{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:50:55Z","timestamp":1791406255823,"version":"4.3.3"},"reference-count":45,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jaci-inpractice.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jaip.2026.06.046","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:40:31Z","timestamp":1791366031000},"page":"2179-2187","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modification of Clinical Practice to Minimize Environmental Impact"],"prefix":"10.1016","volume":"14","author":[{"given":"Susan E.","family":"Pacheco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Hartono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart L.","family":"Abramson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jaip.2026.06.046_bib1","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/S0140-6736(24)01822-1","article-title":"The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action","volume":"404","author":"Romanello","year":"2024","journal-title":"Lancet"},{"key":"10.1016\/j.jaip.2026.06.046_bib2","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1377\/hlthaff.2020.01247","article-title":"Health care pollution and public health damage in the United States: an update","volume":"39","author":"Eckelman","year":"2020","journal-title":"Health Aff (Millwood)"},{"key":"10.1016\/j.jaip.2026.06.046_bib4","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1016\/j.jaci.2021.10.011","article-title":"Climate change and global issues in allergy and immunology","volume":"148","author":"Pacheco","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2026.06.046_bib5","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.iac.2022.06.001","article-title":"Ozone in the development of pediatric asthma and atopic disease","volume":"42","author":"Atkinson","year":"2022","journal-title":"Immunol Allergy Clin North Am"},{"key":"10.1016\/j.jaip.2026.06.046_bib6","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.jaci.2023.09.008","article-title":"Increasing wildfire smoke from the climate crisis: impacts on asthma and allergies","volume":"152","author":"Balmes","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2026.06.046_bib7","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jaci.2022.11.025","article-title":"Environmental justice and allergic disease: a Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee","volume":"151","author":"Burbank","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2026.06.046_bib8","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.jaci.2023.09.015","article-title":"Community- and neighborhood-level disparities in extreme climate exposure: implications for asthma and atopic disease outcomes","volume":"152","author":"Burbank","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2026.06.046_bib11","author":"Protocol"},{"key":"10.1016\/j.jaip.2026.06.046_bib12","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1056\/NEJMp2000331","article-title":"The climate crisis and clinical practice","volume":"382","author":"Salas","year":"2020","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jaip.2026.06.046_bib15","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1056\/NEJMe068096","article-title":"Air pollution and children \u2014 an unhealthy mix","volume":"355","author":"Gauderman","year":"2006","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jaip.2026.06.046_bib16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.8243","article-title":"Association of air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the US: a systematic review","volume":"3","author":"Bekkar","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jaip.2026.06.046_bib17","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3390\/healthcare12030307","article-title":"Clearing the air: understanding the impact of wildfire smoke on asthma and COPD","volume":"12","author":"Wilgus","year":"2024","journal-title":"Healthcare"},{"key":"10.1016\/j.jaip.2026.06.046_bib18","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s11882-023-01090-1","article-title":"The effects of wildfire smoke on asthma and allergy","volume":"23","author":"Noah","year":"2023","journal-title":"Curr Allergy Asthma Rep"},{"key":"10.1016\/j.jaip.2026.06.046_bib19","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1146\/annurev-nutr-111324-111252","article-title":"Climate change, extreme weather events, food security, and nutrition: evolving relationships and critical challenges","volume":"45","author":"Fanzo","year":"2025","journal-title":"Annu Rev Nutr"},{"key":"10.1016\/j.jaip.2026.06.046_bib20","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s41030-024-00257-z","article-title":"The impact of malnutrition on the developing lung and long-term lung health: a narrative review of global literature","volume":"10","author":"Tharumakunarajah","year":"2024","journal-title":"Pulm Ther"},{"key":"10.1016\/j.jaip.2026.06.046_bib21","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.jaip.2024.12.025","article-title":"An overview of climate changes and its effects on health: from mechanisms to one health","volume":"13","author":"Agache","year":"2025","journal-title":"J Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2026.06.046_bib22","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0140-6736(20)32290-X","article-title":"The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises","volume":"397","author":"Watts","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.jaip.2026.06.046_bib24","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1111\/jan.15671","article-title":"The carbon footprint of healthcare settings: a systematic review","volume":"79","author":"Rodr\u00edguez-Jim\u00e9nez","year":"2023","journal-title":"J Adv Nurs"},{"key":"10.1016\/j.jaip.2026.06.046_bib27","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1001\/jamadermatol.2024.5669","article-title":"Carbon footprint analysis of an outpatient dermatology practice at an academic medical center","volume":"161","author":"Silva","year":"2025","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.jaip.2026.06.046_bib29","author":"Morrison"},{"key":"10.1016\/j.jaip.2026.06.046_bib33","article-title":"Revolutionizing healthcare: how telemedicine is improving patient outcomes and expanding access to care","volume":"16","author":"Ezeamii","year":"2024","journal-title":"Cureus"},{"key":"10.1016\/j.jaip.2026.06.046_bib34","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1186\/s12913-025-12449-7","article-title":"The use of telemedicine in family medicine: a scoping review","volume":"25","author":"Mahdavi","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.jaip.2026.06.046_bib35","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3390\/children12070849","article-title":"Impact of telemedicine on asthma control and quality of life in children and adolescents: a systematic review and meta-analysis","volume":"12","author":"Gerriko","year":"2025","journal-title":"Children"},{"key":"10.1016\/j.jaip.2026.06.046_bib36","doi-asserted-by":"crossref","first-page":"447","DOI":"10.37765\/ajmc.2025.89714","article-title":"Impact of telemedicine use on outpatient-related CO2 emissions: estimate from a national cohort","volume":"31","author":"Delarmente","year":"2025","journal-title":"Am J Manag Care"},{"key":"10.1016\/j.jaip.2026.06.046_bib37","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41746-023-00818-7","article-title":"Telemedicine and the environment: life cycle environmental emissions from in-person and virtual clinic visits","volume":"6","author":"Thiel","year":"2023","journal-title":"NPJ Digit Med"},{"key":"10.1016\/j.jaip.2026.06.046_bib39","series-title":"Stanford Health Care Ambulatory Care Report - Allergy Atherton [Internal Report] [Spreadsheet]","year":"2026"},{"key":"10.1016\/j.jaip.2026.06.046_bib41","doi-asserted-by":"crossref","DOI":"10.2196\/57077","article-title":"Bridging the telehealth digital divide with collegiate navigators: mixed methods evaluation study of a service-learning health disparities course","volume":"10","author":"Doueiri","year":"2024","journal-title":"JMIR Med Educ"},{"key":"10.1016\/j.jaip.2026.06.046_bib43","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1136\/thorax-2025-223195","article-title":"Green respiratory healthcare: what really matters","volume":"80","author":"Connett","year":"2025","journal-title":"Thorax"},{"key":"10.1016\/j.jaip.2026.06.046_bib44","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1001\/jama.2024.15331","article-title":"Greenhouse gas emissions and costs of inhaler devices in the US","volume":"332","author":"Tirumalasetty","year":"2024","journal-title":"JAMA"},{"key":"10.1016\/j.jaip.2026.06.046_bib45","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1001\/jama.2025.15638","article-title":"A longitudinal assessment of greenhouse gas emissions from inhaler devices in a national health system","volume":"334","author":"Weppner","year":"2025","journal-title":"JAMA"},{"key":"10.1016\/j.jaip.2026.06.046_bib46","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01705-2023","article-title":"The carbon footprint of as-needed budesonide\/formoterol in mild asthma: a post hoc analysis","volume":"64","author":"Hatter","year":"2024","journal-title":"Eur Respir J"},{"key":"10.1016\/j.jaip.2026.06.046_bib47","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s41030-025-00319-w","article-title":"Switching to the dry powder inhaler: disease control with a lower carbon footprint","volume":"11","author":"Janson","year":"2025","journal-title":"Pulm