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ENVIRONMENTAL CHANGE CLINICAL PRESENTATION CLINICAL TREATMENT AND PREVENTION PUBLIC HEALTH INTERVENTIONS Heat More cases of heat exhaustion and life-threatening heatstroke Recognize and treat in office and in ED Counsel high-risk patients, including those at risk owing to their age (eg, children, the elderly); those with chronic diseases (eg, cardiorespiratory conditions, diabetes, CKD, Parkinson disease); those who take medications that impair the body’s physiologic adaptation to heat (eg, antihistamines, diuretics, psychiatric medications, anticholinergics); those who display social isolation or live in poor housing conditions (eg, no air conditioning, poor ventilation, top-floor rooms); homeless people; outdoor workers; and those who exercise vigorously22 Heat health alert programs22 Extreme weather events Intense rainstorms and floods, causing direct injuries and contamination of water supplies Treat injuries
Treat PTSD
Participate in emergency response teamsInfrastructure repair; maintain clean water supplies
Emergency responseIncrease in air pollution, especially ground-level ozone Exacerbation of asthma, COPD, and cardiac disease Treat exacerbations
Counsel at-risk patients to reduce exposure by following the AQHIAQHI program Air pollution from more frequent forest fires due to drying of the forests and increased damage to forests by the western pine beetle Forest fires are a direct threat to communities
Wood smoke has been shown to lead to increased ED visits for respiratory problems23Treat respiratory cases Fire alerts
AQHI programRagweed and other allergenic plants grow faster and produce more pollen with warmer temperatures Increased incidence of allergic rhinitis Treat allergic rhinitis NA Extension of the range of Lyme disease as warmer temperatures are conducive to survival of the tick vector farther north24 More cases of Lyme disease Diagnose and treat primary Lyme disease with doxycycline (typical “target” rash of erythema migrans)
Participate in surveillancePublic education programs for safe hiking in the bush and tick recognition and removal
Surveillance programsIncreased air and water temperatures improve survival of pathogens; heavy rainfall and flooding facilitate transport of pathogens into drinking water supply Increased incidence of water-borne and food-borne diseases17 Diagnose and treat disease
Participate in surveillanceManage water run-off after heavy precipitation
Monitor safety of drinking waterClimate changes provide optimal conditions for fungal spore elaboration and survival Invasive fungal disease (eg, Cryptococcus gattii in British Columbia25) Diagnose and treat disease
Participate in surveillanceSurveillance programs Extension northward of the range of dengue and malaria, in Latin America, the Caribbean, Asia, and Africa, affecting returning travelers (eg, malaria in some Caribbean vacation destinations)17 More cases of malaria and dengue in returning travelers Be aware of these diseases and treat
Provide appropriate advice to travelers before departurePublic education for travelers Social and economic effects in resource-based communities affected by climate change (eg, fishing, farming, and forestry communities) Increased social and economic distress (owing to unemployment in affected communities) Manage increased individual and family stress Increased socioeconomic support Climate effects in northern communities (eg, ice instability, redistribution and reduced accessibility of wildlife, reduced availability of fresh water)7 Increased accidents, food insecurity, increased water-borne infections, sociocultural disruption due to reduction of traditional or country foods18 Recognize diseases
Support already-stressed communitiesIncreased public health support to already-vulnerable communities -
AQHI—Air Quality Health Index, CKD—chronic kidney disease, COPD—chronic obstructive pulmonary disease, ED—emergency department, NA—not available, PTSD—posttraumatic stress disorder.
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Additional Files
CFPlus Additional Information
This data supplement contains Figures 1 and 2 from the Commentary on Climate Change.
Files in this Data Supplement:
