# data[].attributes.body
Please post the following:

1) PH Challenge.

2) Physician Level (Visit/Clinic/Community).

3) Names/Group Name

4) Three Educational Points, Two Actionable Items

5) Any neat resources

# data[].attributes.body
3 education topics:

1.        MDIs have a much larger carbon footprint than dry powder inhalers (DPIs) or Soft Mist Inhalers (SMIs) due to their hydrofluorocarbon (HFC) propellants, which are very powerful greenhouse gases (effect on climate change up to 3,800 more powerful than carbon dioxide)

2.        Of the roughly 35 Million inhalers prescribed in the UK (between 11-19 Million in Canada), only .5% of inhalers are disposed of properly. This contributes not only to landfill and plastic waste, but releases residual HFC.

3.        Of the MDI’s, Ventolin Evohaler (because contains more volume of propellant) and Symbicort (contains worse type of greenhouse gas) are the most terrible MDI option!

2 Action Items to incorporate into your clinic:

1.        Train staff and have patients demonstrate proper inhaler technique for patients.

2.        Educate on the proper disposal, consider implementing disposal program in your clinic.  At the very least, have a list of pharmacies in your area that participate in the EnvirX Program (found on the Alberta Pharmacists Association website)

Neat resource:

CASCADES Canada: Sustainable Inhaler Prescribing in Primary Care Playbook

Clinical workflows, quality-improvement ideas, prescribing tools, patient communication materials and approaches to reducing unnecessary high-carbon inhaler use.

https://cascadescanada.ca/action-areas/pharmacy-and-prescribing/inhalers/

# data[].attributes.body
PH Challenge:

Medications

Physician Level:

Visit / Community

Educational Points:

Downstream environmental distribution of common antihypertensives, especially beta blockers, can have significant ecological impacts, which is an area of active research.

50% of all medications are not taken as directed, creating large volumes of waste on top of the environmental impacts of medication production and distribution

There is an increasing evidence base for non-pharmacological interventions (NPIs) which can improve a patient's physical and mental health while decreasing environmental impact by limiting the number of medications which need to be prescribed

Actionable Items:

routinely deprescribing unnecessary medications for patients (PMID: 39862041)

When Prescribing medications, Think about their packaging and their impact on the environment

Social prescribing as a form of non-pharmacological therapy promoting engagement with the environment.

Resources:

Database of pharmaceutical compounds detected in the environment: https://www.umweltbundesamt.de/en/themen/chemikalien/arzneimittel/the-uba-database-pharmaceuticals-in-the-environment

# data[].attributes.attachment_link.readable_text
Pharmaceutical residues occur globally in the environment. This is demonstrated in the updated database "PHARMS-UBA". Residues of pharmaceuticals in the environment have been measured in 89 countries in all UN regions. For Germany, 414 active substances or their transformation products were reported, 749 for the European Union and 992 worldwide.

# data[].attributes.attachment_link.title
The UBA database - "Pharmaceuticals in the environment"

# data[].attributes.attachment_link.description
Pharmaceutical residues occur globally in the environment. This is demonstrated in the updated database "PHARMS-UBA". Residues of pharmaceuticals in the environment have been measured in 89 countries in all UN regions. For Germany, 414 active substances or their transformation products were reported, 749 for the European Union and 992 worldwide.

# data[].attributes.headline
Medical Education- Sajad, Hiba, Tianyi, Adibba

# data[].attributes.subject
Medical Education- Sajad, Hiba, Tianyi, Adibba

# data[].attributes.body
1) Challenge:

How can your medical school or your university contribute to overall Planetary Health? Consider facilitators and hurdles.

Barriers

Logistics with space in an already crowded curriculum

Convincing people of the importance of these issues given the geopolitical climate and traditional conceptions of medical education (resistance to change)

Planetary health is not a part of CANMEDS (pending)

Funding

Facilitators

Planetary health is integrated into MCC objectives

Student groups are keeping institutions accountable in following policies through the planetary health report card

New planetary health office and portfolios at the UofC

2) Group: Sajad, Hiba, Tianyi, Adibba

3) Educational priorities

We should recognize that since their inception and until recently, higher education institutions were dominated by religious dogmas, served to reify racism and colonial ideology and new forms of ideologies and dogmas (eg, geopolitical and economic) heavily influence policies. This leads to censorship of certain PH issues, or even punishment towards students/faculty who push for change. Recognizing this history can help us to not repeat it.

Higher education institutions tend to adhere to the principle of employability through the transmission of factual knowledge and hard skills, as the core purpose of the learning process. This then translates to education perpetuating growthism ideology (endless quantitative GDP or net worth growth) as the main indicator of a individual's or society's success.

Environmental damage like air pollution, extreme heat, and water shortages directly cause chronic illnesses, injuries, and new diseases, forcing care providers to treat more climate-driven health emergencies in patients.

Climate change is the greatest health threat of the 21st century.

4) Actionable items

Integrating case based learning and planetary health clinical simulations. E.g. cases can involve managing acute heat illnesses, severe wildfire smoke exposure, climate-driven anxiety, or vector-borne disease expansion in primary care settings.

Integrate learning or quality improvement projects into existing CEL intiative. Addition of community partners focused on planetary health where students can participate, lead initiatives, or learn from preexisting community partners.

Curriculum mapping - to figure out when/what is being covered and where the gaps are

Continue to participate in the planetary health report card through CFMS Heart

Integrating additional material into existing lectures regarding planetary health. E.g. an extra slide at the end of a presentation about anesthetic drugs explaining the carbon footprint of various gases and drugs routinely used in the specialty.

# data[].attributes.body
PH Challenge

Infectious Disease

Physician Level

Visit (patient level)

3 Educational Topics

1. Climate-sensitive infectious diseases (e.g., Lyme disease, West Nile virus, expanding tick and mosquito ranges).

2. Safe food and water practices during heat waves, flooding, and travel.

3. Appropriate antibiotic use and antimicrobial resistance (AMR).

Actionable Items

• Incorporate environmental/travel/exposure history (ticks, floods, wildfire evacuation, animal exposure) into infectious disease assessments.

• Counsel high-risk patients on prevention (tick checks, insect repellent, vaccines, safe water, hand hygiene).

5) Neat Resources

https://changingclimate.ca/site/assets/uploads/sites/5/2022/02/CCHA-REPORT-EN.pdf

https://pmc.ncbi.nlm.nih.gov/articles/PMC11138229/

https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health