Ther"},{"key":"10.1016\/j.jaip.2026.06.046_bib49","author":"Polk"},{"key":"10.1016\/j.jaip.2026.06.046_bib50","article-title":"Decarbonising health systems across OECD countries","year":"2025","journal-title":"OECD Health Policy Stud"},{"key":"10.1016\/j.jaip.2026.06.046_bib52","doi-asserted-by":"crossref","DOI":"10.1016\/j.focus.2025.100377","article-title":"A healthcare system\u2019s path to carbon neutrality: addressing climate change and role of the health care","volume":"4","author":"Shin","year":"2025","journal-title":"AJPM Focus"},{"key":"10.1016\/j.jaip.2026.06.046_bib56","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1007\/s10098-021-02180-2","article-title":"Carbon footprint in higher education institutions: a literature review and prospects for future research","volume":"23","author":"Valls-Val","year":"2021","journal-title":"Clean Technol Environ Policy"},{"key":"10.1016\/j.jaip.2026.06.046_bib57","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-081284","article-title":"Strategies and tactics to reduce the impact of healthcare on climate change: systematic review","volume":"387","author":"Braithwaite","year":"2024","journal-title":"BMJ"},{"key":"10.1016\/j.jaip.2026.06.046_bib58","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-085364","article-title":"Climate footprint of industry-sponsored in-human clinical trials: life cycle assessments of clinical trials spanning multiple phases and disease areas","volume":"15","author":"LaRoche","year":"2025","journal-title":"BMJ Open"},{"key":"10.1016\/j.jaip.2026.06.046_bib59","doi-asserted-by":"crossref","first-page":"568","DOI":"10.3155\/1047-3289.60.5.568","article-title":"Greenhouse gas emissions from U.S. institutions of higher education","volume":"60","author":"Sinha","year":"2010","journal-title":"J Air Waste Manag Assoc"},{"key":"10.1016\/j.jaip.2026.06.046_bib63","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1001\/jama.2024.13506","article-title":"Medical schools are updating their curricula as climate change becomes impossible to ignore","volume":"332","author":"Brouillette","year":"2024","journal-title":"JAMA"},{"key":"10.1016\/j.jaip.2026.06.046_bib64","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4300\/JGME-D-24-00086.1","article-title":"Climate change curricula in US graduate medical education: a scoping review","volume":"16","author":"Cois","year":"2024","journal-title":"J Grad Med Educ"},{"key":"10.1016\/j.jaip.2026.06.046_bib65","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jsurg.2021.09.002","article-title":"Action in healthcare sustainability is a surgical imperative: this is a novel way to do it","volume":"79","author":"Vacharathit","year":"2022","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jaip.2026.06.046_bib67","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1111\/all.15836","article-title":"An EAACI review: go green in health care and research. Practical suggestions for sustainability in clinical practice, laboratories, and scientific meetings","volume":"78","author":"Pali-Sch\u00f6ll","year":"2023","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2026.06.046_bib71","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.2147\/DDDT.S262141","article-title":"The climate is changing for metered-dose inhalers and action is needed","volume":"14","author":"Pritchard","year":"2020","journal-title":"Drug Des Devel Ther"},{"key":"10.1016\/j.jaip.2026.06.046_bib72","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jaci.2024.04.012","article-title":"Volunteerism Addressing Environmental Disparities in Allergy (VAEDIA): the presidential initiative to combat environmental injustice in allergy and immunology\u2014a Work Group Report of the AAAAI VAEDIA task force","volume":"154","author":"Mahdavinia","year":"2024","journal-title":"J Allergy Clin Immunol"}],"container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219826005982?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219826005982?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:58:37Z","timestamp":1791403117000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213219826005982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":45,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S2213219826005982"],"URL":"https:\/\/doi.org\/10.1016\/j.jaip.2026.06.046","relation":{},"ISSN":["2213-2198"],"issn-type":[{"value":"2213-2198","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Modification of Clinical Practice to Minimize Environmental Impact","name":"articletitle","label":"Article Title"},{"value":"The Journal of Allergy and Clinical Immunology: In Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jaip.2026.06.046","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 American Academy of Allergy, Asthma & Immunology","name":"copyright","label":"Copyright"}]}}