Skin problems to hot up with climate change

Skin infections

By Mardi Chapman

27 May 2019

Dermatological conditions including skin trauma, infections and allergic contact dermatitis can be expected to increase due to the direct and indirect health impacts of climate change.

Professor David Karoly, from the CSIRO’s Earth Systems and Climate Change Hub, told the ACD Annual Scientific Meeting that recent flooding in Townsville and bushfires in Tasmania were evidence of the predicted changes across the country.

Australian would continue to see increased rainfall in the northern wet season, less rainfall in the southern states and more extreme weather events.

Storms, droughts, floods and heatwaves were clearly associated with the potential for morbidity and mortality, as were air and water quality, land use and ecological changes.

In addition, health services and infrastructure would come under increased pressure.

Melbourne dermatologist Dr Fiona Bruce told the meeting that clinicians should be aware of the range of infections that could present during floods.

As well as staphylococcal and streptococcal infections, there could be localised infections with Burkholderia pseudomallei, Vibrio vulnificus, and Leptospira species.

She highlighted outbreaks of leptospirosis and melioidosis in the 2011 Central Queensland flood and melioidosis cases including one death in the 2019 Townsville flood.

“I think people might not be tuned into those infections because they are not things they normally see. So it’s good if they are aware that those conditions can occur with flooding and quickly pick them up if it is flooding in their areas,” Dr Bruce told the limbic.

She said dermatologists should also be alert to rashes associated with dengue, Ross River and Barmah Forest arboviruses as they expanded their geographic territory from tropical to more temperate regions.

Dr Bruce said it has been suggested by the International Society of Dermatology Climate Change Committee that a global increase in the incidence of hand, foot and mouth disease, particularly in southeast Asia, may be related to climate change.

There have also been reports that climate change can affect pollen and fungal spore production, seasonality and allergenicity, which may in turn increase the risk of airborne contact dermatitis especially during intense storms.

She called on clinicians to take action on climate change through initiatives such as Clinicians for Planetary Health – as highlighted this month in The Lancet.

“I think it is really important that doctors are advocating in this space; that they recognise that climate change does affect them and their patients. We should not just let it go on in the background.”

No clarity on skin cancer rates

 Dermatologist Associate Professor Stephen Gilmore said the likely impact of climate change on skin cancer was not as straightforward as people might expect.

For example, climate change warms the troposphere but cools the stratosphere, which helped stabilise ozone levels.

“Ozone is an important factor in skin cancer and it’s recovering. So that’s good.”

He said climate change also impacted cloud cover, which can be a potent absorber of UV radiation. And infrared radiation, also affected by cloud cover, mediated the effect of UV radiation.

“Cloud cover and ambient temperature affect human behaviour but it is quite nuanced,” he said.

For example, Melbourne residents were more likely to spend time outdoors on a warm day while Brisbane residents might choose to stay indoors as temperatures climbed.

“Climate change and skin cancer? It depends where in Australia because Australia is so vast. It will be different in different parts of Australia because the climate will be impacted differently.”

He added there was also some interest in whether thermal stress in the skin contributed to carcinogenesis.


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