How Does Climate Change Affect Health?
Climate change and air pollution are inextricably intertwined, as warmer temperatures caused by increases in emissions of heat-trapping greenhouse gases lead to increased concentrations of O3 and PM and a greater frequency of poor air quality days.[48,49] The latest data show that in the United States, 2014 was the hottest year in recorded history, and recorded temperatures for the first half of 2015 were also higher than normal. It has been calculated that if no changes are made in regulatory controls, by the year 2050, combined O3 and PM health effects will be causing between 1000 and 4300 additional premature deaths annually nationwide.
The EPA develops standards for emissions of greenhouse gases from mobile and stationary sources under the CAA. These gases include CO2, which is the most prevalent greenhouse gas pollutant, accounting for 82% of US greenhouse gas emissions, as well as methane (CH4), nitrous oxide (N2O2), and fluorinated gases. From 2012 to 2013, greenhouse gas emissions in the United States increased by 2%, although they were 9% lower than in 2009. "We have made great strides in this country in cleaning up emissions from power plants, but we could do more, and the health studies suggest that we should do more," Dr Balmes stresses. On August 3, President Obama and the EPA announced measures to tackle CO2 emissions from fossil fuel-fired power plants, which are by far the largest source of US CO2 emissions. The Clean Power Plan "puts the nation on track to cut harmful pollution from the power sector by 32% below 2005 levels, while also cutting smog-and soot-forming emissions that threaten public health by 20%." Under the Plan, individual states must ensure that fossil fuel-fired power plants meet CO2 emission performance rates set by the EPA.
Like many other EPA directives, however, opposition to the Clean Power Plan was building even before it was finalized.[52,53] "The EPA gets sued for almost every regulation they announce," Dr Balmes notes. "That's the nature of US environmental regulation." He highlights another example in a recent end-of-term decision by the Supreme Court—"a strikingly bad decision in my opinion"—to remand back to a lower court a federal rule that required coal-fired power plants to limit emissions of mercury and other toxic pollutants.[54,55] The regulation had been challenged by industry groups and about 20 states. "It is interesting that the reason the Justices gave for their decision was that implementation of the rule (ie, the cost of greater control technology in the power plants) would cost billions of dollars, whereas most of the Justices agreed with industry that there would only be millions of dollars in benefits. But they did not include the co-benefits of reductions in health costs associated with the reduction in particulate matter," Dr Balmes explains. "Together with the reduction in toxic emissions, it would actually amount to savings of billions of dollars. So this is potentially a very problematic decision for EPA. Those of us who are public health advocates would say that the court is sort of disallowing the EPA from counting this large co-benefit."
Dr Balmes notes that, "In general, the medical professional societies that deal with relevant outcomes—typically the ATS, the ALA, the AHA, the American Public Health Association, and the American Cancer Society, have rallied in support of EPA regulatory efforts with respect to improving air quality.[56,57] So there is actually pretty good consensus on the part of medical professional organizations and public health organizations about the harmful effects of air pollution and concern about climate change, but we would like to see broader public support. Physicians have a role to play in advocating for better understanding on the part of the public about how air pollution and climate change influence health." Some healthcare providers appear to remain unconvinced about climate change, however. A recent online survey among ATS members indicated that although most (89%) believed that climate change is happening, a substantial proportion (11%) did not. The figures were lower for physicians who agreed that climate change is driven by human activity (68%) and that it is relevant to patient care (65%). "The ATS is a scientific organization, but I would say that [the survey] shows how far-reaching the anti-science rhetoric is," Dr Balmes commented. "Unfortunately I think if you surveyed family physicians, you probably wouldn't even get 89% in agreement."
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Cite this: Linda Brookes. Why Should You Care About the Air? - Medscape - Sep 10, 2015.