MedEvidence! Truth Behind the Data

How Climate Change Threatens Children’s Lungs

• Dr. Michael Koren, Dr. Debra Hendrickson • Episode 351

Share episode

Send us a text

Pediatrician and environmental scientist Dr. Deborah Hendrickson joins Dr. Michael Koren to discuss how the environment affects our health. Dr. Hendrickson uses the example of poor air quality from sources such as wildfires and pollution to explain how this impacts children's breathing, from lung development to allergies and asthma. She also notes that the climate is changing due to human causes, which should inspire hope that human solutions are possible. The doctors conclude by discussing how climate change is making things more difficult everywhere and how the risks to our children, in particular, are increasing.

Be a part of advancing science by participating in clinical research.

Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.com

Listen on Spotify
Listen on Apple Podcasts
Watch on YouTube

Share with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.

Follow us on Social Media:
Facebook
Instagram
X (Formerly Twitter)
LinkedIn

Want to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.com

Music: Storyblocks - Corporate Inspired

Thank you for listening!

Announcer:

Welcome to MedEvidence!, where we help you navigate the truth behind medical research with unbiased evidence-proven facts, hosted by cardiologist and top medical researcher, Dr. Michael Koren.

Dr. Michael Koren:

Hello, I'm Dr. Michael Koren, the executive editor of MedEvidence! And I'm really delighted to have Deborah Hendrickson, a pediatrician and a physician who practices in Reno, Nevada, as a guest today. And Deborah, you're an expert in helping people understand the impact of climate change on the health of our kids. And not only that, you wrote a beautiful book about it. I haven't completed it yet. I've been a third through, but it's a terrific read, and hopefully it'll share some of your thoughts about why you wrote this book and also why it's important for people to know about these issues. So again, uh Deborah, welcome to MedEvidence!

Dr. Debra Hendrickson:

Well, thanks very much for having me.

Dr. Michael Koren:

So let's just start by telling everybody about your background. I mentioned you're a pediatrician, you're in Reno, but just tell us where you grew up and why you ended up becoming a pediatrician and and and some of your passions regarding your day-to-day.

Dr. Debra Hendrickson:

Yeah, so I grew up in the Bay Area in California, um, went to school in New England. Uh so I've lived, you know, both ends of the country and also briefly in Ohio as well, and in Seattle, Washington. So I've I've touched all a lot of the corners, not down in Florida, but a lot of areas of the country. Uh and for uh in college and for 10 years afterward, I was I focused on environmental science. I was uh a degree in environmental science uh as an undergrad. And-

Dr. Michael Koren:

where was that? Which college was that?

Dr. Debra Hendrickson:

At Brown. I went to Brown in Providence.

Dr. Michael Koren:

Yeah.

Dr. Debra Hendrickson:

Um, and I uh worked for 10 years as an environmental analyst and planner for uh government agencies in New England and Washington and uh Washington State in Seattle in the Seattle area. And I worked mainly in flood claim management, you know, using big computer models to study the hydrology and soils and how uh changes in urban uh development in these areas would affect stream flows and salmon habitat, because salmon are so important to the Pacific Northwest. So, anyway, so I had this background in environmental science and then um went through a major life event, which you probably read about in the book, and I had three small children, and I had really grown to enjoy my visits to the pediatrician because he would pull out textbooks and really talk to me about the science of what he was thinking. And I kind of liked the detective aspects of it, and I liked the idea of combining some of my science background with uh caring for kids. And so when I faced this life crisis, I decided to change direction and went back to medical school to become a pediatrician. Um, and uh, so that's that was my background before I became, you know, and and so climate change was kind of uh a way that both of my careers came together, that uh that an environmental issue was affecting the health of my patients.

Dr. Michael Koren:

Interesting. So just to help the listeners and viewers understand this better, you you talk about a lot of things in the book, and the name of the book is called The Air They Breathe. And for that reason, obviously, some elements of uh respiratory issues in in kids is uh is an important part of this, although more broadly you talk about all the effects of climate. But um tell tell us a little bit more about where you got the title and also um some something about childhood asthma. How often is it that people that that young kids come into the emergency room, for example, or come to your office with breathing problems? How often is that related to asthma, or what else can it be? Just so people get a little bit of the medical background of these type of issues.

