Fly Me to the Moon (or Not)

At the end of 2024, I had the pleasure of attending the British Thoracic Society Winter meeting in London. As someone who moved from the UK to the other side of the world (Australia) over 21 years ago, this trip was delightful for many reasons, as it enabled me to see my family, friends and old work colleagues, and meet up with research collaborators. Better still I was upgraded to a blissfully much nicer travel class for the longest leg of my flight from Singapore to London and then back again. And at the conference, there were some excellent sessions with interesting discussions regarding the role of biologics in chronic obstructive pulmonary disease both for acute exacerbations and longer term management. There is thus no doubt that for me personally, attending a conference in-person is a superior experience, enabling greater engagement in conference activities and the ability to network with colleagues and see friends. While the option to attend meetings virtually remains important, during the pandemic I found that invariably other events arose that prevented me from attending conference sessions, unless I was actually presenting and had to be online. Photo by Killian Pham on Unsplash.com. In an era where we are increasingly examining how we can make healthcare more sustainable and environmentally friendly (https://www.england.nhs.uk/greenernhs/whats-already-happening/sustainable-development-unit-archive/), the impact of flying (particularly for business or professional activities) on climate change is a highly pertinent issue. Long haul flights generate substantial carbon emissions (e.g., London to Perth producing 3153 kg CO2 per person), which is a greater amount than the average person produces in some countries in a whole year. Even short haul flights can generate substantial emissions (e.g., London to Rome 234 kg CO2 per person) (https://www.theguardian.com/environment/ng-interactive/2019/jul/19/carbon-calculator-how-taking-one-flight-emits-as-much-as-many-people-do-in-a-year). Importantly, these figures assume travel is taken in economy class, with business class travel producing three times more CO2 emissions per person than economy class travel (https://climateactionaccelerator.org/solutions/economy_class_tickets_only/). Similarly, ultra-long haul, non-stop flights for over 16 h (e.g., from Sydney to London or Singapore to New York) are no better. Those long distance flights must carry more fuel and fewer passengers, making them less efficient than flying the same distance as two flights with a stop-over (https://theconversation.com/bucking-the-trend-is-there-a-future-for-ultra-long-haul-flights-in-a-net-zero-carbon-world-183212). These figures for individual travel are worrying but become even more horrifying when we consider the scale of medical conferences. A study examining carbon emissions associated with air travel for approximately 5000 participants attending the American Society of Tropical Medicine and Hygiene conference in 2019 identified that the participants travelled 44.6 million kilometres, equating to 58 return trips to the moon, with carbon emissions totalling 8,646,000 kg (https://doi.org/10.4269/ajtmh.20-1013). Similarly, a recent Australian study examined the carbon footprint associated with simulated attendance (and air travel) when the Australasian College of Dermatologists Annual Scientific Meeting was held in different host cities (https://doi.org/10.1111/ajd.14381). The authors identified that the host city's location critically impacted distance travelled and number of conference delegates needing to fly and thus carbon emissions, with lowest carbon emissions arising if Sydney or Melbourne hosted the meeting. Offsetting this finding is the additional cost for professional societies (and thus also delegates) to host conferences in more expensive cities. So, while we await the development of alternative aviation fuels and technology (which are currently being researched) in the hope these will reduce carbon emissions, where does this leave us? As individuals, we have a personal and professional responsibility to protect the health of our planet and adopt sustainable practices. Similarly, our national and international respiratory societies must consider the planet and sustainability within their strategic plans. Concrete actions could include measuring and reporting carbon footprints from annual scientific meetings, local events, Board director/Council member travel to meetings etc. and actions to offset carbon emissions. Furthermore, alternating conference formats biennially (in person and online) or adopting decentralised meetings (which utilise multiple regional venues and a mixture of online and in-person presenters) are possible solutions (https://doi.org/10.4269/ajtmh.20-1013). The latter is a particularly tempting option as it still facilitates social connection, enabling people to meet in person, discuss and network. And so, to return to my own conference travel, ‘fly me to the moon and let me play among the stars’ (Bart Howard song 1954)—no thank you. Instead, my new year's resolutions are to adopt more environmentally sustainable practices and to become better at fully engaging in virtual conferences. The author declares no conflicts of interest.