"We need to be prepared" for climate change impacts in EDs
Chair of ACEM’s Public Health and Disaster Committee, FACEM Dr Lai Heng Foong, points to the Black Summer bushfires across 2019-2020 as an example of a “catastrophic natural disaster that resulted in the direct deaths of 33 people and an estimated 430 dying due to smoke inhalation”.
Lai Heng says the findings from a new two-part report released in partnership with ACEM and the NSW Environment Protection Authority (EPA) show that “diagnosis of all cause respiratory conditions during those fires rose by 25 per cent, while diagnosis of asthma and chronic obstructive pulmonary disease (COPD) increased by 42 per cent and 40 per cent respectively”.
“We know that climate change is going to cause more extreme weather events and increase frequency of heatwaves,” she says. “We need to be prepared.”
Research confirms there is more work to do
Globally, says ACEM President Dr Stephen Gourley, 4.5 per cent of greenhouse gas emissions could come from healthcare services, “so it is imperative that emergency departments adapt to reduce this output and prepare for increased presentations due to climate change”.
The ACEM and EPA partnership was announced in August 2023 and was established to create collaborative solutions to help the health system deliver safe, timely and effective care for patients, as climatic events increase.
This month’s report release offers deeper insights into the need for climate change action and highlights the importance of action within EDs.
This report provides an overview of the sustainability practices in all ACEM-accredited EDs and explores sustainability leadership, carbon footprint and waste reduction, as well as sustainable clinical practice and procurement.
In response to the expected increased frequency of natural disasters and extreme weather events, this research draws on published literature, combined with an analysis of presentations to NSW EDs, to examine the impact of climate events on ED functions and patient presentations
Adaptation and evolution
NSW EPA Chief Executive Tony Chappel says the research confirms that climatic events, such as bushfires, floods and storms, have direct impacts on increased presentations to emergency departments.
“The impacts of climate change are serious and wide-ranging, and it’s vital that these institutions are preparing for and adapting to consequences of extreme weather events,” he says.
Changes to ED processes play an important role
The findings of the research reveal Australasian EDs are already implementing changes and processes that can increase sustainability and reduce greenhouse gas emissions, including:
47 per cent of emergency departments reported having taken measures to reduce their carbon footprint.
76 per cent reported making efforts to reduce unnecessary or low-value medical tests and procedures which add to emissions.
96 per cent reported their emergency department has clearly labelled bins for different categories of medical waste.
Sustainable Emergency Care in a Changing Climate
“Being one of the most energy-intensive settings in a hospital, emergency departments have a really big role to play in reducing our Co2 emissions and becoming more sustainable,” says Lai Heng, adding there is still more work to do to increase the sustainability of EDs.
She says the recent establishment of the Sustainable Emergency Medicine and Climate Advocacy Network creates an opportunity to make a positive difference.
“With that, we hope that we’ll be able to have a sustainability lead in every emergency department in Australia and New Zealand.”
Government and hospital leadership support needed
Delivering ongoing support to EDs from hospital leadership and government is crucial, says Steve, with calls for staff to be formally trained in sustainability practices specifically tailored to the unique – and busy – ED settings.
“Frontline healthcare staff who have worked through climatic events know that climate change increases the number of people that need our care. In the 2022 NSW floods, the surge in numbers of patients presenting for care was staggering,” he says. “Climatic events will continue to worsen, and we must work together to prepare the health system so people can continue to get the healthcare they need, when and where they need it.”
To learn about the ACEM and EPA Sustainable Emergency Care in a Changing Climate research and the two-part report released in July 2024, read more.