Post Peak Medicine

Guidelines for contributors

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Introduction

PART 1: FRAMEWORK AND BACKGROUND

Three possible futures

Peak what?

Historical perspective

Awareness and denial

Medical literature review

Legal and ethical issues

Financing a practice

Armed conflict

Peak population and dieback

Personal preparation

Further reading

PART 2: SPECIALTIES

Anesthesiology

Dentistry

Dermatology

Emergency medicine

Family medicine

General surgery

Internal medicine

Midwifery

Nursing

Obstetrics and gynecology

Optometry

Orthopedic surgery

Otolaryngology

Pediatrics

Pharmacy

Psychiatry

Psychology

Public health

Radiology

Urology

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical literature review

A Medline search using the terms "peak oil" and "peak petroleum" produced the following results relevant to medical practice (listed in reverse date order).  For each paper I have provided an abstract or summary.  "Abstract" means that I have used the online abstract provided by Medline.  Where no abstract was provided, I have chosen one or two paragraphs from the paper which appear to represent the views of the author in his own words, and these I have labelled "summary".

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Ann N Y Acad Sci. 2011 Feb;1219(1):52-72. doi: 10.1111/j.1749-6632.2010.05940.x.

Energy return on investment, peak oil, and the end of economic growth.

Murphy DJ, Hall CA.

College of Environmental Science and Forestry, State University of New York, Syracuse, New York.

Abstract

Economic growth over the past 40 years has used increasing quantities of fossil energy, and most importantly oil. Yet, our ability to increase the global supply of conventional crude oil much beyond current levels is doubtful, which may pose a problem for continued economic growth. Our research indicates that, due to the depletion of conventional, and hence cheap, crude oil supplies (i.e., peak oil), increasing the supply of oil in the future would require exploiting lower quality resources (i.e., expensive), and thus could occur only at high prices. This situation creates a system of feedbacks that can be aptly described as an economic growth paradox: increasing the oil supply to support economic growth will require high oil prices that will undermine that economic growth. From this we conclude that the economic growth of the past 40 years is unlikely to continue in the long term unless there is some remarkable change in how we manage our economy.

© 2011 New York Academy of Sciences.

PMID: 21332492 [PubMed - in process]

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BMJ. 2010 Nov 2;341:c5796. doi: 10.1136/bmj.c5796.

Oil, health, and healthcare. Ramifications of peak oil.

McCartney G, Hanlon P.

Comment on:

BMJ. 2010;341:c4596.

Summary

There is an urgent need to emphasise the potential for positive transformation change inherent in this crisis. Understanding the threats to health of peak oil is important but change comes from values, inspiration, empathy and other much less abstract influences.

The uncertainties relating to peak oil are not about whether it will happen, but about when it will happen and what the impacts will be. Policies pursued now will have the effect of either increasing resilience or increasing vulnerability to the effects of peak oil. Raffle's editorial is therefore a commendable step in highlighting some of the policy directions which are required if we are to achieve population health benefits in the face of sustainability challenges.

PMID: 21045030 [PubMed - indexed for MEDLINE]

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BMJ. 2010 Sep 1;341:c4596. doi: 10.1136/bmj.c4596.

Oil, health, and health care.

Raffle AE.

The April 2010 oil leak in the Mexican Gulf illustrates the risks being taken to extract oil from inaccessible fields, and in June a Lloyd's 360 degree risk insight report said, "we have entered a period of deep uncertainty in how we will source energy for power, heat and mobility and how much we will pay for it." The reason why such damaging extraction methods are pursued, and why Lloyd's are telling us we face a "new energy paradigm" rather than normal market volatility, is that oil discoveries peaked 40 years ago, and oil supply is probably at its maximum, with decline soon to follow. This has substantial implications for transport, food, jobs, health, and health care.  Yet many people still haven't heard of "peak oil" and few are discussing it.

Comment in:

PMID: 20810476 [PubMed - indexed for MEDLINE]

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Am J Disaster Med. 2010 Sep-Oct;5(5):315-9.

Mitigate, adapt, or suffer: Peak oil's new disaster paradigm.

Doyle GS.

Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Abstract

OBJECTIVES: To address the impacts of peak oil (PO) on human health and to propose new public health preparedness models and measures mandated by these impacts.

DESIGN: Review of relevant literature. Articles were obtained by searching the PubMed database (including manual searches using "related citations" tool) plus Google and Google Scholar search engines using terms such as "peak oil," "energy scarcity," "human health," "public health," and "preparedness."

RESULTS: Forty-six journal articles were reviewed.

CONCLUSIONS: The projections about PO are concerning, as illustrated by minor PO events in the recent past. There are many opportunities for devising beneficial solutions within healthcare to mitigate the effects of PO. It is essential for disaster medicine professionals to become aware of PO and to advocate for change in clinical practice with patients as well as policy leaders. If we fail to mitigate the effects of PO on healthcare, we will be left with the less pleasant options of adapting to PO or suffering its effects.

PMID: 21162413 [PubMed - indexed for MEDLINE]

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Sci Prog. 2010;93(Pt 1):37-112.

Solar energy: principles and possibilities.

Rhodes CJ.

Fresh-Lands Environmental Actions, Reading, UK. cjrhodes@fresh-lands.com

Abstract

As the world faces an impending dearth of fossil fuels, most immediately oil, alternative sources of energy must be found. 174 PW worth of energy falls onto the top of the Earth's atmosphere in the form of sunlight which is almost 10,000 times the total amount of energy used by humans on Earth, as taken from all sources, oil, coal, natural gas, nuclear and hydroelectric power combined. If even a fraction of this could be harvested efficiently, the energy crunch could in principle be averted. Various means for garnering energy from the Sun are presented, including photovoltaics (PV), thin film solar cells, quantum dot cells, concentrating PV and thermal solar power stations, which are more efficient in practical terms. Finally the prospects of space based (satellite) solar power are considered. The caveat is that even if the entire world electricity budget could be met using solar energy, the remaining 80% of energy which is not used as electricity but thermal power (heat) still needs to be found in the absence of fossil fuels. Most pressingly, the decline of cheap plentiful crude oil (peak oil) will not find a substitution via solar unless a mainly electrified transportation system is devised and it is debatable that there is sufficient time and conventional energy remaining to accomplish this. The inevitable contraction of transportation will default a deconstruction of the globalised world economy into that of a system of localised communities.

PMID: 20222355 [PubMed]

Conserv Biol. 2010 Apr 20. [Epub ahead of print]

The Impending Peak and Decline of Petroleum Production: an Underestimated Challenge for Conservation of Ecological Integrity.

Czúcz B, Gathman JP, McPherson GR.

Department of Plant Ecology, Institute of Ecology and Botany of the Hungarian Academy of Sciences, 2163 Vácrátót, Hungary, email czucz@botanika.hu.

Abstract

In the last few decades petroleum has been consumed at a much faster pace than new reserves have been discovered. The point at which global oil extraction will attain a peak ("peak oil") and begin a period of unavoidable decline is approaching. This eventuality will drive fundamental changes in the quantity and nature of energy flows through the human economic system, which probably will be accompanied by economic turmoil, political conflicts, and a high level of social tension. Besides being a geological and economic issue, peak oil is also a fundamental concern as it pertains to ecological systems and conservation because economics is a subsystem of the global ecosystem and changes in human energy-related behaviors can lead to a broad range of effects on natural ecosystems, ranging from overuse to abandonment. As it becomes more difficult to meet energy demands, environmental considerations may be easily superseded. Given the vital importance of ecosystems and ecosystem services in a postpetroleum era, it is crucially important to wisely manage our ecosystems during the transition period to an economy based on little or no use of fossil fuels. Good policies can be formulated through awareness and understanding gained from scenario-based assessments. Presently, most widely used global scenarios of environmental change do not incorporate resource limitation, including those of the Millennium Ecosystem Assessment and the Intergovernmental Panel on Climate Change. Considering the potential magnitude of the effects of peak oil on society and nature, the development of resource-constrained scenarios should be addressed immediately. Ecologists and conservation biologists are in an important position to analyze the situation and provide guidance, yet the topic is noticeably absent from ecological discussions. We urge politicians, corporate chief executives, thought leaders, and citizens to consider this problem seriously because it is likely to develop into one of the key environmental issues of the 21st century.

