In September, the International Society of Doctors for the Environment (ISDE), Physicians for Social Responsibility and International Physicians for the Prevention of Nuclear War presented a workshop at the UN Department of Public Information in Paris.
Doctors for the Environment Australia (DEA) is a member of ISDE and Graeme Horton, member of DEA Management Committee presented a paper on Climate Change. Below are the summaries of the presentations
Introduction – Cathey E. Falvo, MD–Article 25 of the Universal Declaration of Human Rights addresses the rights to health (a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO)) and emphasizes the special care that is necessary for motherhood and childhood. Health and well being of the population and especially children can not occur in the face of environmental degradation. Environmental health threats come from many sources, some of which will be addressed by the workshop.
Kids and Chemicals – Cathey E. Falvo, MD— Children represent the future of our societies. Thus, protecting their health and environment is critical. Children are in a continuous process of growth and development so that ill effects from environmental exposures may be cumulative and intergenerational, may appear early in life, in adulthood, or in the next generation, and may lead to long-term consequences or disabilities. Effects depend upon toxicity, dose, timing and amount of exposure.
Children are at particular risk because they are growing and differentiating their cells’ functions; eat, drink and breath more per body size than adults because they must meet metabolic growth requirements not just maintenance; are closer to the ground where most environmental toxics are concentrated; put “everything” in their mouth; are for their most critical extra-uterine growth stage at ground level; almost everything that a mother ingests or breaths into her system is passed to the fetus across the placenta; and, almost everything that a mother ingests or breaths into her system is passed to the baby in breast milk. Over 5,000,000 children under 14 years of age die every year from diseases that relate to environmental conditions, mainly in the developing world, and many more are irreparably harmed. For example, an estimated12 million children in developing countries suffer from some form of permanent brain damage from lead poisoning found in gasoline, drinking-water from old pipes, contaminated dust and soil, industrial smelters, battery recycling, ceramic glazes and paint. For each 1 μg/dL increase blood lead level the IQ decreases 0.25–0.5. In a population of 260 million, a five point IQ decrease from lead exposure among children would result in a 57% increase in mentally retarded persons and a loss of some 3.6 million gifted.
Transportation – Hanns Moshammer, MD—Motor vehicle transportation has clearly documented ill effects on health including injury and death, air pollution with both gases and particles which can lead to lung and heart disease, and a significant contribution to climate change. The burden of illness and death from motor vehicles is not uniform. The distribution of motor vehicle pollution in urban areas has an inverse relationship to economic well being; the private vehicles of the well-off as well as the trucks and other vehicles used to transport the goods which create wealth congregate in areas where the poor live and work. Well documented examples of this relationship were shown from London, UK and Vienna, Austria. Likewise noise, another environmental pollutant caused in part by motor vehicles is inversely associated with psychological well being and its effect is enhanced by low birth weight. Further fresh food and sites for physical activity –both helpful in maintaining maximally good health-move to areas of greater wealth where personal motor vehicle is the common form of transportation thus adding the green house gases of climate change which will impact the poor of the world more than the wealthy.
Climate Change – Graeme Horton, MD— My presentation will focus on the educational interventions used by Doctors for the Environment Australia to communicate the health risks of climate change and the strategies which are required to reduce those risks. These interventions have emerged from the membership of DEA and are a result of collaborations with a number of other entities and professional organisations.
In April this year the theme of World Health Day was “Protecting Health from Climate Change” and as part of a World Health day strategy, researchers around the world were encouraged to gather and publish current available information about the health impacts in their countries and communities of climate change so that citizens would be more alert to the need to address this problem and hopefully would persuade policy makers to take the required actions urgently. With the help of Professor Tony McMichael, Director of the National Centre for Epidemiology and Population Health, at The Australian National University, we prepared the Climate Change Health Check 2020 Report for Climate Institute, another NGO with the aim of communicating the importance of climate change. The report summarizes recent research and emphasises expected changes in medical practice: how patients will come to their doctors in future years with illness due to climate change; how health services might best meet community needs; what role the health sector, with particular attention to general practitioners, might play in climate change mitigation. Hopefully the understanding will aid formulation of good pollicy
A poster, distributed to all members of the AMA to be displayed in their waiting rooms, was developed to help focus on some of the health impacts of climate change: heatwaves are expected to increase in frequency and intensity in coming years causing increased heat exhaustion, cramps, heart attacks and strokes; increased risk of bushfires, the health impacts of which include fatalities, injuries and burns, poor air quality resulting in increased presentations with asthma and other respiratory diseases.
