Turbulent times: how to stay healthy in a warmed-up world

The Climate Change Plan for the health sector contains advice on extreme weather events

The idea that the impacts of climate change will only be felt by future generations has been knocked on the head by extreme weather events around the world in the last few years. "We live in the climate change era and we face weather issues daily," says Vladimir Kendrovski of the European Centre for Environment and Health in the World Health Organisation (WHO).

Kendrovski was speaking at the Environment Health and Wellbeing conference in Dublin recently, where Irish health sector plans on how to help people cope with the consequences of climate change were outlined.

With one in four deaths across the world – and one in five in Europe – linked to environmental factors, it's crucial that healthcare workers are prepared to deal with emergencies caused by flash floods, heatwaves and increase in insect-borne diseases such as Lyme disease. Kendrovski pointed out that Dublin is one of the cities in Europe most prone to flooding. But, of course, we know that other Irish cities, Cork in particular, have suffered severe flooding in recent years.

Most people will remember when the 'extra-tropical' Storm Ophelia made landfall over Ireland on October 16th, 2017. There were widespread road closures and flight cancellations. Schools and colleges were closed. HSE appointments, Bus Éireann services and court sittings were cancelled as people were encouraged to stay in their homes. Hundreds of trees were knocked by the storm and three people were killed. Coastal defences were breached in Galway and there was flooding in Limerick. Water treatment and waste water treatment plants were affected in some areas.


Biggest global health threat

The Irish healthcare system’s adaptation plan to deal with climate change, which was published in late October, acknowledges that climate change is the biggest global health threat of the 21st century. And the health effects of climate change will be felt more by the most by vulnerable groups – older people, children, those with pre-existing medical conditions, the urban poor, farmers and coastal populations.

We need appropriate warning systems for climate events which are targeted at those most at risk

For example, people with respiratory and cardiac diseases will see symptoms worsen due to air pollution (from forest fires, increase in mould and fungus due to damper conditions), elderly people are more vulnerable to temperature extremes – cold or hot – and migrants with poor English may have difficulties following health advice during emergencies.

At the launch of the Climate Change Adaptation Plan for the health sector, Minister for Health Simon Harris said that as hospitals quickly become overcrowded during and shortly after climate emergencies, it's crucial that community healthcare teams can manage acute and chronic medical conditions in the home.

Informing the public about what to do to protect themselves from extreme weather events will become essential as flash floods, storms, cold snaps and heatwaves become more frequent. "We need appropriate warning systems for climate events which are targeted at those most at risk," says Prof Patrick Goodman, lecturer in environmental physics at Technological University Dublin and co-author of the 2019 European Academies Science Advisory Council report, The Imperatives of Climate Action to Protect Human Health in Europe.

Goodman says messages on websites won't be enough, as advice on how to cope with extreme weather events will need to reach older people in remote areas. "For example, during heatwaves, people will need specific advice to stay in north-facing rooms and to generate draughts through their houses. In one recent heatwave in France, people suffered from dehydration and then in the following one, they suffered from over-hydration, so precise advice is important. People also need to be aware of the risk of food poisoning in heatwaves."

Sun protection advice

With warmer summers predicted and skin cancer already on the rise in Ireland, more comprehensive sun protection advice will also be needed. The Climate Change Adaptation Plan for the health sector sees a public health heatwave plan in 2020 as an important step to cope with warmer summers.

The first thing that is needed to be done is to extend the smoky coal ban countrywide because air pollution is a bigger killer in Europe than tobacco and cardiac deaths

Speeding up the rate of conversion of heating systems from fossil fuels to renewable energies – particularly in homes of older people – will reduce indoor air pollution and improve the health of those suffering from respiratory conditions.

Tim Collins, chief executive of the Irish Heart Foundation, says there are several health co-benefits from early climate action. "The first thing that is needed to be done is to extend the smoky coal ban countrywide because air pollution is a bigger killer in Europe than tobacco and cardiac deaths," he says.

Collins also says we need to "re-engineer" our cities to remove private vehicles to reduce air pollution. "The Hague in the Netherlands did this in 10 years by reducing the through routes for cars and increasing the through routes for cyclists. Increasing levels of physical activity – when it's built into the daily commute – is a health benefit that comes from this form of climate action."

And, finally, hospitals, community healthcare facilities and emergency service vehicles will also have to be made more resilient to more frequent extreme weather events so the very buildings required to treat people from health related effects of climate change will be able to cope. Planning for emergency deliveries of medical supplies will also be important during climate emergencies.

Preparations needed for climate emergencies

The Climate Change Adaption Plan for Health sets out a number of scenarios in which people will need to prepare themselves to cope during extreme weather events. Here are some examples.

1. People will need to be prepared to use alternative power such as battery lights during power outages. Food will have to be prepared and cooked in advance and warm drinks kept in flasks.

2. Vulnerable older people should make a prior arrangement for a neighbour or public health nurse to visit.

3. A stock of bottled fresh water should be kept in homes where water supplies might be disrupted due to flooding.

4. People using oxygen or dialysis equipment in their homes may need to go to hospital if their equipment becomes damaged due to electricity disruption.

5. Hospitals need to ensure their emergency generators have sufficient alternative fuel to last during a power outage.