Dr. Debra Hendrickson:

Yeah. So the title comes from one of the major themes of the book, which is that it's really impossible to separate a child's health from the health of the environment and particularly the quality of the air that they breathe. Um, and so there's a whole passage in the book about this in the introduction that you you probably read. Um, that uh, you know, for example, the lungs, uh, you know, children are born with most lung development happens after birth, like 80 to 85%. So you're born with like 30 to 50 million of these saccules that then differentiate into hundreds of millions of alveoli. And we know that um kids who are born or raised in areas with bad air quality uh are uh they tend to have smaller, stiffer lungs by the time they reach adulthood because they're there it impairs the differentiation of the alveoli. They tend to have um increased elastance of the lungs, so stiffer lungs and the immunity of the lungs is affected too. And that has, of course, lifelong implications. So um, and also I go into some detail in the book about how the brain can be affected by the quality of air we breathe. We now know that air pollution is a um a major derailler of normal development uh in kids living in high pollutant areas. And the reason this is an issue with climate change, it's not just that fossil fuels increase um air pollution and on their own, even if they weren't causing climate change, they would be having many of these impacts, but they have been another impact, which is increasing wildfire smoke, increasing ozone or urban smog, increasing aeroallergens. So they're having a number of uh, you know, they're also looping back and causing even further uh impacts, especially in areas of the West out here where we're so impacted by wildfire smoke. So that's so the main point of the title was that kids develop through interaction with the environment and particularly with the air they breathe. Um, and so that that that's a very important determinant of health.

Dr. Michael Koren:

Yeah, fascinating. Yeah.

Dr. Debra Hendrickson:

The second part of your question about um asthma versus other things, you know, we often see small children in pediatrics who, of course, have bronchiolitis, you know, like RSV or metapneumovirus. Um they'll come in wheezing, coughing, and it'll seem and sound a lot like asthma, but um you can sometimes tell just from the exam because it's more coarse and uh, you know, the slightly different presentation, or or they'll be positive for RSV on the on the lab test that you have in the office. You'll know that it's it's bronchiolitis and not asthma, although those kids are going to be a little bit more prone to asthma afterward. Um, so the there are, you know, and and sometimes kids will just come in during a smoke event and be short of breath. Or, you know, I've had patients end up in the hospital during a smoke event in our town, because we have that's what's been the biggest impact of climate change here. Well, we're 10 miles from the California border, so we get a lot of wildfire smoke from just west of us. Um and they may never have another episode, but but the smoke was the cause. It was a you know an environmental trigger, uh, not that they have asthma underlying it.

Dr. Michael Koren:

Interesting, interesting. So one of the things that occurred to me as we're talking about things is that 100 years ago you would read in novels and other pieces of literature that people move from New England to warm climates like Arizona for their health, particularly respiratory illnesses.

Dr. Debra Hendrickson:

Yes.

Dr. Michael Koren:

With the concept being that it's warmer and drier. But maybe that's different nowadays with climate change.

Dr. Debra Hendrickson:

Uh yeah, and the the second chapter of the book is actually all about Phoenix, and I go into some of that history because um, yeah, and it was it was interesting because there was a whole field of medicine at that time called climatology, which of course has a very different meaning now. But it was this idea that you could prescribe people a place to move to and that a different climate would improve their health. And a lot of people did improve when they moved to Arizona, but it was probably in many cases just because they were getting out of some of the 19th century tenement conditions in some of these cities. Um uh so yeah, that is a big part of the of the history of the Southwest.

Dr. Michael Koren:

Um so writing this book is a huge endeavor. Um, I'm always impressed by my guests that have put the time and effort. It's it's it's not easy, especially when you're still practicing and you you have lots of other parts of your life. So so tell me a little bit more about what drove you to write this book. Was it you one incident, multiple uh incidents, what what was it that made you decide to literally spend the time to put together such a nice piece of work?

Dr. Debra Hendrickson:

Oh, thank you. Yeah, um, I had, you know, as as I was seeing more and more impacts of the smoke in the office, I I really wanted to to help parents understand uh both the urgency of the moment that we're in right now with climate change uh and their own agency to do something about it. I kind of think parents are the sleeping giant in the climate fight. And I was kind of hoping to tap into that fierce protectiveness that anybody in pediatrics has seen in their interactions with parents in the clinics and hospitals and help them be as concerned about this as they are with any other aspect of their kids' health and give them some guidance about what to do about it. And it was also, I really wanted it to be kind of a moral call to action. You know, I wanted it to evoke powerful emotions and wake up people to the implications of what's happening to the people we love most in the world. Um, because I do think that climate change is a crime against children. I think this is the greatest moral crisis that humanity has ever faced, and it's up to all of us as individuals to do something about it. And um there was one specific incident that triggered me writing the book. I don't know if you wanted me to talk about that too, that you read about it.

