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MedPage Today: Pediatrician Questioned at House Hearing on Climate Change

Committee member doubts climate change’s relationship to asthma exacerbations

WASHINGTON — The causes — or not — of asthma were front and center at a House hearing Wednesday on the effects of climate change on health.

“Children are disproportionately burdened by and uniquely vulnerable to the health impacts of climate change as a result of their physiology,” said Aparna Bole, MD, a Cleveland pediatrician who spoke on behalf of the American Academy of Pediatrics (AAP) at a hearing held by the House Select Committee on the Climate Crisis.

“Pediatricians see first-hand how kids’ health is affected by climate change today. For example, in my home state of Ohio, we care for infants hospitalized during increasingly frequent extreme heat events; children whose drinking water is less safe because of how increased extreme precipitation and increased water temperatures promote toxic algae in our Great Lake; and children with asthma exacerbations because of high ozone and allergens in the air we breathe.”

“We Don’t Know What Causes Asthma”

Rep. Gary Palmer (R-Ala.) attacked the premise of Bole’s remarks. “You talk about asthma rates, and the fact is we don’t know what causes asthma,” he said. Although exacerbations may be related to carbon emissions, “since 1970, when we passed the Clean Air Act, the economy has grown by 295%, yet emissions have declined by 74%, and that includes nitrogen dioxide related to traffic congestion, which is a factor in exacerbating asthma. So you come in here and talk about these things as though climate change or CO2 or something like that is causing asthma; that’s a misrepresentation.”

Bole stood her ground. “I did not state that CO2 causes asthma,” she said. “But we do know a lot about what exacerbates asthma, and there are air pollutants that exacerbate asthma that result from burning fossil fuels, both from transportation and from power plants. In addition, rising surface temperatures in the context of climate change are resulting in alterations in air quality itself when it comes to increased surface ozone, and increased allergens that do have an impact in pediatric asthma.”

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Pediatrician Aparna Bole, MD, explains how climate change causes asthma exacerbation. (Photo courtesy House livestream)

Another witness at the hearing, former Environmental Protection Agency (EPA) administrator Gina McCarthy, said that when she was at the EPA, “our success was measured in lives saved, healthier kids, and fewer asthma attacks. Climate change was in our purview because our mission was to protect people from pollution, just like the carbon pollution that is fueling climate change.”

“We need to restore science as the foundation of sound public policy,” said McCarthy, who is now president and CEO of the Natural Resources Defense Council. “We don’t have time to put our heads in the sand any more, or to muzzle our scientists.”

Big Issue for Farm Workers

During her testimony, Bole noted that the AAP supports comprehensive climate legislation that “accelerates energy efficiency and renewable energy production while decreasing incentives for fossil fuel production,” including a carbon fee and dividend plan. In addition, “The U.S. healthcare sector must adapt to both reduce its contribution to climate change and improve its resilience,” she said. “We must educate health providers and vulnerable patients about climate-associate health risks and how climate change impacts our clinical practice.”

The third witness, Arturo Rodriguez, president emeritus of the United Farm Workers union, discussed the need for a “national heat standard” to protect farm workers and others who labor for hours outside in increasingly hotter temperatures. In 2005, the state of California enacted a heat standard in 2005, and it requires that workers be provided with basic protections: cool water, shade at 80 degrees, high heat procedures at 95 degrees, monitoring of workers, and training to identify and prevent heat illness, Rodriguez said. He argued for passage of a national heat illness standard “to stop unnecessary illnesses and deaths.”

Rep. Julia Brownley (D-Calif.) noted that Ventura County, which is part of her district, experienced the greatest temperature increase of any county in the continental U.S. She expressed concern about the health of farm workers’ children. “When we talk about environmental justice, I think it’s the children of farm workers that are most affected by that.” She asked Rodriguez whether any data was being collected on health impacts on farm workers.

Rodriguez said his organization didn’t have hard data, “but we’re working with universities in Fresno County and other researchers to measure what is the impact on farm workers and children, not only of climate change but also of pesticides.”

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Arturo Rodriguez, president emeritus of the United Farm Workers union, argued for a national heat standard to protect outdoor laborers. (Photo courtesy House livestream)

Rep. Carol Miller (D-W.Va.) took a different slant; she discussed the negative effect of higher energy costs resulting from use of renewable energy. “A few years back, West Virginia made an attempt to require major utilities to have at least 25% of their energy come from renewable sources by 2025. This shift resulted in high energy costs where many had to make decisions about keeping the light on or getting necessities like prescription drugs or putting food on their table and the legislation was subsequently repealed.”

“I have seen ‘energy poverty’ with my own eyes … and the negative impacts it has on health economic and more. It is so important for us to be good stewards of our environment; however, that does not mean we need to completely get rid of baseload energy.” She asked Bole how important baseload energy was to ensuring that hospitals could continue care during an extreme weather event. “You’re right that reliable energy is important for hospitals during times of crisis, and we know investing in efficiency and converting to renewable energy is part of the solution,” Bole replied.

Fossil Fuels Versus Emissions

Rep. Garret Graves (R-La.), the committee’s ranking member, said it was important to distinguish between fossil fuels and emissions. “It’s concerning to me when folks talk about the Paris Accords and how great they are, when under that agreement, China was allowed to increase emissions,” he said. “That’s contrary to the direction we need to head in.”

Rep. Buddy Carter (R-Ga.) said that his state was “the number one forestry state in the nation” and asked about rural areas’ unique challenges regarding climate change.

“As a result of climate change, we have seen in your state — as well as in many others — an increase in temperatures, especially during harvest season times, and within the last 2 years we had a farm worker die in your state as a result of exposure to heat illness,” said Rodriguez. In rural areas, “definitely we have to ensure that doctors and medical facilities are knowledgeable about heat exposure.”

There was also an unusual amount of bickering among committee members, though it was polite. As the hearing drew to a close, Graves disputed Carter’s characterization of Georgia as being number one in forestry. “It’s actually the state of Maine that has the highest percentage of forestry. Georgia’s down near number nine, which is somewhere in the proximity of where their football team ended in the college football rankings,” he said.

Graves also asked to submit under unanimous consent rules several reports relating to climate change as well as a report detailing the forestry rankings. Committee chairmen usually agree to such requests as a matter of course, but committee chairman Rep. Kathy Castor (D-Fla.) did not. “We unfortunately did not get copies of those reports, so I’m going to reserve a ruling on that,” she said.