As the world grapples with the pressing challenges of climate change and sustainability, it becomes increasingly evident that every sector must play a role in addressing these issues. In this ongoing and urgent conversation, one aspect, often overlooked, is the significant impact of the healthcare sector. While industries like transportation and agriculture are scrutinised for their carbon footprints, the healthcare system's contribution to environmental degradation tends to fade into the background.
However, upon closer inspection, it becomes evident that in every aspect of medicine, from the production and disposal of pharmaceuticals to the carbon footprint of healthcare facilities, medicine's impact on the environment is substantial and multifaceted.
Climate change refers to the long-term alteration of global weather patterns, including shifts in temperature, precipitation and sea levels, largely driven by human activities such as burning fossil fuels and deforestation. Global warming, a subset of climate change, specifically refers to the increase in Earth's average surface temperature due to greenhouse gas emissions trapping heat in the atmosphere. Sustainability, on the other hand, encompasses practices that ensure the well-being of current and future generations by balancing environmental, social and economic considerations. The urgency of addressing climate change and promoting sustainability stems from the profound impact these issues have on ecosystems, human health and societal stability. Rising temperatures lead to more frequent and severe weather events, disruptions in food and water supplies, and the spread of infectious diseases. By adopting sustainable practices, we can mitigate these risks and build a more resilient future for all.
The healthcare industry, a global giant, accounts for approximately 4%-5% of global greenhouse gas emissions, rivalling the output of entire industrialised nations. Energy-intensive practices, from sterilising equipment to powering life-saving machines, coupled with the potent greenhouse gases used in anaesthesia, contribute significantly to this staggering statistic. Furthermore, the medical field generates waste on a colossal scale. Used needles, discarded syringes, mountains of pharmaceutical packaging and countless other medical discards end up in landfills or pollute ecosystems, posing a threat not only to wildlife but also to human health through potential contamination. Water, the very elixir of life, faces its own strain from healthcare's insatiable thirst. Hospitals and clinics consume water at alarming rates, often exceeding the average household by several times, placing a burden on already stressed water resources, particularly in vulnerable regions.
Furthermore, in the fast-paced environment of emergency medicine, energy consumption and waste generation are prevalent concerns. Emergency departments operate round-the-clock, leading to high energy usage. Moreover, the urgency of care often results in the generation of significant medical waste. To address these challenges, emergency departments can implement energy-saving measures such as motion-sensor lighting and HVAC system optimisation. Waste reduction initiatives, including proper segregation of recyclables and hazardous materials, are also essential steps in promoting sustainability within emergency settings.
The realm of primary care and internal medicine is not exempt from environmental considerations. Prescription medications and over-the-counter drugs contribute to pharmaceutical pollution through their production and disposal. Healthcare providers in these specialities can promote evidence-based prescribing practices to reduce unnecessary medication use and educate patients on proper medication disposal methods, such as drug take-back programmes.
In the realm of public health and preventive medicine, environmental considerations intersect with disease prevention and health promotion efforts. Public health programmes require resources for surveillance, vaccination and health education. By incorporating climate change adaptation strategies into public health initiatives and advocating for policies that address the social determinants of health, public health professionals can help build resilience in communities facing climate-related challenges
But the story doesn't end there. Climate change, fuelled by unsustainable practices, throws a boomerang back at human health. Rising temperatures exacerbate heatstroke and respiratory illnesses, extreme weather events disrupt healthcare infrastructure, and changing ecosystems expose populations to new and emerging diseases. This creates a vicious cycle: unsustainable practices worsen climate change, which amplifies health risks, necessitating more healthcare, and so on. Addressing one without the other is like tackling a hydra, futile and ultimately, detrimental.
In conclusion, every medical speciality has a unique role to play in addressing climate change and promoting environmental sustainability within the healthcare sector. By implementing sustainable practices tailored to their respective fields, healthcare professionals can reduce their environmental impact while continuing to provide high-quality care to patients. Collaboration among medical associations, policymakers and environmental organisations is essential to driving systemic change and creating a more sustainable healthcare system for future generations.
So, let's don our stethoscopes and surgical masks, not just to mend broken bones and soothe troubled minds, but also to nurture our precious blue planet back to vibrant health. After all, when it comes to saving lives, every speciality - even environmental medicine - has a vital role to play.
About the authors
Renald Blundell is a biochemist and biotechnologist with a special interest in Natural and Alternative Medicine. He is a professor at the Faculty of Medicine and Surgery, University of Malta
Emma Camilleri is currently a medical student at the University of Malta