0:00:00] You're listening to the ATS Breathe Easy podcast brought to you by the American Thoracic Society.
Welcome to the ATS Breathe Easy podcast. I'm your host, Erika Moseson, a pulmonary and critical care physician in Oregon. And I'm a member of the ATS Environmental Health Policy Committee and host the AirHealth OurHealth podcast. Today, I am here with fellow ATS Environmental Health Policy Committee member, Dr.
Dan Croft. We are here to discuss an ATS workshop report called Climate Change and Respiratory Health Opportunities to Contribute to Environmental Justice, which is appearing in this month's issue of the Annals of the American Thoracic Society. Dr. Croft, why don't you tell us about yourself and how you came to participate in this project?
Thank you, Erica. I'm glad to be here. As you mentioned, I have a focus on [00:01:00] environmental health with my research career, and my key research is on the health effects of air pollution. And a little background about myself, I was I grew up in South Bend, Indiana, and spent my youth volunteering for Habitat for Humanity, learning about how homes are built, but also how communities are built.
And during my medical school training, I was also able to get a master's in public health degree, which furthered my interest in population health. And in my pulmonary and critical care fellowship at the University of Rochester, that's where I was able to start blending my interest in population health and respiratory health.
within my environmental epidemiology research. And due to this feedback loop between air pollution and climate that we'll discuss, that's part of the reason that I've started to become more active within the climate field. So I think Uh, the key motivations for me are that I'd like to see a healthy [00:02:00] planet for my children to grow up in and for all humanity.
Hey, those sound like worthy goals. And I had an opportunity to see the workshop report and it is outstanding. First, can you tell those who might not be familiar what an ATS workshop is in general and what prompted this one? Absolutely. The assembly projects through the American Thoracic Society are, they are opportunities where many folks from ATS and outside of ATS experts in the field get together and, and study a subject and think about the challenges and opportunities of a certain topic.
So in this instance, uh, we wanted to update the 2012 ATS assembly workshop on climate change and human health by Kent Pinkerton, and his colleagues. And You know, in this workshop, the key was we wanted to update those challenges and opportunities within [00:03:00] the climate change field, but also have a key additional focus of environmental justice.
Yeah. And so, I mean, a workshop tackling climate change is a pretty big endeavor. Where are we on climate change? Well, unfortunately, we're seeing continued warming. 2024 was the warmest year on record in terms of temperature recordings after the Industrial Revolution. Unfortunately, this has contributed to an increased frequency and intensity of natural disasters, including hurricanes, typhoons, heat waves, and wildfires.
And the other pillar of this workshop report is environmental justice. So I think those of us who practice medicine are familiar with the four bioethical principles of autonomy, beneficence, non maleficence, and justice. And this report focuses on the latter in terms of environmental justice. So what is that and how does it fit into the climate story?
Environmental justice is broadly defined as something that focuses on equity and [00:04:00] inclusion. And so the formal definition is the fair treatment and meaningful involvement of all people, regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.
And what that means practically is that there's inequity in exposures. And so, uh, the, in the workshop, we talk about, uh, three types of climate sensitive, uh, exposure inequities, one being differential exposure. Two, being a differential, a susceptibility, and three, being a differential resilience or access to climate adaptation resources, and, uh, some of what we'll mention, uh, soon will be Dr.
Robert Bullard, uh, the father of environmental justice, uh, who will who summarizes this inequity as folks being exposed first, worst, and [00:05:00] longest. Yeah, you opened the workshop report with a quote from Dr. Bullard that was beautiful. Can you tell us about him? Well, Dr. Bullard is the founding director of the Bullard Center for Environmental and Climate Justice.
He's a distinguished professor of urban planning, environmental policy at Texas Southern University. He is often called, as I mentioned, the father of environmental justice, and he's co founded a consortium for Gulf Coast Equity, the HBCU Climate Change Consortium, as well as the National Black Environmental Justice Network.
And he's, uh, a proud Vietnam era Marine Corps veteran. He's authored 18 books or more on environmental racism, urban land use, housing, transportation, sustainability, smart growth, climate justice and community resilience. So truly a leader in the field who has been a mentor to many. important figures within, [00:06:00] uh, this field.
Absolutely. And I think it's really important to understand what some of those terms mean in a medical context. Cause I think a lot of times people try to redefine what equity or inclusion might mean outside the medical field. And so examples of that might include, you know, differential exposure to air pollution might be, you know, outdoor workers being more exposed to wildfire smoke.
Differential susceptibility might be children or pregnant people, you know, breathing in pollution and then differential resilience would that be, you know, if you don't have a lot of money or resources to be able to move, if there's a hurricane or a fire, am I getting those categories? Correct? Yes. No, that's a, that's a good summary.
So those are the two big focuses of the workshop. So what areas in general did the workshop cover? We covered four broad areas. We covered, uh, we defined, you know, the respiratory health effects of climate change, uh, through this lens of environmental justice. We focused on the environmental justice and respiratory health issues [00:07:00] impacting the Disproportionately affected low and middle income countries.
Uh, the third section was on, you know, considering these environmental justice and communities within the climate change, uh, mitigation and adaptation strategies. And lastly, we thought about. Uh, how do we include environmental justice within the reason these priority research infrastructure needs to address climate change?
So what are some of the key respiratory health threats of climate change? There are many related to both the natural disasters and heat, but I think one of the most, uh, helpful ways to think about is through the viewpoint of someone with asthma. And I know, uh, as all of us treat patients with asthma, We always are counseling them to watch out for triggers to their asthma or things that could exacerbate their asthma.
So you think about the heat. So I just said hottest year on record. So heat is a exacerbating factor [00:08:00] of asthma itself, but climate change can indirectly. Uh, threaten asthma stability through, uh, the other natural disasters through wildfire smoke allergens due to prolonged allergen seasons. Uh, the, the climate change has led to roughly two, three weeks of additional, uh, time within an allergy season.
Uh, and then you think about flooding after a hurricane, uh, with mold exposure and allergens, uh, from that as well. Uh, and then finally, something I study. is the health effects of air pollution and respiratory infections. Uh, we have to be concerned about, uh, planetary health, the one health idea where we think about humans and animals.
And as habitat destruction occurs and animals and humans are put closer together, we have to worry about things like H5N1. bird flu, that we have, uh, animals and humans closer together and infections can spread between them. [00:09:00] Absolutely. You know, I really feel like my asthmatic patients or patients in general with lung disease or fibrotic interstitial lung diseases are just the canaries in the coal mine for all these, you know, changes from climate change and air pollution and more.
Absolutely. And I think the key. Uh, there is that while folks with asthma are particularly susceptible, uh, that all of us, it affects all of our lungs. The air that we're breathing, uh, irritates all of our lungs when there's pollution present. So that's an important, uh, important thing to think about.