PMID: 20412088

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Ambio. 2010 Feb;39(1):85-90.

Climate change and peak oil: the urgent need for a transition to a non-carbon-emitting society.

Peñuelas J, Carnicer J.

Global Ecology Unit CSIC-CEAB-CREAF, CREAF, Edifici C, Universitat Autònoma de Barcelona, 08193 Bellaterra, Catalonia, Spain. Josep.Penuelas@uab.cat

PMID: 20496657 [PubMed - indexed for MEDLINE]

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Aust N Z J Public Health. 2009 Aug;33(4):307-11.

Policy on global warming: fiddling while the globe burns?

Weston D.

Curtin University Sustainability Policy Institute, Curtin University, Western Australia, Australia. dweston1@westnet.com.au

Abstract

OBJECTIVE: To assess the extent that the health consequences of global warming and the responses to it take due account of its impact on poverty and inequality. METHOD: Reviewing the relevant literature on global warming, proposed solutions and the impact. RESULTS: To date, too little attention has been paid to the health consequences arising from the increased poverty and inequality that global warming will bring. When these are combined with issues arising from the economic melt-down, food shortages, peak oil, etc. we are heading for a global public health crisis of immeasurable magnitude. CONCLUSION: Solutions lie in rethinking the global economic system that we have relied upon over the past several decades and the global institutions that have led and fed off that global system - the IMF, the World Bank and so on. IMPLICATIONS: Public health practitioners need to look and act globally more often. They need to better recognise the links between global warming and the global financial crisis. How the latter is dealt with will determine whether the former can be resolved. It is in this global political economy arena that future action in public health lies.

PMID: 19689589

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Sci Prog. 2009;92(Pt 1):39-90.

Oil from algae; salvation from peak oil?

Rhodes CJ.

University of Reading, Reading, Berkshire, UK. cjrhodes@fresh-lands.com

Abstract

A review is presented of the use of algae principally to produce biodiesel fuel, as a replacement for conventional fuel derived from petroleum. The imperative for such a strategy is that cheap supplies of crude oil will begin to wane within a decade and land-based crops cannot provide more than a small amount of the fuel the world currently uses, even if food production were allowed to be severely compromised. For comparison, if one tonne of biodiesel might be produced say, from rape-seed per hectare, that same area of land might ideally yield 100 tonnes of biodiesel grown from algae. Placed into perspective, the entire world annual petroleum demand which is now provided for by 31 billion barrels of crude oil might instead be met from algae grown on an area equivalent to 4% of that of the United States. As an additional benefit, in contrast to growing crops it is not necessary to use arable land, since pond-systems might be placed anywhere, even in deserts, and since algae grow well on saline water or wastewaters, no additional burden is imposed on freshwater-a significant advantage, as water shortages threaten. Algae offer the further promise that they might provide future food supplies, beyond what can be offered by land-based agriculture to a rising global population.

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Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2483-9.

Overcoming systemic roadblocks to sustainability: The evolutionary redesign of worldviews, institutions, and technologies.

Beddoe R, Costanza R, Farley J, Garza E, Kent J, Kubiszewski I, Martinez L, McCowen T, Murphy K, Myers N, Ogden Z, Stapleton K, Woodward J.

Rubenstein School of Environment and Natural Resources, George D. Aiken Center, Gund Institute for Ecological Economics, and Community Development and Applied Economics, University of Vermont, Burlington, VT 05405, USA.

Abstract

A high and sustainable quality of life is a central goal for humanity. Our current socio-ecological regime and its set of interconnected worldviews, institutions, and technologies all support the goal of unlimited growth of material production and consumption as a proxy for quality of life. However, abundant evidence shows that, beyond a certain threshold, further material growth no longer significantly contributes to improvement in quality of life. Not only does further material growth not meet humanity's central goal, there is mounting evidence that it creates significant roadblocks to sustainability through increasing resource constraints (i.e., peak oil, water limitations) and sink constraints (i.e., climate disruption). Overcoming these roadblocks and creating a sustainable and desirable future will require an integrated, systems level redesign of our socio-ecological regime focused explicitly and directly on the goal of sustainable quality of life rather than the proxy of unlimited material growth. This transition, like all cultural transitions, will occur through an evolutionary process, but one that we, to a certain extent, can control and direct. We suggest an integrated set of worldviews, institutions, and technologies to stimulate and seed this evolutionary redesign of the current socio-ecological regime to achieve global sustainability.

