Bill Klaproth (host): This is the Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth, and with me is Dr. Carol Fonseca, a pediatrician at MarinHealth Pediatric Care, a UCSF Health Clinic.

Dr. Fonseca welcome.

Carolina Ellinger Da Fonseca, MD: Thank you, Bill, and thank you for having me today. Thank you for your time.

Host: You bet. Happy to talk with you. This is going to be an interesting conversation as we talk about the intersection between climate change and health. So let's start with the big picture Dr. Fonseca. How is climate change impacting children's health today?

Carolina Ellinger Da Fonseca, MD: So with the current trends in climate, we are seeing a lot of different areas that are affecting health in general, and pediatric patient's are just more vulnerable. So some of the ways that we are seeing is just more extreme heat events, worse air quality, more extreme weather events changing the vector distribution.

Also longer pollen seasons, which leads to longer allergy seasons. And then environmental degradation and water and food insecurities are some of the ways. And actually the World Health Organization has declared climate crisis as a health crisis, and they estimate that about 88% of the climate related disease burden falls on kids under the age of five.

Host: Well, that's kind of sobering information you just gave us, Dr. Fonseca. There is a lot going on out there and anyone certainly can attest to the volatility and extreme nature of our weather, certainly over the past several years. So, you mentioned poor air quality. That is a major concern in many communities.

How do rising pollution and wildfire smoke specifically impact kids' lungs and development?

Carolina Ellinger Da Fonseca, MD: So with the current trends, we are seeing more wildfires as those of us in California have witnessed and with the wildfire smoke, it really fills the air with these fine particles that are also known as SPM 2.5 for particular matter 2.5. And those can really, they penetrate deep into the lung tissue.

And kids just by their physiology, they breathe more times per minute than adults. So they're being exposed to more pollutants. And they also have the still developing organs that are more sensitive to these exposures. So, it can trigger asthma, coughing, chest tightness. It can sometimes lead to headaches.

And also with the smoke exposure, we are seeing disruption in routines, especially for prolonged smoke exposure. And that can have an effect on the quality of life of for families and kids.

Host: That's very interesting. I was going to ask you why it affects kids more, and you just said kids breathe more often because they're smaller and they still have all of these organs that are still developing. So, it really is a concern.

You also mentioned extreme heat. We're seeing this all over these extreme heat events. So what kinds of health risks do high temperatures pose for infants and children?

Carolina Ellinger Da Fonseca, MD: So kids also tend to heat up faster than adults and they rely on adults for hydration and protection. They're just more vulnerable by nature. And a lot of people are just not aware of days of extreme heat. In those, if you're not preparing and hydrating, avoiding sun exposure, making sure you're looking for shade and avoiding exercise during the peak heat hours, you really, we are seeing an increased incidence of dehydration, heat exhaustion, and just heat associated illness and stress in pediatric patients.

Host: Yeah, that's right. This extreme heat is just crazy. And I'm thinking then extreme heat also extends allergy seasons too. Those are getting longer and more intense. So what are you seeing in your practice around asthma and seasonal allergies?

Carolina Ellinger Da Fonseca, MD: So we are seeing pollen seasons, as you mentioned, starting earlier and also lasting longer. And that can really affect just to call it, from anybody who has suffered from allergy. You know, that that can really make you feel just tired, have congestion, cough, itchy eyes, lead to poor sleep. And it can also be a common trigger for asthma exacerbation for pediatric patients.

So we are seeing all of those just coming to clinic and just affecting the quality of life for patients.

Host: So are there any particular diseases or things like tick-borne and mosquito-borne illnesses that you're seeing worsen as a result of climate change?

Carolina Ellinger Da Fonseca, MD: That's a great question too, because we are also seeing a change in the in vector distribution and that's worldwide. But to talk more specifically about California as an example, we are seeing tick distribution change, which is leading to exposure to Lyme disease in areas that weren't necessarily there before, but worldwide we are just seeing a change in vector distribution leading to vector born illnesses in places that we didn't see before, and just higher incidences as well.

