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Your climate disaster zone is ruining your skin.
If you’ve been avoiding making your annual skin screening appointment for, like, years, rest assured that some things never change: Dermatologists are still obsessed with telling you to wear sunscreen, and your mole probably isn't cancerous (you should get it tested, anyway). But while paper robes with confusing openings aren’t going anywhere, conversations about climate change don’t typically make it into the examination room.
Some doctors think maybe they should. Our skin is our largest organ as well as the one that interacts most immediately with our environment, serving as the first line of defense against harmful microbes; a barrier against UV radiation and pollution; and a regulator of our body temperature via sweat glands. It is, as a result, on the frontline of how our bodies handle their increasingly extreme environments.
Though the International Journal of Women’s Dermatology devoted an entire 2020 issue to climate change, which ran over 120 pages, looking at dermatology through a climate lens is still gaining traction in the medical community.
“When I lecture about climate change, I invariably get lower grades and more negative comments, including hate mail,” Dr. Misha Rosenbach, an associate professor of dermatology at the University of Pennsylvania, co-founder of the American Academy of Dermatology’s climate change and environmental issues expert resource group, and the co-author of the Women's Dermatology introduction told me, speaking in the capacity as an individual. “And every time I give a lecture, someone will stand up and say it’s a hoax from China — like literally, without fail, no matter what venue, some doctor says it’s a hoax.”
At the same time, the dermatologic response shouldn’t be limited to “wear more sunscreen” and “limit your time in wildfire smoke.” Since our skin is our primary defense against the external world, it is also being impacted in as many ways as there are expressions of climate change. Here are just a few, broken down loosely by American geography.
The northeastern United States is warming faster than the rest of the country, and unlike the southern U.S., where climbing temperatures will make regions far less habitable, winters and shoulder seasons in the East are becoming, well, pretty pleasant!
But the good weather also means people are spending more time outside. And remember the ozone layer? Though the Montreal Protocol in 1987 helped eliminate the chemicals that were causing its depletion and consequently exposing people to higher levels of UV radiation, its full recovery isn’t expected “until 2050,” the World Health Organization warns. Skin cancer rates, partially as a result, have been rising: Between 2000 and 2010, the overall rates of basal cell carcinoma rose 145 percent and squamous cell carcinoma rose 263 percent, the American Academy of Dermatology reports.
More time outside also means more exposure to pollutants generally. “I grew up in Harlem,” Dr. Lynn McKinley-Grant, the current president of the Skin of Color Society and an associate professor of dermatology at Howard University College of Medicine, told me. “The people who grew up there have a lot of these diseases that affect the skin like sarcoidosis and lupus” — an inflammatory disease that can cause small growths on the skin, and an autoimmune disease that can cause rashes — and “there are some people who have had mycosis fungoides,” a skin cancer that often begins its presentation with a rash. “It’s something we’ve seen for a while,” McKinley-Grant went on, “unrelated to the sun but related environmentally to things that affect us.”
“Urban air stagnation events” — four or more days of low wind speeds and little precipitation, when pollutants can settle — are also a risk, the International Journal of Women’s Dermatology’s introduction adds. Those pollutants can trigger autoimmune skin diseases like lupus, and a blistering disease called pemphigus vulgaris also has “increased hospitalizations if there’s high pollution in the environment,” Rosenbach told me.
There are small annoyances, too: Apparently more CO2 also means more poison ivy.
Pollen seasons across the country are getting worse due to climate change, but particularly so in places like Wisconsin, Minnesota, North Dakota, and parts of Canada — something any sufferer of seasonal hay fever will tell you can quickly develop into a nasty dermatology concern.
Speaking of nasty, research also shows that increased rainfall in the Great Lakes region due to climate change is resulting in a runoff of “metals, pesticides, pathogens, and fecal indicator bacteria” into recreational waters. “Summertime bacteria concentrations in an inland lake in Wisconsin,” for example, exhibited “positive, significant correlations” with the amount and duration of seasonal rainfall. Swimmer’s itch also appears to be on the rise due to warming temperatures. Fun!
