario de Cambio Global, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Rojas-Rueda
- Environmental and Radiological Health Sciences, Colorado State University, CO, USA
- Colorado School of Public Health, Colorado State University, CO, USA
| | - Bruno Takahashi
- Departament of Communication, Michigan State University, MI, USA
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Francisco Chesini
- Departamento de Salud Pública, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
| | - Carolina Gil Posse
- Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nelson Gouveia
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Nahid Mohajeri
- Institute of Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Chrissie Pantoja
- Nicholas School of the Environment and Sanford School of Policy Policy, Duke University, Durham, NC, USA
- Departamento Académico de Economía, Universidad del Pacífico, Lima, Peru
| | - Elizabeth J.Z. Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
| | | | - Raquel Santiago
- Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Enzo Sauma
- Engineering Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Santos-Vega
- Grupo de Biología y Matemática Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
- Departamento Ciencias Biológicas, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | | | | | - Cecilia Sorensen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, Department of Emergency Medicine, Columbia Irving Medical Center, NY, USA
| | - Juan D. Umaña
- Grupo de Biología y Matemática Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
| | - Marisol Yglesias-González
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | - Daniel Buss
- Pan American Health Organization, Washington, DC, USA
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
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Sverdlik A, Kothiwal K, Kadungure A, Agarwal S, Machemedze R, Verma S, Loewenson R. Understanding the interplay of occupational, public health, and climate-related risks for informal workers: A new framework with findings from Zimbabwe and India. Soc Sci Med 2024; 348:116750. [PMID: 38531215 DOI: 10.1016/j.socscimed.2024.116750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 12/21/2023] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats-including heatwaves, drought, and floods-negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers.
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Affiliation(s)
- Alice Sverdlik
- Global Development Institute (GDI), University of Manchester, 1.075 Arthur Lewis Building, Oxford Road, M13 9PL, United Kingdom.
| | - Kanupriya Kothiwal
- Urban Health Resource Centre (UHRC), A 2/159, Basement, Safdarjang Enclave, Delhi, 110029, India
| | - Artwell Kadungure
- Training and Research Support Centre (TARSC), 47 Van Praagh Avenue, Milton Park, Harare, Zimbabwe
| | - Siddharth Agarwal
- Urban Health Resource Centre (UHRC), A 2/159, Basement, Safdarjang Enclave, Delhi, 110029, India
| | - Rangarirai Machemedze
- Training and Research Support Centre (TARSC), 47 Van Praagh Avenue, Milton Park, Harare, Zimbabwe
| | - Shabnam Verma
- Urban Health Resource Centre (UHRC), A 2/159, Basement, Safdarjang Enclave, Delhi, 110029, India
| | - Rene Loewenson
- Training and Research Support Centre (TARSC), 47 Van Praagh Avenue, Milton Park, Harare, Zimbabwe
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Stoneman S, Balmer F, Moore L, Fontana M, Kielstein JT, Woywodt A. Meet and greet but avoid the heat: a reflection on the carbon footprint of congresses prompted by ERA2023. Clin Kidney J 2024; 17:sfae062. [PMID: 38699480 PMCID: PMC11063956 DOI: 10.1093/ckj/sfae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Indexed: 05/05/2024] Open
Affiliation(s)
- Sinead Stoneman
- Department of Nephrology, Cork University Hospital, Cork, Ireland
| | - Frances Balmer
- Sustainability Fellow, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | - Louise Moore
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
| | | | - Jan T Kielstein
- Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany
| | - Alexander Woywodt
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
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Padget M, Peters MA, Brunn M, Kringos D, Kruk ME. Health systems and environmental sustainability: updating frameworks for a new era. BMJ 2024; 385:e076957. [PMID: 38688557 DOI: 10.1136/bmj-2023-076957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Affiliation(s)
- Michael Padget
- Massachusetts General Hospital Center for the Environment and Health, Boston, MA, USA
| | | | - Matthias Brunn
- Laboratory for Interdisciplinary Evaluation of Public Policies (LIEPP), Sciences Po, Paris, France
| | - Dionne Kringos
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
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Anton B, Cuevas S, Hanson M, Bhutta ZA, Langlois EV, Iaia DG, Gasparri G, Borghi J. Opportunities and challenges for financing women's, children's and adolescents' health in the context of climate change. BMJ Glob Health 2024; 9:e014596. [PMID: 38677778 PMCID: PMC11057322 DOI: 10.1136/bmjgh-2023-014596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/14/2024] [Indexed: 04/29/2024] Open
Abstract
Women, children and adolescents (WCA), especially in low-income and middle-income countries (LMICs), will bear the worst consequences of climate change during their lifetimes, despite contributing the least to global greenhouse gas emissions. Investing in WCA can address these inequities in climate risk, as well as generating large health, economic, social and environmental gains. However, women's, children's and adolescents' health (WCAH) is currently not mainstreamed in climate policies and financing. There is also a need to consider new and innovative financing arrangements that support WCAH alongside climate goals.We provide an overview of the threats climate change represents for WCA, including the most vulnerable communities, and where health and climate investments should focus. We draw on evidence to explore the opportunities and challenges for health financing, climate finance and co-financing schemes to enhance equity and protect WCAH while supporting climate goals.WCA face threats from the rising burden of ill-health and healthcare demand, coupled with constraints to healthcare provision, impacting access to essential WCAH services and rising out-of-pocket payments for healthcare. Climate change also impacts on the economic context and livelihoods of WCA, increasing the risk of displacement and migration. These impacts require additional resources to support WCAH service delivery, to ensure continuity of care and protect households from the costs of care and enhance resilience. We identify a range of financing solutions, including leveraging climate finance for WCAH, adaptive social protection for health and adaptations to purchasing to promote climate action and support WCAH care needs.