Host: Yeah, more heat, uh, longer seasons, more mosquitoes. So, Dr. Fonseca, beyond physical health, are you seeing any effects on children's mental or emotional wellbeing, like anxiety around natural disasters or environmental worries?

Carolina Ellinger Da Fonseca, MD: Yes, definitely. And I appreciate you asking this because that's a big area of interest of mine too. We are definitely seeing kids being affected mental health wise. And that could be if they were exposed to something themselves, like if kids have been through a disaster, like a wildfire or flooding exposure, that often leads to increased anxiety, sleep problems. It can also lead to PTSD or post-traumatic stress disorder. But in addition to that, there is a new term that has been coined that's called eco anxiety, that we are seeing a lot of teenagers and young kids coming with concerns about just the health of the planet, the future of the planet, and the health of the planet.

Host: It's interesting that there is an actual term for that now because of our changing weather and volatility of the weather and everything that's happening. So this kind of puts parents in a tough position. How can parents help protect their kids from environmental exposures while still allowing them to be kids and go outside and play?

Carolina Ellinger Da Fonseca, MD: So I think that education is very important to bring awareness. So talking about this during appointments with parents and in schools as well, but mainly education so that they can talk to the kids about it. And because climate change is a health threat, but it's also an area where there are things we can make a change and do things about it.

But some of the more actionable things that people can do is just be aware that, you know, you can look at your air quality in your local neighborhood before you take your kids out or before a soccer game or any kind of event outside to make sure the air quality is good. Providing shade and hydration for the kids and they're wearing clothes that is appropriate for the weather.

And when they go hiking or go in areas that have more grass and nature, just making sure either checking for ticks or using repellants on the skin. Just being aware. But I definitely also think it's important to emphasize that spending time in nature and being outside is very important for us to reconnect with nature and try to protect the beauty that we still have.

Host: Yeah, there is a balance there. You want kids to be outdoors and play outside and have fun, but you want to make sure that they're protected. So taking precautions is good. So I'm thinking on a community or school-wide basis, I'm wondering are there things that could make a difference in keeping children healthy as the climate shifts?

Carolina Ellinger Da Fonseca, MD: So I definitely think education is the main one. So making sure that people know to check for air quality, make sure that they're well hydrated. Make sure that they're doing their part to contribute less to climate change and to greenhouse gas emissions. And just protect themselves and protect the environment.

Host: Good to know. Okay, so for families listening, a mom and a dad, a parent who want to help; what are a few practical steps they can take both to safeguard their children's health and to support a healthier planet?

Carolina Ellinger Da Fonseca, MD: I would say that educating them, I know I keep saying education, but educating themselves, voting with the environment in mind is a big one. And also talking to the kids I think is important. And pointing the things, the positive aspects and things that, actionable things that we can do, even starting small, which is recycling, composting, being aware of your contribution to the environment and being aware of our connection.

So checking air quality, as I mentioned, checking temperature and making sure that they're staying well hydrated and having sunscreen, cool, cool spaces to cool down when needed, things like that and voting.

Host: Yeah, that's all really good advice. Uh, so as you said, pay attention to politicians who are for the safety of our environment. Talk to your kids, make them aware. This is all smart things. Make sure they're hydrated, sunscreen protection when they go outdoors. So these are all really good steps.

Before we wrap up, Dr. Fonseca, is there anything else you want to add?

Carolina Ellinger Da Fonseca, MD: No, I just want to add for healthcare professionals too that you know the healthcare industry by itself is a big pollutant, a big contributor. So there are a lot of things that we as clinicians or healthcare administrators can do to also try to work towards a better environment and less pollution.

Host: Yeah. That's a really good thought. Looking inward, how can we help in this situation as well. So I love that thought. Dr. Fonseca, thank you for your time today. This has really been informative.

Carolina Ellinger Da Fonseca, MD: Thank you, Bill. I appreciate it.

Host: Absolutely. And once again, That is Dr. Carol Fonseca. And for more information, you can go to mymarinhealth.org.

And if you enjoyed this podcast, please share it on your social channels and check out the entire podcast library for topics of interest to you. I'm Bill Klaproth. This is The Healing Podcast, brought to you by MarinHealth. Thanks for listening.