Sentinel Practitioners for the Environment and their Role in Connecting up Global Concerns due to Climate Change with Local Actions: How to Spread Awareness and Skills all over the World

Climate-change (C-C) health effects are among the most challenging concerns in our future. The health impacts are currently not well assessed through current statistics. In particular, activities by clinicians in relation to environment and health are still rather underdeveloped. We carried out a systematic bibliographic review on Sentinel Physician Networks. These were considered in numerous articles (6691 from 1984 to 2017), but very few dealt with environmental-health (EH) issues (just 14 in the same period). Thus we propose the development of a structured system, aimed at monitoring the effects of environmental issues critical for population health , both by raising awareness and by reporting any situation raising concerns. In fact we believe that Family Doctors (FDs) and Pediatricians (PEDs) could play a crucial role in putting global concerns in connection with local actions. As such three two-day courses were staged in Italy to train 61 FDs/PEDs, and covering the following issues : i) C-C health effects, ii) Statistics and environmental epidemiology, iii) EH bibliographic data-bases, iv) Communication and advocacy, v) Educational methods. A quantitative evaluation was carried out and 100% of trainees agreed to join a systematic training platform to further develop their skills in EH issues. A Sentinel Physicians for the Environment (SPE) Manual is underway. Due to scarcity of experiences across the world, an agreement with the World Health Organization(WHO) Public Health and Environment Dpt. was reached to develop fact sheets to share and disseminate awareness and skills in this field. An international panel of expert has been established. The main aim of this collaboration is the definition of a list of criteria to guarantee sound science, authoritativeness and collaboration at all institutional levels. This proposal in collaboration with WHO could contribute to improving environment and health especially in deprived areas.