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Affiliation(s)
- Blanca Anton
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Soledad Cuevas
- Instituto de Economía, Geografía y Demografía, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Mark Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Zulfiqar Ahmed Bhutta
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Etienne V Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Domenico Gerardo Iaia
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Giulia Gasparri
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Josephine Borghi
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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Blaustein JR, Quisel MJ, Hamburg NM, Wittkopp S. Environmental Impacts on Cardiovascular Health and Biology: An Overview. Circ Res 2024; 134:1048-1060. [PMID: 38662864 PMCID: PMC11058466 DOI: 10.1161/circresaha.123.323613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Environmental stressors associated with human activities (eg, air and noise pollution, light disturbance at night) and climate change (eg, heat, wildfires, extreme weather events) are increasingly recognized as contributing to cardiovascular morbidity and mortality. These harmful exposures have been shown to elicit changes in stress responses, circadian rhythms, immune cell activation, and oxidative stress, as well as traditional cardiovascular risk factors (eg, hypertension, diabetes, obesity) that promote cardiovascular diseases. In this overview, we summarize evidence from human and animal studies of the impacts of environmental exposures and climate change on cardiovascular health. In addition, we discuss strategies to reduce the impact of environmental risk factors on current and future cardiovascular disease burden, including urban planning, personal monitoring, and mitigation measures.
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Affiliation(s)
- Jacob R. Blaustein
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
| | - Matthew J. Quisel
- Department of Medicine, Boston University Chobanian and Avedision School of Medicine
| | - Naomi M. Hamburg
- Section of Vascular Biology, Whitaker Cardiovascular Institute, Chobanian and Avedisian School of Medicine, Boston University, Boston, USA
| | - Sharine Wittkopp
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
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71
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Severoni S, Hiam L, Garry S. Climate change and health: displaced and migrant populations must be included. Lancet 2024; 403:1537-1538. [PMID: 38642947 DOI: 10.1016/s0140-6736(24)00243-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/06/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Santino Severoni
- Department of Health and Migration, Division of Universal Health Coverage and Healthier Populations, World Health Organization, Geneva 1202, Switzerland
| | - Lucinda Hiam
- Department of Health and Migration, Division of Universal Health Coverage and Healthier Populations, World Health Organization, Geneva 1202, Switzerland.
| | - Sylvia Garry
- Department of Health and Migration, Division of Universal Health Coverage and Healthier Populations, World Health Organization, Geneva 1202, Switzerland
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van Daalen KR, Wyma N, Schauer-Berg J, Blom IM, Mattijsen J, Othman R, Eissa M, Parks RM, Wyns A, Aboushady AT, Hassan M, Ezzine T, Khan S, Zayed MAE, Neggazi S, Alqodmani L, Lowe R. The global health community at international climate change negotiations. BMJ Glob Health 2024; 9:e015292. [PMID: 38637120 PMCID: PMC11029429 DOI: 10.1136/bmjgh-2024-015292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/31/2024] [Indexed: 04/20/2024] Open
Affiliation(s)
- Kim Robin van Daalen
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Nanine Wyma
- African Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
- Physicians Association for Nutrition South Africa, Pinelands, South Africa
| | - Johanna Schauer-Berg
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Iris M Blom
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Juliette Mattijsen
- Julius Center for Health Sciences and Primary Health, University Medical Centre Utrecht, Utrecht, Netherlands
- Department of Public Health, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Razan Othman
- The National Ribat University, Khartoum, Khartoum, Sudan
| | - Mohamed Eissa
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Robbie M Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Arthur Wyns
- Melbourne Climate Futures, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ahmed Taha Aboushady
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Muha Hassan
- Wye Valley NHS Trust, Hereford, Herefordshire, UK
| | - Tarek Ezzine
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Salman Khan
- Grant Government Medical College and Sir J J Group of Hospitals, Mumbai, Maharashtra, India
- International Federation of Medical Students' Associations (IFMSA), Copenhagen, Denmark
| | - Menna-Allah Elsayed Zayed
- Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
- International Pharmaceutical Federation, The Hague, South Holland, Netherlands
| | - Sarah Neggazi
- Faculty of Pharmacy, University of Algiers 1, Alger, Algeria
- International Pharmaceutical Students' Federation, the Hague, Netherlands
| | | | - Rachel Lowe
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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73
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Corrente A, Pace MC, Fiore M. Climate change and human health: Last call to arms for us. World J Clin Cases 2024; 12:1870-1874. [PMID: 38660546 PMCID: PMC11036518 DOI: 10.12998/wjcc.v12.i11.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/03/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Climate change, now the foremost global health hazard, poses multifaceted challenges to human health. This editorial elucidates the extensive impact of climate change on health, emphasising the increasing burden of diseases and the exacerbation of health disparities. It highlights the critical role of the healthcare sector, particularly anaesthesia, in both contributing to and mitigating climate change. It is a call to action for the medical community to recognise and respond to the health challenges posed by climate change.