Dr. Michael Koren:

Absolutely.

Dr. Debra Hendrickson:

Yeah, so it was um it was about 12 years ago. It was uh the first of the we we had a we've had a series of major, uh we call them smoke crises here, where we just get um weeks up to months of smoke. Um, where we, you know, that it's very um it's very overwhelming and and oppressive. Um, but the first one of these really was in 2013. Uh it was called the Yosemite Rim Fire. And I was seeing a little girl in my office uh who had already had some respiratory issues, some asthma symptoms, and she was only about 10 months old. And uh outside the windows of the hospital that day, uh ash was raining from the sky like snow, and it was just swirling around the building. Uh, and uh it was just an apocalyptic scene. And uh her mom brought her in because she just couldn't get her symptoms under control, and she'd put this damp baby blanket over the car seat to try to keep her protected, and it was covered with little flakes of ash when she came in. Anyway, I had this baby on the table and I was listening to her lungs, and she was just looking up at me with these big brown eyes, struggling to breathe. And that was really the moment that I realized that I was seeing things that I had learned about in my environmental education and career in terms of the forests uh burning at much higher rates. And we didn't realize it at the time because that was a really unusual event at the time, but it became a very routine event over the subsequent decade.

Dr. Michael Koren:

Interesting. That, you know, having an interaction with a patient like that can be incredibly motivating for us physicians and uh and to your point a call to action. And this gets into a little bit of the controversies around climate change. And again, we're not political here. We just like to report the facts and let people make their own decisions. But there are some debates about how much of climate change is man-made and how much of it is from other sources. And um you can weigh in a little bit on that, and uh I think that's important for people to hear. Is it is it something that, in your view, is entirely man-made? Is it something that it's other sources and and how does that matter for protecting your patients at the end of the day?

Dr. Debra Hendrickson:

Oh, yeah, no, this is this is a man-made problem, and you know, 98% of scientists in the world agree. You'll you'll always found find some outliers uh in any question of science. But uh no, the the issue is that the green greenhouse gases in the atmosphere have been steadily increasing in concentration since the dawn of the industrial age, and those gases trap heat that would normally radiate back out into space. And you can uh they have the the models that predicted what would happen as CO2, which is the most important greenhouse gas, as CO2 rose and what we expected, have been almost exactly on the nose. And in fact, you you probably know that uh the oil companies themselves knew this. In in 19 the 1970s and early 1980s, Exxon, for example, devoted millions of dollars of research to uh investigating the alarms being raised by some of their own scientists about what their products would do. And there's a very famous graph that they produced that predicted almost to a tenth of a degree exactly where we are now in terms of CO2 concentration and the temperature of the planet. Uh so this is a man-made problem, which means that we can also do something about it, you know, that we we need to cut back these gases dramatically in the next few years, which is you know more challenging now because of the administration in the US. Um, but it's a problem, it's it's technologically feasible to do what we need to do. It's uh entirely a political problem.

Dr. Michael Koren:

Yeah. And again, uh I I would say I personally agree with most of what you're saying, not 100%. I think there's certainly room for looking at the the course of CO2 concentrations in the environment over time, literally millennia, and big fluctuations. So with all things in in research, there's room for interpretation, but no doubt there's a there's a major contribution from man-made activities. I think we anybody with a reasonable uh look at the literature and a reasonable look at uh the data would would come up with that conclusion. Um but that gets into the whole concept of what can we do about it. And of course, we have the the short-term issues are how to protect our kids, and then the the longer-term issues is how do we change our economy so that we can hopefully have a more sustainable long-term trajectory for our kids, kids, and our kids, kids, kids, and our kids, kids, kids, kids, kids. So maybe uh you can jump into that a little bit because uh you made a super interesting comment about medical climatology being its own specialty, and maybe we still need to be thinking in those terms to some degree.