Absolutely. And then, you know, we're all paying for health care premiums and taxes for Medicare and Medicaid. So I tell everyone that, you know, unhealthy air affects us all, even if you got the healthiest lungs in the world. Um, well, I'm excited to talk more about this with you and we will be right back after this short break.
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Register now to attend. Go to conference. thoracic. org today. Welcome back. Well, you have provided a very robust workshop report about all the different ways that climate change affects respiratory and critical care medicine. Um, what are some areas where our audience can be able to make a difference? Our audience is in a unique position, both to personally affect positive changes here to help the climate, but also within their professional work.
So I think The personal choices, we think about things like, uh, trying to lead a less carbon intensive life, [00:11:00] uh, trying to, uh, you know, batch travel so that you're not making two flights instead of one, trying to decrease food waste, which is a key contributor to greenhouse gas. emissions from, uh, you know, the landfills.
And, um, in addition to that, things, you know, other personal choices like trying to limit clothing consumption, the fast fashion industry is a large contributor to Uh, climate change. Those are all personal things and there are many more, but within our professional work at hospitals, you know, hospitals are large contributors to, uh, greenhouse gas, uh, emissions and, you know, roughly, um, about 8%, 8.
5 percent of U. S. uh, greenhouse gas emissions are from climate change. Uh, the medical, uh, medical system. And so one of the key ways to think about reducing those greenhouse emissions would be, uh, through procurement. So the things that we [00:12:00] buy, the things that come into the hospital, uh, that accounts for almost 82 percent of the emissions in U.
S. healthcare is just trying to get things into the hospital that the patients need. And trying to optimize this, uh, doctors, uh, sergeant and team from McMaster University, Uh, and our neighbors to the north in Canada. Uh, they had a nice description where they, where they talked about what we could save trying to, they had a peach tree diagram where they talked about the peaches that the low hanging peaches that could be grabbed to first, that's both save money, but also save carbon emissions.
And they estimated that, uh, by de prescribing, so just by, uh, taking, You know, 5 percent prescribing 5 percent fewer meds on the inpatient side for a 200 bed hospital would reduce the carbon emissions of that hospital by 100 tons annually while saving up to a million dollars for the hospital. And I think, uh, with increased financial stress on healthcare institutions, uh, cost saving and carbon savings [00:13:00] is, uh, you know, it's something that you definitely want to go for.
And those things often dovetail nicely with the Choose Wisely campaign. I mean, we know there's a lot of things we do in medicine because we worry about some potential thing that might happen that's very unlikely and we may be harming people more than helping them, um, with a lot of our choices. So I'm sure there's, again, a lot of low hanging peaches that we could all grab.
That's right, you know, and including in the cafeteria, right? Trying to eliminate the single use plastics and, uh, thinking about the food that we, uh, bring into the The hospital itself, uh, you know, looking for the opportunities for local growers and then thinking about the workers, right? Some of the folks that we, uh, treat in the, in the hospital for heat stress, uh, folks are, are, um, colleagues and, uh, friends and neighbors that work in, uh, you know, the agricultural industry are at particular risk to climate change between the, the heat stress and, Uh, he'd stroke and, [00:14:00] um, you know, other diseases that they're exposed to there.
So, uh, that's, that's the holistic view of, uh, we need to try to help, uh, both the global health, but also that, uh, has a beneficial effect for personal health too. Absolutely, and I like the focus of that throughout the workshop because I think a lot of people worry about, you know, doctors and researchers and scientists kind of sitting in these ivory towers making recommendations, but people's experiences often those things come down and are actually harming frontline communities.
And so I really like the idea of let's bring the outdoor worker to the table, right? Let's bring the person suffering heat stress to the table. Let's bring the person working in the cafeteria to the table, right? And I appreciated one figure in your workshop report about how to engage with communities.
Um, can you talk about that? Absolutely. And so this was an important, uh, section within the workshop and something that we had, uh, you know, great discussion on is how do we reach out to the communities, uh, that we want to help without overburdening them. [00:15:00] Now, some of the communities around our hospital systems, Uh, individuals have low incomes, they may have, uh, two or three jobs that they're trying to work and trying to manage child care and manage illness in the family, take care of a grandparent, um, you know, in a multi generational home, uh, that's a lot of stress.
And so we can't come to them and say, okay, well, here's some things that we'd like you to do, uh, you know, to, to really shoulder the burden of this, uh, you know, the climate effort, you know, trying to counter that. And so. The figure that we have is really showing the spectrum of how you can, uh, engage with the community and the, and that the community can engage, um, where they are, you know, with what time they have.
And so, on the, uh, one side of the spectrum would be outreach, where we simply give helpful information to the community and say, we've, we have a, you know, a hot period coming up. Uh, you know, please stay inside. Um, or, you know, try to [00:16:00] avoid, if there's wildfire smoke, uh, give the tips to try to avoid, uh, you know, avoid the worst, um, exposure from that.
Uh, all the way to involving, where they can be a part of the research. Uh, and then at the, at the very, uh, most intensive would be to Involve them as leaders, you know, as shared leadership within a research project where they're, they're part of the leadership team of research project and, you know, where they're helping make a dashboard, for example, about impacts of the food system.
And so we have some nice examples there of how you can engage and try to meet people where they are. And really, the key with all of this is we cannot put an undue burden on already disproportionately affected communities. Absolutely. I think about that a lot in Oregon where a lot of my patients, even though they know it's bad for them to light a wood stove or light a fire inside their house to heat, they just can't afford the electricity bills, right?
They, you know, they say, I would love to not be using my fireplace, but [00:17:00] I can't afford the heat. So I'm breathing all this extra smoke because I just can't afford it. So this is where. health professionals potentially be helping with policy changes could come in. So what policy changes do we think could help?
There are many policy changes. We think about, uh, remember we talked about the inequities. And so, uh, trying to, uh, bridge what is called the climate gap. Uh, the climate gap is the gap between the health outcomes of individuals, uh, with privilege and high income and those, uh, with low income and who are disproportionately affected.
And one of the biggest, uh, contributors to that is poverty. And so that's a hard thing because you come into the pulmonary clinic, how can we solve poverty? Well, we can't solve it one clinic, you know, visit at a time, we need to help engage and help. Uh, you know, nation, nationally and internationally, uh, help, uh, reduce poverty and that, that gap.
[00:18:00] Now, that takes education. So, we have to educate our providers. So, our healthcare professionals need to be educated on what are the challenges of, uh, climate change. What health effects, you know, just like we're talking about now, what health effects. Uh, could our patients have from this? And then, you know, we think about, um, we talked a lot about, uh, data availability.
