This Earth Day be a Champion for Environmental Science

Did you know that doctors are among the most trusted professionals in this country, specifically with regard to information about climate change? Environmental factors are hurting the health of millions of Americans every day and yet there is still a considerable lack of awareness about the harmful effects of things like extreme weather events, air pollution and other toxins.

As Earth Day approaches, it seems fitting that this year’s campaign is focused on environmental and climate literacy because it reminds us as ob-gyns how important it is for us to participate in the effort by leveraging the trust our patients have in us.  Our partner organization, the International Federation of Gynecology and Obstetrics, has kicked off the week by launching a social media awareness campaign around Earth Day.  You can follow them on Twitter under the handle @FIGOHQ.

Last month, I spoke at the launch of the Medical Society Consortium on Climate Change and Health that has brought together ten associations representing nearly 500,000 physicians, including ACOG, to help increase awareness among the public and policymakers about the negative health effects of climate change on Americans. During my talk, I spoke about the fact that women face some of the greatest risks from climate change over the course of their lives, and especially during pregnancy. In affected regions, climate change puts women at risk of disease, malnutrition, poor mental health, lack of reproductive control, and even death. Additionally, women’s exposure to toxic environmental agents during the preconception and prenatal stages can have a profound and lasting effect on obstetrical and later life outcomes, including increased risk of birth defects and childhood cancer.

In 2016, ACOG adopted a policy which recognizes that climate change is an urgent women’s health concern and a major public health challenge endangering fetal health. In fact, we discover new evidence every day of how it can disturb fetal development. A recent NIH study found that exposure to extreme hot and cold temperatures during pregnancy leads to increased risk of low birth weight in infants.

While the connection between climate change and women’s health may not at first seem obvious, there are a number of ways it directly impacts women’s health.  You can look at them in several categories: a healthy pregnancy starts with clean air, clean water, no toxic chemicals, and stable climate.

Air pollution poses serious risks for women’s health.  It is linked to pregnancy loss, low birth weight babies, and preterm delivery.  Fine particle air pollution affects the placenta in pregnancy, and can interfere with fetal brain development.  Ambient and household air pollution result in 7 million deaths globally per year; these effects are worse in low-resource areas.

Heavy downpours and flooding mixed with high temperatures can spread bacteria, viruses, and chemicals that lead to contaminated food and water. This results in higher levels of methylmercury in fish and shellfish, a known cause of birth defects.

Increased use of pesticides can interfere with the developmental stages of female reproductive functions, including puberty, menstruation and ovulation, menopause, fertility, and the ability to reproduce multiple offspring. These toxic exposures also affect fetal brain development, and contribute to learning, behavioral, or intellectual impairment, as well as neurodevelopmental disorders such as ADHD and autism spectrum disorder.

Extreme temperatures have fostered increases in the number and geographic range of insects. For example, Zika-carrying mosquitos have led to more than 1,500 infections in pregnant women across the United States and District of Columbia, and more than 3,200 infections in Puerto Rico and U.S. territories. Furthermore, extreme heat during pregnancy is tied to a 31 percent increase in low birthweight babies less than 5.5 pounds.

Unfortunately, in many cases, underserved and vulnerable populations are disproportionately affected by climate change. This includes individuals living in poverty, exposed to toxic materials via their occupation, who lack nutritious food, and live in low quality housing. That’s why access to health care is so critical.

We don’t all have to be experts in environmental science, but we all need to support rigorous scientific investigation into the effects of climate change and toxic environmental agents. With evidence to support us, ob-gyns must be the authoritative voice and help to ensure that the discussion on climate change includes protecting the health and safety of all women and children.

This blog post was co-authored by Nathaniel DeNicola, MD, MSHP, the ACOG liaison to the American Academy of Pediatrics Executive Council on Environmental Health, and social media director for the International Federation of Gynecology and Obstetrics Working Group on Reproductive and Developmental Environmental Health.

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About Tom Gellhaus, MD

Tom Gellhaus, MD is ACOG President through 2017. He is a Clinical Associate Professor in the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Dr. Gellhaus graduated from Yankton High School in Yankton, South Dakota, received his Bachelor of Arts Degree in Chemistry from Augustana College in Sioux Falls, South Dakota and his Doctor of Medicine Degree from the University of Oklahoma in Oklahoma City, Oklahoma. He completed his residency in Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics. Following residency, he entered private practice in Davenport, Iowa and after 20 years in private practice, he returned to academic medicine at the University of Iowa. Over the past 20 years, Dr. Gellhaus has served in many ACOG positions at the local, regional, national and international levels. Dr. Gellhaus’ interests are in the areas of health care advocacy and policy. He has also been very involved and active in global healthcare. He has completed the McCain Fellowship, a month long in-depth experience in advocacy, at ACOG in Washington, D.C. in 1999. In 2001, he was a Primary Care Policy Fellow with the U.S. Department of Health and Human Services. He has remained active in Advocacy and Policy as a member of ACOG’s Government Affairs Committee and the Ob/Gyn PAC. Dr. Gellhaus has also been very active in leading groups on short-term medical and surgical mission projects for the last 20 years. He has done numerous presentations about these short-term medical and surgical mission projects throughout the United States.

