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Climate change and human health Dr Rebecca Garland Climate Studies, Modelling and Environmental Health Research Group, Natural Resources and the Environment Unit, CSIR Gauteng Climate Change Forum Meeting 12 August 2016 Introduction: CSIR Climate Studies, Modelling and Environmental Health Research Group at CSIR • • • • • Perform regional and global climate modelling – Working towards improving representation of Africa in global climate model that we run (CCAM) – Understanding impacts and risks of climate projections – Working across timescales – weather (days lead time), seasonal (1-3 months lead time), climate change (until end of the century) climate change and health work across these timescales, today highlight climate change timescales First research focus of our health impact work was on increasing temperatures across Africa Southern Africa: Temperature anomalies (departures from 1961-1990 average) since mid1970s most are positive Rate of increase in max and min temperatures is also increasing Temperatures over the interior regions of South Africa are projected to rise at about twice the global rate of temperature increase Collaborative suite of projects (and plans) with SAWS, MRC, UCT, CoJ, UP Model simulated annual temperature anomalies relative to the 1971-2005 climatological average Blues mean cooler annual temperature than reference period Yellows and reds mean warmer annual temperature than reference period Emission Scenarios and Representative Concentration Pathways (IPCC AR5) Only RCP 2.6 can safely keep us well below 2°C above preindustrial, whilst the world is currently between A2 and RCP 8.5 © CSIR 2007 www.csir.co.za Highlighting differences in temperature anomaly for different emission scenarios CSIRO-CSIR collaboration: 0.5° resolution global climate change downscalings for CORDEX using CCAM Downscaling six CMIP5/AR5 global climate models © CSIR 2007 www.csir.co.za Climate change signals may be classified as… Plausible Defensible Actionable (robust) …and form the cornerstone for climate services. The temperature signal is regarded as actionable (Engelbrecht et al., 2015). Figure: projected changes in average temperatures (degrees C) over southern Africa for 2080-2100 relative to 1971-2000 for RCP4.5 (left) and RCP8.5 (right) CSIR-CSIRO-CHPC © CSIR 2007 www.csir.co.za Future climate change over Tshwane Warm and dry Warm and wet Drastic rises in temperature are projected – an increase of more than 4-7°C (compared to present-day climate ) in annual average temperature is plausible under low mitigation scenarios by the end of the century. Midcentury increases are plausible to be in the order of 2-3°C. Extreme temperature events, number of heat waves and high fire-danger days are projected to increase in frequency over Tshwane. Cool and dry Cool and wet It is plausible for Tshwane to become generally drier with a higher frequency of dry-spell days, but with an increase in intense thunderstorms. Health Sector: Critical to understand impacts • • • • Climate change can impact human health in many ways Mapping potential health impacts from climate change turns into a spider web Many current health risks have climate sensitivity, e.g., – Air pollution: formation and transport; allergens – Malnutrition: food security – Vector-borne diseases: malaria transmission – Water: drought, flood and waterborne diseases IPCC AR5 states that largest risks will be in those populations currently impacted by climate-related diseases Strong need for research to understand and unravel impacts, and to develop adaptation strategies – esp in Africa Health Impacts of Climate Change Source: Confalonieri et al. 2007 IPCC AR4 • IPCC AR4 mapped out health impacts from climate change • “Modifying influence” shown here may impact exposure to climate change impacts, or change to magnitude of the health effects (e.g., overburdened health care system may lead to greater health impacts as can not treat those who become ill) What are health impacts from increasing temperatures? • Exposure to extreme temperature increase mortality and morbidity • Ballester et al. (2011) studied health impacts in Europe – Relationships of cold and hot weather to health different hot end of curve increasing more rapidly and non-linear – Note relationship across parameters • In general, those that are especially vulnerable to heat stress are Source: Ballester et al. Nature Communications, 2011 – Elderly – In urban areas (pollution and urban heat island effect) – With pre-existing cardiovascular and respiratory disease – With compromised coping capacities Heat waves – when heat impacts become obvious • August 2003 heat waves across Europe – hottest summer in over 500 years, 3.5°C above normal, estimates up to 45 000 heat-related deaths Some of those at higher risk of mortality – over 75 yrs old, being female or being an unmarried man Source: Confalonieri et al. 2007 IPCC AR4 • Climate Change and Human Health Research • • • • Looking at “those who are vulnerable”, many people in South Africa fit those characteristics AND modelled temperature projections show increases as great as 46˚C for region by 2100 Will increasing temperatures from climate change be a health risk? And if so, where? Where are the hotspots? This project: Analyzed the risk to human health from increases in temperature over Africa – from current to 2100 under business as usual scenario (A2 scenario for IPCC AR4) Additional factors not taken into account yet, such as • Background health • Acclimatization – not well understood how quickly populations can acclimatize. Also, technological interventions (e.g. AC, may not be practical for many populations) Dearth of data on response in Africa to extreme temperatures Limited studies in Africa to document impacts and understand temperature-health relationship • • • Most epidemiological studies to understand the association between temperature and health have been in industrialized countries in temperature climates few studies from Africa An example of recent research on developing this relationship for Africa Study used “75th percentile temperature” as a threshold value to discuss increases in mortality risk Very few data available for this type of analysis across the continent – South Africa is not different – however heat is a public and occupational health risk Informal settlements in Nairobi Egondi et al., 2012 • Use Apparent Temperature to describe health impacts • • • Apparent Temperature (AT) describes “how hot it feels” – Combines Temperature, Relative Humidity and wind speed AT can then be related to health impacts through Symptom Bands We used a symptom table developed by US National Weather Service potential limitations as relationship has not