So you'll see great, you'll see a nice world map about climate where we say, okay, we have some challenges and, um, you know, in this area or in another country with heat. But then you look at Africa and you just see a blank. You see that there's no data generated from, uh, Sub Saharan Africa, and that is a problem because there are significant heat stress, heat deaths in Africa that are not being, uh, not being recorded.
And so we need to help, we as a global community. Uh, need to help with the data infrastructure so that our colleagues and friends and, uh, you know, neighbors in [00:19:00] Africa can, uh, can have that data, um, to help lead, uh, you know, lead these, uh, and engage with, uh, these, these different initiatives. Um, and it's estimated, you know, when we think about all the climate data, we need more climate data and there's already.
Over 50, uh, petabytes of data annually. And I think this was, uh, maybe a new word for, uh, some listeners in that one pet. I had never heard petabyte before , right? And, uh, you know, I had to get a sense of it as well. Uh, and so this is 10 to the 15th bytes. So, uh, you know, one quadrillion bytes, you know, a mil, a million gigabytes, so an absolute ocean of data.
But that's what, you know, having data centers and, uh, with all the, uh, innovation within the data space, uh, that can be put to good use for climate data and to help, um, you know, help with environmental justice as well to get information to the people [00:20:00] that need it. Yeah, and you know, sometimes when we're talking about the global scale or even just climate change in general, it just feels overwhelming, right?
It feels like such a big problem. This massive train just coming down the tracks, um, that's already, you know, running over people. Um, and it shows up in different specific ways in different places. So where I live in the Pacific Northwest, we are very affected by wildfires, for example, and everyone. wants to make those get better.
Every community wants to get a better plan for wildfires, make their communities resilient. Um, and it seems that seems like something we can tackle a little bit better together is being more specific than climate change, helpful for communities to come together for solutions. Absolutely. And you think about examples within agriculture.
Well, if you're talking to a farmer, you know, I'm, I'm from Indiana. And so there's corn farm, you know, uh, farming, uh, operations all over the state and in the Midwest and, and elsewhere. And we think about what's important to the [00:21:00] farmer. You think about soil conservation. Changing ecosystems. Those are things that they think about and that they're actually expert, uh, expert in, more expert than, than us.
And so that's where we can engage, we can learn, uh, you know, from our neighbors there. And thinking about if we're talking about, if we're worried about, Wildfires or we're worried about, uh, hurricanes. We just talk about those natural disasters and how, you know, and how the climate change, uh, can worsen those.
Uh, that's important. But we need to talk about disaster planning. Uh, you know, that's a key, uh, a key part of all this. So, um, I think, uh, words, words are important and words, um, you know, can also. Um, sometimes make people think, uh, think about something differently and maybe not in a productive way. So, um, I think, you know, focusing on specificity is important.
So what role can medical societies play in this? The medical [00:22:00] societies, there are many different things that the medical societies can do. I think the ATS as a medical society is very active within multiple areas. The, the Environmental Health Policy Committee of ATS is, is very active within this field and specifically it's done, uh, the ATS and this, uh, EHP.
Um, committee has done hard work on the health consequences of increased heat, uh, the burden of wildfire smoke exposure and, you know, thinking about how we can develop a more robust or comprehensive social cost of carbon estimate, uh, which is important when you're thinking about priorities from a national international level, you have to think about what does that carbon cost, you know, and how to.
Uh, if we're going to make decisions about renewable energy, we're going to make decisions about power generation. Uh, you have to think about how much that, [00:23:00] uh, the carbon emissions cost. Yeah, I have to say, um, on a personal note, as the mother of three young kids and a pulmonary critical care doctor living in wildfire country, I often feel significant anxiety about what the future holds for all of us.
And, you know, I worry about things like flying to medical conferences, um, and whether if I'm using a plug in hybrid or an electric stove, is this really going to move the needle? Um, anything in this workshop report to help people like me? Well, I think we emphasize, uh, in one of our, our first figure, we talk about the expanding rings from a personal to a community, uh, to society and global level, the expanding rings of actions that can be taken.
Um, but it will, it will take all the, it will take the entire spectrum of action to truly, you know, make a, uh, a very significant impact on On climate change. And so this is a large challenge. So it's going to take everyone working together. And I think, uh, one thing that, uh, we didn't [00:24:00] emphasize in the workshop, but I think can be helpful for framing is the something called the climate shadow.
And this is by a journalist and author, Emma Hattie. Um, and she wants to want to focus on. the, you know, a more holistic view of the impact of an individual's impact on climate, both the good and bad. And I think rather than just focusing on carbon footprint and saying, all right, what's my tally? Oh, I drove to work.
I, you know, I ate, uh, ate meat, uh, one day. And, you know, rather than just tallying that up, um, I feel like that, uh, and I think. Others would agree that that puts us into little bubbles of shame where we're ashamed of what we did. Does that hurt the climate? Well, that doesn't lead to us feeling confident and feeling like we want to engage.
It wants us to all stay separate. And I think when we are separated, this goes for many things, uh, when we are separate and acting as individuals, we just aren't as strong. We need to band [00:25:00] together. Uh, to face big challenges and this is one of the biggest, uh, that we, that we face. So the climate shadow thinks about, okay, well, what are the, some of the things that you, you know, contributed, you know, in terms of CO2, but what are some of the good things you did?
Did you, you know, think about getting a battery powered either vehicle or lawn equipment, or did you listen to this podcast on climate? Um, did you, you know, do, do talk to neighbors, talk to family members, you know, and. All those choices make it different. It may seem small, um, but those choices really, uh, you know, really help, uh, start change and, and really sustain it.
But I think the key is we just have to, we have to come together and not say that someone's doing it slightly wrong so that their way is not going, is not valid. We need to all work together and it's going to look differently, but. Um, this is, uh, with Americans having about 16 tons of CO2 [00:26:00] generation each year, we have some work to do.
We've got to reduce, uh, we've got to reduce that. Yeah, absolutely. I love the idea of popping the bubbles of shame and because we emit so much kind of anything we do is going to help. So, you know, just grab something and go, you know, we focus a lot on carbon dioxide, but climate change actually has a lot of complex drivers.
So what else can we focus on doing besides CO2 emissions? Not that they're not important. Well, absolutely. CO2 and CO2 is important. Uh, but we also have to think about methane emissions. So, uh, methane is very important. That's where there's been efforts to try to cap these, uh, fracking, old fracking wells that are just spewing methane out.
That's a problem. Let's just cap those. Or maybe we get a win win and turn those fracking wells into geothermal energy creation. You know, there's there are very innovative ideas out there to try to tackle the climate change climate challenge with something, you know, something synergistic in that way and all around the world.
This is a key part. As I mentioned before, [00:27:00] we don't want to come in and tell people. You know what their community needs and what, you know, this kind of top down approach we need to learn from communities. We need to learn from communities around the world. Let's say that biomass is a key, you know, in some areas of the world.
