Solutions to Prevent Climate Change-Related Illness, with Janelle Bludorn, PA-C

As previously covered in an interview at the American Academy of Physician Associates (AAPA) 2024 Conference & Expo in Houston, TX, this week, the issue of climate change-related health outcomes is becoming an increasingly burdensome matter for clinicians—and unfortunately one with few clear solutions to the crisis.¹

What is available to help improve care for issues including heat-related illnesses are best practices involving preventive and patient-tailored risk discussion.

In the second segment of an interview with HCPLive at AAPA 2024,Janelle Bludorn, PA-C, assistant professor at Duke School of Medicine, discussed tangible solutions to combat climate change-related health outcomes. As she acknowledged, a majority of focus on the crisis is reserved for her colleagues in more scientific realms like the Centers for Disease Control and Prevention (CDC). But there are some proven measures at the level of direct care.

The first from Bludorn: consider screening every patient.

“Consider that there may be risk for every single person that you have on your primary care panel for heat-related illness,” Bludorn said. “So, (that means) asking them those questions, looking at things in terms of their past medical history, or just their characteristics—like their age, are they pregnant, those type of things—because we know that people who are older, who are younger people, who are pregnant, people who have disability or mobility, they're at higher risk.”

Bludorn additionally advocated for involving social work colleagues in the event that a high-risk individual may need additional education on signs and symptoms, or if they may warrant regular wellness checks during seasons of high heat exposure. What’s key is for both caregivers and patients alike to be cognizant of who constitutes as a high-risk patient, and how they can be reached.

“In my talk, I did provide some statistics around the fact outdoor agricultural workers…are actually 35 times as likely to die of heat-related illness compared to people that work in any other occupation.² That's pretty profound,” Bludorn said. “But there's information from the CDC that actually says that 78% of people who are outdoor agricultural workers actually identify as Hispanic.”

This distinct disparity in outcomes among a racial/ethnic minority group points to the need to meeting where such high-risk patients are—and what language they speak, even.

“I know that the CDC does have some wonderful handouts that are available in both English and Spanish that are actually patient-facing³,” Bludorn said. “They have a list of different symptoms and what the patient should do based on those symptoms. And it can be something that can be life-saving, or it could be something that actually just saves a trip to the emergency department if it's like mild symptoms that could be managed at home.”

References

1. ^{Kunzmann K. The Rising Rate of Heat-Related Illness, with Janelle Bludorn, PA-C. HCPLive. Published May 19, 2024. https://www.hcplive.com/view/rising-rate-heat-related-illness-janelle-bludhorn-pa-c}
2. ^{Gubernot DM, Anderson GB, Hunting KL. Characterizing occupational heat-related mortality in the United States, 2000-2010: an analysis using the Census of Fatal Occupational Injuries database. Am J Ind Med. 2015;58(2):203-211. doi:10.1002/ajim.22381}
3. ^{The National Institute for Occupational Safety and Health (NIOSH). HEAT STRESS. Web page. Last reviewed August 31, 2020. Accessed May 20, 2024. https://www.cdc.gov/niosh/topics/heatstress/default.html}