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These Irish doctors are available to help with the environment
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These Irish doctors are available to help with the environment

Dr Rachel MacCann, at St Vincent's hospital . Photograph Moya Nolan

The World Health Organisation (WHO) declared climate change the biggest health threat facing humanity in its last month. It warned that global climate change would lead to increasing mental and physical health problems.

Already, the signs are there. A 2018 Belgian studyThe positive correlation between temperatures rising above 21C, and admissions to emergency departments was found. This confirmed the findings of a French study in 2003 that looked at data from 16 European nations and found a positive relationship between temperatures rising above 21C and admissions to emergency rooms.

Other factors can also impact our health, such as the quality of the environment. A WHO report 2021Air pollution is believed to be responsible for 13 deaths per minute due to the exacerbation of conditions such as heart disease, lung cancer, stroke, and heart disease.

The Environmental Protection Agency has linked air pollution to an annual 1,300 premature deathsin Ireland.

Four doctors became so concerned about the impact of climate change on their health in 2018, they founded Irish Doctors for the Environment. The charity now has almost 400 members, including students and healthcare professionals.

Dr Aoife Kirk says that climate change is irrevocably linked to human health. As doctors, we see it as our responsibility to raise awareness and take action on environmental health issues. We also encourage patients and clinicians to do the same.

Kirk is a doctor in internal medicine at Dublin’s Mater Hospital. Two founding members of IDE are her and Dr Rachel MacCann. Rachel is a specialist registrar in infectious disease at St Vincents Hospital, Dublin.

MacCann states that it is easy to assume that climate change doesn’t affect Ireland. Take Covid-19, for example. Although it didn’t start here, the interconnected world meant that it affected us all and put immense pressure on our healthcare system.

Kirk lists possible Irish health problems. We’ve known for a long time about the importance of air quality in our respiratory and cardiovascular systems. But now we know more about its role as a factor in other health conditions.

A review of research from Australia and Britain in 2019 showed that dementia risk was increased by airborne pollutants. 2021Vital Strategies is a global public-health organisationIt was found that children suffering from air pollution are more likely to suffer permanent cognitive and physical disabilities.

Kirk says floods and other extreme weather conditions are another risk factor. They will become more frequent. Will the HSE be able handle that extra pressure?

There is also a risk that viruses may increase in the heat. A 2021 London School of Hygiene and Tropical MedicineThe conclusion was that an additional 4.7 billion people could be in danger of getting malaria or other mosquito-borne diseases by 2070.

Starting from the bottom

 Dr Rachel MacCann, at St Vincent's hospital . Photograph Moya Nolan

Dr Rachel MacCann at St Vincent’s Hospital. Photograph Moya Nolan

These looming threats are being addressed by IDE in a variety ways. MacCann says, “We were working from bottom up to educate healthcare workers on the health consequences of the climate crisis.” We also wanted to have an impact on policymaking from above. We have submitted to local councils, HSE working group and the Government regarding issues ranging from the introduction of a climate action plan for healthcare to ongoing discussions about the turf ban.

Kirk highlights the ongoing efforts of IDE to encourage cities and towns to promote active travel as an option to driving. This included a campaign in 2020 to create cycle lanes linking Cork University Hospital with Bon Secours Cork and Mercy University Hospital.

She believes that this campaign demonstrates how interconnected human and planet health can be. She says that reducing motorized travel reduces carbon emissions, increases physical activity, and lowers our risk for respiratory diseases, heart disease, diabetes, and some cancers.

While they wait for government policies to be implemented in their countries, IDE members are already working on an individual basis to effect change in their hospitals.

MacCann, for instance, has established a Green Network Committee in St Vincents. These committees promote sustainable practices in hospital settings. Her committee A project to recycle the 4.4 million inhalers used in Ireland each year has been established. An audit of the endoscopy unit revealed that 70% of the waste could be recycled.

Another strand of IDE focuses upon reducing carbon emissions from the healthcare system. Kirk reports that 4.4% global carbon emissions are due to healthcare, according to a report from Healthcare without Harm. It accounts for 9.7% in Ireland.

Ana Rakovac, a consultant chemical pathologist at Tallaght University Hospital, is the chair of IDEs Sustainable Healthcare Working Group, which is looking for ways to improve.

Rakovac states that energy is responsible for 10% of this carbon footprint. Switching to renewable energy for electricity and healthcare is a good idea for hospitals and other healthcare facilities.

Procurement accounts for 60% in the sector’s energy emissions. Rakovac wants to see HSE use its vast buying power to influence suppliers to adopt sustainable policies.

The HSE is currently creating a national steering body on sustainability in healthcare. She hopes it will establish national sustainability procurement criteria. This will ensure that sustainability is a deciding factor in any project that goes out for tender.

Rakovac’s main goal as chair of the sustainable health care working group is to create a professional umbrella organization to guide the healthcare sector in a more sustainable way.