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Affiliation(s)
- Antonio Corrente
- Department of Anaesthesiology and Intensive Care Medicine, The Anastasia Guerriero Hospital, Marcianise 81025, Caserta, Italy
| | - Maria Caterina Pace
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Marco Fiore
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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74
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Gepp S, Otieno MA, Buse K. Planetary health: challenging power and privilege is key to a fairer and healthier future. BMJ 2024; 385:q853. [PMID: 38621788 DOI: 10.1136/bmj.q853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
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75
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Issa R, Forbes C, Baker C, Morgan M, Womersley K, Klaber B, Mulcahy E, Stancliffe R. Sustainability is critical for future proofing the NHS. BMJ 2024; 385:e079259. [PMID: 38604667 DOI: 10.1136/bmj-2024-079259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Affiliation(s)
- Rita Issa
- School of Global Development, University of East Anglia, Norwich, UK
- FXB Center for Health and Human Rights, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Institute for Global Health, University College London, London, UK
| | - Callum Forbes
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Catherine Baker
- Royal Sussex County Hospital, University Hospitals Sussex, Brighton, UK
| | - Matt Morgan
- Cardiff University, Cardiff, UK
- University Hospital of Wales, Cardiff, UK
- Curtin University, Perth, WA, Australia
| | - Kate Womersley
- The George Institute for Global Health at Imperial College London, London, UK
- NHS Lothian, Scotland, UK
| | - Bob Klaber
- Imperial College Healthcare NHS Trust, London, UK
- School of Public Health, Imperial College London, London, UK
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76
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Cave JA. Medicines and global warming: a complex problem. Drug Ther Bull 2024:dtb-2024-000003. [PMID: 38594061 DOI: 10.1136/dtb.2024.000003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
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77
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Naser K, Haq Z, Naughton BD. The Impact of Climate Change on Health Services in Low- and Middle-Income Countries: A Systematised Review and Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:434. [PMID: 38673345 PMCID: PMC11050668 DOI: 10.3390/ijerph21040434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Aim: The aim of this study was to assess the impact of climate change on health services as categorized by the WHO's Building Blocks for creating Climate-Resilient Health Systems. Objective: The objective was to conduct a systematized review of the published literature concerning the impact of climate change, using a thematic analysis approach to address our aim and identify areas for further research. Design: A search was conducted on 8 February 2022 using the Embase and PubMed research databases. Peer-reviewed scientific studies that were published in English from 2012 to 2022, which described at least one report concerning the impact of climate change on health services in LMICs, were included. Studies were organized based on their key characteristics, which included the date of publication, objective, method, limitations, participants, and geographical focus. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the risk of bias in the included studies. Results: Twenty-three studies were included in this review. Five areas of health services which align with the WHO building blocks framework were impacted by climate change. These health service areas included: (1) Service Delivery, (2) Human Resources, (3) Health Finance, (4) Healthcare Products and Technology, and (5) Leadership and Governance. However, research concerning the impact of climate change on health information systems, which is part of the WHO building blocks framework, did not feature in our study. The climatic effects were divided into three themes: meteorological effects, extreme weather events, and general. The research in this study found that climate change had a detrimental impact on a variety of health services, with service delivery being the most frequently reported. The risk of bias varied greatly between studies. Conclusions: Climate change has negatively impacted health services in a variety of different ways, and without further actions, this problem is likely to worsen. The WHO building blocks have provided a useful lens through which to review health services. We built an aligned framework to describe our findings and to support future climate change impact assessments in this area. We propose that further research concerning the impact of climate change on health information systems would be valuable, as well as further education and responsible policy changes to help build resilience in health services affected by climate change.
