Although the impacts of climate change on human health conditions are reasonably well documented, specific influences on rheumatic diseases remain incompletely characterized. The goal of this scoping review was to better understand how climate change is impacting rheumatic diseases, either directly or indirectly, as well as how climate change affects the geographical distribution of infectious diseases with arthritogenic manifestations, which will impact rheumatic disease care.
A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR).
149 papers were identified regarding the impact of climate change related exposures on patients with rheumatic diseases. The most common climate-related exposure was air pollution, with other factors including excess heat or cold, precipitation, exposure to ultraviolet light, and malnutrition. The vast majority of studies identified associations of climate related factors with increased disease activity or incidence. 105 studies were identified that addressed the influence of climate change on the observed or projected changes in the geographical range of diseases with arthritogenic manifestations spread by arthropods or environmental vectors. The majority of studies focused on dengue, Lyme disease and chikungunya and found an increase in the geographical range with climate change. A grey literature search of rheumatology organization websites suggests that the field of rheumatology remains inadequately prepared for climate change impacts.
The existing literature was summarized and gaps were highlighted that are deserving of further exploration such that rheumatologists can be better prepared to care for their patients, educate them on potential health harms, and advocate for policies to proactively address the climate crisis.
The cascading impacts of climate change have significant implications for public health and healthcare delivery globally. This review explores how climate change impacts the health system workforce (both public health and healthcare service delivery), and what adaptation strategies are being deployed to mitigate against extreme climate events.
The review draws from English language peer-reviewed articles published between 2003 and 2023, that forefront experiences and adaptations to climate change events as they relate to the health system workforce. Out of 1662 articles, upon completing title and abstract review, two reviewers completed full-text review of 130 articles, removing 92 for not meeting inclusion criteria, resulting in 38 articles. Articles were analyzed in relation to the World Health Organization Climate Resilient Health Systems Framework.
Emergent themes highlight occupational health impacts such as physical hazards, burn out and psychosocial impacts. Adaptive strategies to address these impacts include bolstering transformative leadership praxis, psychosocial support provision, emergency preparedness and planning, and scaling up climate-related emergency preparedness through the development of climate change core competencies and multi-sectoral collaboration strategies.
Our review illustrates the limitations and opportunities of current adaptive strategies being utilized to support the healthcare workforce around the world, highlights the need for immediate emissions reductions that will reduce future hazards, and provides recommendations for how these findings can be applied to better prepare the health workforce for a range of climate futures.
Climate change presents an urgent and growing threat to the health and well-being of people and the planet. More frequent and intense heatwaves, droughts and floods are breaching critical ecosystem boundaries, causing cascading impacts that are increasingly complex to govern. Unsustainable development pathways and economic choices that are fueling the climate crisis are also directly engendering global health issues. Furthermore, the global response to climate change has been uneven and the lack of a conceptual framework for loss and damage has allowed developed countries the latitude to adopt differing takes on its framing, undermining the urgency and progression of the loss and damage mechanism to the detriment of developing countries. Current research on the governance of climate ethics posits that while economic and legal considerations largely influence climate policies, decision-making processes in climate adjacent sectors such as health need to be further grounded on ethically sound principles. Framing the health impacts of climate change as a moral issue can therefore be viewed as an effort to reshape the current political discourse with a humanistic lens and move the international community and state-level actors to action. The framing of this issue is particularly important as it recenters the focus on human health as an imperative for effective climate policies rather than as a contributor to the cache of peripheral co-benefits. It also underscores climate change as an ethical issue, in which failure to respond to the climate impacts can worsen health inequities, especially for socially and economically marginalized communities and vulnerable groups.
Due to climate change, the frequency of heatwaves and extreme heat events (EHE) has increased over the last five decades and is expected to continue increasing.
In this scoping review, we searched the literature for how EHEs and heatwaves impact pediatric health and how children can adapt to these threats. We used the PRISMA Extension for Scoping Reviews framework and searched several databases for studies pertaining to pediatric health, heatwaves, and EHEs.
The search generated 1719 studies that were screened by the authors. Ultimately, 113 studies were included in this review. We found that extreme heat exposure leads to a variety of adverse health outcomes in pediatric patients; some of the most notable are increased risks of adverse birth outcomes, including preterm birth and low birth weight. Extreme heat exposure was also associated with increased rates among children of emergency department visits, asthma exacerbations, heat illness, and impaired school performance.
Children will continue to face the repercussions of extreme heat as global temperatures continue to rise. It is imperative that future research includes adaptation measures to help keep children healthy and safe during periods of extreme heat.