3 thoughts on “This Earth Day be a Champion for Environmental Science

  1. When I noted that ACOG was becoming involved in a Consortium on Climate Change and Health my interest was aroused. This blog heightened that to great concern ACOG has become involved, assuming it represents the understandings of the Consortium which do not appear to fall within what is meant and understood by the term “climate change.” My comments are based on the subject of Climate Change (formerly known by the much less inclusive title of Global Warming) which I have been studying for over a decade. Initially becoming obvious was the labeling of an opinion as science, attempting to cloak it in veracity (not unlike most trusted professionals in this country, specifically with regard to information about climate change in the blog’s first sentence). Then one encounters a statement that “science is settled” so further inquiry is not necessary. With Climate Change, it is generally understood to mean “anthropogenic” so we have a responsibility to act.
    True science by its very nature is never “settled” – or as Einstein said of his work, the whole world could believe he was correct, but it would take only one person with demonstrated scientific evidence to prove him wrong. With Climate Change, it is not wise to buy into a theory just because the government, mainstream media, marching masses, or even many “experts” espouse a particular view. Ever heard of Galileo?
    Climate Change quite strictly involves just that or events proven to be related to it. The initial understanding must be the fact that the climate has experienced change for millennia, with temperatures over lengthy periods either decreasing or increasing. Currently, there appears to be a lengthy period of very gradual increase. Real honest records show increases to be not remarkable or dangerous. You won’t read that in the newspaper or see it on TV. Questions have been honestly raised about quality and interpretation of data. There are many “inaccuracies” popularly conveyed which are primarily based on dozens of “models” ALL of which are wrong. Using them, one cannot predict what is known to have already happened and been recorded, let alone the future. Oft quoted comments about 97% of scientists, more severe weather events such as storms and hurricanes, sea levels rising, glaciers melting (truth: some are, others are increasing – net about zero), polar bears dying (truth: 40% increase by count in Norway) are quite simply NOT TRUE. For a thorough review of the documented peer-reviewed literature and its conclusions, please see Why Scientists Disagree About Global Warming available from The Heartland Institute, http://www.heartland.org either downloaded free or by mail. If you have any specific questions, you can contact Jim Lakely at Heartland JLakely@heartland.org.
    Of course, the culprit of the supposed problem to solve are “Greenhouse Gases”, particularly CO2, often referred to simply as Carbon (as in Carbon Tax), and of lesser importance also methane and others. CO2 can be measured, even from gas bubbles frozen in ice millennia ago, revealing when combined with temperatures at the time, also subject to determination, it rises AFTER temperatures rise. If one believes in cause and effect, that is obviously not consistent with CO2 being a cause. If we are to do something to reduce warming supposedly caused by CO2, why has no one suggested that we reduce or stop breathing? Regarding methane, some wizards have suggested that research be done to reduce cattle farts. The simple fact is that true science really has a very inadequate idea as to what causes Climate Change. Sunspots are very likely a strong factor. Ocean currents and particularly El Niño are likely contributory as are volcanic eruptions. These and other possibilities are NOT factored into the models, so depending on current theories is fraught with error. Those who question the popular thoughts are derisively called “deniers.”
    This blog is a conflation of terrible things most of which are totally irrelevant to a discussion of Climate Change, a term under which they should not be included. It is important to attack and solve problems such as true air pollution, food contamination, and the plethora of disastrous maladies including infections, malignancies, and those of genetic origin yet affecting our patients. Even remotely possibly related human problems due to “extreme temperatures” are unlikely as the changes predicted by the loudest alarmists of @1.4 C. over an extended time are not extreme. Efforts to limit CO2 make no sense as it obviously is not a pollutant in even much larger amounts than being now experienced or projected (despite the claims to the contrary) nor causative, and is actually beneficial, being piped into greenhouses and showing effects on satellite pictures of improving cultivation worldwide. With even slight gradual warming, a better environment is being created. If you want to talk about decreasing poverty and increasing health without utter hypocrisy, it’s time to get off the Climate Change bandwagon and understand real science and not masquerade under its banner. ACOG needs to better understand this issue and spend its precious resources and encourage others to use theirs on real potential benefits to humanity.
    During my years of active practice, many problems were addressed worldwide by competent research. Two among others solved were of great benefit to my patients. First came the solution to Rh disease and later the development of the quadrivalent (now nonavalent) HPV vaccine, for which I was involved in recommending half of the seventeen initial study sites for the large clinical trial. The tragedy of fetal or infant loss in private practice and the treatment of over 6,000 patients in a college health setting with HPV related diseases can’t help but leave a profound memory of the seriousness of our profession. To see ACOG involved in a futile and truly non-scientific effort is indeed disappointing.
    Please do not hesitate to contact me.
    Henry W. Buck, M.D., FACOG, FACS, FACHA
    hbuck@ku.edu

  2. Thank you for making this a priority issue and calling attention to the impact on the disproportionate impact to women’s health.

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