Why All Oncology Nurses Should Be Environmentalists
Research shows that climate change (https://www.planetaryhealthalliance.org/climate-change) is associated with profound disruptions to biodiversity (https://www.planetaryhealthalliance.org/biodiversity-shifts) and changes in biogeochemical flow (https://www.planetaryhealthalliance.org/changing-biogeochemical-flows), but what does the health of our planet have to do with oncology nursing?
Every day, oncology nurses depend on the sustainability of our planet to keep us and our patients well. We may not recognize it in our day-to-day lives, but planetary health plays a major role in the health of patients with cancer. From forest fires in California (https://www.cbsnews.com/news/california-fires-firefighters-study-cancer/) to water and air pollution in India (https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30708-3/fulltext), climate change and the destruction of our natural world exposes populations around the world to increased risks for cancer.
The Link Between Climate Change and Cancer
Climate change not only increases a person’s exposure to carcinogens, but it can decrease their access to care (https://www.hsph.harvard.edu/c-change/news/climate-change-and-cancer/). Extreme temperatures, forest fires, and natural disasters are having devastating effects (https://www.cnbc.com/2020/05/18/climate-change-fuels-extreme-weather-that-lowers-cancer-survival-rate.html) on patients’ ability to cancer screenings and treatment. One study showed (https://jamanetwork.com/journals/jama/fullarticle/2738278) that patients receiving radiation therapy for lung cancer had a 27% higher relative risk for death because of therapy delays if a hurricane disaster occurred during their treatment.
Many environmental concerns have a disproportionate impact on vulnerable patient populations. Studies found that rural communities, who already face geographic health disparities, also have 13% increased risk for lung cancer (https://pubmed.ncbi.nlm.nih.gov/27639278/) and a 24% increased risk of stomach cancer (https://pubmed.ncbi.nlm.nih.gov/27639278/) because of metals found in water and a 54% increased risk of leukemia (https://academic.oup.com/aje/article/164/3/200/70064) from metals in environmental exposures to petrochemicals from occupational hazards from emerging industries like fracking.
Health Care’s Carbon Footprint
The first step in creating a healthier environment and reducing climate-related health risks is taking accountability for our own carbon footprint. We must acknowledge that healthcare institutions contribute a significant amount (https://www.healthaffairs.org/do/10.1377/hblog20191011.432819/full/) of waste and carbon emissions. Planetary health is an important concern regardless of nursing specialty, but it is especially critical when it comes to treating patients with cancer. Given oncology’s heavy reliance on surgeries, radiology services, and pharmaceuticals, cancer care may be a large contributor (https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21610) to health care’s overall carbon footprint.
What Nurses Can Do
Oncology nursing also has a carbon footprint, but we have opportunities to reduce our greenhouse gas emissions (https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21610). We can:
Optimize operating room ventilation based on occupancy and demand.
Prioritize anesthetic gases based on their warming potentials.
Use more energy‐efficient imaging machines.
The healthcare system also purchases significant amounts of food and can decrease its environmental impact (https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21610) by seeking low‐carbon food manufacture, shipment, and waste options.
And nurses can be a voice of advocacy for planetary health. Nurses Drawdown (https://www.nursesdrawdown.org/) is a community of nurses committed to taking evidence-based actions to improve the health of our planet and communities. The Alliance of Nurses for Healthy Environments (https://envirn.org/) is also a great place for information and resources for nurse-led initiatives.
At the very local level, start by looking at your own practice. What are the areas in which you could reduce waste? For example, you may be able to prevent wasting medications or supplies and ensure that unnecessary lighting is turned off during the day.
If we all participate, health care could make a substantial difference in its energy and resource consumption. By exploring resources and taking planetary health seriously, we can achieve a healthy and sustainable future for our patients, our planet, and ourselves.