Download Climate Change - Distributive Impacts

Climate Change:
Distributive Impacts
Elizabeth Cullen &
John Sweeney,
NUI, Maynooth
NUI MAYNOOTH
Ollscoil na Éireann Má Nuad
IPH, 25th February 2010
Warming relative to 1961-90
Mean January figures are predicted
to increase by 1.5oC by mid century
with a further increase of 0.5oC-1.0oC
by 2075.
By 2050, the extreme south and
south west coasts may have a mean
January temperature of 8.0oC. By
then, winters in Northern Ireland and
in the north Midlands will be similar
to those presently experienced
along the Cork/Kerry coast.
July temperatures will increase by
2.5oC by 2050 and a further increase
of 1.0oC by 2075 can be expected.
Maximum July temperatures of the
order of 22.5oC will prevail generally
with areas in the central Midlands
experiencing maximum July
temperatures of 24.5oC.
Rainfall relative to 1961-90
Overall increases in precipitation are
predicted for the winter months of
December- February. On average
these amount to 11%. The greatest
absolute increases are suggested
for the north west.
Marked decreases in rainfall during
the summer and early autumn
months across eastern and central
Ireland are predicted. Nationally,
these are of the order of 25% with
decreases of over 40% in some parts
of the south-east.
Differences in Seasonal Warming
19612005
Spring
Max
Spring
Min
Summer
Max
Summer
Min
Autumn
Max
Autumn
Min
Winter
Max
Winter Min
Valentia
0.68*
1.05*
0.43
1.20**
0.54
0.87*
1.17**
1.34*
Shannon
1.27**
1.58**
1.18*
1.70**
1.01*
1.28**
1.50**
1.83**
Malin
0.75*
1.18**
0.63
1.13**
0.47
0.84**
1.04*
1.20**
Belmullet
1.40**
1.21**
1.30**
1.39**
1.16**
0.80*
1.44**
1.23*
Phoenix Park
1.41**
0.88*
1.43**
0.92**
0.84*
0.41
2.52**
0.85
Clones
1.27**
1.33**
1.36**
1.63**
0.92**
1.04*
1.33**
1.41*
Rosslare
1.06**
1.28**
1.12**
1.19**
0.97**
1.02**
1.62**
1.32**
Claremorris
1.32**
1.19**
1.25**
1.49**
0.92*
0.84*
1.22**
1.32*
Kilkenny
1.40**
1.18**
1.22*
1.46**
0.95*
1.21**
1.52**
1.40**
Casement
1.05**
1.27**
0.83*
1.40**
0.55
1.15**
1.61**
1.36*
Birr
1.18**
0.95*
0.98*
1.21**
0.77*
0.77
1.44**
1.14*
HEALTH EFFECTS OF CLIMATE CHANGE
CLIMATE
CHANGE
Temperature Rise 1
Sea level Rise 2
Hydrologic Extremes
1
2
3°C by yr. 2100
40 cm “ “
IPCC estimates
Temperature/Heat
Stress
Heat Stress
Cardiorespiratory failure
Air Pollution
Respiratory diseases, e.g.,
COPD & Asthma
Vector-borne Diseases
Water-borne Diseases
Water resources & food
supply
Environmental
Refugees
Malaria
Dengue
Encephalitis
Hantavirus
Rift Valley Fever
Cholera
Cyclospora
Cryptosporidiosis
Campylobacter
Leptospirosis
Malnutrition
Diarrhea
Toxic Red Tides
Forced Migration
Overcrowding
Infectious diseases
Human Conflicts
Temperature-Related Deaths in 11
Eastern U.S. Cities
Source: Curriero, et al., 2002.
LAGGED EFECT
HEAT WAVE EUROPE
Heat Index Summer 2003
35,000 Excess
Deaths in two weeks
Heat Stress: Some Populations
Are Particularly Vulnerable
European heat-wave 2003 - 35,000 died
Swiss Temperature Series for June-August 1864-2003
Analysis shows it likely that most of the
risk of the event is due to increase in
greenhouse gases - also
- by 2050, likely to be average event
- by 2100, likely to be a cool event
extremely
rare
event
(Schär et al. 2004, Nature, 427, 332-336,
Stott et al 2004, Nature 432 610-614)
Climate Change and Air Quality
U.S. National Assessment of Climate Change
Health Effects of
Ground-Level Ozone

Increased risk of hospital admissions and ER
visits for people with asthma
(Friedman et al, JAMA, 2001, 285:897-905)

3X greater risk of DEVELOPING asthma
(McConnell et al, Lancet, 2002, 359: 386-391)
Air pollution
Climate change
Allergic Illnesses and
Aeroallergens
• Earlier onset of pollen season
• Increased CO2 and temperature
– increase pollen production
– Increase length of pollen season
• Increased pollen counts
• Increase in allergenic (reactive)
content of pollen appears likely
Relationship between temperature and
malaria parasite development time
inside mosquito (“extrinsic incubation
period” or EIP). EIP shortens at higher
temps, so mosquitoes become infectious
sooner.
