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Chapter 49: Climate Change and Worker Health: Implications for Clinical Practice

Cecilia J. Sorensen; Margaret Cook-Shimanek; Lee S. Newman

INTRODUCTION

There is unambiguous scientific evidence that climate change is occurring and widespread scientific consensus that climate change is anthropogenic. In recent years, global climate change has resulted in increased frequency and intensity of adverse weather events including heat waves, droughts, wildfires, extreme weather events, and flooding. These events have affected all regions of the United States, resulting in economic costs in the billions of dollars and extensive health impacts that are projected to increase if environmental changes continue to occur with under-mitigated carbon release.

Climate change results from a process whereby increased production of carbon dioxide (CO2), and other greenhouse gases (GHGs), leads to increased retention of heat energy in the planet’s atmosphere and oceans. Trapped heat as well as increasing CO2 result in a series of environmental changes including increased ambient temperatures, heavier and more variable precipitation, warmer oceans, increased frequency and intensity of extreme weather, melting of land-based snow and ice, ocean acidification, and a rise in sea level. These environmental changes drive exposure pathways (eg, extreme heat) (Table 49–1) that in turn have significant impacts on worker’s physical, mental, and community health (Figure 49–1).

Figure 49–1.

Medical and physical health, mental health, and community consequences of climate change.

An illustration depicts the consequences of climate change to mental and physical health and the community.
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Table 49–1.Impacts of climate change on worker health.
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Table 49–1. Impacts of climate change on worker health.
Exposure Pathway Description Health Effect At-risk Occupational Groups
Extreme heat Increasing frequency of extreme heat events and rising average seasonal temperatures Heat illness, exacerbation of underlying cardiovascular, respiratory, renal, or psychiatric disease, increased risk of accidental and nonaccidental trauma, obstetric complications Outdoor workers, agricultural workers, electricity and pipeline utility workers, factory workers, firefighters, manufacturing workers, military, migrant workers, athletes, workers with underlying cardiac, renal, or respiratory disease; older workers
Air pollution Combustion of fossil fuels leads to fine particulate matter (PM2.5) and ozone air pollution that is intensified by rising temperatures, resulting in poor air quality Exacerbation of underlying respiratory disease (asthma, COPD, allergic disease), cardiovascular disease, premature mortality Outdoor workers, agricultural workers, construction workers, delivery workers, workers with underlying respiratory and cardiac disease
Extreme weather events Increasing frequency of weather-related disasters, including hurricanes, flooding and wildfires with resultant increased exposure to potentially traumatic events, forced migration and relocation secondary to disasters Trauma, electrocutions, drownings, exposure to toxic chemicals, exposure to biologically contaminated waste, delays in treatment for chronic underlying medical conditions, mental health and trauma-related effects (eg, posttraumatic stress disorder, depression, anxiety, substance abuse) First responders, medical workers, engineering/construction worker, those involved in recovery efforts, those with a history of depression, substance abuse or anxiety
Changes in vector, pathogen, and host characteristics Changes in temperature, precipitation, and ecology are altering the geographic distribution of vector-borne diseases Increased exposure to vector-borne diseases transmitted by mosquitos, ...

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