Biomass is an important way for folks to heat their homes, for them to cook their food. Um, well, then we need to come up with, you know, see if there are affordable alternatives. Uh, for those individuals, I try to limit the, you know, the black carbon, uh, is one of the climate force or something that worsens climate change is a pollutant called black carbon.
And, you know, that is, you know, that is an important part, both for the biomass, but also for old diesel vehicles, for example, you know, can we get, uh, vehicles tuned up or alternatives. Uh, you know, to those vehicles in some areas of the country, so or the country and world. So I think the key is being sensitive to where, [00:28:00] what different communities, what their expertise is and what their, what their challenges are and, and trying to work together.
Absolutely. And clinicians can often have powerful and trusted voices in their own communities, whether at the city, county, or state level. And hopefully this report will give them ideas on where they can help be of service, you know, in their own communities through advocacy, engagement, education. Are there any other areas of those low hanging peach fruit for the respiratory care professional?
Absolutely. So, uh, as my colleagues at, uh, University of Rochester know, I love to talk about smoking cessation and tobacco dependence treatment. And so, tobacco. So, when people are smoking, right, we think, what's the best way that we could help our patient? I frequently tell, uh, my patients this. that one of the biggest things I could do is help you in your journey to quit smoking.
And I think that is a key one. Both we can directly improve the respiratory health, but then indirectly, think about all the carbon emissions, uh, [00:29:00] from, uh, the cigarette production industry. And, you know, it's a It is a fraction of the airline industry, but it's something that is not necessary for health, right?
If, if cigarettes are not, um, you know, a food that we need to eat or something that's essential for life, um, can they be eliminated and, or at least very greatly reduced? So, I think you, so I want to encourage everyone. We talked about climate shadow. What are you doing? You are already working on climate change.
You are already affecting positive change by helping your patients quit smoking. Keep doing that. Keep doing that. And then start reaching for those other branches. Help your sustainability coordinators at your hospital. If there's not one, maybe you're it. Maybe you're the new sustainability coordinator.
And Just really, really get involved and support your colleagues that are working on this, whether it's at ATS in your, uh, in your hospital or, you know, in your area, just, uh, you know, supporting them [00:30:00] and keeping them going. It can be a bit of a grind, I think, as we both know, when we think about the daunting challenges of, uh, of climate change and, um, and respiratory health.
And so I think we need to help lift each other up and keep us, um, you know, keep everyone, uh, working towards positive change. Absolutely. And thanks for bringing up the tobacco issue, the uh, the amount of microplastics in those filters, which we know do nothing and they're just microplastics. So the second most littered item in the world and obviously they come from the petrochemical industry.
So I think tobacco is just one of those other things that's just so prevalent. It's almost invisible. And then when these disposable electronic cigarette devices, it's just electronic waste that often ends up getting incinerated and that lithium could be better used in, you know, electric vehicles or something.
I think that's a great point. And also on the this. Disposables, right? So maybe over 60 percent of the e cigarette market is now to the disposable e cigarettes Those disposables, they're going, unfortunately, on our roadways and waterways, but also into the landfill, [00:31:00] and to waste treatment facilities, uh, and to, uh, waste management facilities, causing fires, right?
Those batteries are causing fires, but then they're releasing more smoke, um, so that's a, it's a health problem. You know, the health concerns with those, but also, uh, environmental, uh, concerns, too. I think while you mentioned plastic, plastic's a, uh, an important thing to think about, too, in that, um, I remember back in third grade, I came home as a little student with a backpack as big as I was.
And the topic of that day was recycling. So I came back and I told my family, we're going to start recycling. And so then every week, we gathered up all the recycling. And for years and years and years, uh, we did that only to find out that much of the plastic that's going to recycling is being thrown in the trash.
And so that, that, these are some of the motivating forces [00:32:00] where I say we need to keep doing better. It's the right, that's one of those examples, that's the right idea, but what's the problem is that plastics are made from fossil fuels. And so now we're just wasting, we're using plastic, fossil fuels, uh, to make plastics, and then we're not even effectively recycling them.
And so, and there's a growing concern with the plastics ending up in our bodies too, which I think isn't, you know, again, one more thing to worry about. So, you know, let's just move away. Right. Well, and I think, you know, that's the, um, you know, that that's the tough part about this space. But I think the key there is that in this circle, if you remember the circle of recycling, right?
The first, there's three R's reduce, reuse, recycle. Recycling is meant to be the third R. That got moved to the top. Uh, it is important and recycling is, um, is important, but reducing, that's what we talked about with the medications in your facilities, uh, reducing that, reducing your own personal consumption, reducing fossil fuel [00:33:00] consumption, reducing is just absolutely what we need to do.
We need to, uh, basically take it down a notch, uh, within the consumption framework. Erika, I know you're working on a lot of things for the upcoming ATS meeting. Uh, what can ATS members, uh, do to learn more about, uh, these efforts? Well, if people are coming to the meeting, you can attend an event called Strategies to Reduce Pulmonary and Critical Care Practice Emissions, which is going to be in the Networking Center, uh, Tuesday, May 20th at noon.
Um, there is also a workshop report on that topic that should be coming out sometime this year. Um, and I would say, you know, this is important across every section of ATS, whether you work in lung cancer, asthma, environmental health. So whatever your section is at ATS, go to the meeting and ask what you guys are doing about climate change and making sure everyone's represented at the table and that we're reaching out to all the right communities.
Um, and also many. States have regional chapters of American Thoracic Society. We have one here in Oregon, um, and it's nice because you can collaborate with other local organizations like the American Lung Association or [00:34:00] the American Heart Association on actually working at your county, state, and local level to, you know, address problems from climate change and, you know, decreasing tobacco use.
And it's always better to do things together. Um, and then we know everyone's busy. So you can also check the show notes for a host of resources, including many of the Air Health, Our Health podcast episodes that feature members of the Environmental and Occupational Health Assembly. I'm the host of that podcast as well.
Um, and also the ATS makes a host of patient fact sheets because we know everyone's busy and sometimes it's good to just be able to put something in your after visit summary for a patient. And there's a host of resources that are relevant to this topic. And we'll also link to those. So thanks for giving me a chance to highlight all that, Dan, and I want to thank you so much for your time and for this wonderful workshop report.
I know from experience that these workshops take a ton of time and effort, and especially if you're leading the workshop, which I have never done, um, I have such great admiration for all the effort that goes into this. Absolutely. And it was great to talk to you as well and to [00:35:00] our, to our community. And I just want to thank everyone that was part of the workshop.
It was a complete team effort there, uh, trying to get all these important ideas and, uh, ideas and efforts on paper there. So thank you to everyone that worked on the project and thank you to everyone listening. Yeah, and hope to see you all at the meeting.