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Affiliation(s)
- Kamar Naser
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, D02PN40 Dublin, Ireland
| | - Zaeem Haq
- Save the Children St Vincent House, 30 Orange Street, London WC2H 7HH, UK
| | - Bernard D. Naughton
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, D02PN40 Dublin, Ireland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, Kings College London, London SE1 9NH, UK
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78
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Chen C, Miller G, Setoguchi S. Climate change and excess length of stay: A call to action for health equity and environmental sustainability. J Hosp Med 2024. [PMID: 38563357 DOI: 10.1002/jhm.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/09/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Catherine Chen
- Department of Medicine, Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | | | - Soko Setoguchi
- Department of Medicine, Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Institute for Health, Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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79
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Arnot G, Pitt H, McCarthy S, Warner E, Thomas S. 'You can't really separate these risks, our environment, our animals and us': Australian children's perceptions of the risks of the climate crisis. Health Promot Int 2024; 39:daae023. [PMID: 38452241 PMCID: PMC10919885 DOI: 10.1093/heapro/daae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Perceptions of the risks associated with the climate crisis are shaped by a range of social and political contexts and information sources. While some have expressed concerns about the impact of the spread of climate misinformation through social media platforms on young people, others have shown that the youth climate movement has played a key role in countering misinformation. Despite this, there has been very limited research with children about how they conceptualize the risks associated with the climate crisis, how they receive climate information, and how they understand and apply this to their own and others' lives. The following qualitative study used photo-elicitation techniques and in-depth interviews with Australian children to address this gap. A total of n = 28 children (12-16 years) participated, with four themes constructed from the data using a reflexive approach to thematic analysis. Children were concerned about how the climate crisis would continue to harm their futures and the health of planet and people. They recognized that some groups and countries would experience more risks associated with the climate crisis as compared to others. While they received information from a range of different sources (school, family, social media), they mostly used social media to seek out climate information. They recognized that social media sites could be a source of climate misinformation, and argued that a range of strategies were needed to identify and counter false information about the climate crisis. Children's perspectives must be harnessed to improve information about climate risks and action.
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Affiliation(s)
- Grace Arnot
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Hannah Pitt
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Simone McCarthy
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Elyse Warner
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Samantha Thomas
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
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80
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Tee NCH, Yeo JA, Choolani M, Poh KK, Ang TL. Healthcare in the era of climate change and the need for environmental sustainability. Singapore Med J 2024; 65:204-210. [PMID: 38650058 PMCID: PMC11132617 DOI: 10.4103/singaporemedj.smj-2024-035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 04/25/2024]
Abstract
ABSTRACT Climate change is an existential threat to humanity. While the healthcare sector must manage the health-related consequences of climate change, it is a significant contributor to greenhouse gas emissions, responsible for up to 4.6% of global emission, aggravating global warming. Within the hospital environment, the three largest contributors to greenhouse gas emissions are the operating theatre, intensive care unit and gastrointestinal endoscopy. Knowledge of the health-related burden of climate change and the potential transformative health benefits of climate action is important to all health professionals, as they play crucial roles in effecting change. This article summarises the available literature on the impact of healthcare on climate change and efforts in mitigation, focusing on the intrinsic differences and similarities across the operating theatre complex, intensive care unit and gastrointestinal endoscopy unit. It also discusses strategies to reduce carbon footprint.
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Affiliation(s)
- Nicholas Chin Hock Tee
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Jo-Anne Yeo
- Duke-NUS Medical School, Singapore
- Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore
| | - Mahesh Choolani
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Kian Keong Poh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Hospital, Singapore
| | - Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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81
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Tong S, Bambrick H, Ebi KL. Striving for a climate-resilient future. Lancet Planet Health 2024; 8:e214-e215. [PMID: 38580421 DOI: 10.1016/s2542-5196(24)00044-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024]
Affiliation(s)
- Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4001, Australia.
| | - Hilary Bambrick
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
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82
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Pearson H. The rise of eco-anxiety: scientists wake up to the mental-health toll of climate change. Nature 2024; 628:256-258. [PMID: 38600270 DOI: 10.1038/d41586-024-00998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
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83
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Ang TL, Choolani M, Poh KK. Healthcare and environmental sustainability. Singapore Med J 2024; 65:203. [PMID: 38650057 PMCID: PMC11132623 DOI: 10.4103/singaporemedj.smj-2024-068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Tiing Leong Ang
- Editor-in-Chief Designate, Singapore Medical Journal, Singapore
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84
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Etzel RA. It's Easy Being Green. Acad Pediatr 2024; 24:387-388. [PMID: 38159597 DOI: 10.1016/j.acap.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Ruth A Etzel
- Milken Institute School of Public Health, The George Washington University, Washington, DC.