Dr. Debra Hendrickson:

So uh the good news is that there's actually been an explosive growth of solar energy around the world and battery storage. Um China's uh growth in solar is so astounding that they're meeting their Paris goals ahead of schedule, and they're likely to become the first electrostate that is powered entirely by renewable energy and battery storage. Um so there's a lot of good, hopeful signs around the world. Uh I this is, you know, and and these energies are cheaper, faster to create. And um, you know, a lot of the barriers right now are just how to connect them to the grid and technological issues like that, but but those can be overcome with the with the right funding and governments in place. Um so it's it's it's entirely a problem we can solve. And there's a lot of hopeful signs on the horizon. The issue is how fast it's happening in countries like ours, you know, wherever we have a very limited window of time to avoid the most catastrophic warming. Uh, the modeling has shown that we're supposed to cut the greenhouse gas CO2 emissions in half by the end of this decade to avoid going over 1.5 degrees um centigrade centigrade warming in the trend line of warming. So um it's uh, you know, and that's obviously a window that's rapidly closing. So we're probably going to exceed it, but every tenth of a degree matters. And so we need to just work as fast as we can to make this transition happen.

Dr. Michael Koren:

Well, if I'm not mistaken, the models also would suggest that if we stopped all CO2 production tomorrow by some miracle, we're still going to see warming in the environment. So there's certain, there's going to be a certain period of time we're going to have to deal with this, which gets into this whole issue of how do we protect our kids in the short run. And so I'm curious about your thoughts about that.

Dr. Debra Hendrickson:

Yeah, the modeling shows that warming, well, the most recent modeling that was done on this anyway, showed that warming would stop in three to five years if we completely stopped CO2 tomorrow. Um so in terms of how to protect kids, there's there's kind of two avenues parents can take. One is adaptation. That's what do we do to protect our kids right now from things that are happening right now. And the other is, you know, mitigation or sustainability. What do we do to keep uh this problem from getting worse? And in terms of adaptation, it depends which issue you're talking about, whether it's wildfire smoke, you know, or air quality or heat waves or hurricanes, you know, and there's a list of recommendations I go through in the book for each of those for how to protect uh our kids. And then for sustainability, you know, it's uh I usually tell people to think of your own life as being in the center of a series of spheres, you know, and um your child is in a home with a family and uh and that's the center sphere. The next sphere out might be their school and your job and then your neighborhood, your city, your county. And take an inventory of your own greenhouse gas use in each of those, or or the the of your community's use in each of those spheres, and just pick one thing to work on. Um, it might be electric school buses for your kids' school or help or helping the school convert to a heat pump uh with solar panels instead of a standard HVAC system. And getting kids involved in those kinds of projects can really help them with um how they're feeling about this issue as well. So um I think you know those that those are the two avenues that parents of action that parents can look at. And um, and like I said, I went into more detail this at the end of the book.

Dr. Michael Koren:

That's terrific. So are you recommending people move to different places if they're growing up in a desert environment and there's wildfires and they're being subject to the ash? Should they be moving someplace else back echoes of what happened 100 years ago when people are moving to warmer climates?

Dr. Debra Hendrickson:

Yeah, well, um it I think with climate change, it's kind of an issue of pick your poison because you know, yeah, if you're in Arizona, the the temperature projections for Phoenix are it's hard to imagine living there uh if if these bear out, um, that we're gonna see temperatures in the 130s by mid-century. So yeah, so so even just going outside and those kind of temperatures, and obviously that's just for the hottest parts of the year, but the length of periods where they're seeing over 100 degrees is getting longer and longer every year, too. So if you're somebody who's very sensitive to the heat, like an older person, that may not be a place that you can live anymore. If you have a if you're a person with a lot of respiratory problems, living in the West is gonna cause some issue. But of course, wildfire particles now spread across the country. The New York area and Chicago have been experiencing the the upper Midwest of have been experiencing smoke from wildfires in Canada for several years now. Um, so I and you know, if you're in Florida, it's hurricanes that you have to worry about or the Gulf states. So uh there's there's no place that will be untouched by this. Um, and so that's uh it's it's hard to say where people should move, but I guess it depends on your own uh susceptibilities and fears.

Dr. Michael Koren:

Yeah, because you mentioned something about uh air pollution being a determinant of even development. And um is there a better place to live uh with that concept in mind?

Dr. Debra Hendrickson:

Um yeah, I mean, the the West is definitely most impacted by wildfire smoke. Like I said, you can do things to protect your kids. Like what we do here is um you can even just something as simple as weatherizing your home, which is a low-cost thing to do, makes your home more energy efficient, it uh can seal out pollutants pretty well too. And then a lot of us here have freestanding air purifiers. You can um uh you can build them from instructions online as well. Uh, if you use a high-grade filter in your central air conditioning system, that can help. You know, going when you go outside, wear masks or do other things to protect yourself. So there are things you can do to reduce the exposure, but if you have a young child, especially one with a lot of respiratory problems, uh it would be an issue to think about.

