Reducing Medical Sector Carbon Emissions Could Save Many Lives

By Becky Gillette

The changing climate disrupts human health in some ways that are obvious and others
that are not, said Victor Dzau, MD, president of the National Academy of Medicine at
Duke University, who spoke March 30 at the University of Arkansas for Medical
Sciences as part of the Richard and Ellen Sandor Lecture series.

Climate disruption is causing human disease, suffering and death.

“That is not a well-known thing,” Dzau said. “If the public knew this, we would act much
faster. Globally 20 million people die in climate-related events each year. That is more
than deaths from COVID. Some investigators have shown the amount of harm done by
carbon emissions from the health sector is almost more than the harm done by medical
errors.”

Dzau said some ways climate affects human health are obvious such as extreme weather
including hurricanes, tornadoes, forest fires, dangerous heat and cold, flooding and
droughts. Less obvious are impacts such as forest fires that can cause air pollution
resulting in respiratory and cardiovascular diseases, impacts on food availability causing
famine and warmer temperatures increasing the geographic range of insects such as
mosquitoes and ticks that are vectors of disease. Storms that destroy people’s homes
and livelihoods can lead to not just physical but mental problems.

“Climate affects human health in a big way,” Dzau said. “It is a public health crisis. The
problem is now. Most people don’t know that. It is also about our future generations.
Several hundred thousand people die each year from air pollution alone. People in
poorer areas suffer the most and are the least able to adapt.

“Rural areas are very much dependent on natural resources. Crop production is affected
by severe drought and flooding that can shift planting and harvesting times. Losses from
fire affect the natural resources people depend upon. The U.S. is experiencing increasing
rates of climate disasters. Large disaster events are hitting the U.S. a lot more
frequently.”

His lecture called, “Climate, Health and Equity: The Case for Collective Action from the
Health System,” noted that a surprising amount of the carbon emissions leading to
climate disruptions come from the healthcare sector.

“Healthcare as a sector emits 8.5 percent of carbon emissions,” Dzau said. “It is huge. To
break it down, about 20 to 30 percent of emissions are from clinics and hospitals, and
70 percent is related to supplies including pharmaceutical products, medical equipment
and personal protective equipment. We need to bring together physicians, nurses,
hospitals, pharmaceutical companies and others involved in the healthcare supply chain
to work on ways to reduce carbon emissions. We need a collaborative effort to
decarbonize the U.S. health sector. It is a bold project, but we are working on it.”

Dzau advocates activating the entire biomedical community, driving changes through
research, innovation and policy, and educating the public about climate change and
health. Yet many hospitals in Arkansas and other states, particularly those in rural
areas, are under tremendous financial pressure right now.

Dzau said while the task is not easy, collective efforts can help make the necessary shifts.
“First of all, hospitals need a lot more funding to be sure they are effective and have
enough physicians and other healthcare workers,” Dzau said. “Hospitals need to look at
the way buildings are constructed, heated and cooled. Anesthesia products emit a lot of
greenhouse gasses. We need to focus on waste reduction. Look at the huge amount of
waste from disposable gowns, masks and gloves. More and more people are wondering
if we can sterilize and reuse them.”

Another potential is greater use of telemedicine avoiding the energy used to transport
patients—especially those who live a long distance away--to a hospital or clinic. With the
use of telehealth during the pandemic, carbon emissions went down.

“Telehealth is more convenient for patients and allows them to be cared for closer to
home,” Dzau said. “We can also focus more on prevention instead of treatment of
disease. A combination of these things can also help the hospitals in being more cost
effective.”

With shortages of healthcare providers, how can they be expected to take on the
additional role of educating patients about climate change? But Dzau sees it as a
continuation of the messages advising patients to eat right, exercise, control blood
pressure, avoid smoking, drink alcohol moderately if at all and control chronic disease
like diabetes.

“To be healthy, you need a better environment,” Dzau said. “You need to be aware of the
environment you live in and breathe in. As a healthcare provider, part of the Hippocratic
Oath is to reduce suffering and make patients healthier. We aren’t asking health workers
to do something that they don’t care about. They care about what people eat and drink,
and the environment that is very much affecting their health. They can provide
education so people can be more mindful about what climate change is doing fo all of us.
We are all culprits; we should all be part of the solution to reduce carbon emissions.”
Dzau argues that understanding climate change will make people better doctors and
nurses.

“It is important to know that healthcare providers can do something about it and
prevent more people from dying from climate disasters,” Dzau said. “Doctors and nurses
can reduce carbon emissions by reducing the waste being generated, changing to more
telehealth, reducing wasteful chemicals and being more efficient with the use of energy.
Being able to reduce carbon emissions while providing better care is a win-win for
everybody.”