Environmental health and clinicians: time to promote more action.

Abstract

Climate change and ambient air pollution are threats to human health, with dramatic short- and long-term effects on mortality and morbidity. Pollution generates fears among citizens who rarely receive adequate information for risk mitigation. A large burden of evidence is describing since decades the health effects of pollution, linking environmental exposure to pathophysiological mechanisms (mainly, low-grade chronic inflammation) that lead to an array of chronic non-communicable diseases. Epidemiologists are deeply involved to depict environment-related diseases, identify risk factors as well as to offer suggestions for prevention policies. However, their warnings are frequently disregarded by clinicians and policymakers. In clinical practice, diagnostic evidence is the basis for therapeutic interventions. Conversely, epidemiological evidence in the field of environmental health rarely generates appropriate preventive and clinical actions. Despite the great interest and concerns of citizens and epidemiologists, the perception of pollution as a major hazard to health is often scarce among clinicians, as witnessed by thepoor presence of environmental health in the majority of clinical guidelines, meetings of scientific societies, and medical curricula. As a consequence, inaction is not uncommon among clinicians, who often fail to routinely engage in counseling their patients on how to reduce their health risks from living in an unsafe environment nor toact as advocates in orderto enact changes in the community. This gap should be urgently bridged by creating opportunities for health professionals to be adequately informed and trained to play an active role in tackling environmental risks.