Dr. Michael Koren:

So you're not recommending people move to Iceland quite yet.

Dr. Debra Hendrickson:

No, no, I think uh I don't think there's any place you can guarantee yourself you won't suffers experience some other impact of this. You know, and one other impact that I just wanted to mention too, and I think this is relevant for everybody in medicine, that, you know, because of the threat that climate change poses to healthcare infrastructure, you know, um this is an issue that threatens really every area of medicine. Um, but it is a particular issue for children because, and this has been in the news somewhat lately because of what's going on at HHS. You know, uh the fact that we we expect our children to survive to adulthood, that is a fairly recent phenomenon, you know. Um throughout most of human history, uh, you know, the odds of a child surviving to adulthood were about 50-50. And that it was up until the beginning of the 20th century. Uh, you know, in 1900, 40% of all deaths in the US were children five and under, and that was mainly from infectious diseases. So a lot of the improvement we've seen in that is because of vaccines, which have of course been in the news, but also clean drinking water, uh, sewage treatment, um, milk pasteurization, mosquito control programs, you know, all the aspects of public health and hospitals and clinics where we can get the supplies we need. You you probably um saw in the news or experienced when Hurricane Helene hit Western North Carolina, uh, the factory that made 60% of the IV fluids in the United States was badly damaged. And so we had a nationwide IV fluid shortage. And that's just one example. There's some from every disaster of hospitals that never reopen, of supply chains that are interrupted. So everyone in medicine is going to be affected by this. Uh, and but but children, because they've they benefited so much from public health improvements as those, if as those start to unravel because of a warming environment, a warming climate, um, and all the chaos that that's going to unleash, that's a you know big, big threat to the next generation. Um and if I could just make one other point, it's that the healthcare system itself is a contributor to uh greenhouse gases. Four to five percent of all greenhouse gas emissions globally, and between eight and ten percent in the US are from the healthcare sector. So if physicians are listening to this and want to get involved, just getting involved in your own hospital's uh waste and emissions profile and trying to do something about that uh can be helpful.

Dr. Michael Koren:

Well, Deborah, this has been an absolutely fascinating discussion. Thank you so much. Um any final words for the parents out there that I know um your your focus is is definitely on some public health elements and public policy elements, but I do think a lot of people that are listening to these things also want to make sure that they're doing whatever they're possible for their kids and their grandkids to protect them. So any uh final recommendations for that?

Dr. Debra Hendrickson:

Yeah, so in terms of adaptations parents can take to, for example, a heat wave, you can go to heatheatrisk.gov or the um the heat risk advisory system for CDC. It will tell you if there are any heat advisories for your county uh that week. Um, obviously do your errands early in the morning, uh, drink plenty of water, take shade breaks if your kids are in sports. Uh, be sure the coach is aware of the risk of heat illness and of the signs of heat illness, especially in for football players, uh, because they're more at risk because of the padding that they wear. So football coaches are supposed to have a tub of water on the field uh for kids to be dunked in if they get too hot, and they should have a wet globe uh thermometer device, um, wet bulb globe thermometer uh on the field to tell them the full risk, not just from the temperature but all the other conditions. Uh and you know, there are adaptations like this for for air quality as well.

Dr. Michael Koren:

So one other thing in your book that I found interesting was about insect-borne illnesses. Can you make a comment on that? That's a some like a practical thing that people would take away.

Dr. Debra Hendrickson:

Uh yeah, so for vector-borne illnesses in the spring and summer, uh, you want to use um uh uh good uh insect repellent. If you go to the American Academy of Pediatric site for parents, which is called healthychildren.org, they have a table there of insect repellents that are safe for children of various ages that you can use to repel uh mosquitoes and ticks, which are both uh the risks from both of those insects are rising uh as the climate warms and the and the environment changes. Uh and then you can use uh bed screens if you're gonna be out camping in an area with a lot of uh mosquitoes, uh, and um also uh hats that have uh some netting sometimes can be used to help uh older kids.

Dr. Michael Koren:

Well, we so much appreciate your passion. We so much appreciate your expertise, terrific. Uh if you haven't looked at it yet, please take a look at this book. I think it's a very valuable read. And thank you very much for educating, informing me, and our listeners and viewers of MedEvidence! Thank you so much.

Dr. Debra Hendrickson:

Thank you very much.

Announcer:

Thanks for joining the MedEvidence Podcast. To learn more, head over to Medevidence.com or subscribe to our podcast on your favorite podcast platform.

Head Shot

Dr. Michael Koren

Host