The Intersection of Pediatric Surgery, Climate Change, and Equity

  • Hannah C. Cockrell
    Corresponding author. Division of Pediatric General and Thoracic Surgery Seattle Children’s Hospital 4800 Sand Point Way NE Seattle, WA 98105 USA
    Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA

    Department of Surgery, University of Washington, Box 356410, 1959 NE Pacific St, Seattle, WA 98195, USA
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  • Elizabeth E. Hansen
    Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, 4800 Sand Point Way, NE, Seattle WA 98105, USA

    Department of Anesthesiology and Pain Medicine, University of Washington, Box 356540, 1959 Pacific Street, BB-1469, Seattle, WA 98195, USA
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  • Kenneth Gow
    Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA

    Department of Surgery, University of Washington, Box 356410, 1959 NE Pacific St, Seattle, WA 98195, USA
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  • Annie Fecteau
    Division of General and Thoracic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario Canada M5G1X8
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  • Sarah L.M. Greenberg
    Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA

    Department of Surgery, University of Washington, Box 356410, 1959 NE Pacific St, Seattle, WA 98195, USA
    Search for articles by this author


      Climate change is occurring at an unprecedented rate. Recent years have seen heatwaves, wildfires, floods, droughts, and re-emerging infectious diseases fueled by global warming. Global warming has also increased the frequency and severity of surgical disease, particularly for children, who bear an estimated 88% of the global burden of disease attributable to climate change. Health care delivery itself weighs heavily on the environment, accounting for nearly 5% of global greenhouse gas emissions. Within the health care sector, surgery and anesthesia are particularly carbon intensive. The surgical community must prioritize the intersection of climate change and pediatric surgery in order to address pediatric surgical disease on a global scale, while reducing the climate impact of surgical care delivery. This review defines the current state of climate change and its effects on pediatric surgical disease, discusses climate justice, and outlines actions to reduce the climate impact of surgical services.

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