She says that we can’t continue to ask medical professionals who are already very busy to give more of their time. This must be done at the official level.

Rakovac is especially interested in the effects of plastics on human health. In 2008, I attended the Endocrine Society’s meeting. It was shocking to learn about the endocrine disrupting chemicals in plastics and their effects on health. They can increase the risk of developing breast and prostate cancers, as well as obesity and reduce fertility.

This is why she joined IDE. She said that I initially wanted my medical knowledge to help the cause to ban plastic. However, as I got more involved, it became clear that climate action is needed in many other ways.

Anaesthesiology, carbon emissions

Dr. Ola Lkken Nordrum in Galway. Photo: Ray Ryan

Dr. Ola Lkken Nordrum in Galway. Photo: Ray Ryan

Galway University Hospital anaesthesiology trainee Dr Ola Klken Nordrum. He is the leader of the sustainable anaesthesiology group and is driven by the desire for environmental improvements in his field of medicine.

Nordrum states that anaesthesia has a unique role in healthcare’s carbon emissions. We aim to reduce the amount of anaesthetic gases we use, which are hundreds or thousands times more potent that CO2, and we do so by using anaesthetic chemicals.

He mentions a recent initiative by the NHS to collect Entonox, which is used as pain relief during labor. He says it is better than the Irish policy that releases it into the atmosphere.

Education is essential. Nordrum states that anesthesiologists must be aware of the fact that certain gases contribute more to greenhouse gas emissions than others. This should influence their choices.

This is a area where there are significant improvements. Nordrum hails recent establishment of the College of Anaesthesiology’s sustainability committee as a significant step in the right directions.

Nordrum is also involved with the IDEs campaign to include the climate change in the medical curriculum. 2020 StudyHe claims that only 15% percent of international medical schools have included the link between climate and health in their curriculum. We are lobbying the Irish Medical Organisation and Irish medical schools to change this. A changing environment requires a new medical curriculum.

IDE collaborates with international groups to bring about change on a global level. It is affiliated with the Planetary Health Alliance and Healthcare Without Harm, Global Green and Healthy Hospitals, and WONCA Working Part of Environment, which are European societies for GPs.

It is also receiving support from the medical profession.

MacCann states that people didn’t understand what to make of us in the beginning.

Lancet Countdown Reports now monitors the
The health effects of climate change on health are becoming more concerning. There is a growing need for information about the connections between environment and health and how to improve both.

The pandemic presented a new challenge to medics. Kirk says that while we were grateful to have PPE in place of so many of their colleagues around the globe, so much of it was disposable. It is necessary to continue research and develop sustainable methods. There must be another way.

IDE is committed to finding the best way. Kirk says that we work together as a team to effect positive change. The environment is becoming more dangerous than ever, and so is the human health. We want to find and implement more sustainable ways of doing things that will benefit both the planet’s health and its inhabitants.

Here are some ways to reduce carbon footprint

Ana Rakovac is a consultant chemical pathologist at Tallaght University Hospital

Ana Rakovac works as a consultant chemical pathologist in Tallaght University Hospital.

Small changes can have a positive effect on our environment as well as our health. Dr Ana Rakovac says that generally, what is good to you is also good for the planet. Here are some tips by Irish Doctors for the Environment.

1. When possible, choose walking or cycling over driving. It will reduce carbon emissions and help to burn more calories. This has many benefits for your mental and physical health.

2. Reduce your meat intake and eat more vegetables. A 2021 study was published in NatureA 2019 study by the University of California at Berkeley found that meat emitted twice as much greenhouse gas emissions to the atmosphere than plant-based food. Journal
American Heart FoundationThe risk of developing cardiovascular conditions like stroke, heart attack, and/or heart failure was reduced by 16% when you eat more vegetables than meat.

3. Switch to a sustainable energy provider

4. Ask yourself if there are alternatives to burning solid fuel in the home. Rakovac states that solid fuels contribute to air pollution by introducing particles into the house and the surrounding environment.

5. Reduce your plastic use. Avoid plastic packaging of fruit, vegetables and meat.

6. You should choose quality, long-lasting clothing over fast fashion that you may only wear once before it needs to be thrown out.

7. When possible, advocate for greener policies. Consider encouraging colleagues to bring in their own cups to replace disposable or plastic cups used in the workplace.

8. Talk to your family and friends. Dr Aoife Kirk’s parents didn’t care about the environment until she began to discuss it at the dinner table. She claims that they now eat far fewer meats and recycle far more.

9. For local politicians to prioritize the environment, you should exert pressure. Rakovac says it is the most pressing issue of our times. Our grandchildren will live a harsher life than us if we don’t do something. Ask candidates what they plan to do about it. This is not about party politics. It is about survival.

10. Sign up for the IDEs monthly newsletter or join a group. It includes tips for behavior change and activities that you can join across the country. Kirk says it is easy to feel paralysed when faced with a challenge such as climate change. This can be helped by working with others and small changes. Even small changes can have a huge impact.

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