Then there’s Lyme disease, which causes a rash that, if addressed quickly with antibiotics, can head off the development of more serious post-treatment Lyme disease syndrome. The concern is, ticks are now moving into areas where they haven’t been seen before — “dermatologists in Canada went their whole careers without ever encountering Lyme disease,” Rosenbach said — as well as emerging earlier in the season and hanging around through the late fall. “And that ... can mean that you’re not expecting Lyme disease [when] it walks in the door,” Rosenbach said. “And if you don’t recognize that, you can have severe consequences.”
Alaska, meanwhile, gets to enjoy thinking about a “worst-case scenario” of smallpox re-emerging from the melting permafrost.
When a fire burns through the West, it doesn’t just burn trees — there are cars, houses, and other not-great-to-breathe-in materials being incinerated and ending up in the air. Our skin doesn’t love that. Last year, a study that looked at the 2018 Camp Fire near San Francisco found that instances of eczema rose in local health clinics compared to 2015 and 2016. “Fully 89% of the patients that had itch during the time of the Camp Fire did not have a known diagnosis of [eczema], suggesting that folks with normal skin also experienced irritation and/or absorption of toxins within a very short period of time,” one of the authors said.
Skin is also affected by pollution, which disproportionately affects Black and Latino neighborhoods. Due to historic redlining, these areas are often “low-income, densely populated urban areas adjacent to industrial activities and lacking green spaces,” conditions that compound “health impacts such as chronic dermatitis exacerbations and carcinogenic skin damage,” the International Journal of Women’s Dermatology found. One study that looked at pemphigus flares — that’s the blistering autoimmune disease — “found an association between UV index and hospital admissions only in the subset of Hispanic/Latino patients,” despite using a representative U.S. sample.
The high heat in the West is also a concern since being unable to properly cool off via sweat can cause heat-related illnesses, currently the leading cause of death from extreme climate events in the United States. “The laborers who are out there working in the sun, not only do they get skin cancer, but they end up getting very dehydrated,” McKinley-Grant said, citing studies that have found high rates of kidney failure in agricultural workers and construction workers who labor in high heat conditions.
If you’re taking a dermatology board exam and the question mentions that a patient went camping in Costa Rica, “everyone knows the answer is leishmaniasis,” Rosenbach said. “The key word is ‘Costa Rica.’”
Leishmaniasis is a parasitic disease spread by sand flies that can cause skin sores and impact internal organs, but it’s taught to aspiring doctors as being a tropical and subtropical disease. Yet parts of the United States are now subtropical too, including Texas and Oklahoma — where, indeed, endemic leishmaniasis cases have begun to appear. But if dermatologists aren’t looking for leishmaniasis in patients with no travel history, they could miss a crucial diagnosis.
Speaking of new diseases, “chikungunya and dengue are now reported within the southern United States, with Zika on the horizon,” one of the papers in the Women’s Dermatology special issue found. And with more powerful storms and flooding slamming southern coasts, “there is terrible dermatitis,” said McKinley-Grant, who has seen firsthand how unidentified infections arose in patients in North Carolina after they waded through waters up to their waists. In extreme environmental conditions such as we live in now, infections of any kind “need to be addressed immediately,” McKinley-Grant went on to stress, even if they seem as innocuous as a bug bite.
Skin problems are actually the “most common issues” medics see after major storms, Rosenbach said. Part of the reason is simple things, “like laceration from flying debris,” he went on. Part of it is that when water rises, “humans and animals are in closer contact, you get animal bites and things like that.” And part of it is that when “you get standing water [...] it releases some of these vector-borne things.”
Oh yeah, and then there are jellyfish. Seabather eruption, an itchy skin reaction caused by jellyfish larvae, “has become increasingly common potentially because of increased ocean temperatures,” the Women’s Dermatology paper found. “This eruption can occur in up to 16% of patients swimming during peak seasons in southeast Florida.”
If you go to the hospital for a broken hip, a doctor might suggest a home safety search. Someone will come to your house, tape down your carpets, and move low-hanging objects in order to prevent future trips and falls.
Rosenbach envisions a future where doctors would do the same for something like repeated childhood asthma hospitalizations. “What if someone at your house was like, ‘Hey, you have a gas-burning stove, and you have mold here, and you’re actually losing a lot of heat through these single pane windows and no insulation. And what we should do is, get rid of your gas stove, rip out this mold, and make your environment better and have some air filters, or whatever,” he mused. “Imagine you could go and make these changes, and suddenly this kid never had asthma anymore, never [needed to be] admitted to the hospital.”
