A narrative review of the current available literature on the intersection between the climate crisis and paediatric surgical care

The climate crisis exacerbates health inequities, including in paediatric surgery, creating a vicious cycle. We sought to review (a) existing evidence on the connection between paediatric surgery and climate and (b) how this addresses the vicious cycle. A PubMed search was conducted on 23-08-2023. Articles not commenting on "climate change" and "paediatric surgery" were excluded. Included papers were categorised into emerging themes. Out of 151 search results, seven articles were included. The emerging themes related to "Effect of climate on paediatric surgical illness" (n = 3), "Effect of surgery on climate" (n = 2), and "Mitigating impact of paediatric surgery" (n = 2). Five articles were observational studies, and two were literature reviews, all papers published after 2020. We found limited primary research focusing on the intersection between climate change and paediatric surgery. Articles tend to focus on quantifying impact and mitigation, which does not lend itself to climate justice. The syndemic model of health focuses on the complex interconnections and pathways through which health conditions interact within populations to exacerbate adverse health outcomes. We suggest future research needs to be reframed, with the interconnection between health inequities, the climate crisis, and the wider health system addressed together.