Abstract
Living in an unpolluted environment is fundamental for human health and well-being. This general concept is obvious, but the interactions between environment and health/disease are very complex and truly arduous to assess scientifically.
Air pollution, suboptimal water quality and poor sanitation are established threats to human health. However, it is increasingly clear that chemicals in the environment, noise, depletion of stratospheric ozone and degradation of soil constitute major problems for mankind.
Respiratory, cardiovascular and kidney diseases, as well as cancer and reproductive and neurodevelopmental diseases, are all in part environmental disorders. The relation between health care and environment/climate change is bidirectional.
On the one hand, environment/climate change has identifiable effects on various aspects of human health, while the health care sector, when globally considered, also has a clear effect on the environment. It is estimated that between 5 and 10% of the global greenhouse gas emissions come from health care-related activities.
This is in conflict with the general theme in medicine of 'primum non nocere'. While the attention of health professionals, policymakers and politicians to environmental problems in general is on the rise, the issue that the health care sector itself is a contributor to greenhouse gas emissions that affect the health of today's and future generations in a negative way is still largely ignored by most health professionals and by the community at large.
One of the few exceptions is the UK, where the National Health Service put the subject on the agenda years ago. This document is a call for action to medical professionals, both as individuals and as representatives of professional organizations such as the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) to contribute to efforts aimed at establishing a more 'green' health care sector.