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85
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Fletcher C, Ripple WJ, Newsome T, Barnard P, Beamer K, Behl A, Bowen J, Cooney M, Crist E, Field C, Hiser K, Karl DM, King DA, Mann ME, McGregor DP, Mora C, Oreskes N, Wilson M. Earth at risk: An urgent call to end the age of destruction and forge a just and sustainable future. PNAS NEXUS 2024; 3:pgae106. [PMID: 38566756 PMCID: PMC10986754 DOI: 10.1093/pnasnexus/pgae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Human development has ushered in an era of converging crises: climate change, ecological destruction, disease, pollution, and socioeconomic inequality. This review synthesizes the breadth of these interwoven emergencies and underscores the urgent need for comprehensive, integrated action. Propelled by imperialism, extractive capitalism, and a surging population, we are speeding past Earth's material limits, destroying critical ecosystems, and triggering irreversible changes in biophysical systems that underpin the Holocene climatic stability which fostered human civilization. The consequences of these actions are disproportionately borne by vulnerable populations, further entrenching global inequities. Marine and terrestrial biomes face critical tipping points, while escalating challenges to food and water access foreshadow a bleak outlook for global security. Against this backdrop of Earth at risk, we call for a global response centered on urgent decarbonization, fostering reciprocity with nature, and implementing regenerative practices in natural resource management. We call for the elimination of detrimental subsidies, promotion of equitable human development, and transformative financial support for lower income nations. A critical paradigm shift must occur that replaces exploitative, wealth-oriented capitalism with an economic model that prioritizes sustainability, resilience, and justice. We advocate a global cultural shift that elevates kinship with nature and communal well-being, underpinned by the recognition of Earth's finite resources and the interconnectedness of its inhabitants. The imperative is clear: to navigate away from this precipice, we must collectively harness political will, economic resources, and societal values to steer toward a future where human progress does not come at the cost of ecological integrity and social equity.
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Affiliation(s)
- Charles Fletcher
- School of Ocean and Earth Science and Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - William J Ripple
- Department of Forest Ecosystems and Society, Oregon State University, Corvallis, OR 97331, USA
| | - Thomas Newsome
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW 2006, Australia
| | - Phoebe Barnard
- Center for Environmental Politics and School of Interdisciplinary Arts and Sciences, University of Washington, Seattle, WA 98195, USA
- African Climate and Development Initiative and FitzPatrick Institute, University of Cape Town, Cape Town 7700, South Africa
| | - Kamanamaikalani Beamer
- Hui ‘Āina Momona Program, Richardson School of Law, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
- Hawai‘inuiākea School of Hawaiian Knowledge, Kamakakūokalani Center for Hawaiian Studies, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Aishwarya Behl
- School of Ocean and Earth Science and Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Jay Bowen
- Institute of American Indian Arts, Santa Fe, NM 87508, USA
- Upper Skagit Tribe, Sedro Woolley, WA 98284, USA
| | - Michael Cooney
- School of Ocean and Earth Science and Technology, Hawai‘i Natural Energy Institute, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Eileen Crist
- Department of Science Technology and Society, Virginia Tech, Blacksburg, VA 24060, USA
| | - Christopher Field
- Doerr School for Sustainability, Stanford Woods Institute for the Environment, Stanford University, Stanford, CA 94305, USA
| | - Krista Hiser
- Department of Languages, Linguistics, and Literature, Kapi‘olani Community College, Honolulu, HI 96816, USA
- Global Council for Science and the Environment, Washington, DC 20006, USA
| | - David M Karl
- Department of Oceanography, School of Ocean and Earth Science and Technology, Honolulu, HI 96822, USA
- Daniel K. Inouye Center for Microbial Oceanography, Research and Education, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - David A King
- Department of Chemistry, University of Cambridge, Cambridge CB2 1DQ, UK
| | - Michael E Mann
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Davianna P McGregor
- Department of Ethnic Studies, Center for Oral History, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Camilo Mora
- Department of Geography and Environment, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Naomi Oreskes
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
| | - Michael Wilson
- Associate Justice, Hawaii Supreme Court (retired), Honolulu, HI 96813, USA
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86
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Salas RN, Burke LG, Phelan J, Wellenius GA, Orav EJ, Jha AK. Impact of extreme weather events on healthcare utilization and mortality in the United States. Nat Med 2024; 30:1118-1126. [PMID: 38424213 DOI: 10.1038/s41591-024-02833-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
Climate change is intensifying extreme weather events. Yet a systematic analysis of post-disaster healthcare utilization and outcomes for severe weather and climate disasters, as tracked by the US government, is lacking. Following exposure to 42 US billion-dollar weather disasters (severe storm, flood, flood/severe storm, tropical cyclone and winter storm) between 2011 and 2016, we used a difference-in-differences (DID) approach to quantify changes in the rates of emergency department (ED) visits, nonelective hospitalizations and mortality between fee-for-service Medicare beneficiaries in affected compared to matched control counties in post-disaster weeks 1, 1-2 and 3-6. Overall, disasters were associated with higher rates of ED utilization in affected counties in post-disaster week 1 (DID of 1.22% (95% CI, 0.20% to 2.25%; P < 0.020)) through week 2. Nonelective hospitalizations were unchanged. Mortality was higher in affected counties in week 1 (DID of 1.40% (95% CI, 0.08% to 2.74%; P = 0.037)) and persisted for 6 weeks. Counties with the greatest loss and damage experienced greater increases in ED and mortality rates compared to all affected counties. Thus, billion-dollar weather disasters are associated with excess ED visits and mortality in Medicare beneficiaries. Tracking these outcomes is important for adaptation that protects patients and communities, health system resilience and policy.