PMID: 19240221 [PubMed - indexed for MEDLINE]PMCID: PMC2650289Free PMC Article

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Public Health Rep. 2009 Jan-Feb;124(1):5-19.

Energy and public health: the challenge of peak petroleum.

Frumkin H, Hess J, Vindigni S.

National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 4770 Buford Hwy., MS F-61, Atlanta, GA 30341-3717, USA. hfrumkin@cdc.gov

Abstract

Petroleum is a unique and essential energy source, used as the principal fuel for transportation, in producing many chemicals, and for numerous other purposes. Global petroleum production is expected to reach a maximum in the near future and to decline thereafter, a phenomenon known as "peak petroleum." This article reviews petroleum geology and uses, describes the phenomenon of peak petroleum, and reviews the scientific literature on the timing of this transition. It then discusses how peak petroleum may affect public health and health care, by reference to four areas: medical supplies and equipment, transportation, energy generation, and food production. Finally, it suggests strategies for anticipating and preparing for peak petroleum, both general public health preparedness strategies and actions specific to the four expected health system impacts.

PMID: 19413022

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Sci Prog. 2008;91(Pt 4):317-75.

The oil question: nature and prognosis.

Rhodes CJ.

University of Reading, UK. cjrhodes@freshlands.com

Abstract

A review is given of the nature and origins of crude oil (petroleum) along with factors relating to its production and demand for it. The modern globalised world economy and its population has grown on the assumption of limitless supplies of cheap crude oil. Almost all agriculture now is completely dependent on available oil and natural gas to run machinery and to make chemical fertilizers. Our complacent regard for oil is however invalid and a gap between the relentlessly rising demand for oil and its supply is expected to appear at some time in the period 2010-2015. The global peak in oil production "peak oil" predicted by M. King Hubbert in 1956, will exacerbate the situation, and the world must seek to run and organise itself in an imminent reality where supplies of conventional crude oil are both limited and increasingly expensive. Providing the equivalent of 30 billion barrels of oil a year as is currently used across the globe, by unconventional kinds of oil, e.g. from oil shale and tar sands is not realistic. Since most of the oil produced in the world is refined into liquid fuels to run transportation, human survival will depend on devising localised economies and communities that necessarily rely far less on personalised transport (cars).

PMID: 19192735 [PubMed]

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Public Health. 2008 Jul;122(7):647-52. Epub 2008 Jun 6.

Peak oil: will it be public health's greatest challenge?

Hanlon P, McCartney G.

University of Glasgow, 1 Lilybank Gardens, Glasgow, UK.

Abstract

The health of populations is determined more by the social and economic determinants of health than by changes in technology, health services or short-term policy interventions. In the near future, there is likely to be a significant shortfall in energy supply, resulting in high energy prices and a reversal of many of the aspects of globalization that are currently taken for granted. If this happens, economic recession and restructuring could have a negative impact on health, not dissimilar to that experienced by the former Soviet Union when it attempted a rapid change in its economy. There is, however, the potential, through economic planning and sustainable development, to reduce the adverse effects of this change and use this opportunity to impact on a range of diseases which are, at least in part, caused by overconsumption, inequality and loss of community.

PMID: 18538808

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Public Health. 2008 Jul;122(7):667-8; discussion 669-70. Epub 2008 Jun 4.

The days of cheap oil have gone, but the peak oil theory is far too bleak.

Lea R.