A Pilot Educational Intervention for Environmentally Sustainable General Practice was developed. It includes face to face educational meeting and an action kit with suggestions including: install low energy lighting, buy Green power for the clinic, turn off computers and appliances to save energy, use energy efficient refrigerators, aim for a paper free office, reduce car journeys, recycle paper and plastics, buy recycled paper and stationery, save water in the kitchen, bathroom and consulting room, baseline and repeat audit of waste management, energy and water usage.
At the Global Healing Conference convened late last year jointly by DEA , Rural Health West and the Fremantle Hospital and Area health Service health professionals together considered how our health is ultimately dependent on the integrity and wellbeing of our ecosystems. Effective health strategies require collaboration between health professionals and other sectors of the community.
The Director General of WHO has described climate change as the defining issue for public health during this century. According to WHO, health damage from climate change is already happening; already accounts for more than 60,000 deaths globally from climate-related natural disasters every year, along with at least another 100,000 deaths from malaria, malnutrition and child diarrhoea. Climate change threatens to reverse our progress in fighting diseases of poverty. It also threatens to promote war as resources for human survival become more scarce.
War – Cathey E. Falvo, MD—War and militarism affect human rights in many ways. War causes destruction of human life & habitat, of agricultural land & vegetation; has adverse effects on wildlife with possible elimination of species, craters land (breeding ground for malaria/dengue fever-carrying mosquitoes), disrupts entire ecosystems, displaces people causing further problems, and the effects can persist for decades as evident from continuing problems with unexploded ordinance.
The preparation for war and maintaining a military force diverts resources from human needs. A 2004 estimate is that the world spends $1100 billion on maintaining its military – roughly $2.1 billion every day. 1% of this military spending will meet the Millennium Development Goals for sanitation; 5% in anti-poverty programmes over the next decade would create basic social services for the whole world; less than 1% a year for the next decade could educate every child on Earth.
Besides direct dollar spending, the world’s military establishments occupy land, sea and air space and their training, research and development create environmental health damage in many areas: In the former Soviet Union the defence ministry controlled about 420,000 km2, about 2% of land cover. Western Europe estimates are between 1-3% depending on the region. The military is a major consumer of energy with consequent damage to the environment and contribution to climate change: an F-16 jets fuel use in an hour is twice the annual consumption of an average motorist, an F-4 Phantom fighter/bomber uses 6,359 L fuel/hour (supersonic speeds increase fuel consumption by 20 times) and battleships use 10,810 L fuel/hour. Supersonic jets at all heights of flight can cause acute hearing damage, disturbance of intestinal tract and other organs as well as the migration and feeding behaviour of caribou herds. Sonar produces very loud sounds- 235 dB- which can injure, deafen and even kill cetaceans and other marine life.
Waste from nuclear weapons production creates further problems – more than 50 Nagasaki- sized bombs could be manufactured from the waste that has leaked just from Hanford’s (Washington state, USA) underground tanks.
Cathey E. Falvo, MD, MPH – VP for North American, ISDE as representative from Physicians for Social Responsibility (USA), Professor of Public Health Practice and Clinical Pediatrics, New York Medical College (retired) has worked on water and sanitation, heavy metal poisoning and in a variety of international settings.
Dr Graeme Horton – A Senior Lecturer in General Practice at the University of Newcastle, Australia. He holds a Masters degree in Environmental Studies and has published on the links between preventative health advice and environmental sustainability. He is a member of the Management Committee of Doctors for the Environment, Australia.
Hanns Moshammer MD – Environmental health researcher at Medical University of Vienna participated in several international (including WHO and EU) projects on topics including air pollution, road transport, and health impact assessment. Chair of ÄrztInnen für eine gesunde Umwelt (ISDE Austria), president elect of ISDE