Climate Change and Emergency Medicine: A Scoping Review Across Emergency Medicine Subspecialties

Abstract

Introduction Climate change is reshaping emergency medicine (EM) practice through rising temperatures, extreme weather events, and deteriorating air quality. Emergency medicine serves as a critical frontline indicator for climate-sensitive health conditions, yet evidence describing climate impacts across EM subspecialties remains fragmented. This scoping review synthesizes existing literature at the intersection of climate change and EM to identify key findings, knowledge gaps, and priorities for building climate-resilient emergency care systems. Methods We conducted a scoping review with reporting aligned to the PRISMA Extension for Scoping Reviews. We searched PubMed, Scopus, and Embase through March 2025, combining climate-related terms with EM terms. Two independent reviewers screened 794 articles, with 35 studies meeting inclusion criteria. We extracted data on study characteristics, climate exposures, EM outcomes, vulnerable populations, and system-level impacts across five EM subspecialties: emergency medical services; trauma; disaster medicine; toxicology; and mental health. Results Across 35 studies spanning five EM subspecialties, most examined temperature-related exposures, with additional focus on extreme weather events and air quality. In emergency medical services, heatwaves and compound climate events were associated with increased call volume and operational strain, with vulnerabilities identified among older adults, working-age males, and populations in resource-limited settings. Trauma studies demonstrated consistent associations between ambient temperature and injury patterns, including traffic injuries, falls, and assaults with reproducible lag effects of 1–6 days. Disaster medicine studies highlighted critical preparedness and infrastructure gaps, including limited emergency management capacity, and predictable post-event surges in emergency department (ED) utilization. Toxicology studies linked higher temperatures and air quality changes to increased emergency visits for substance-related overdoses and respiratory conditions, while mental health studies consistently reported increased ED use and hospitalizations for psychiatric and substance use disorders during periods of extreme heat. Across subspecialties, socially marginalized populations, including individuals experiencing homelessness, those of lower socioeconomic status, older adults, and people with mental health or substance use disorders were disproportionately affected. Conclusion Climate change is placing increasing strain on emergency care systems while amplifying existing health inequities. Current evidence is limited by geographic concentration in high-income settings, a predominant focus on temperature-related hazards, a lack of evaluated interventions, and insufficient integration of climate projections into health system planning. Addressing these gaps will be essential for developing climate-informed emergency medicine strategies capable of protecting vulnerable populations as climate-related health risks intensify.