Thank you for joining us today. To learn more, visit our website at thoracic. org. Find more ATS Breathe Easy podcasts on Transistor, YouTube, Apple Podcasts, and Spotify. Don't forget to like, comment, and subscribe so you never miss a show.
Welcome to the ATS Breathe Easy podcast. I'm your host, Erika Moseson, a pulmonary and critical care physician in Oregon. And I'm a member of the ATS Environmental Health Policy Committee and host the AirHealth OurHealth podcast. Today, I am here with fellow ATS Environmental Health Policy Committee member, Dr.
Dan Croft. We are here to discuss an ATS workshop report called Climate Change and Respiratory Health Opportunities to Contribute to Environmental Justice, which is appearing in this month's issue of the Annals of the American Thoracic Society. Dr. Croft, why don't you tell us about yourself and how you came to participate in this project?
Thank you, Erica. I'm glad to be here. As you mentioned, I have a focus on [00:01:00] environmental health with my research career, and my key research is on the health effects of air pollution. And a little background about myself, I was I grew up in South Bend, Indiana, and spent my youth volunteering for Habitat for Humanity, learning about how homes are built, but also how communities are built.
And during my medical school training, I was also able to get a master's in public health degree, which furthered my interest in population health. And in my pulmonary and critical care fellowship at the University of Rochester, that's where I was able to start blending my interest in population health and respiratory health.
within my environmental epidemiology research. And due to this feedback loop between air pollution and climate that we'll discuss, that's part of the reason that I've started to become more active within the climate field. So I think Uh, the key motivations for me are that I'd like to see a healthy [00:02:00] planet for my children to grow up in and for all humanity.
Hey, those sound like worthy goals. And I had an opportunity to see the workshop report and it is outstanding. First, can you tell those who might not be familiar what an ATS workshop is in general and what prompted this one? Absolutely. The assembly projects through the American Thoracic Society are, they are opportunities where many folks from ATS and outside of ATS experts in the field get together and, and study a subject and think about the challenges and opportunities of a certain topic.
So in this instance, uh, we wanted to update the 2012 ATS assembly workshop on climate change and human health by Kent Pinkerton, and his colleagues. And You know, in this workshop, the key was we wanted to update those challenges and opportunities within [00:03:00] the climate change field, but also have a key additional focus of environmental justice.
Yeah. And so, I mean, a workshop tackling climate change is a pretty big endeavor. Where are we on climate change? Well, unfortunately, we're seeing continued warming. 2024 was the warmest year on record in terms of temperature recordings after the Industrial Revolution. Unfortunately, this has contributed to an increased frequency and intensity of natural disasters, including hurricanes, typhoons, heat waves, and wildfires.
And the other pillar of this workshop report is environmental justice. So I think those of us who practice medicine are familiar with the four bioethical principles of autonomy, beneficence, non maleficence, and justice. And this report focuses on the latter in terms of environmental justice. So what is that and how does it fit into the climate story?
Environmental justice is broadly defined as something that focuses on equity and [00:04:00] inclusion. And so the formal definition is the fair treatment and meaningful involvement of all people, regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.
And what that means practically is that there's inequity in exposures. And so, uh, the, in the workshop, we talk about, uh, three types of climate sensitive, uh, exposure inequities, one being differential exposure. Two, being a differential, a susceptibility, and three, being a differential resilience or access to climate adaptation resources, and, uh, some of what we'll mention, uh, soon will be Dr.
Robert Bullard, uh, the father of environmental justice, uh, who will who summarizes this inequity as folks being exposed first, worst, and [00:05:00] longest. Yeah, you opened the workshop report with a quote from Dr. Bullard that was beautiful. Can you tell us about him? Well, Dr. Bullard is the founding director of the Bullard Center for Environmental and Climate Justice.
He's a distinguished professor of urban planning, environmental policy at Texas Southern University. He is often called, as I mentioned, the father of environmental justice, and he's co founded a consortium for Gulf Coast Equity, the HBCU Climate Change Consortium, as well as the National Black Environmental Justice Network.
And he's, uh, a proud Vietnam era Marine Corps veteran. He's authored 18 books or more on environmental racism, urban land use, housing, transportation, sustainability, smart growth, climate justice and community resilience. So truly a leader in the field who has been a mentor to many. important figures within, [00:06:00] uh, this field.
Absolutely. And I think it's really important to understand what some of those terms mean in a medical context. Cause I think a lot of times people try to redefine what equity or inclusion might mean outside the medical field. And so examples of that might include, you know, differential exposure to air pollution might be, you know, outdoor workers being more exposed to wildfire smoke.
Differential susceptibility might be children or pregnant people, you know, breathing in pollution and then differential resilience would that be, you know, if you don't have a lot of money or resources to be able to move, if there's a hurricane or a fire, am I getting those categories? Correct? Yes. No, that's a, that's a good summary.
So those are the two big focuses of the workshop. So what areas in general did the workshop cover? We covered four broad areas. We covered, uh, we defined, you know, the respiratory health effects of climate change, uh, through this lens of environmental justice. We focused on the environmental justice and respiratory health issues [00:07:00] impacting the Disproportionately affected low and middle income countries.
Uh, the third section was on, you know, considering these environmental justice and communities within the climate change, uh, mitigation and adaptation strategies. And lastly, we thought about. Uh, how do we include environmental justice within the reason these priority research infrastructure needs to address climate change?
So what are some of the key respiratory health threats of climate change? There are many related to both the natural disasters and heat, but I think one of the most, uh, helpful ways to think about is through the viewpoint of someone with asthma. And I know, uh, as all of us treat patients with asthma, We always are counseling them to watch out for triggers to their asthma or things that could exacerbate their asthma.
So you think about the heat. So I just said hottest year on record. So heat is a exacerbating factor [00:08:00] of asthma itself, but climate change can indirectly. Uh, threaten asthma stability through, uh, the other natural disasters through wildfire smoke allergens due to prolonged allergen seasons. Uh, the, the climate change has led to roughly two, three weeks of additional, uh, time within an allergy season.
Uh, and then you think about flooding after a hurricane, uh, with mold exposure and allergens, uh, from that as well. Uh, and then finally, something I study. is the health effects of air pollution and respiratory infections. Uh, we have to be concerned about, uh, planetary health, the one health idea where we think about humans and animals.
And as habitat destruction occurs and animals and humans are put closer together, we have to worry about things like H5N1. bird flu, that we have, uh, animals and humans closer together and infections can spread between them. [00:09:00] Absolutely. You know, I really feel like my asthmatic patients or patients in general with lung disease or fibrotic interstitial lung diseases are just the canaries in the coal mine for all these, you know, changes from climate change and air pollution and more.
Absolutely. And I think the key. Uh, there is that while folks with asthma are particularly susceptible, uh, that all of us, it affects all of our lungs. The air that we're breathing, uh, irritates all of our lungs when there's pollution present. So that's an important, uh, important thing to think about.