Rather than play whack-a-mole with medical symptoms, then, Rosenbach is thinking like a dermatologist — that is, we ought to cut out the real cancer, which is our dependence on fossil fuels.
Admittedly, that’s daunting to tackle if you’re more immediately concerned with the weird rash you keep getting at the beach. But beyond “eating less meat, flying less, electrifying everything,” from a health-care standpoint, “I don’t think a lot of people think about talking about climate change with their medical team,” Rosenbach said. “And if they do, it pushes the medical team to educate themselves and educate the field.”
Good news for oversharers — talking about your weird rash with friends and acquaintances is also praxis. “No one should be afraid to say, ‘I saw my doctor and they said I got Lyme. I got bit by the tick in February, because of climate change! That’s kind of crazy!’” Rosenbach added. “Just having those conversations and showing people that these are real-time impacts that they’re experiencing I think is important.”
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Current conditions: Typhoon Ragasa slammed into East Asia as the year’s strongest storm to date, killing 14 and leaving dozens missing in southern Taiwan and forcing more than 400,000 to evacuate in China • Hurricane Gabrielle intensified into the second major hurricane in the Atlantic this season, churning rip currents on East Coast beaches in the U.S. and lashing Europe with heavy rain later this week • Argentina is facing an ongoing drought.
President Donald Trump speaking at the U.N. Michael M. Santiago/Getty Images
In his speech to the United Nations General Assembly on Tuesday, President Donald Trump called climate change “the greatest con job ever perpetrated on the world.” He complained that scientists used to warn the governments about “global cooling … then they said global warming will kill the world.” Yet “all of these predictions made by the United Nations and many others, often for bad reasons, were wrong. They were made by stupid people” from countries with “no chance for success.” He urged other nations that “if you don’t get away from this green scam, your country is going to fail.”
Scientists first suggested over a century ago that the carbon dioxide released from burning fossil fuels could create a greenhouse effect warming the planet and destabilizing the climate norms in which human beings evolved to survive. As global emissions of carbon and other planet-heating gases have surged over the past several decades, the Earth’s average temperature has risen by more than 1 degree Celsius, an increase that the overwhelming majority of scientists around the world attribute to pollution from fossil fuels and agriculture. The Trump administration issued a report written by contrarians who raised the possibility that climate change won’t be as bad as most scientists say, but more than 1,000 peer-reviewed researchers signed onto a letter condemning the findings. In a statement on the president’s UN speech, Gina McCarthy, the Obama-era Environmental Protection Agency chief and the Biden administration’s climate policy director, said Trump “continues to embarrass the U.S. on the global stage and undermine the interests of Americans at home. He’s rejecting our government’s responsibility to protect Americans from the increasingly intense and frequent disasters linked to climate change that unleash havoc on our country.” For more on the basics of climate change, you can consult this explainer by Heatmap’s Jeva Lange.
As part of this week’s New York Climate Week, we’re hosting Heatmap House, a live journalism exploring the future of cities, energy, technology, and artificial intelligence. We’ll also be livestreaming all day for those who aren’t able to join in person. Register here and tune in any time from 10:30 a.m. to 6:30 p.m. EST on Wednesday to catch Heatmap journalists including Robinson Meyer, Emily Pontecorvo, Katie Brigham, and Matthew Zeitlin, in conversation with the likes of Senator Brian Schatz and executives from Amazon, Microsoft, and Duke Energy. We hope you’ll join us!
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Rhode Island’s biggest labor federation has brokered a deal for union workers to carry out the construction on the SouthCoast Wind project, a 2.4-gigawatt offshore turbine array — and won what the Rhode Island AFL-CIO called the first agreement in the nation guaranteeing organized labor handles all the operations and maintenance of the facility. On a panel I moderated for the Climate Jobs National Resource Center on Tuesday evening, Rhode Island’s AFL-CIO president, Patrick Crowley, told me the “labor peace agreement” will help the union organize more workers in the offshore-wind industry. “The labor movement is in this to win, and we’re not ready to give up the fight yet,” he told me. “If developers want to have a winning strategy, they have to partner with organized labor, because we’re going to make sure that, come hell or high water, we get these things built.”
