Transcript carbon_addict_Dec09

Carbon Dependence
A healthcare challenge
www.carbonaddict.org
• The carbon addict: health effects of a
high carbon lifestyle
• Is the NHS addicted?
• Complications: adverse effects of a high
carbon health service
• Detox: what can health professionals do
about it?
• Health services for a low carbon future
The carbon addict: health effects of
a high carbon lifestyle on
individuals
Carbon Dependence
Epidemiology
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Early case reports date back to the 19th century, with
prevalence rising exponentially in the last 50 years
Now reached epidemic proportions in the UK – affecting
almost 100% of the population
Fears of global pandemic
Causes
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No genetic influences identified
Environmental factors important – e.g. out-of-town shopping
Carbon Dependence
Symptoms
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T-Shirt in winter
Car journeys under
3 miles
Vegetable intolerance /
meat-bingeing
New-variant Consumption
(nvC)
A carbon-dependent
society?…
…What’s wrong with that?
Carbon Dependence
Early Complications
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Reduced exercise tolerance
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Anxiety, stress
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fossil fuel use is replacing physical activity in daily living
 negative impacts on cardiovascular health
physical activity has psycho-protective effects, so doing less of
it has negative impacts on mental health
dissatisfaction
Respiratory symptoms
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asthma and allergies. Less air pollution and more time spent
in natural environments could reduce the risk of these
complications.
Carbon Dependence
Late Complications
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Obesity and diabetes– due to high fat diet and inactivity
Cardiovascular disease – high salt and fat diet, and inactivity
Colorectal cancer – correlates with high meat intake
Falls – inactivity  low muscle mass, falls due to SE of medication
Fuel poverty – using more fuel costs money
Social isolation – interaction via facebook? TV entertainment?
Am J Prev Med 2004;27(2)
each hour in car per day:
risk obesity by 6%
Circulation July 6, 1999
Walking <0.25 mile/day:
risk CHD x2
urnal of the National Cancer Institute, Vol. 97, No. 12, June 15, 2005
Red/processed meat:
risk colorectal cancer
Carbon Dependence
Late Complications
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Obesity and diabetes– due to high fat diet and inactivity
Cardiovascular disease – high salt and fat diet, and inactivity
Colorectal cancer – correlates with high meat intake
Falls – inactivity  low muscle mass, falls due to SE of medication
Fuel poverty – using more fuel costs money
Social isolation – interaction via facebook? TV entertainment?
Carbon Dependence
Climate Toxicity
004: Hurricane Catarina – the first South Atlantic hurricane
Carbon Dependence
Climate Toxicity
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Already responsible for many deaths
worldwide: malnutrition, malaria, diarrhoeal
disease (WHO)
Severity not related to intensity of same
individual’s carbon addiction
CO2 concentrations
“Sustainable Energy – without the hot air”
2008
Climate projections
IPCC Fourth Assessment Report
(2007)
What’s happening now?
Synthesis Report – Climate Change, Global Risks,
Challenges & Decisions, Copenhagen 2009
Is the NHS addicted? Understanding
the carbon footprint of NHS
England.
Carbon Footprint
NHS England
18 million tonnes
CO2 in 2004
Carbon Footprint NHS
England – procurement
Complications: adverse effects of a
high carbon health service.
“Is the NHS getting flabby…?”
High Carbon Care
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Elective surgery cancelled after last-minute
anaesthetic review
Blood tests repeated because not on system
Hospital-acquired infections
Post-operative pain
Drugs to treat side-effects – of drugs
High Carbon Care (2)
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Patients attending for appointments without
knowing why they are there
Drugs continued when no longer needed
Related conditions managed on separate days
by separate teams
Hi-tech interventions preferred, even
where alternatives exist
High Carbon Care
Activity ≠ outcome
Risk-benefit: can a move to single
use instruments cause harm?
Health risks?
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lower quality surgical instruments > bleeding
chemical exposure?
Environmental impacts?
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energy and carbon for manufacture
transport
pollution from waste disposal
Waste of NHS resources?
Risk-benefit: can referral to a
specialist cause harm?
Health risks?