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Affiliation(s)
- Renee N Salas
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Harvard Global Health Institute, Cambridge, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Laura G Burke
- Harvard Medical School, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, USA
| | - Jessica Phelan
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Boston University School of Public Health, Center for Climate and Health, Boston, MA, USA
| | - E John Orav
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ashish K Jha
- Brown University School of Public Health, Providence, RI, USA
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87
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Dutta A, Olopade CO. Transitioning to gaseous and liquid fuels: a right step towards clean cooking in low-income and middle-income countries. THE LANCET. RESPIRATORY MEDICINE 2024; 12:257-258. [PMID: 38310917 DOI: 10.1016/s2213-2600(23)00465-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 02/06/2024]
Affiliation(s)
- Anindita Dutta
- Department of Medicine and The Center for Global Health, University of Chicago, Chicago, IL, USA
| | - Christopher O Olopade
- Department of Medicine and The Center for Global Health, University of Chicago, Chicago, IL, USA.
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88
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Wang W, Wang F, Yang C, Wang J, Liang Z, Zhang F, Li P, Zhang L. Associations between heat waves and chronic kidney disease in China: The modifying role of land cover. ENVIRONMENT INTERNATIONAL 2024; 186:108657. [PMID: 38626496 DOI: 10.1016/j.envint.2024.108657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/18/2024]
Abstract
The increasing frequency of heat waves under the global urbanization and climate change background poses elevating risks of chronic kidney disease (CKD). Nevertheless, there has been no evidence on associations between long-term exposures to heat waves and CKD as well as the modifying effects of land cover patterns. Based on a national representative population-based survey on CKD covering 47,086 adults and high spatial resolution datasets on temperature and land cover data, we found that annual days of exposure to heat waves were associated with increased odds of CKD prevalence. For one day/year increases in HW_975_4d (above 97.5 % of annual maximum temperature and lasting for at least 4 consecutive days), the odds ratio (OR) of CKD was 1.14 (95 %CI: 1.12, 1.15). Meanwhile, stronger associations were observed in regions with lower urbanicity [rural: 1.14 (95 %CI: 1.12, 1.16) vs urban: 1.07 (95 %CI: 1.03, 1.11), Pinteraction < 0.001], lower water body coverage [lower: 1.14 (95 %CI: 1.12, 1.16) vs higher: 1.02 (95 %CI: 0.98, 1.05), Pinteraction < 0.001], and lower impervious area coverage [lower: 1.16 (95 %CI: 1.14, 1.18) vs higher: 1.06 (95 %CI: 1.03, 1.10), Pinteraction = 0.008]. In addition, this study found disparities in modifying effects of water bodies and impervious areas in rural and urban settings. In rural regions, the associations between heat waves and CKD prevalence showed a consistent decreasing trend with increases in both proportions of water bodies and impervious areas (Pinteraction < 0.05). Nevertheless, in urban regions, we observed significant effect modification by water bodies, but not by impervious areas. Our study indicates the need for targeted land planning as part of adapting to the kidney impacts of heat waves, with a focus on urbanization in rural regions, as well as water body construction and utilization in both rural and urban regions.
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Affiliation(s)
- Wanzhou Wang
- National Institute of Health Data Science at Peking University, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - Fulin Wang
- National Institute of Health Data Science at Peking University, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking University, Ministry of Education of the People's Republic of China, Beijing, China
| | - Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Feifei Zhang
- National Institute of Health Data Science at Peking University, Beijing 100191, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University, Beijing 100191, China; Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China.
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89
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Baid H. Essential steps towards an environmentally sustainable intensive care unit. Intensive Crit Care Nurs 2024; 81:103621. [PMID: 38219432 DOI: 10.1016/j.iccn.2023.103621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Affiliation(s)
- Heather Baid
- School of Sport and Health Sciences, University of Brighton, Westlain House, Village Way, Falmer, Brighton BN1 9PH, United Kingdom.
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90
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Beggs PJ, Trueck S, Linnenluecke MK, Bambrick H, Capon AG, Hanigan IC, Arriagada NB, Cross TJ, Friel S, Green D, Heenan M, Jay O, Kennard H, Malik A, McMichael C, Stevenson M, Vardoulakis S, Dang TN, Garvey G, Lovett R, Matthews V, Phung D, Woodward AJ, Romanello MB, Zhang Y. The 2023 report of the MJA-Lancet Countdown on health and climate change: sustainability needed in Australia's health care sector. Med J Aust 2024; 220:282-303. [PMID: 38522009 DOI: 10.5694/mja2.52245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 03/25/2024]
Abstract
The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020, 2021 and 2022. It examines five broad domains: health hazards, exposures and impacts; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the sixth report of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Our results highlight the health and economic costs of inaction on health and climate change. A series of major flood events across the four eastern states of Australia in 2022 was the main contributor to insured losses from climate-related catastrophes of $7.168 billion - the highest amount on record. The floods also directly caused 23 deaths and resulted in the displacement of tens of thousands of people. High red meat and processed meat consumption and insufficient consumption of fruit and vegetables accounted for about half of the 87 166 diet-related deaths in Australia in 2021. Correction of this imbalance would both save lives and reduce the heavy carbon footprint associated with meat production. We find signs of progress on health and climate change. Importantly, the Australian Government released Australia's first National Health and Climate Strategy, and the Government of Western Australia is preparing a Health Sector Adaptation Plan. We also find increasing action on, and engagement with, health and climate change at a community level, with the number of electric vehicle sales almost doubling in 2022 compared with 2021, and with a 65% increase in coverage of health and climate change in the media in 2022 compared with 2021. Overall, the urgency of substantial enhancements in Australia's mitigation and adaptation responses to the enormous health and climate change challenge cannot be overstated. Australia's energy system, and its health care sector, currently emit an unreasonable and unjust proportion of greenhouse gases into the atmosphere. As the Lancet Countdown enters its second and most critical phase in the leadup to 2030, the depth and breadth of our assessment of health and climate change will be augmented to increasingly examine Australia in its regional context, and to better measure and track key issues in Australia such as mental health and Aboriginal and Torres Strait Islander health and wellbeing.
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Affiliation(s)
| | | | | | - Hilary Bambrick
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Anthony G Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | | | | | | | | | - Donna Green
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes, UNSW, Sydney, NSW
| | - Maddie Heenan
- Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW
- The George Institute for Global Health, Sydney, NSW
| | - Ollie Jay
- Thermal Ergonomics Laboratory, University of Sydney, Sydney, NSW
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | | | - Mark Stevenson
- Transport, Health and Urban Design (THUD) Research Lab, University of Melbourne, Melbourne, VIC
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tran N Dang
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra, ACT
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Sydney, NSW
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91
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Bradford DRR, Aletta F. UK Public Health Science 2024: a call for abstracts. Lancet 2024; 403:1120-1121. [PMID: 38513678 DOI: 10.1016/s0140-6736(24)00527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Daniel R R Bradford
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8TB, UK.
| | - Francesco Aletta
- Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
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92
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Marchiori GDL, Friel S. Making COP28 rhetoric a reality. Lancet 2024; 403:1005-1007. [PMID: 38367638 DOI: 10.1016/s0140-6736(24)00199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Giorgia Dalla Libera Marchiori
- Planetary Health Equity Hothouse, School of Regulation and Global Governance, The Australian National University, Canberra, ACT 2601, Australia
| | - Sharon Friel
- Planetary Health Equity Hothouse, School of Regulation and Global Governance, The Australian National University, Canberra, ACT 2601, Australia.
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93
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Montgomery H. Final call: Climate change and us. J R Coll Physicians Edinb 2024; 54:101-104. [PMID: 38494727 DOI: 10.1177/14782715241239085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Affiliation(s)
- Hugh Montgomery
- Department of Medicine, University College London, London, UK
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94
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Galozzi P, Sciacovelli L, Basso D. A call-to-action for energy conservation and sustainability in the clinical laboratory: Experiences from the University of Padova. Clin Biochem 2024; 125:110727. [PMID: 38336160 DOI: 10.1016/j.clinbiochem.2024.110727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Healthcare has a considerable environmental impact, yet it has been largely overlooked. Clinical laboratories, in particular, consume significantly more energy and water per unit area compared to standard office buildings. It is crucial to raise awareness among laboratories about the significance of embracing eco-friendly practices. Numerous energy-saving measures do not incur additional costs but necessitate a shift in organizational culture and mindset. DESIGN & METHODS This paper conducts a cost-benefit analysis of energy consumption at the Laboratory Medicine Unit of University Hospital of Padova, beginning with laboratory refrigerators and freezers. RESULTS The need to rationalize the existing units, especially the combined refrigerators-freezers, and reorganize the contents of the Ultra-Low Temperature freezers with an energy-saving perspective has emerged. CONCLUSIONS By implementing these practices, this initiative can gradually expand to encompass more green activities in the future.