After a federal judge lifted Trump’s stop-work order halting construction on the Revolution Wind farm off Rhode Island’s coast, a project that was 80% complete before the president’s abrupt intervention, Crowley said executives immediately directed workers onto boats to restart work on the turbines.
Microreactor developer Oklo’s stock price has been on a tear for months, surging to $21 billion in September despite no revenue or completed facilities. That’s starting the change. On Tuesday, the company broke ground on its debut nuclear plant at the Idaho National Laboratory. The California startup, which is also seeking to construct the nation’s first nuclear recycling plant, is the only company in the Department of Energy’s newly established Reactor Pilot Program to secure two projects in the federal effort to prove that new reactor technologies – Oklo’s tiny reactors use a different and rarer kind of coolant and fuel than the entire U.S. commercial fleet – can successfully sustain fission reactions by next July.
“As advancements in artificial intelligence drive up electricity demands, projects like this are critical to ensuring the United States can meet that need and remain at the forefront of the global AI arms race,” Secretary of the Interior Doug Burgum said in a statement.
Earlier this month, the federal Defense Logistics Agency backed Xerion Advanced Battery Corp. to help the Ohio-based startup’s efforts to commercialize a novel technology for processing cobalt for batteries. Now, as I reported in an exclusive for Heatmap on Tuesday, the company is applying its approach to refining gallium, another key industrial metal over which China has a monopoly grip.
It’s not the so-called DLA’s only push into minerals. On Tuesday, Reuters reported that the agency is seeking to stockpile up to $40 million worth of scandium oxide over the next five years. The agency plans to buy the rare earth element used as an alloying agent used in aerospace, defense, and automotive technologies from mining giant Rio Tinto.
A team of researchers in China found a way to turn clothianidin, a widely used pesticide notorious for accumulating in soil and crops and harming human health, into a nutrient for plants that removes the chemical from the dirt. Scientists at Hunan Agricultural University developed a novel biochar-based catalyst that converts the pesticide residues into ammonium nitrogen, a form of fertilizer that helps crops grow. “Instead of simply eliminating pesticides, we can recycle their nitrogen content back into the soil as fertilizer,” Hongmei Liu, a co-author of the study, said in a press release. “It offers a win–win solution for food safety and sustainable agriculture.”
Rob and Jesse talk to Ember’s Kingsmill Bond about how electricity is reshaping global geopolitics.
A new stack of electricity technologies — including solar panels, batteries, electric vehicles, and power electronics — seem to be displacing fossil fuels across China and the developing world. Are we watching an irresistible technological revolution happen? Or is something weirder going on — something that has far more to do with China’s singular scale and policy goals than physics and economics?
Kingsmill Bond argues that a global electrotech revolution has already begun — and that it will soon sweep Europe and the United States, too. Bond is an energy strategist at Ember, a London-based electricity data think tank. He previously worked for more than 30 years as a financial market analyst and strategist, including at Deutsche Bank and Citibank.
On this week’s show, Rob and Jesse talk with Bond about what the electrotech revolution looks like worldwide in 2025, why electricity will win out against fossil fuels, and how American and European climate policy should respond to this moment — and if they can respond at all. Shift Key is hosted by Robinson Meyer, the founding executive editor of Heatmap, and Jesse Jenkins, a professor of energy systems engineering at Princeton University.
Subscribe to “Shift Key” and find this episode on Apple Podcasts, Spotify, Amazon, YouTube, or wherever you get your podcasts.
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Here is an excerpt from our conversation.
Robinson Meyer: How do we know this is a true solar, battery, EV-led revolution — with the full electrotech, the full beautiful, zero-carbon electrotech stack — and not just the continued march of electrification, which is as happy to accept energy from giant coal plants as it is to accept energy from solar panels.
Kingsmill Bond: It is always fun to debate this, but the point I think you nearly said — countries don’t have solar, but they do have coal — that’s the whole point. Everyone’s got lots of solar today. Unless you’re talking about mine mouth coal and existing assets, solar also beats coal. And that’s why we are spending $400 billion a year on expanding our solar and $40 billion a year, whatever it is, on expanding coal in a very small number of locations.
