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Greening up: Environmental sustainability in general practice

What is climate change?

Climate change resulting from human activity presents an urgent, significant and growing threat to health worldwide. (1) Activities such as burning fossil fuels for energy and changes in land use – particularly deforestation – increase the levels of carbon dioxide and other gases in the atmosphere, holding heat near the surface of the earth. Increased levels of carbon dioxide in the atmosphere, and the resulting increased heat, are altering the planetary systems of Earth, including ocean circulation, prevailing winds and cloud cover. (1) Increased carbon dioxide is considered the largest single contributor to humaninduced climate change. (2) The second main contributor to climate change driven by emissions from human activities is methane, a potent greenhouse gas largely produced by agriculture (from livestock, such as sheep and cattle). (3) You can read more in the Intergovernmental Panel on Climate Change’s summary for policymakers. (4) 

  1. Parise I. A brief review of global climate change and the public health consequences. Aust J Gen Pract 2018,47(7):451–56.
  2. AdaptNSW. Causes of climate change. Sydney South, NSW: New South Wales Government [date unknown] [Accessed 17 May 2022].
  3. Climate Council. Agriculture’s contribution to Australia’s greenhouse gas emissions. Sydney, NSW: Climate Council, 2021 australia‑agriculture‑climate‑change‑emissions‑methane [Accessed 17 May 2022].
  4. Intergovernmental Panel on Climate Change. Climate change 2021: The physical science basis – Summary for policymakers. Geneva: IPCC, 2021 downloads/report/IPCC_AR6_WGI_SPM_final.pdf [Accessed 17 May 2022].
  5. World Health Organization. Climate change overview. Geneva: WHO [date unknown] climate‑change#tab=tab_1 [Accessed 17 May 2022].
  6. World Health Organization. Climate change and health. Geneva: WHO, 2021 fact‑sheets/detail/climate‑change‑and‑health [Accessed 17 May 2022].
  7. The Royal Australian College of General Practitioners. Climate change and human health: Position statement. Melbourne, Vic: RACGP, 2019 media/documents/RACGP/Position%20statements/Climatechange‑and‑human‑health.pdf [Accessed 17 May 2022].
  8. National Health Service. Delivering a ‘net zero’ National Health Service. London: NHS, 2020. Available at www.england. delivering‑a‑net‑zero‑national‑health‑service.pdf [Accessed 17 May 2022].
  9. McAlister S, McGain F, Peterson M, et al. The carbon footprint of hospital diagnostic imaging in Australia. Lancet, 2022.24:100459.
  10. British Medical Association. Sustainable and environmentally friendly general practice: GPC England policy document. London: BMA, 2020 media/2570/bma‑sustainable‑and‑environmentally‑friendlygeneral‑practice‑report‑june‑2020.pdf [Accessed 17 May 2022].
  11. Pernigotti D, Stonham C, Panigone S, et al. Reducing carbon footprint of inhalers: Analysis of climate and clinical implications of different scenarios in five European countries. BMJ, 2021,8:e001071. doi:10.1136/ bmjresp‑2021‑00107. [Accessed 17 May 2022].
  12. Woodcock, A, et al. Effects of switching from a metered dose inhaler to a dry powder inhaler on climate emissions and asthma control: Post‑ hoc analysis. Thorax BMJ, 2022. doi:10.1136/ thoraxjnl‑2021‑218088. [Accessed 17 May 2022].
  13. New South Wales EPA. The waste hierarchy. Sydney, NSW: NSW EPA 2021 [Accessed 17 May 2022].
  14. E bi K, Tong S. Preventing and mitigating health risks of climate change. Environ. Res., 2019;174:9–13. doi:10.1016/j. envres.2019.04.012. [Accessed 17 May 2022].
  15. Royal College of General Practitioners. Sustainable development, climate change and green issues. London: RACGP, 2022 [Accessed 17 May 2022].
  16. Xie E, de Barros EF, Abelsohn A, et al. Challenges and opportunities in planetary health for primary care providers. Lancet Planet. Health, 2018;2(5):e185–e187. doi:10.1016/S25425196(18)30055‑X. [Accessed 17 May 2022].
  17. B ansal A, Blashki G. Six steps to both greener and better primary care. London: The BMJ Opinion, 2020 [Accessed 17 May 2022].
  18. Office of Environment and Heritage. I am your optimisation guide: Heating, ventilation and air conditioning systems. Sydney, NSW: New South Wales Government, 2015 business/150317HVACGuide.pdf [Accessed 17 May 2022].
  19. Sustainability Victoria. Reduce heating, ventilation and air conditioning (HVAC) costs in your business. Melbourne, Vic: Victorian Government, 2021. Available at www.sustainability. [Accessed 17 May 2022].
  20. The Royal New Zealand College of General Practitioners. Greening general practice: A toolkit for sustainable practice. Auckland: RNZCGP, 2016 [Accessed 17 May 2022].
  21. Sustainability Victoria. Avoid food waste at home. Melbourne, Vic: Victorian Government, 2022 avoid‑waste/food‑waste [Accessed 17 May 2022].
  22. Downes J, Borg K, Florin F. A type of ‘biodegradable’ plastic will soon be phased out in Australia – That’s a big win for the environment. Melbourne, Vic: The Conversation, 2021 [Accessed 17 May 2022].
  23. Greener Practice. Why Environmentally Sustainable Practice? UK: Greener Practice, [date unknown] [Accessed 17 May 2022].
  24. SEE Sustainability. Helping you get your practice to netzero. UK: SEE Sustainability, 2022. Available at https:// [Accessed 17 May 2022].
  25. Myhre G, Shindell D, Bréon FM, et al. Anthropogenic and natural radiative forcing. In: Stocker TF, et al, editors. Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press; 2013. [Accessed 17 May 2022].
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