Absolutely. And then, you know, we're all paying for health care premiums and taxes for Medicare and Medicaid. So I tell everyone that, you know, unhealthy air affects us all, even if you got the healthiest lungs in the world. Um, well, I'm excited to talk more about this with you and we will be right back after this short break.
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Register now to attend. Go to conference. thoracic. org today. Welcome back. Well, you have provided a very robust workshop report about all the different ways that climate change affects respiratory and critical care medicine. Um, what are some areas where our audience can be able to make a difference? Our audience is in a unique position, both to personally affect positive changes here to help the climate, but also within their professional work.
So I think The personal choices, we think about things like, uh, trying to lead a less carbon intensive life, [00:11:00] uh, trying to, uh, you know, batch travel so that you're not making two flights instead of one, trying to decrease food waste, which is a key contributor to greenhouse gas. emissions from, uh, you know, the landfills.
And, um, in addition to that, things, you know, other personal choices like trying to limit clothing consumption, the fast fashion industry is a large contributor to Uh, climate change. Those are all personal things and there are many more, but within our professional work at hospitals, you know, hospitals are large contributors to, uh, greenhouse gas, uh, emissions and, you know, roughly, um, about 8%, 8.
5 percent of U. S. uh, greenhouse gas emissions are from climate change. Uh, the medical, uh, medical system. And so one of the key ways to think about reducing those greenhouse emissions would be, uh, through procurement. So the things that we [00:12:00] buy, the things that come into the hospital, uh, that accounts for almost 82 percent of the emissions in U.
S. healthcare is just trying to get things into the hospital that the patients need. And trying to optimize this, uh, doctors, uh, sergeant and team from McMaster University, Uh, and our neighbors to the north in Canada. Uh, they had a nice description where they, where they talked about what we could save trying to, they had a peach tree diagram where they talked about the peaches that the low hanging peaches that could be grabbed to first, that's both save money, but also save carbon emissions.
And they estimated that, uh, by de prescribing, so just by, uh, taking, You know, 5 percent prescribing 5 percent fewer meds on the inpatient side for a 200 bed hospital would reduce the carbon emissions of that hospital by 100 tons annually while saving up to a million dollars for the hospital. And I think, uh, with increased financial stress on healthcare institutions, uh, cost saving and carbon savings [00:13:00] is, uh, you know, it's something that you definitely want to go for.
And those things often dovetail nicely with the Choose Wisely campaign. I mean, we know there's a lot of things we do in medicine because we worry about some potential thing that might happen that's very unlikely and we may be harming people more than helping them, um, with a lot of our choices. So I'm sure there's, again, a lot of low hanging peaches that we could all grab.
That's right, you know, and including in the cafeteria, right? Trying to eliminate the single use plastics and, uh, thinking about the food that we, uh, bring into the The hospital itself, uh, you know, looking for the opportunities for local growers and then thinking about the workers, right? Some of the folks that we, uh, treat in the, in the hospital for heat stress, uh, folks are, are, um, colleagues and, uh, friends and neighbors that work in, uh, you know, the agricultural industry are at particular risk to climate change between the, the heat stress and, Uh, he'd stroke and, [00:14:00] um, you know, other diseases that they're exposed to there.
So, uh, that's, that's the holistic view of, uh, we need to try to help, uh, both the global health, but also that, uh, has a beneficial effect for personal health too. Absolutely, and I like the focus of that throughout the workshop because I think a lot of people worry about, you know, doctors and researchers and scientists kind of sitting in these ivory towers making recommendations, but people's experiences often those things come down and are actually harming frontline communities.
And so I really like the idea of let's bring the outdoor worker to the table, right? Let's bring the person suffering heat stress to the table. Let's bring the person working in the cafeteria to the table, right? And I appreciated one figure in your workshop report about how to engage with communities.
Um, can you talk about that? Absolutely. And so this was an important, uh, section within the workshop and something that we had, uh, you know, great discussion on is how do we reach out to the communities, uh, that we want to help without overburdening them. [00:15:00] Now, some of the communities around our hospital systems, Uh, individuals have low incomes, they may have, uh, two or three jobs that they're trying to work and trying to manage child care and manage illness in the family, take care of a grandparent, um, you know, in a multi generational home, uh, that's a lot of stress.
And so we can't come to them and say, okay, well, here's some things that we'd like you to do, uh, you know, to, to really shoulder the burden of this, uh, you know, the climate effort, you know, trying to counter that. And so. The figure that we have is really showing the spectrum of how you can, uh, engage with the community and the, and that the community can engage, um, where they are, you know, with what time they have.
And so, on the, uh, one side of the spectrum would be outreach, where we simply give helpful information to the community and say, we've, we have a, you know, a hot period coming up. Uh, you know, please stay inside. Um, or, you know, try to [00:16:00] avoid, if there's wildfire smoke, uh, give the tips to try to avoid, uh, you know, avoid the worst, um, exposure from that.
Uh, all the way to involving, where they can be a part of the research. Uh, and then at the, at the very, uh, most intensive would be to Involve them as leaders, you know, as shared leadership within a research project where they're, they're part of the leadership team of research project and, you know, where they're helping make a dashboard, for example, about impacts of the food system.
And so we have some nice examples there of how you can engage and try to meet people where they are. And really, the key with all of this is we cannot put an undue burden on already disproportionately affected communities. Absolutely. I think about that a lot in Oregon where a lot of my patients, even though they know it's bad for them to light a wood stove or light a fire inside their house to heat, they just can't afford the electricity bills, right?
They, you know, they say, I would love to not be using my fireplace, but [00:17:00] I can't afford the heat. So I'm breathing all this extra smoke because I just can't afford it. So this is where. health professionals potentially be helping with policy changes could come in. So what policy changes do we think could help?
There are many policy changes. We think about, uh, remember we talked about the inequities. And so, uh, trying to, uh, bridge what is called the climate gap. Uh, the climate gap is the gap between the health outcomes of individuals, uh, with privilege and high income and those, uh, with low income and who are disproportionately affected.
And one of the biggest, uh, contributors to that is poverty. And so that's a hard thing because you come into the pulmonary clinic, how can we solve poverty? Well, we can't solve it one clinic, you know, visit at a time, we need to help engage and help. Uh, you know, nation, nationally and internationally, uh, help, uh, reduce poverty and that, that gap.
[00:18:00] Now, that takes education. So, we have to educate our providers. So, our healthcare professionals need to be educated on what are the challenges of, uh, climate change. What health effects, you know, just like we're talking about now, what health effects. Uh, could our patients have from this? And then, you know, we think about, um, we talked a lot about, uh, data availability.
