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Enviromedics: Our Marble Needs to Stay Blue

The following is an excerpt from the book “Enviromedics: The Impact of Climate Change on Human Health” that was recently published by Rowman & Littlefield.

By Jay Lemery, MD, and Paul Auerbach, MD

As any astronaut who has gazed down during spaceflight can tell us, Earth is a planet of water. But only 1 percent of it is potable for humans, and less than that is safe to drink.

Population growth will increase water demand at least well into the mid-twenty-first century, and climate change will degrade water security through extreme weather events and sea-level rise. In the majority of countries today, existing water supplies are insufficient to meet urban, industrial, agriculture, and environmental needs.
Credit: Chris Johns/National Geographic Creative

The UN World Water Development Report predicts that if increasing water needs grow on the current trajectory, global demand for water will exceed its supply by 40 percent in 2030. Global health efforts have made tremendous progress in the past few decades to reduce disease from waterborne pathogens. However, the assumption has been that we live for the most part in a steady state with regard to waterborne diseases. If these diseases grow tremendously, all bets are off.

Most alteration of water results from human actions. We cannot contaminate and consume water as if we have a limitless supply, because we neither have enough nor have we shown the discipline to enforce its proper use and preservation.

We can only hope that the water insecurity that results from climate change does not significantly add to the burden of illness in an increasingly thirsty world. This is an issue of sufficient importance to require constant surveillance, strictly enforced regulations, and strategies to conserve, purify, and protect every water source on this planet.

Q&A with Paul Auerbach

Credit: Paul Auerbach

What motivated you to write Enviromedics?

In 2008, I wrote an opinion piece in JAMA entitled “Physicians and the Environment.” Dr. Jay Lemery read it and then helped establish the Environmental Council of the Wilderness Medical Society. Next, he edited a multi-authored textbook entitled Global Climate Change and Human Health: From Science to Practice. I suggested that he write a book for laypersons, and he invited me to partner with him. I’m very grateful for the opportunity.

You write that in medicine and the environment, cascading cumulative effects are the rule. What does this mean for human health over the next 10-20 years?

Human health will suffer if we continue to support activities that contribute unnecessarily to climate change. We haven’t posited new diseases – just pointed out that entities such as heat, cold, drowning, and emotional depression are made worse because they are more frequent. The environment interacts with man constantly, and there are many unfortunate episodes of health care erosion during natural disasters. Current events suggest that health is going to increasingly take a hit.

We’ve seen a rise in extreme weather due to “climate energizing.” What types of medical issues do you see as a result of what you call this environmental blender?

When the storms get bigger, floods deeper, and heat hotter, they cause more destruction. The evidence for this is all around us – hurricanes, tornadoes, heat waves. Moisture sucked up from warm oceans enters storm clouds destined to cause trauma from tornadoes, injuries among the homeless and refugees, and feelings of hopelessness on the part of patients, who must learn to handle more frequent deteriorations of existing diseases and disorders. Floodwaters distribute sewage and nasty germs that cause infections. Airborne particles travel with the winds. Climate change as a health threat multiplier is worldwide and relentless.

What are the risks of a warmer world combined with more people living in urban areas along with the rise of global refugee environments?

The risks depend on a number of variables, such as the underlying health status of a person and population, the actual environmental temperature, the ratio of number of persons over a square mile territory counterposed against efforts taken and outcomes achieved. Refugee situations magnify infirmities, spread infectious diseases, and are a constant threat to public health. Furthermore, they’re a setting for conflict, which worsens everything.

Rowman & Littlefield

Earth will survive climate change, but what is the prognosis for the next couple of human generations?

The next generation will see acceleration of data collection and bonafide climate science, and so information should improve from there. However, until such time as we demonstrate that we have the will and methods to halt excessive greenhouse gasses accumulation, the assumption should be that all the diseases we encounter could possibly be worsened by adverse environmental situations, in particular climate change and pollution.

Humans have proven to be a highly-adaptive species. Can we simply learn to live with many of these environmental changes? 

Geoengineering might one day offer reasonable solutions to specific erosion of assets and elimination of species, but it’s not there yet and highly theoretical. We’ll have choices about where and how to live, but without significant resolve and financial support, we may have a very rough existence approaching. Humans will live with what they can tolerate or are forced to accept. We are nowhere near managing our planet in the best interests of its inhabitants.

What three things would you like to see each of us do to align human well-being with our home planet?

We should thoroughly understand the current state and contentions of climate science, and continuously improve upon it. We should be willing to answer any and all medical questions related to climate change. Finally, we need to get to the point that we’re bold enough to preserve what we have and show little tolerance for bad environmental behavior.

Credit: Paul Auerbach (left) and Jay Lemery

Jay Lemery, MD, is Associate Professor of Emergency Medicine at the University of Colorado School of Medicine, Chief of the Section of Wilderness and Environmental Medicine, and an Affiliate Faculty Member of the Colorado School of Public Health. He is a past-President of the Wilderness Medical Society and has provided medical direction to health care providers operating at both poles, most recently serving as the EMS Medical Director for the U.S. Antarctic Program.

Paul Auerbach, MD, is the Redlich Family Professor in the Department of Emergency Medicine at the Stanford University School of Medicine, and Adjunct Professor of Military/Emergency Medicine at the F. Edward Hébert School of Medicine of the Uniformed Services University of the Health Sciences. He is a founder and past-President of the Wilderness Medical Society and elected member of the Council on Foreign Relations. Dr. Auerbach is Editor of the Definitive Textbook Wilderness Medicine and author of Field Guide To Wilderness Medicine And Medicine For The Outdoors. He was the founding Co-Editor of the Journal Wilderness & Environmental Medicine and is one of the world’s leading experts in wilderness medicine and emergency medicine.

Thursday: Wildfire

Enviromedics is available at Amazon, Barnes & Noble and Books, Inc.