Introduction:
Climate change negatively affects health as it brings about challenges related to infectious diseases, compromised water quality, and disruptions in food availability. The global temperature has increased by 1.2 degrees Celsius since pre-industrial times, with the past seven years being the hottest on record. Projections denote an increase of 2.4 degrees Celsius in the next 70 to 80 years. Despite a temporary decline in greenhouse gas emissions during the COVID-19 pandemic, post-pandemic recovery is predicted to result in a rebound, with emissions surpassing a 5 percent increase. From 2030 to 2050, cautious projections indicate that the consequences of climate change, such as infectious diseases, heat stress, and malnutrition, may result in an annual surplus of 250,000 deaths.
Who Is Affected by Climate Change Often?
Regrettably, the negative effects of climate change on health disproportionately affect vulnerable populations, including children and older adults, and individuals facing social inequalities globally. Children are especially prone to gastrointestinal diseases, while seniors with comorbidities and reduced resilience are more vulnerable to extreme temperatures and compromised air quality. Those with lower socioeconomic status often reside in areas prone to flooding, heavy pollution, and limited access to sanitation and clean water, increasing their risk of homelessness. Emergency medicine (EM) stands at the forefront and is highly susceptible to substantial impacts arising from these challenges.
How Does Climate Change Impact Emergency Medicine?
Health is fundamental to overall well-being, happiness, and quality of life. Numerous factors contribute to an individual’s health, including gender, race, age, and even geographical location. Following are some of the climate changes affecting health:
1. Heat Waves: Heat waves contribute to increased rates of mortality and morbidity by causing environmental illnesses such as dehydration and heat stroke. Furthermore, heat waves are linked with an increased number of emergency department visits for various physical health ailments, including stroke, ischemic heart disease (damaged heart’s major blood vessels due to plaque build-up), dehydration, presyncope (also known as near-syncope in which a person feels they are about to faint), and renal failure.
The physiologic mechanisms underlying these relationships are complicated and not completely understood. The impact on the cardiovascular system is believed to be linked to the strain induced by heat on the thermoregulation system, resulting in inflammation, vasodilation (blood vessels widening), coagulopathy (a blood clotting impairment), and alterations in heart and respiratory rates. Furthermore, heat events exacerbate mental health conditions.
2. Air Pollution: Presently, ambient air pollutants are associated with 3.3 million annual global deaths, and their atmospheric concentrations are on the rise. The increasing temperatures and diminished precipitation are additionally contributing to more frequent wildfires, significantly heightening nearby air pollutant levels by a factor of 10. Airborne pollutants exhibit diverse respiratory effects. For example, ozone acts as a pulmonary irritant, directly leading to an increase in emergency department visits for chronic obstructive pulmonary disease (a disease affecting airflow causing difficulty breathing) and asthma exacerbations (a progressive increase in asthma symptoms).
Conversely, fine particulate matter settles in the alveoli and is associated with an increased mortality rate. The conjunction of warmer temperatures and increased atmospheric CO2 (carbon dioxide) levels may also enhance the volume and dispersion of pollen, resulting in a heightened number of emergency department visits for allergic rhinitis (allergic reaction causing sneezing and itchy, watery eyes) and asthma. Despite the excellence of emergency physicians in handling acute respiratory conditions, these effects will exacerbate the already substantial demands placed on EDs nationwide.
3. Insect and Tick-Related Disorders: Rising warm temperatures have expanded the geographical range where ticks can live. Ticks are known carriers of Lyme disease (tick-borne illness caused by Borrelia burgdorferi resulting in joint pain), and if not treated completely, Lyme disease can result in long-term illness. Moreover, warm temperatures have created favorable conditions for the growth of mosquitoes. Factors such as mild winters, which can become more frequent due to climate change, have been linked with outbreaks of West Nile virus (causative agent of West Nile fever resulting in neurological disease and death), among other factors affecting its transmission.
4. Natural Disasters:
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The emission of greenhouse gasses traps heat in the earth's atmosphere, leading to a rise in the intensity and frequency of extreme weather events.
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Throughout a span of six months in 2020, 84 disasters, including floods, storms, and droughts, affected 51.6 million people globally.
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In the future, the growing occurrence of natural disasters is expected to result in more mass-casualty events, primarily addressed by pre-hospital and emergency medicine services.
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Natural disasters have numerous impacts on emergency medicine. Primary hazards comprise trauma resulting from storm-related debris, drowning incidents, burns due to wildfires, and hypothermia (a dangerous drop in body temperature) associated with floods.
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Also, these can potentially harm the hospital buildings, and there can be disruptions to power and supply chains.
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This scenario can quickly aggravate local emergency departments, preventing them from managing their patients.
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As patients either face isolation or are compelled to evacuate, there is a concurrent rise in motor vehicle collisions, instances of food and water-borne diseases, and exacerbations of chronic diseases stemming from reduced access to medications and primary care.
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Also, after the event resolves, there can be post-traumatic stress (a psychological problem in which the affected individuals fail to recover from a terrifying event that has already happened) related to their life experiences.
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Emergency medicine physicians can assume an important role in readiness for such events by advocating for their hospitals and communities to assess local risks linked with specific natural calamities.
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Promoting the use of thorough disaster management and strong plans is vital for improving preparedness and response capabilities.
Conclusion:
Climate change has a broad impact on people's health as the climate undergoes alterations. Increasingly, individuals may face exposure to extreme weather events such as floods, heatwaves, storms, droughts, and wildfires. The worsening climate crisis is already significantly affecting emergency departments worldwide. This situation can worsen in nature. Therefore, preventive measures like disaster preparedness should be made to mitigate the risks associated with climate change. Additionally, the potential increase in childhood exposure to pollution and malnutrition may increase susceptibility to chronic diseases, leading to a long-term rise in emergency department presentations.
