Emergency Medicine and Climate Change: Our Role in Helping to Explain a Difficult Concept

This letter is written as a rebuttal to the editorial by D.C. Cone et al. titled “Emergency Medicine and Climate Change” that appeared in the August 2009 issue of Academic Emergency Medicine (AEM).1 I would suggest that this editorial did a major disservice to the spirit of academic emergency medicine. As a practicing emergency physician, I have, over the years, come to expect AEM to provide me with rigorously peer-reviewed articles. Unfortunately, the editorial appears to have ignored these high standards by giving the same credence to opinion pieces by nonexperts as that provided by expert panels. As critically thinking individuals, I would hope that we would be able to recognize good science from bad. The fact that between 1993 and 2003, peer-reviewed journals such as Science and Nature had published 928 articles on climate change, none of which refuted the claim that climate change was occurring and that human release of greenhouse gases was responsible, should give pause to the blanket acceptance of climate change deniers.2 I do not believe that there are this many articles supporting anything we believe in emergency medicine. The authors also should be the first to appreciate the time lags between experimental discovery and publication. To be specific, the “2007 Intergovernmental Panel on Climate Change (IPCC)” was a secondary publication that relied on previously published peer-reviewed articles. The science that led to those articles was observed years before. In addition, the 2007 IPCC publication was a consensus document. Again, the authors must realize that consensus statements tend to moderate toward the middle when there is a range of evidence (in this case, models). In fact, the recent release of the United Nations report, 2009 Climate Change Science Compendium, based on 400 peer-reviewed studies published since 2006, found that both the pace and the scale of climate change are accelerating, along with the confidence among researchers in their forecasts.3 The report also showed that while carbon dioxide emissions from fossil fuel burning grew by 1.1% annually from 1990 to 1999, this increased to 3.5% between 2002 to 2007. The conservative nature of the consensus models that came out of the IPCC 2007 report is immediately apparent. The fact that there is still controversy and debate on this topic is in some part thanks to a well-organized campaign akin to the one organized by the tobacco industry years ago. (One of the steps taken by tobacco was to create The Advancement of Sound Science Coalition [TASSC].) This was an organization whose objective was to appear as a credible source for reporters and to encourage the public to question, from the grassroots up, the validity of scientific studies. TASSC has now moved into the climate change arena. The other reason for controversy and debate is, I suspect, secondary to the fact that most of us (me included) do not want to change our lifestyle and are unwilling to apply the same rigor to this topic as we do in our professional lives. Finally, while I applaud Hess et al. on their article,4 I suspect that issues such as emergency medical services vehicle emissions will be a very small part of the problem in the future. Emergency physicians should be aware of reports being used by the military and intelligence communities, such as the 2007 “National Security and the Threat of Climate Change” document5 and the “Age of Consequences: The Foreign Policy and National Security Implications of Global Climate Change.”6 Taking “old” data from the 2007 IPCC report, these documents create political and strategic scenarios that include food shortages and waves of Central American refugees moving north as changing rainfall patterns cause droughts and crop failures in the southwestern United States and Central America. In summary, academic emergency physicians have the tools to distinguish good science from bad. We should recognize the extraneous factors trying to raise doubt around climate change where none should exist, and we should advocate for our patients’ and our families’ futures by helping to provide clarity on this important subject.

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