Dermatologists can no longer be climate change ‘bystanders’: experts

Dermatologists are being urged to take a leading role in tackling anthropogenic climate change, with experts arguing there are major opportunities for the specialty to reduce emissions.

A recent perspective for the British Journal of Dermatology [link here] has also made the case for why the specialty has a particular obligation to fight global warming, given the predicted impact of climate change on dermatological conditions including atopic dermatitis, autoimmune bullous diseases and infections.

Despite this, dermatology had been largely absent from global health campaigns on the topic, wrote Dr Eva Rawlings Parker of Vanderbilt University Medical Centre and Dr Markus Boos of the University of Washington School of Medicine.

They pointed to the campaign run last year by the major medical journals calling for emergency action to limit global temperature rises.

Some 233 journals took part by publishing the same editorial on mass, but none represented the specialty of dermatology, the pair pointed out.

“Dermatology can no longer be complicit, nor a bystander,” they wrote (link here).

“We must engage more meaningfully on key climate issues, moving beyond merely discussing skin-related impacts of climate change.”

Quoting from the 2019 Lancet Countdown on health and climate change, they said healthcare was among the most carbon intensive sectors globally – contributing to 4.6% of total global greenhouse gas emissions.

Only a fraction of this was caused by dermatology, but there was still scope for action by the speciality both on a systems level and in decisions around day-to-day care, the perspective said.

“Commissioning of buildings, proper waste stream segregation, recycling of common use items and appropriate reprocessing of single-use medical devices are critical sustainability milestones to reduce health systems’ contributions to GHG emissions,” the authors wrote.

“However, everyday practice can also have a major impact on decarbonisation. Significant reductions in carbon emissions are readily achieved in dermatology by increased utilisation of telehealth services, as demonstrated for isotretinoin follow-up visits.”

They suggested there were many other conditions in which follow-up could reasonably conducted via telehealth including rosacea, actinic keratosis field treatment, biologic monitoring in well-controlled disease, and postoperative wound checks.

The specialty’s carbon footprint could be further reduced by holding medical meetings virtually and even conducting residency interviews via teleconference, they added.

“These straightforward steps toward decarbonisation also offer tangible time and cost co-benefits to patients and doctors alike, including less time taken off from work and reduced reliance on childcare.”

“Moreover, given that dermatologists often have longitudinal relationships with patients, our profession is poised to enhance the climate literacy of patients: dermatologists can teach patients about their vulnerabilities, educating on prevention strategies such as donning sun- and heat-protective clothing and utilisation of apps for heat, air quality and UV indices to plan outdoor activities.”

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