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infection, side effects, complications of invasive tests
Psychosocial factors?
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perception of condition, stress
time off work
Environmental impacts?
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energy, transport - carbon emissions
production of material resources: needles, forms, gloves
pollution from waste disposal
Waste of NHS resources?
Climate Toxicity
Hospitals in heatwaves (press stories)
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Nurses and administrative staff walked out in protest at high
temperatures in brand-new PFI hospital "We can't work in this- we're
suffering from heat exhaustion and everything“
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Angry relatives claimed hospital could not provide for its most
vulnerable patients. People on strict nil by mouth diet were left to lie in
pools of their own sweat without ice and proper air conditioning as
their limbs swelled in the heat
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Hospital facing demands for an enquiry into how vital equipment was
allowed to break down during recent heat-wave, forcing the
cancellation of scores of operations
Climate Toxicity
Hospitals in heatwaves (press stories 2)
• Public Health (Pathology) Laboratory stopped work machines failed in heat.
• Nurses on cardiac ward were in tears at their inability to
keep patients as cool as they should have been
• Drugs may be vulnerable to extreme temperatures in
summer
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Andy Williamson, Chair – GSTT Kidney
Patients’ Association:
“As a kidney patient, I’m acutely aware of my own
vulnerability to climate events, and my
dependence on drugs and dialysis equipment
which rely on cheap oil for their availability.”
Discussion point
Detox: what can health professionals
do about carbon addiction?
In your patients?
What are the barriers..?
Medical Intervention
• Medical interventions are carbon intensive
– risk of increasing carbon dependence
• How can health professionals reduce
medical interventions by
PREVENTING ill-health?
Active Travel
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Cycling burns about 300 calories per hour (5 calories per minute)
Regular cyclists enjoy a fitness level equal to that of a person ten
years younger and a life expectancy 2 years above the average
Cycling regularly to work is the most effective thing an individual can
do to improve health and increase longevity.
If one third of all short car journeys were made by bike, national
heart disease rates would fall by between 5 and 10 percent
Only 28% of women in England and Scotland and 24% in Wales
meet the government’s guidelines for physical activity levels.
During rush hour a bicycle is about twice as fast as a car.
Housing & energy
“Housing improvement programmes benefit almost all carbon
addicts, but particularly the elderly, living alone, those with
cardiovascular or respiratory disease”
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Referral systems from health services to fuel poverty
schemes
Educating patients on specific health
benefits of housing improvements
J Epidemiol Community Health 2008;62:793–797
BP 142/85
123/73
Discussion point
Detox: what can health professionals
do about carbon addiction?
In the NHS?
What are the barriers..?
Health services for a low carbon
future: designing clinical care
which is preventative, develops
self-reliance, uses lean pathways
and low carbon technologies.
www.sdu.nhs.uk
NHS England CO2 baseline to 2020 with Climate Change targets
25.00
20.00
NHS England
10% target from 2007
NHS England forecast
2007 baseline
15.00
Mt CO2
Carbon Reduction Strategy Target
10% target from 2007
1990 baseline
26% target from 1990 baseline
Climate Change Act Target
10.00
26% target from 1990 baseline
64% target from 1990 baseline
80% target from 1990 baseline
64% target from 1990 baseline
5.00
80% target from 1990 baseline
0.00
1990
1995
2000
2005
2010
2015
2020
Year
2025
2030
2035
2040
2045
2050
sustainable estates
& facilities
sustainable
healthcare
=
+
sustainable
clinical practice
Principles of Sustainable
Clinical Practice
(The Campaign for Greener Healthcare)
• Prevention
• Patient partnership
• Lean systems
• Low carbon treatment choices
www.greenerhealthcare.org/clinical-transformation
Carbon Dependence
Prognosis
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Recent advances have transformed outcome
in what was previously a universally disabling
disease.
With help of multidisciplinary team, addicts
may even achieve full recovery.
Carbon Addict is an opensource project of The
Climate Connection and
The Campaign for Greener Healthcare.
The illustrations are by
www.worldofinferiors.co.uk and are licensed
under a Creative Commons License.
www.CarbonAddict.org
www.carbonaddict.org