Sustainable general practice.

BACKGROUND: Climate change is a health emergency, and general practitioners have an important role in both mitigation and adaptation to the effects of climate change. Climate change is already impacting health in a myriad of ways, including death and illness from increasingly frequent extreme weather events, disruptions to food systems and changes in vector-borne diseases. General practice can demonstrate leadership by embracing sustainability as part of a primary care ethos aligning it with quality care. OBJECTIVE: The aim of this article is to outline the steps required to achieve and promote sustainability from practice operations through to clinical care and advocacy. DISCUSSION: Achieving sustainability requires not just a consideration of energy use or waste, but also a fundamental re-evaluation of the purpose and practice of medicine. A planetary health perspective requires us to recognise our connectedness to and dependence on the health of nature. It demands a change to models of healthcare that are sustainable, prioritise prevention and are inclusive of the social and environmental dimensions to health.

Health risks from indoor gas appliances.

BACKGROUND: Cooking and heating with gas is common in Australian homes and is a risk factor for several important health problems; however, there is little awareness of these risks among doctors or the public. Gas stove use is estimated to cause 12% of childhood asthma in Australia. OBJECTIVE: The aim of this article is to help general practitioners identify when gas combustion products such as nitrogen dioxide might be contributing to asthma in children and adults and to alert them to the risks of carbon monoxide (CO) poisoning, which can be hard to diagnose. DISCUSSION: There are excellent alternatives to the use of gas in domestic appliances and some simple behavioural changes that can reduce exposure in situations where appliances cannot yet be removed. CO poisoning can be insidious. Mild exposure can cause headache, nausea, vomiting, dizziness, malaise and confusion, so it can be mistaken for common conditions such as influenza or gastroenteritis. The COMA mnemonic is clinically useful. Increased awareness of these issues can provide patients with safer and healthier living environments.

The mining and burning of coal: effects on health and the environment.

Australia's coal conundrum is that all political parties say they are concerned about climate change while sanctioning an unprecedented expansion of coalmining and coal seam gas extraction in Australia. Australia's coal contributes to climate change and its global health impacts. Each phase of coal's lifecycle (mining, disposal of contaminated water and tailings, transportation, washing, combustion, and disposing of postcombustion wastes) produces pollutants that affect human health. Communities in which coalmining or burning occurs have been shown to suffer significant health impacts. The health and climate costs of coal are unseen, and when costs to health systems are included, coal is an expensive fuel.