How we can all protect the health of the planet

The healthcare sector has an important role to play in combatting the climate crisis

I can’t be the only one who is increasingly feeling the growing gnawing dread of environmental anxiety in recent times. Even ignoring the damp squib that was the outcome of the recent COP26 conference, the simultaneous news stories of floods and fires across Europe and North America, or even just the unseasonably mild autumn we’ve been having, would have all but themmost staunch climate change denier realise that we’re definitely in a new phase of climate change and maybe even at a point of no return.

Such anxiety can overwhelm into paralysis. It’s easy to ask why should one person even bother when countries and large corporations are doing the bare minimum. However, it is thought that healthcare contributes to 4 per cent of Ireland’s greenhouse gas emissions alone. Even making small changes in how we do our jobs could have a significant impact on our future. There is now a greater movement in medicine towards green prescribing and the concept of ‘planetary health’. It seems logical that the health of the planet and the health of its people are inextricably linked. Living in a more inhospitable world is, of course, going be detrimental to our health.

As doctors, even something as simple as changing what inhaler we prescribe can make a difference. It is estimated
that the mostly commonly prescribed inhaler in Ireland, the well-known ‘blue inhaler’, Ventolin, with its hydrocarbon emitting spray mechanism releases 28kg of carbon per inhaler per year compared to the new dry powder devices which only release 1kg of carbon. Another push factor is that clinical guidelines are now suggesting that we should
move away from the reliever inhalers alone towards the combination dry powder formulations.

We do, however, also have to consider that the newer inhalers are many times more expensive and can represent a significant cost burden to patients when many have to pay for the full cost of inhalers themselves. If asthma was recognised as a longterm illness, with the subsequent funding of all prescribed medication, such as inhalers, this would be a valuable state intervention that could allow doctors and patients to make better choices for both themselves and the planet, rather than putting all the onus on the individual.

There is also medicine’s contribution to the vast generation of single-use non-recyclable plastic waste. Even an afternoon of administering Covid vaccines generates a bin full-to-bursting with syringe and needle wrappers. It staggers the mind to think of this being replicated across the world as we try to vaccinate ourselves out of this mess. Of course, this is certainly not an argument to not vaccinate against Covid, but we have to consider whether there is anything that can be done to combat this huge amount of waste that goes to landfill. Perhaps consumer pressure can be put on the companies, which make the syringes and needles, to no longer supply them in packaging coated in plastic that makes it impossible for the individual to recycle.

Single-use instruments are used extensively in all healthcare settings and their benefits for convenience and infection control are obvious. However, all that plastic, metal, and packaging that goes into the yellow bin is incinerated, which has clear environmental impacts. Perhaps we should consider going back to the old days of the autoclave machine and reusable instruments where possible.

Maybe we need to examine whether we are careless about throwing things in the expensive yellow clinical waste bins that don’t need to be incinerated or specially disposed. Simple things like making a bigger effort to recycle nonclinical waste in healthcare settings, shredding and recycling paper, turning off lights, and switching off computers completely at the end of the day would seem obvious to a child, but are very easy to do if we make the effort to think of them.

More significant reform on an institutional and organisational level can also be made. If the roasting hot hospitals and nursing homes of Ireland would only turn down theirmheat by a couple of degrees, we would probably get several decades more out of the polar ice caps at least.

There is no one perfect answer or solution to this. But many little changes that seem infinitesimally small in the grand scale of things can make a difference. Yes, we do need the worst emitting countries and corporations to get on board. While we wait for them, rather than giving up, we as individuals can try our best to make a difference and hopefully protect our planet for future generations.