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Dermatologists’ role critical in depoliticizing climate change

Dermatologists can help reduce the carbon footprint in their communities and practices by joining efforts to broaden awareness of the health consequences of “the single greatest public health challenge of our lifetime,” according to a viewpoint published in JAMA Dermatology.

Climate change is a “solvable problem, and physicians have a critical role to play in depoliticizing the issue and encouraging solutions,” Sarah J. Coates, MD, from the department of dermatology, University of California, San Francisco, and colleagues wrote.

The U.N. Intergovernmental Panel on Climate Change (IPCC) released its landmark special report in October 2018, from 91 authors in 40 countries.

The report explained the effects of a 1°C increase in the average global temperature that started with the Industrial Revolution, and also warned “that limiting further warming to only 1.5°C will require rapid, expansive and unprecedented changes to human behavior by 2030,” the viewpoint authors wrote.

“Unfortunately, the ongoing politicization of climate change makes it challenging to take necessary actions,” they continued.

Dermatologists must become versed in ways climate change threatens patients, practices and well-being, Coates and colleagues argued. A growing body of literature brings attention to the effects of climate change on the geographic range of cutaneous infections. For example, coccidioidomycosis, previously restricted to the American Southwest, has been reported as far north as Washington, they wrote.

Other studies link spikes in temperature and/or humidity with a rise in hand, foot and mouth disease cases.

According to the authors, additional expanding vector-borne infections include Lyme disease, murine typhus and the viruses transmitted by the Aedes aegypti mosquito vector, including dengue, chikungunya and Zika. “Dermatologists will be critical to their diagnoses, but this may require additional training,” they wrote.

Climate change will also affect inflammatory and neoplastic skin conditions.

Atopic dermatitis flares can be triggered from environmental pollutants from fossil fuel emissions and wildfires.

In California, after a large wildfire, San Francisco, Stockton and Sacramento became the most polluted cities in the world for several days, they wrote.

“With many hospitals in Northern California operating at full capacity during recent wildfires, these events illustrate the vulnerability of the health care system’s response to prolonged and extreme environmental disasters,” the authors wrote.

Furthermore, pollutants lead to oxidative damage to the skin and when combined with higher temperatures that affect sunlight exposure and UV-protective behaviors, contribute to skin aging and cancer, they wrote.

Coates and colleagues suggest a greater reliance on telecommunication for professional education and networking, the provision of central locations and/or remote interviewing modalities in group residency and fellowship interviews as potential strategies to adopting wise practices to reduce one’s carbon footprint.

Recently, AMA announced it is divesting from companies that obtain most of their income from extracting and refining fossil fuels, the authors wrote.

In addition, they wrote, American Academy of Dermatology members and dermatology residents are encouraged to join the newly formed Climate Change and Environmental Affairs Expert Resource Group, which seeks to raise awareness and take collective action.

Additionally, The AAD recently joined the Medical Society Consortium on Climate and Health, which brings together 21 medical societies, and dermatologists may join the consortium as individual advocates.

“A comprehensive response to climate change is perhaps the single greatest public health challenge of our lifetime. This is a solvable problem and physicians have a critical role to play in depoliticizing the issue and encouraging solutions,” they concluded. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.