Impact of climate change on skin diseases and vulnerable populations

More than 3 billion people worldwide live in highly vulnerable areas with implications for skin health, according to climate change policymakers.

The skin is very sensitive to the climate. Exposure to extreme weather conditions poses a significant risk to dermatological health, especially in marginalized populations.

A review by the Department of Dermatology at the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center identified extreme weather – floods, wildfires and heat-related health hazards – likely to increase in magnitude, prevalence and geographical area, as well as the dermatological manifestations linked to these events. Their findings appear in The Journal of Climate Change and Health.

“We wanted to provide dermatologists and other practitioners with a comprehensive overview of extreme weather-related skin diseases as a basis for patient education, implementing early therapeutic interventions, and improving disease outcomes,” said said lead author Eva Rawlings Parker, MD, in a press release.

In nearly 200 documentations of extreme weather conditions, flooding was associated with health risks such as traumatic wounds, infectious dermatoses, bacterial infections, fungal infections, non-infectious skin conditions, inflammatory skin processes, irritant contact dermatitis, immersion foot syndrome, pernio, and insect and animal bites.

Inland flood risks are likely to increase, especially in parts of Southeast Asia, East Africa, India and the South American Andes region, according to an update from the Committee on Climate Change of the International Society of Dermatology. More than 50 million people were affected by floods and storms worldwide in 2018 alone, according to the Center for Research on the Epidemiology of Disasters.

Forest fires pose a serious threat due to climate change. From 2016 to 2019, 114 countries experienced an increase in the number of high wildfire risk days. Additionally, there have been 194,000 additional daily exposures to wildfires each year globally, according to a 2020 report by Lancet.

Dermatological implications of wildfires include skin cancer, atopic dermatitis, and other inflammatory disorders.

Similarly, extreme heat conditions are associated with skin thermoregulation and acute heat-related illnesses, heat-related dermatoses, exacerbation of chronic inflammatory dermatoses, and infections.

In addition, extreme heat events influence behavior. Increases in temperature have been associated with more time spent outdoors while wearing fewer clothes, which presents greater exposure to air pollution, ultraviolet rays and insects.

Black and Hispanic populations living in low-income areas were found to be more likely to be exposed to health risks due to climate change.

Children, the elderly, pregnant women, people with underlying respiratory conditions and homeless people were also at higher risk due to extreme weather events (EWEs).

Traumatic effects, such as loss of loved ones and property, housing instability and lack of access to health care services are common among victims of natural disasters. These victims have been observed with a range of mental health issues, such as post-traumatic stress disorder, grief, sleep disturbances and anxiety.

Forced migration also has direct and indirect effects on mental health, “accompanied by a profound sense of loss of place and origin among migrant populations,” the researchers wrote.

The researchers of this review believe that further population-based clinical and occupational health studies are needed to better understand the effects of EWE and high-risk populations, in hopes of mitigating these effects using equitable health policies and interventions.

Floods, wildfires and extreme heat events will likely continue to increase in magnitude, prevalence and geographic area. Therefore, clinicians, policy makers, conservationists and researchers around the world must be acutely aware of the current and future disruptions that climate change and EWE pose to human health and aggressively address the [greenhouse gases] emissions to mitigate the impact of the climate crisis,” the researchers concluded.

References

Parker ER, Mo J, Goodman RS. Dermatological manifestations of extreme weather events: a comprehensive review of skin disease and vulnerability. The Journal of Climate Change and Health. 10.1016/j.joclim.2022.100162