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Public health in the Netherlands is deteriorating due to climate change. That is what four doctors say on Friday in the Dutch Journal of Medicine (NTvG). “In terms of health, there are positive sides to climate change, but the negative ones weigh more heavily,” says Jeffrie Quarsie, first author of the article and doctor at the GGD Rotterdam-Rijnmond. He focuses specifically on medical environmental science.
What is the main negative effect?
“The biggest health risk is the increasing heat in the summers. Four hundred people died from the heat wave in 2019. Heat increases the risk of a stroke. If you drink too little, you can become dehydrated and develop kidney problems. And people sleep worse. In the Netherlands, more than 40 percent of the population lives in cities, where it becomes even warmer due to the heat island effect: materials in the city store heat and heat the environment extra. The elderly are vulnerable, but so are the chronically ill, pregnant women, young children and socially isolated people.”
But the winters are getting less cold. Isn’t that beneficial?
“There is probably less death from, for example, cardiovascular diseases and the flu. There are probably fewer fatalities in traffic due to slippery roads. But whether winter mortality has decreased in recent decades is not clear.
“The effects cannot all be quantified equally well. But the majority of the health effects of climate change are negative. We can say with high probability that climate change is worsening public health.”
The authors also see an increase in allergies and respiratory symptoms. Due to warming, plants and trees bloom longer and release pollen for longer. New types of vegetation that people are allergic to are moving from the south.
In addition, the number of infectious diseases is increasing. GPs see more patients with tick bites. The oak processionary caterpillar has advanced from the south and can cause itching, eye irritation and severe allergic reactions with its shed stinging hairs. Furthermore, exotic mosquitoes such as the tiger mosquito survive more easily in the Netherlands. They can potentially transmit diseases such as dengue.
You also mention air pollution as a risk. But if we move away from fossil fuels, won’t air quality improve?
“Air pollution is complex. On the one hand, you have particulate matter, which is created, among other things, from exhaust gases. That is declining. But we see an increase in the formation of ozone. That creates more summer smog. And that exacerbates heart, vascular and lung problems.”
But isn’t ozone formed in the presence of nitrogen oxides, which are released during the combustion of fossil fuels?
“That is indeed contradictory. Traffic has become cleaner in recent decades, but we are still seeing more disease and death associated with ozone. The concentration is related to the temperature.”
You can cool down the city by planting trees. But this way you may also introduce extra pollen.
“The health benefit of cooling is greater than any additional allergies. You can also take into account the type of plants you are planting.”
All effects on public health are described in previously published reports, including those of the RIVM. Why did you write this article anyway?
“No doctor reads those hundreds of page summary reports. Nor are they focused on the clinical practice of the physician seeing patients. We wanted to make a practical translation that is relevant for the consultation room. And if you want to reach doctors, you must publish in the NTvG or in Medical Contact.”
Climate problems have been felt in the Netherlands for several years, with more drought, heat waves and floods. Is this the first time that the NTvG has published about these risks?
“Twelve years ago there was an article about it. But that was the point: we don’t know that much yet. There is now more knowledge about it, but it was scattered. In general medicine, dermatology, allergology. We swept everything together.”
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