Vector-borne and
Zoonotic (VBZ)
Diseases
• Disease vectors are widely
present in temperate
regions
• Forces underlying VBZ
disease risk:
–weather/climate
–ecosystem change
–social and behavioral factors
–globalization
Infectious Disease:
Dengue Risk
• In 1990, almost 30% of the world population,
1.5 billion people, lived in regions where the
estimated risk of dengue transmission was
>50%
• In 2085, an estimated 50-60% of the projected
global population, 5-6 billion people, would
be at risk of dengue transmission, compared
with 35% (3.5 billion) if climate change didn’t
happen.
Hales, de Wet, Maindonald, Woodward, The Lancet, 2002, 360:830
Dengue along the Texas – Mexico border
How Bad is the Water Problem?
• 1/3 of the world’s
population, about 2
billion people, currently
lives in water-stressed
countries (UNEP, IPCC)
• By 2025, that number is
expected to increase to
5 billion (UNEP, IPCC)
• Nearly 1/3 of the world’s
land surface may be at
risk of extreme drought
by 2100 (Burke et.al.
Journal of Hydrometeorology,
Sept. 2006)
Water Usage
• 70% for agriculture globally (90% in some
countries)
• 10% global food production depends on overpumping of groundwater (India 25%)
• 1Kg of grain requires 1,000 to 3,000 litres
water
• Grain-fed beef requires 20 X more water per
calorie than wheat
Extreme Rainfall Events are Unhealthy
• 67% of waterborne disease outbreaks in the US were
preceded by precipitation above the 80th percentile (across a
50 yr. climate record), p < 0.001
• 51% of outbreaks were preceded by precipitation above the
90th percentile, p < 0.002
• Surface water-related outbreaks had strongest correlation
with extreme precipitation in the month of outbreak;
groundwater-related outbreaks lagged 2 months following
extreme precipitation.
Curriero, Patz*, Rose, Lele, 2001.
Health Effects of Floods
• Cause injuries
and deaths
• Long term
psychological
and physical
effects
• Increased risk
of infectious
disease
• Mold
• Contaminate
water
supplies:
surface &
wells
Photo courtesy of FEMA
New Orleans
after Hurricane Katrina
Ballinasloe
(Credit: Sean Collins)
Athlone
(Credit: Paula Murray)
Health Effects of Droughts

Concentrate micro-organisms
and contaminants in water
supplies
 Crop failures
 ~1 billion people hungry
 5 million children die
starvation
 Water shortages for hygiene
 Increase risk of forest fires
 Increase risk of infectious
disease
Deaths Attributed to Climate Change NOW
150,000 per year
xxx
Patz, Jonathan, et. al (November, 2005). Impact of regional climate
change on human health. Nature, Vol. 438.
Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on
human health. Nature, Vol. 438.
Relative vs Attributable Risk
Water and Food-borne Disease:
Climate-Susceptible Pathogens
Rising
temperatures
Increasing
rainfall
Shifts in
reservoir
ranges
Salmonella
X
X
X
Campylobacter
X
X
X
Vibrio
X
X
Leptospira
X
X
Enteroviruses
X
X
Naergleria
fowleri
X
Cryptosporidium
X
X
Giardia
X
X
Sea level
changes
X
Cryptosporidiosis
• 405,000 cases
• 100 fatalities
• Preceded by heaviest
rainfall in 50 years
Mental Health Needs
and Hurricane Katrina
In the aftermath of Hurricane
Katrina, mental health services in
New Orleans were challenged by
an increased incidence of serious
mental illness
Nearly half of all survey
respondents indicated a need for
mental health care with less than
2% receiving professional care
(Weisler et al. 2006).
What does climate
change mean for
environmental health in
Ireland?