This coal pathway to development was the China path up to 2000, but they’ve kind of opened up a new pathway that other countries can now take. The classic example now is India, which is clearly taking a very different pathway to that taken by China 20 or 25 years ago. And incidentally, it’s a similar story in the transport market.
Certainly until recently — and indeed, even now for those who haven’t got the memo — are still forecasting that the emerging markets will follow the U.S. development path and have 16 barrels of oil per person per day of demand. But actually, China’s peaked at two and is already falling, and you’re going to see other countries following that path simply because it’s a lot cheaper. Whether or not this was by genius or design or luck, but the Chinese happened to have stumbled into a very, very successful path of finding a cheaper energy source — or a better mousetrap, as it were. I think that that’s what’s now happening across the emerging markets.
If I may make one other point, let us not forget that the emerging markets are going down this path very quickly. And to give you a couple of stats on this, the classic one is the fact that from our calculations, two thirds of the emerging markets, by design, already have a higher share of solar in their electricity system than the United States, which is astonishing given that the United States is a global leader in so many other respects. In terms of electrification, it’s a quarter of the emerging markets, also, ahead of the U.S. — or Europe, actually, for that matter.
And so we are seeing here that the emerging markets are going down a new path, which was not expected. And if you contrast that with the internet, for example — after 2000, internet was a pretty clear, standard graph of the U.S. leads and then Japan follows — and Western Europe, and then China, and then the other markets. But this time around, these folks are streaming into these technologies much earlier than expected.
Mentioned:
Ember’s research on solar-plus-batteries
Oxford’s Doyne Farmer on how clean energy tech will get cheaper
Jesse’s upshift; Rob’s upshift.
This episode of Shift Key is sponsored by …
Hydrostor is building the future of energy with Advanced Compressed Air Energy Storage. Delivering clean, reliable power with 500-megawatt facilities sited on 100 acres, Hydrostor’s energy storage projects are transforming the grid and creating thousands of American jobs. Learn more at hydrostor.ca.
Music for Shift Key is by Adam Kromelow.
Xerion is using molten salt to refine the key battery mineral domestically and efficiently.
When John Busbee started his battery technology company in 2010, his strategy was about making just one small part that could be widely used by other manufacturers. He launched Xerion Advanced Battery Corp. at a University of Illinois startup incubator in a bid to commercialize a novel breakthrough in nanostructured foam for the internal components of batteries.
That same logic has since led the company to produce other key materials for the energy transition, including cobalt and, now, gallium, Heatmap has learned.
The same year Busbee started Xerion, some 7,000 miles west across the Pacific, China cut off shipments of rare earth metals to Japan amid a geopolitical spat over contested islands. The move shocked the democratic world and made apparent a troubling fact — that over the preceding few decades, China had seized nearly full control of the global supply of these key metals for magnets and electronics. In the years since, Beijing has used export restrictions on rare earths and other minerals to the U.S. and its allies as a geopolitical cudgel, leading Busbee and others to look for ways to rewire global supply chains away from China.
Xerion had previously experimented with molten salt electrolysis, a process that involves running an electrical current through salt that’s been heated to somewhere from 800 to 1,600 degrees Fahrenheit — hot enough to achieve a liquid state, corrosive enough to eat through rock ore but leave behind the desired metals.
Ultimately the team at Xerion found that this method could be used to process cobalt, which is sourced mostly from Chinese-controlled mines in the Democratic Republic of the Congo. The molten salt would eat away at the igneous rock containing the bluish battery metal, leaving behind the mineral. The company opened its pilot cobalt-refining facility in Dayton, Ohio, in April, and reached its goal of producing 5 metric tons for the year.
Now Xerion is expanding into producing gallium. The U.S. has no domestic industry to produce the soft, silvery metal, and imports of the raw material – widely used in solar cells, nuclear sensors, electric vehicle batteries, and semiconductors – have skyrocketed by nearly threefold since 2020. China banned exports to the U.S. in December.