So you'll see great, you'll see a nice world map about climate where we say, okay, we have some challenges and, um, you know, in this area or in another country with heat. But then you look at Africa and you just see a blank. You see that there's no data generated from, uh, Sub Saharan Africa, and that is a problem because there are significant heat stress, heat deaths in Africa that are not being, uh, not being recorded.
And so we need to help, we as a global community. Uh, need to help with the data infrastructure so that our colleagues and friends and, uh, you know, neighbors in [00:19:00] Africa can, uh, can have that data, um, to help lead, uh, you know, lead these, uh, and engage with, uh, these, these different initiatives. Um, and it's estimated, you know, when we think about all the climate data, we need more climate data and there's already.
Over 50, uh, petabytes of data annually. And I think this was, uh, maybe a new word for, uh, some listeners in that one pet. I had never heard petabyte before , right? And, uh, you know, I had to get a sense of it as well. Uh, and so this is 10 to the 15th bytes. So, uh, you know, one quadrillion bytes, you know, a mil, a million gigabytes, so an absolute ocean of data.
But that's what, you know, having data centers and, uh, with all the, uh, innovation within the data space, uh, that can be put to good use for climate data and to help, um, you know, help with environmental justice as well to get information to the people [00:20:00] that need it. Yeah, and you know, sometimes when we're talking about the global scale or even just climate change in general, it just feels overwhelming, right?
It feels like such a big problem. This massive train just coming down the tracks, um, that's already, you know, running over people. Um, and it shows up in different specific ways in different places. So where I live in the Pacific Northwest, we are very affected by wildfires, for example, and everyone. wants to make those get better.
Every community wants to get a better plan for wildfires, make their communities resilient. Um, and it seems that seems like something we can tackle a little bit better together is being more specific than climate change, helpful for communities to come together for solutions. Absolutely. And you think about examples within agriculture.
Well, if you're talking to a farmer, you know, I'm, I'm from Indiana. And so there's corn farm, you know, uh, farming, uh, operations all over the state and in the Midwest and, and elsewhere. And we think about what's important to the [00:21:00] farmer. You think about soil conservation. Changing ecosystems. Those are things that they think about and that they're actually expert, uh, expert in, more expert than, than us.
And so that's where we can engage, we can learn, uh, you know, from our neighbors there. And thinking about if we're talking about, if we're worried about, Wildfires or we're worried about, uh, hurricanes. We just talk about those natural disasters and how, you know, and how the climate change, uh, can worsen those.
Uh, that's important. But we need to talk about disaster planning. Uh, you know, that's a key, uh, a key part of all this. So, um, I think, uh, words, words are important and words, um, you know, can also. Um, sometimes make people think, uh, think about something differently and maybe not in a productive way. So, um, I think, you know, focusing on specificity is important.
So what role can medical societies play in this? The medical [00:22:00] societies, there are many different things that the medical societies can do. I think the ATS as a medical society is very active within multiple areas. The, the Environmental Health Policy Committee of ATS is, is very active within this field and specifically it's done, uh, the ATS and this, uh, EHP.
Um, committee has done hard work on the health consequences of increased heat, uh, the burden of wildfire smoke exposure and, you know, thinking about how we can develop a more robust or comprehensive social cost of carbon estimate, uh, which is important when you're thinking about priorities from a national international level, you have to think about what does that carbon cost, you know, and how to.
Uh, if we're going to make decisions about renewable energy, we're going to make decisions about power generation. Uh, you have to think about how much that, [00:23:00] uh, the carbon emissions cost. Yeah, I have to say, um, on a personal note, as the mother of three young kids and a pulmonary critical care doctor living in wildfire country, I often feel significant anxiety about what the future holds for all of us.
And, you know, I worry about things like flying to medical conferences, um, and whether if I'm using a plug in hybrid or an electric stove, is this really going to move the needle? Um, anything in this workshop report to help people like me? Well, I think we emphasize, uh, in one of our, our first figure, we talk about the expanding rings from a personal to a community, uh, to society and global level, the expanding rings of actions that can be taken.
Um, but it will, it will take all the, it will take the entire spectrum of action to truly, you know, make a, uh, a very significant impact on On climate change. And so this is a large challenge. So it's going to take everyone working together. And I think, uh, one thing that, uh, we didn't [00:24:00] emphasize in the workshop, but I think can be helpful for framing is the something called the climate shadow.
And this is by a journalist and author, Emma Hattie. Um, and she wants to want to focus on. the, you know, a more holistic view of the impact of an individual's impact on climate, both the good and bad. And I think rather than just focusing on carbon footprint and saying, all right, what's my tally? Oh, I drove to work.
I, you know, I ate, uh, ate meat, uh, one day. And, you know, rather than just tallying that up, um, I feel like that, uh, and I think. Others would agree that that puts us into little bubbles of shame where we're ashamed of what we did. Does that hurt the climate? Well, that doesn't lead to us feeling confident and feeling like we want to engage.
It wants us to all stay separate. And I think when we are separated, this goes for many things, uh, when we are separate and acting as individuals, we just aren't as strong. We need to band [00:25:00] together. Uh, to face big challenges and this is one of the biggest, uh, that we, that we face. So the climate shadow thinks about, okay, well, what are the, some of the things that you, you know, contributed, you know, in terms of CO2, but what are some of the good things you did?
Did you, you know, think about getting a battery powered either vehicle or lawn equipment, or did you listen to this podcast on climate? Um, did you, you know, do, do talk to neighbors, talk to family members, you know, and. All those choices make it different. It may seem small, um, but those choices really, uh, you know, really help, uh, start change and, and really sustain it.
But I think the key is we just have to, we have to come together and not say that someone's doing it slightly wrong so that their way is not going, is not valid. We need to all work together and it's going to look differently, but. Um, this is, uh, with Americans having about 16 tons of CO2 [00:26:00] generation each year, we have some work to do.
We've got to reduce, uh, we've got to reduce that. Yeah, absolutely. I love the idea of popping the bubbles of shame and because we emit so much kind of anything we do is going to help. So, you know, just grab something and go, you know, we focus a lot on carbon dioxide, but climate change actually has a lot of complex drivers.
So what else can we focus on doing besides CO2 emissions? Not that they're not important. Well, absolutely. CO2 and CO2 is important. Uh, but we also have to think about methane emissions. So, uh, methane is very important. That's where there's been efforts to try to cap these, uh, fracking, old fracking wells that are just spewing methane out.
That's a problem. Let's just cap those. Or maybe we get a win win and turn those fracking wells into geothermal energy creation. You know, there's there are very innovative ideas out there to try to tackle the climate change climate challenge with something, you know, something synergistic in that way and all around the world.
This is a key part. As I mentioned before, [00:27:00] we don't want to come in and tell people. You know what their community needs and what, you know, this kind of top down approach we need to learn from communities. We need to learn from communities around the world. Let's say that biomass is a key, you know, in some areas of the world.
