Recognizing Increasing Health Threats From Climate Change

If you’ve looked up at the sky in the last few days you may have noticed a yellowish haze. The sunrise and sunset are strikingly orange. And if you’re very attentive to such things, you may even notice a bit of a smoky smell to the air.

The wildfire smoke tainting our air is coming from literally thousands of miles away but the impact is all around us. Today again it isn’t all that safe to be outdoors, especially if you have asthma or other health problems.

Climate change has many health effects, two of which are on my mind today. I love to go running on the trail but when the air quality is like this it doesn’t really matter how many times I hit my asthma inhaler. I also get more calls from patients who have coughs, sore throats, or wonder if they’re coming down with something.

Changing climate patterns have had a dramatic effect on our lives. You can’t really pin any single event on climate change—it’s more the pattern. There are more wildfires, they are happening earlier in the season, lasting longer, and this has measurable effects on public health. For example, during the 2023 Canadian wildfires, US asthma-related emergency room visits went up by 17%. ¹ This is costly in both dollars spent and in human suffering.

Wildfire smoke isn’t the only climate-change driven health problem I see in my practice. As average temperatures rise and winter temperatures become more moderate, the range of Lyme disease-carrying ticks has increased.² Southeast Michigan has historically not been a hot spot for Lyme disease but this could be changing. Lyme cases in Michigan have risen 168% in the last five years. 

Unfortunately, working on climate change won’t necessarily help us with today’s problems.³ For that we will need other strategies. Lyme and other diseases spread by insects and other arthropods are on the rise. ⁴ One of my first summers as an attending physician, I admitted a number of elderly patients with headaches, confusion, and weakness. West Nile Virus was something we had very little experience with and it was pretty frightening. Malaria, dengue fever, and other nasty disease will likely continue to move northward toward America’s largest population centers.

It is vital to fight climate change for our kids and generations to come. But here in the present, we need strategies to mitigate the disaster we’ve wrought. Just as science denialism has helped accelerate climate change, anti-science forces have directly impacted our ability to deal with problems in the here and now.

Over 25 years ago the FDA approved a human vaccine for Lyme disease. It had it’s limitations but it was a great potential tool to prevent Lyme disease, especially in endemic areas like the northeast US. Unfortunately, anti-vaccine activists played a large part in the manufacturer withdrawing the shot from the market.

So we’ve got more bad air and bad bugs. What are some practical things we can do right now? Keep an eye on weather websites for air quality reports. When air quality is bad, try to stay indoors. If you are at high risk for lung problems, an N95 mask may help if you need to be outdoors.

Prevention of tick-borne diseases like Lyme require a bit of work. If you are going to be spending time in sports fields, woods, or hiking trails, make sure you use a good insect repellent (for example any product with 30% DEET); tuck pants into socks if possible and use the repellent on clothes as well as skin. Inspect your skin and your pets for ticks and remove them when found. If you can, keep the tick so that we can see which kind it is. If you have been spending time outdoors and you develop a typical rash, fevers, joint pains, or headaches without any other explanation, see a doctor. Lyme disease is easily treated with antibiotics, especially if caught early.

Science denialism has a direct effect on our health. It’s easy for all of us to fall prey to it. If a science topic happens to intersect with our personal or political beliefs, we are at risk of making bad decisions. In the current highly-polarized media environment there are a couple of strategies that can help you sort scientific truth from fact.

First, be wary of your own biases. If you read or hear something that you immediately agree with, be skeptical. Look for other sources. It’s far too easy to simply accept something if it confirms your own beliefs.

Second, when looking up facts, it is natural to keep looking until you find something that confirms your own beliefs. Don’t do that. Look for the majority expert opinion. You can always find an “expert” to confirm your incorrect belief. Is that expert in sync with other experts? It is very uncomfortable when facts contradict your fundamental beliefs but if you want to understand the world and make choices that improve your life, you need to let in those uncomfortable facts.

This may seem like quite a digression, but science denialism and a tendency to only accept ideas that jibe with your pre-existing beliefs affects my work every day. It prevents at-risk patients from getting needed vaccines. It prevents people with heart disease from taking vital medications. Denialism leads to bad policies and at the individual level kills people.

Stay well.

-pal

1  McArdle CE, Dowling TC, Carey K, et al. Asthma-Associated Emergency Department Visits During the Canadian Wildfire Smoke Episodes — United States, April– August 2023. MMWR Morb Mortal Wkly Rep 2023;72:926–932. DOI: http://dx.doi.org/10.15585/mmwr.mm7234a5

2  Couper LI, MacDonald AJ, Mordecai EA. Impact of prior and projected climate change on US Lyme disease incidence. Glob Chang Biol. 2021 Feb;27(4):738-754. doi: 10.1111/gcb.15435. Epub 2020 Nov 22. PMID: 33150704; PMCID: PMC7855786.

3  Ogden NH, Dumas A, Gachon P, Rafferty E. Estimating the Incidence and Economic Cost of Lyme Disease Cases in Canada in the 21st Century with Projected Climate Change. Environ Health Perspect. 2024 Feb;132(2):27005. doi: 10.1289/EHP13759. Epub 2024 Feb 13. PMID: 38349724; PMCID: PMC10863724.

4  Parums DV. Editorial: Climate Change and the Spread of Vector-Borne Diseases, Including Dengue, Malaria, Lyme Disease, and West Nile Virus Infection. Med Sci Monit. 2024 Jan 1;29:e943546. doi: 10.12659/MSM.943546. PMID: 38161310; PMCID: PMC10768291.

5  Nigrovic LE, Thompson KM. The Lyme vaccine: a cautionary tale. Epidemiol Infect. 2007 Jan;135(1):1-8. doi: 10.1017/S0950268806007096. Epub 2006 Aug 8. PMID: 16893489; PMCID: PMC2870557.