been tested in southern Africa Symptom Band AT (˚C) Health Impact/Symptom I 27-31 Fatigue possible with prolonged exposure and/or physical activity II 31-41 Sunstroke, heat cramps and heat exhaustion possible with prolonged exposure and/or physical activity III 41-54 Sunstroke, heat cramps, or heat exhaustion likely and heatstroke possible with prolonged exposure and/or physical activity IV >54 Heatstroke/sunstroke highly likely with continued exposure Source: “Heat Index” http://www.crh.noaa.gov/pub/heat.php Number of days where AT>27˚C (Hda2) • The maximum AT for these time periods were used: • Number of days within a band for reference period: 1961-1990 • The projected change in number of days relative to the reference period • Results shown as an average projected change in days per year for three time periods • Joburg Example: 34.5 (ref) + 37 (2011-2040) = 71.5 average projected days per year with AT>27˚C No decreases projected: largest increases in southern Africa and East Africa highlands. Ref:1961-1990 Change: 2011-2040 vs. Ref Change: 2041-2070 vs. Ref Change: 2071-2100 vs. Ref Garland et al., 2015 • • Also, analyzed AT ≤ 27 ˚C decreases across whole region for all time periods Focusing on South Africa • • • • • Maps highlight present day climate (A), and then change in hot days Gauteng projected to see large increases in hot days Graph – avg. hot days per year (10th, median and 90th percentile show spread in projections) This study the focus was on Africa and utilized global runs tailored regional climate modelling for decision support can be performed at higher resolution CCAM seamless system across timescales – e.g. seasonal timescale for planning for hot seasons Importance on Non-climate factors • • • • With respect to climate change, health sector focuses on adaptation – In a changing climate, what are we going to do to protect the health of South Africans? Large focus needs to be on non-climate factors: Non-climate factors are everything else that can increase vulnerability or protect people’s/community’s health This are critical as we can control these we can’t always eliminate increased risk to health from climate change, but we can aim to decrease the impact – Temperature: heat-health action plans and early warning systems with public health advice – Air pollution: decrease emissions, early warning systems with public health advice – Water-borne diseases: Continuous supply of clean drinking water, even in floods/droughts/etc. Early warning systems, climate and health surveillance, and on the ground action are key needs to adapting to climate change in health sector Heat Alert and Response Systems (HARS) • • • Heat Alert and Response Systems (HARS) have been successful in mitigating health impacts – few in tropical and sub-tropical countries necessary for South Africa communities HARS is set of measures that will be enacted when “high temperatures” are forecast need effective forecasts (and what is “high temperature”) and effective management and intervention system Health Canada has created a framework for the development and implementation of HARS, through assessment of existing HARS across countries. The core elements are – community mobilization and engagement through a lead organization to prepare community for the upcoming heat season, as well as to identify any needs in the community – an alert protocol that will be followed, which begins with identification and forecasting of weather conditions that may have an impact on health, and the communication of when this will happen (i.e. through weather forecasts) to key leading organizations and stakeholders – a community response plan that implements the agreed upon interventions and actions that will be implemented to mitigate health impacts during a heat alert period – communication plan that provides advice on individual actions that can protect health from high temperatures – an evaluation plan, to assess the HARS and its performance.. Summary • • • • • • Climate change is expected to have large impacts on health, but little is known what impacts have already happened and what might happen in future area where local observations and information are needed Warming has already been happening Many current health issues are climate-sensitive and thus may be impacted by climate change adding an additional stressor to health field (public and occupational) Important to include assessment of non-climate factors into understanding what might be health impact Projections of hot days for South Africa show large increases in “Hda2” for Gauteng Province. Moving forward need to quantify potential risk – need local relationships of temperature and mortality. Also, on-going work on heat wave projections. Current critical needs are in local studies of impact of climate on health (past present and future) DATA Recent articles on heat-health Bidassey-Manilal, S., Wright, C.Y., Engelbrecht, J.C., Albers, P.N., Garland, R.M. and Matooane, M. “Students’ perceived heat-health symptoms increased with warmer classroom temperatures in Johannesburg, South Africa” International Journal of Environmental Research and Public Health, 13, 2016. Garland, R.M., Matoaane, M., Engelbrecht, F.A., Bopape, M.J., Landman, W.A., Naidoo, M., van der Merwe, J. and Wright, C.Y. “Regional projections of high temperature days in Africa and the related potential risk to human health” International Journal of Environmental Research and Public Health, 12, 12577-12604, 2015. Engelbrecht, F, Adegoke, J, Bopape, M.J., Naidoo, M., Garland, R.M., Thatcher, M., McGregor, J., Katsfey, J., Werner, M., Ichoku, C. and Gatebe, C., “Projections of rapidly rising surface temperatures over Africa under low mitigation” Environmental Research Letters, 10, 2015. Upcoming SARVA Hard Copy Atlas Health Chapter, case study on heat-health and HARS Thank you! Rebecca Garland [email protected] Extra Slides • Top Hda3 = Days where ATmax ≥32 ˚C Middle Hda4 = Days where ATmax ≥39 ˚C Bottom Hda5 = Days where ATmax ≥51 ˚C Reference on left, change in 2071-2100 on right Highlights the different thresholds where projected increases in hot days begin – different for different areas Below – can use projections to analyse the projected rate of increase acclimatization possible? Garland et al., 2015 • • • • • City of Tshwane – Current Climate • Tshwane is located in the summer rainfall region of eastern South Africa, an annual average rainfall of about 670 mm • Isolated heat thunderstorms and wide-spread rainfall occur frequently during the warmer months. • Experiences storms frequently associated with hail, damaging winds and flash floods; occasionally experience drought and heat waves • The Figure shows the annual cycle in rainfall (mm, top) and temperature (°C, bottom) over Tshwane