Biomass is an important way for folks to heat their homes, for them to cook their food. Um, well, then we need to come up with, you know, see if there are affordable alternatives. Uh, for those individuals, I try to limit the, you know, the black carbon, uh, is one of the climate force or something that worsens climate change is a pollutant called black carbon.
And, you know, that is, you know, that is an important part, both for the biomass, but also for old diesel vehicles, for example, you know, can we get, uh, vehicles tuned up or alternatives. Uh, you know, to those vehicles in some areas of the country, so or the country and world. So I think the key is being sensitive to where, [00:28:00] what different communities, what their expertise is and what their, what their challenges are and, and trying to work together.
Absolutely. And clinicians can often have powerful and trusted voices in their own communities, whether at the city, county, or state level. And hopefully this report will give them ideas on where they can help be of service, you know, in their own communities through advocacy, engagement, education. Are there any other areas of those low hanging peach fruit for the respiratory care professional?
Absolutely. So, uh, as my colleagues at, uh, University of Rochester know, I love to talk about smoking cessation and tobacco dependence treatment. And so, tobacco. So, when people are smoking, right, we think, what's the best way that we could help our patient? I frequently tell, uh, my patients this. that one of the biggest things I could do is help you in your journey to quit smoking.
And I think that is a key one. Both we can directly improve the respiratory health, but then indirectly, think about all the carbon emissions, uh, [00:29:00] from, uh, the cigarette production industry. And, you know, it's a It is a fraction of the airline industry, but it's something that is not necessary for health, right?
If, if cigarettes are not, um, you know, a food that we need to eat or something that's essential for life, um, can they be eliminated and, or at least very greatly reduced? So, I think you, so I want to encourage everyone. We talked about climate shadow. What are you doing? You are already working on climate change.
You are already affecting positive change by helping your patients quit smoking. Keep doing that. Keep doing that. And then start reaching for those other branches. Help your sustainability coordinators at your hospital. If there's not one, maybe you're it. Maybe you're the new sustainability coordinator.
And Just really, really get involved and support your colleagues that are working on this, whether it's at ATS in your, uh, in your hospital or, you know, in your area, just, uh, you know, supporting them [00:30:00] and keeping them going. It can be a bit of a grind, I think, as we both know, when we think about the daunting challenges of, uh, of climate change and, um, and respiratory health.
And so I think we need to help lift each other up and keep us, um, you know, keep everyone, uh, working towards positive change. Absolutely. And thanks for bringing up the tobacco issue, the uh, the amount of microplastics in those filters, which we know do nothing and they're just microplastics. So the second most littered item in the world and obviously they come from the petrochemical industry.
So I think tobacco is just one of those other things that's just so prevalent. It's almost invisible. And then when these disposable electronic cigarette devices, it's just electronic waste that often ends up getting incinerated and that lithium could be better used in, you know, electric vehicles or something.
I think that's a great point. And also on the this. Disposables, right? So maybe over 60 percent of the e cigarette market is now to the disposable e cigarettes Those disposables, they're going, unfortunately, on our roadways and waterways, but also into the landfill, [00:31:00] and to waste treatment facilities, uh, and to, uh, waste management facilities, causing fires, right?
Those batteries are causing fires, but then they're releasing more smoke, um, so that's a, it's a health problem. You know, the health concerns with those, but also, uh, environmental, uh, concerns, too. I think while you mentioned plastic, plastic's a, uh, an important thing to think about, too, in that, um, I remember back in third grade, I came home as a little student with a backpack as big as I was.
And the topic of that day was recycling. So I came back and I told my family, we're going to start recycling. And so then every week, we gathered up all the recycling. And for years and years and years, uh, we did that only to find out that much of the plastic that's going to recycling is being thrown in the trash.
And so that, that, these are some of the motivating forces [00:32:00] where I say we need to keep doing better. It's the right, that's one of those examples, that's the right idea, but what's the problem is that plastics are made from fossil fuels. And so now we're just wasting, we're using plastic, fossil fuels, uh, to make plastics, and then we're not even effectively recycling them.
And so, and there's a growing concern with the plastics ending up in our bodies too, which I think isn't, you know, again, one more thing to worry about. So, you know, let's just move away. Right. Well, and I think, you know, that's the, um, you know, that that's the tough part about this space. But I think the key there is that in this circle, if you remember the circle of recycling, right?
The first, there's three R's reduce, reuse, recycle. Recycling is meant to be the third R. That got moved to the top. Uh, it is important and recycling is, um, is important, but reducing, that's what we talked about with the medications in your facilities, uh, reducing that, reducing your own personal consumption, reducing fossil fuel [00:33:00] consumption, reducing is just absolutely what we need to do.
We need to, uh, basically take it down a notch, uh, within the consumption framework. Erika, I know you're working on a lot of things for the upcoming ATS meeting. Uh, what can ATS members, uh, do to learn more about, uh, these efforts? Well, if people are coming to the meeting, you can attend an event called Strategies to Reduce Pulmonary and Critical Care Practice Emissions, which is going to be in the Networking Center, uh, Tuesday, May 20th at noon.
Um, there is also a workshop report on that topic that should be coming out sometime this year. Um, and I would say, you know, this is important across every section of ATS, whether you work in lung cancer, asthma, environmental health. So whatever your section is at ATS, go to the meeting and ask what you guys are doing about climate change and making sure everyone's represented at the table and that we're reaching out to all the right communities.
Um, and also many. States have regional chapters of American Thoracic Society. We have one here in Oregon, um, and it's nice because you can collaborate with other local organizations like the American Lung Association or [00:34:00] the American Heart Association on actually working at your county, state, and local level to, you know, address problems from climate change and, you know, decreasing tobacco use.
And it's always better to do things together. Um, and then we know everyone's busy. So you can also check the show notes for a host of resources, including many of the Air Health, Our Health podcast episodes that feature members of the Environmental and Occupational Health Assembly. I'm the host of that podcast as well.
Um, and also the ATS makes a host of patient fact sheets because we know everyone's busy and sometimes it's good to just be able to put something in your after visit summary for a patient. And there's a host of resources that are relevant to this topic. And we'll also link to those. So thanks for giving me a chance to highlight all that, Dan, and I want to thank you so much for your time and for this wonderful workshop report.
I know from experience that these workshops take a ton of time and effort, and especially if you're leading the workshop, which I have never done, um, I have such great admiration for all the effort that goes into this. Absolutely. And it was great to talk to you as well and to [00:35:00] our, to our community. And I just want to thank everyone that was part of the workshop.
It was a complete team effort there, uh, trying to get all these important ideas and, uh, ideas and efforts on paper there. So thank you to everyone that worked on the project and thank you to everyone listening. Yeah, and hope to see you all at the meeting.
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