“Gallium was low-hanging fruit,” Busbee told me. “It’s in all the radars. It's in all the missiles. It’s in all the planes. All the new chargers that are really compact are made with gallium nitride. It’s also in the cell phones. And it’s something where China has the market cornered.”
The U.S. stopped producing its own gallium in 1987, according to a U.S. Geological Survey report. Before then, the metal came as a byproduct of turning bauxite into aluminum; in China, where the vast majority of global production moved, the government requires alumina refineries to also extract gallium. As alumina processing disappeared in the U.S., there was no market incentive for refineries to invest in the complex process of also extracting gallium, which makes up a tiny fraction of 1% of the total bauxite ore.
At least one major proposed rare earths mine in the U.S., the Sheep Creek site in Montana, boasts large deposits of gallium, and U.S. Critical Materials Corp., the project’s Salt Lake City-based developer, inked a deal to work on building a pilot plant to test its own refining technology with the Idaho National Laboratory this summer. But the project is still at an early stage.
The benefit of using molten-salt electrolysis, Busbee said, is that it provides a shortcut. “I tell people I’m kind of dumb and stubborn,” he said. “What I mean by dumb is that I wasn’t in the industry, so I didn't know that it was widely known that you don’t use this method because it’s so aggressively corrosive that it’s a pain in the butt. And by stubborn I mean that, once we picked that, we stuck with it and spent 10 years optimizing these incredibly corrosive molten salts for the battery space.”
Since the molten salt will eat through nearly everything the Ohio-based Xerion isn’t looking to collect, the process can pull gallium out of mining waste and other sources with low concentrations of the metal.
“It’s a one-step process,” Busbee told me. “A lot of people dissolve in acid, then have to evaporate it and recrystallize it. Sometimes there are multiple rounds. There can be 15 to 100 steps. Ours is one step.”
Asked what the catch might be, Busbee laughed. “It’s been a pinch-me technology,” he said. “As we keep going further, we keep finding good things.”
There’s still some waste rock left behind after the process, and the company said it’s figuring out useful ways to sell that material.
Despite its 15 years in operation, Xerion’s bid to enter the critical minerals market is new enough that many analysts were unfamiliar with the company and its approach. BloombergNEF declined to comment. Benchmark Mineral Intelligence, the London-based battery metals consultancy, cautioned that Xerion’s claims of “very high recoveries” of materials “seems to be in a lab environment rather than at scale.”
“With respect to Xerion’s original cobalt line, my understanding is this is still at pilot stage, so difficult to compare against industry production,” William Talbot, the lead cobalt analyst at Benchmark, told me via email.
But Ryan Alimento, an energy analyst at the Breakthrough Institute, said the ability of molten salt to refine minerals to much higher concentrations than water-based solutions is real.
“The advantage of molten salt is exactly what Xerion says,” he told me. Still, he said, opening a pilot plant is just “the first stage in the entrepreneurial valley of death.”
“There’s still a lot more steps needed along the way,” Alimento said. “When you have a company introducing a new processing technology like this that really diverts from the norm, it requires a lot of capital.”
Xerion has raised “a little over $100 million” from venture capitalists and family offices, Busbee said. As the company moves into manufacturing, however, he told me he plans to tap into more large institutional investors. That may offer some promise. Critical minerals are undergoing something of a dealmaking boom as investors clamber for stakes in companies whose metals could win the bonus tax credits the Biden administration offered for domestically-produced materials or avoid the trade penalties the Trump administration has slapped on imports from adversary nations.
President Donald Trump has also used the military to invest directly into rare earths production. The Department of Defense bought a stake in MP Materials, the only active rare earths producer in the U.S., in what The Economist described as the federal government’s biggest intervention in a private company since nationalizing the railroads during World War I. While it’s not a direct ownership stake, the federal Defense Logistics Agency earlier this month awarded Xerion funding through the Small Business Innovation Research program to carry out tests on the economic viability of its technology. Xerion said it expects to complete the first phase of the testing in the first quarter of next year, and plans to pursue grants for the second and third phase analyses.
“This is definitely a priority for the U.S., which is good because what companies need is unambiguous and long-sustained government support for something like this,” Alimento said. “It does not surprise me that a company like Xerion would be thriving in this kind of industrial-policy ecosystem.”