Arbuthnot Banking Group and London School of Economics, London, UK. ruth.lea@btinternet.com

PMID: 18534643

Summary

Oil prices will remain high and almost inevitably rise further.  Production costs will be greater, and demand will be such that, for those who can pay, high prices will have to be paid.  The days of cheap oil as a source of energy have surely gone.  However, this should not be seen as an inevitable disaster for the poor.  High oil prices will inevitably stimulate technological developments into substitute energy sources, and these technological developments may well provide energy sources at very affordable prices.  Let us hope they do.

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Public Health. 2008 Jul;122(7):664-6; discussion 669-70. Epub 2008 Jun 4.

Peak oil: threat, opportunity or phantom?

Wilkinson P.

London School of Hygiene and Tropical Medicine, London, UK. paul.wilkinson@lshtm.ac.uk

PMID: 18534642

Summary

Even if peak oil is not the threat that many believe it to be, it is increasingly clear that there are many ways in which current lifestyles, based so heavily on fossil fuels, are detrimental to health.  Tackling that dependence is likely to lead to very worthwhile net benefits for health.  This is an important message for public health to make, and ensuring it is fully recognised in the development of public policy will require the type of vision and leadership that McCartney and Hanlon describe.

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Environ Sci Technol. 2007 Nov 1;41(21):7193.

Peak oil or peak emissions?

Schnoor JL.

est@uiowa.edu

PMID: 18044484

Summary

We're in a dramatic race to decrease fossil fuel demand (and emissions) before the looming economic disruption caused by scarce oil and global warming becomes reality.  Energy security, the climate, and the economy are all at stake.  Declining oil demand will trump the effects of peak oil.  But we need leaders who will challenge us, we need a plan, and we must start soon.

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JAMA. 2007 Oct 10;298(14):1688-90.

Peak petroleum and public health.

Frumkin H, Hess J, Vindigni S.

National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, US Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. hfrumkin@cdc.gov

PMID: 17925522

Summary

At some point early in the 21st century, likely well before mid-century, petroleum production will peak and begin to decline.  This will increase prices for petroleum and for the many goods and services that require petroleum for their production and transport.  This transition will have far-reaching effects across society.  Within the health sector, direct and indirect effects will be felt in medical supplies and equipment, transportation, energy, and food.  Health professionals need to anticipate, prepare for, reduce, and adapt to petroleum scarcity to protect public health in coming decades.

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Nature. 2007 Mar 15;446(7133):257.

Scientists need to confront economists about peak oil.

Lardelli M.

PMID: 17361158

Summary

The proponents of the peak-oil theory are predominantly scientists whereas the vocal opposition are, to a significant extent, economists.  They seem to believe that the geological reality of finite conventional oil resources and the thermodynamic constraints on energy production from alternative hydrocarbon sources can be overcome by a sufficiently high price signal.  Most people lack sufficient scientific training to appreciate the strong evidence for, and dire consequences of, an imminent decline in oil production.  They are easily lulled into complacency by those with a vested interest in delaying any mitigating responses.  The scientific community must unite behind the issue of energy decline. 

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Nature. 2007 Jan 4;445(7123):14-7.

Energy: that's oil, folks...

Witze A.

PMID: 17203036 [PubMed]

Summary

Don’t say they didn’t warn us. The poster for the meeting of the Association for the Study of Peak Oil and Gas in Boston this October featured American revolutionary Paul Revere on his midnight ride, bringing news of imminent calamity. Only this time it is not the British who are coming, but the end of the oil era, and with it much of western civilization. Many attendees at the meeting were people who could tell you how to stock a bunker to survive the inevitable collapse of civilization, and then opine at length about the extent and characteristics of the great tar-sand deposits of Canada. Some of them conduct a thriving mini-business in preparing for the coming apocalypse — “deal with reality or reality will deal with you”, as one website claims — while scrutinizing table after table of data on world oil production.

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J R Soc Promot Health. 2006 Mar;126(2):62-3.

Peak oil, climate change, public health and well-being.

Harrison D.

PMID: 16562768

Summary

All public policy will have to develop a wider, more connected analysis than is currently being envisioned.  Indicators show that, since at least the early 1970s, increasing gross domestic product has not increased measures of life satisfaction.  If the long-term protection of both planet and public health is increasingly connected to reduced carbon dependency, then we need to consider "consumption" as a public mental health issue.