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Affiliation(s)
- Paola Galozzi
- Laboratory Medicine Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy.
| | - Laura Sciacovelli
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy.
| | - Daniela Basso
- Laboratory Medicine Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy; Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy.
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95
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Papies EK, Nielsen KS, Soares VA. Health psychology and climate change: time to address humanity's most existential crisis. Health Psychol Rev 2024:1-31. [PMID: 38320578 DOI: 10.1080/17437199.2024.2309242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024]
Abstract
Climate change is an ongoing and escalating health emergency. It threatens the health and wellbeing of billions of people, through extreme weather events, displacement, food insecurity, pathogenic diseases, societal destabilisation, and armed conflict. Climate change dwarfs all other challenges studied by health psychologists. The greenhouse gas emissions driving climate change disproportionately originate from the actions of wealthy populations in the Global North and are tied to excessive energy use and overconsumption driven by the pursuit of economic growth. Addressing this crisis requires significant societal transformations and individual behaviour change. Most of these changes will benefit not only the stability of the climate but will yield significant public health co-benefits. Because of their unique expertise and skills, health psychologists are urgently needed in crafting climate change mitigation responses. We propose specific ways in which health psychologists at all career stages can contribute, within the spheres of research, teaching, and policy making, and within organisations and as private citizens. As health psychologists, we cannot sit back and leave climate change to climate scientists. Climate change is a health emergency that results from human behaviour; hence it is in our power and responsibility to address it.
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Affiliation(s)
- Esther K Papies
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, United Kingdom
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96
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Okada Y, Hughes F, Ong MEH. We need better preparedness and emergency responses to heat waves. CAN J EMERG MED 2024; 26:73-74. [PMID: 38329676 DOI: 10.1007/s43678-024-00648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Affiliation(s)
- Yohei Okada
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Preventive Services, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Fintan Hughes
- Department of Anesthesiology, Duke University Hospital, Durham, USA
| | - Marcus Eng Hock Ong
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
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97
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Stancliffe R, Eling J, Barker J. Climate change is a clear and present danger to health, says UKHSA. BMJ 2024; 384:q66. [PMID: 38228330 DOI: 10.1136/bmj.q66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
| | | | - Jennifer Barker
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
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98
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Marsland R, Staples J. Time for a Focus on Climate Change and Health. Med Anthropol 2024; 43:1-4. [PMID: 38240743 DOI: 10.1080/01459740.2023.2293125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
| | - James Staples
- Department of Social and Political Sciences, Brunel University London, UK
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99
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Pega F, Hamzaoui H, Hassan MN, Momen NC. How can Ministries of Health and Labour add the new indicator on work-related diseases to the monitoring system for the United Nations global goals? INDUSTRIAL HEALTH 2024; 62:153-160. [PMID: 38825506 PMCID: PMC11170086 DOI: 10.2486/indhealth.62_300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Switzerland
| | - Halim Hamzaoui
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Switzerland
| | - Mohd Nasir Hassan
- Department of Healthier Populations and Noncommunicable Diseases, World Health Organization Regional Office for South-East Asia, India
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Switzerland
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100
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Rom WN. Annals of Education: Teaching Climate Change and Global Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:41. [PMID: 38248506 PMCID: PMC10815579 DOI: 10.3390/ijerph21010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024]
Abstract
The climate crisis is a health emergency: breaking temperature records every successive month, increasing mortality from hurricanes/cyclones resulting in >USD150 billion/year in damages, and mounting global loss of life from floods, droughts, and food insecurity. An entire course on climate change and global public health was envisioned, designed for students in public health, and delivered to Masters level students. The course content included the physical science behind global heating, heat waves, extreme weather disasters, arthropod-related diseases, allergies, air pollution epidemiology, melting ice and sea level rise, climate denialism, renewable energy and economics, social cost of carbon, and public policy. The methods included student engagement in presenting two air pollution epidemiological or experimental papers on fossil fuel air pollution. Second, they authored a mid-term paper on a specific topic in the climate crisis facing their locale, e.g., New York City. Third, they focused on a State, evaluating their climate change laws and their plans to harness renewable wind, solar, storage, nuclear, and geothermal energy. Students elsewhere covered regional entities' approach to renewable energy. Fourth, the global impact was presented by student teams presenting a country's nationally determined contribution to the Paris Climate Agreement. Over 200 Master's students completed the course; the participation and feedback demonstrated markedly improved knowledge and evaluation of the course over time.
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Affiliation(s)
- William N Rom
- Department of Global and Environmental Health, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA
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