Temperature/Mortality in Ireland
140
130
120
110
100
90
80
70
-7
-5
-3
-1
1
mean temperature
3
5
7
9
11
13
15
17
19
21
23
Source: E. Cullen
24
3.2
Maximum
temperatures
(Kilkenny) and total
mortality in Ireland on
the hottest day in
recent decades (13th
July 1983)
3.0
Mortality per 100,000
2.8
Total mortality per
100,000
Maximum
temperature
divided by 10
2.6
2.4
2.2
2.0
1.8
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
Day
Source: E. Cullen
Milder winters
Reduced hospital admissions
2-3% reduction in winter deaths with
2-2.5 C increase in temperature (2050)
Impact of hot summers
Increased Heat-related deaths
are likely
• Hot weather increases daily mortality in Ireland,
though less than in most EU countries
• Elderly particularly vulnerable
–
–
–
–
>80 years
Bedridden
Heart disease
Diabetes
• Reduction in winter cold mortality will greatly
exceed any increase in summer heat mortality
Some infectious diseases are
likely to increase in incidence
• Food poisoning
• Water borne disease
• Malaria?
• Tick borne disease?
Salmonella
• Approximately 500 cases per annum in
Ireland
• August maximum 5 times higher than
February minimum
• Highly significant correlations with
maximum temperature
Country
Threshold
temperature
0
C
% change per degree
0
C rise above
threshold
Poland
6
8.7
Scotland
3
4.7
Denmark
15
1.1
5
12.4
England and
Wales
Mean
temp
Mean
cases
50
40
30
20
10
0
13
18.3
The Netherlands
7
9.3
Czech Republic
-2
9.5
Switzerland
3
8.8
Slovak Republic
6
2.5
Spain
6
4.9
2.7
7.4
Ireland
60
51
46
41
36
31
26
21
16
11
6
1
Estonia
Cases of campylobacter
Salmonella
Week
Salmonella incidence in
Republic of Ireland
(Sources: Kovats, Cullen)
Vector-borne and Water borne
Diseases
• Local outbreaks of malaria may occur by mid
century, though it is considered unlikely that the most
dangerous strains are unlikely to become
established in Ireland
• Tick borne diseases are not likely to become major
concerns before mid century
• Cholera and typhoid are not likely to become a
problem in Ireland
• Decreased dilution water in rivers may pose
problems for public water quality, however.
Increased UV exposure
Vulnerable Populations
Climate Sensitive Health Outcomes
Illnesses and Deaths Related To….
Examples of Particularly Vulnerable Groups
Heat
Elderly, those with chronic medical conditions, infants
and children, urban and rural poor, outdoor workers,
the socially isolated
Children, pre-existing heart or lung disease, diabetes,
athletes, outdoor workers
The poor, pregnant women, people with chronic
medical conditions, mobility and cognitive constraints
Elderly, infants, the immunocompromised, specific
risks for specific consequences (e.g., Campylobacter
and Guillain-Barre syndrome, E. coli O157:H7)
Air Quality
Extreme Weather Events
Water- and Food-borne Pathogens
Vector-borne Pathogens
- Lyme Disease
- Hantavirus
- Dengue
- Malaria
Source: Derived from SAP 4.6, Chapter 2
-
Children, outdoor workers
Rural poor, occupational groups
Infants, elderly
Children, the immunocompromised, pregnant
women, the genetically predisposed (e.g. G6PD
status)
Environmental Health Actions for
Coping with Climate Change in
Ireland
• Raise awareness of health implications of climate
change in Ireland
• Raise awareness of potential health benefits of action
to reduce impact of climate change
• Increased monitoring of food
• Health impact assessments to identify and develop
adaptation strategies for vulnerable sectors
• Interdisciplinary research
Adaptation Strategies to Reduce Climaterelated Health Risks
Vectorborne Diseases
Waterborne Diseases
Air Quality
Decision Support
Tools
Enhance early warming
systems based on
climate and
environmental data for
selected diseases
Develop early warming
systems based on
climate and
environmental data for
conditions that may
increase selected
disease
Enhance alert systems
for high air pollution
days
Technology
Development
Develop vaccines for
West Nile and other
vector-borne diseases
Develop more rapid
diagnostic tests
Surveillance and
Monitoring
Enhance vector
surveillance and control
programs and monitor
disease occurrence
Enhance surveillance
and monitoring
programs for
waterborne diseases
Infrastructure
development
Consider possible
impacts of infrastructure
development such as
water storage tanks
Consider possible
Improve public transit
impacts of placement
systems to reduce traffic
of sources of water and emissions.
food borne pathogens
Enhance health data
collection systems to
monitor for health
outcomes due to air
pollution
Conclusions
• Human health is inextricably bound to weather and climate as well as
to many complex natural and man-made systems.
• There are many uncertainties, but projected changes in climate are
likely to impose risks to human health.
• Health impacts are multi-factorial with interactions that cascade across
a range of confounding and moderating factors.
• An extensive suite of adaptation strategies will be key to addressing
climate-related health outcomes.