Climate Change: Distributive Impacts
IPH, 25th February 2010NUI MAYNOOTHOllscoil na Éireann Má Nuad
Elizabeth Cullen & Elizabeth Cullen & John SweeneyJohn Sweeney, , NUI, MaynoothNUI, Maynooth
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 WarmingDifferences in Seasonal Warming1961-
2005 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*
CLIMATE CHANGE
Temperature Rise 1
Sea level Rise 2
Hydrologic Extremes
Temperature/Heat Stress
Air Pollution
Vector-borne Diseases
Water-borne Diseases
Water resources & food supply
Environmental Refugees
Heat StressCardiorespiratory failure
Respiratory diseases, e.g., COPD & Asthma
MalariaDengueEncephalitisHantavirusRift Valley Fever
CholeraCyclosporaCryptosporidiosisCampylobacterLeptospirosis
MalnutritionDiarrheaToxic Red Tides
Forced MigrationOvercrowdingInfectious diseasesHuman Conflicts
1 3°C by yr. 21002 40 cm “ “IPCC estimates
HEALTH EFFECTS OF CLIMATE CHANGE
Temperature-Related Deaths in 11 Temperature-Related Deaths in 11 Eastern U.S. CitiesEastern U.S. Cities
Source: Curriero, et al., 2002.
LAGGED EFECT
HEAT WAVE - HEAT WAVE - EUROPEEUROPE
Heat Index Summer 2003Heat Index Summer 2003
35,000 Excess 35,000 Excess DeathsDeaths in two in two weeksweeks
Heat Stress: Some Populations Heat Stress: Some Populations Are Particularly VulnerableAre Particularly Vulnerable
European heat-wave 2003 - 35,000 diedEuropean heat-wave 2003 - 35,000 died
extremelyrare
event
(Schär et al. 2004, Nature, 427, 332-336,Stott et al 2004, Nature 432 610-614)
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
Climate Change and Air QualityClimate Change and Air Quality
U.S. National Assessment of Climate Change
Health Effects of Health Effects of Ground-LevelGround-Level Ozone 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 asthma3X greater risk of DEVELOPING asthma (McConnell et al, Lancet, 2002, 359: 386-391)
Air pollution Climate change
Allergic Illnesses and Allergic Illnesses and AeroallergensAeroallergens
• 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
Source: JL Gamble, et al., 2008. USEPA Report.
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 Vector-borne and Zoonotic (VBZ) Zoonotic (VBZ)
DiseasesDiseases•Disease vectors are widely
present in temperate regions
•Forces underlying VBZ
disease risk:–weather/climate
–ecosystem change
–social and behavioral factors
–globalization
Infectious Disease: Infectious Disease: Dengue RiskDengue 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 estimated 50-60% of the projected global population, 5-6 billion peopleglobal 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 borderDengue along the Texas – Mexico border
How Bad is the Water Problem?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 UsageWater Usage• 70% for agriculture globally (90% in some
countries)• 10% global food production depends on over-
pumping 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%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%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 FloodsHealth Effects of Floods
• Cause injuries and deaths
• Long term psychological and physical effects
• Increased risk of infectious disease
• Mold• Contaminate Contaminate
water water supplies: supplies: surface & surface & wellswells
Photo courtesy of FEMA
New Orleans
after Hurricane Katrina
Ballinasloe (Credit: Sean Collins)
Athlone (Credit: Paula Murray)
Health Effects of DroughtsHealth 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 Deaths Attributed to Climate Change NOWNOW150,000 per year150,000 per year
Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on human health. Nature, Vol. 438.
xxx
Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on human health. Nature, Vol. 438.
Relative vs Attributable RiskRelative vs Attributable Risk
Water and Food-borne Disease:Water and Food-borne Disease:Climate-Susceptible Pathogens Climate-Susceptible Pathogens
Rising temperatures
Increasing rainfall
Shifts in reservoir ranges
Sea level changes
Salmonella X X XCampylobacter X X XVibrio X X XLeptospira X XEnteroviruses X XNaergleria fowleri
X
Cryptosporidium X X
Giardia X X
• 405,000 cases
• 100 fatalities
• Preceded by heaviest rainfall in 50 years
CryptosporidiosisCryptosporidiosis
Mental Health Needs Mental Health Needs and Hurricane Katrinaand 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 What does climate change mean for change mean for
environmental health in environmental health in Ireland?Ireland?
Temperature/Mortality in IrelandTemperature/Mortality in Ireland
mean temperature
242321191715131197531-1-3-5-7
Val
ue m
ean
mor
talit
y at
2 d
egre
e in
terv
als
140
130
120
110
100
90
80
70
Source: E. Cullen
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day
1.8
2.0
2.2
2.4
2.6
2.8
3.0
3.2M
orta
lity
per
100,
000
Total mortality per 100,000Maximum temperature divided by 10
Maximum temperatures (Kilkenny) and total mortality in Ireland on the hottest day in recent decades (13th July 1983)
Source: E. Cullen
Milder wintersMilder wintersReduced hospital admissions
2-3% reduction in winter deaths with 2-2.5 C increase in temperature (2050)
Impact of hot summersImpact of hot summers
Increased Heat-related deaths Increased Heat-related deaths are likelyare 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 Some infectious diseases are likely to increase in incidence likely to increase in incidence
• Food poisoning
• Water borne disease
• Malaria?
• Tick borne disease?
SalmonellaSalmonella
• Approximately 500 cases per annum in Ireland
• August maximum 5 times higher than February minimum
• Highly significant correlations with maximum temperature
Salmonella Salmonella
(Sources: Kovats, Cullen)
1 6 11 16 21 26 31 36 41 46 51
Week
0
10
20
30
40
50
60
Cas
es o
f cam
pylo
bact
er Mean tempMean cases
Salmonella incidence in Republic of Ireland
Vector-borne and Water borne Vector-borne and Water borne DiseasesDiseases
• 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 exposureIncreased UV exposure
Vulnerable PopulationsVulnerable PopulationsClimate 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
Air Quality Children, pre-existing heart or lung disease, diabetes, athletes, outdoor workers
Extreme Weather Events The poor, pregnant women, people with chronic medical conditions, mobility and cognitive constraints
Water- and Food-borne Pathogens Elderly, infants, the immunocompromised, specific risks for specific consequences (e.g., Campylobacter and Guillain-Barre syndrome, E. coli O157:H7)
Vector-borne Pathogens
- Lyme Disease
- Hantavirus
- Dengue
- Malaria
- Children, outdoor workers - Rural poor, occupational groups - Infants, elderly - Children, the immunocompromised, pregnant
women, the genetically predisposed (e.g. G6PD status)
Source: Derived from SAP 4.6, Chapter 2
Environmental Health Actions for Environmental Health Actions for Coping with Climate Change in Coping with Climate Change in
IrelandIreland• 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
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
Enhance health data collection systems to monitor for health outcomes due to air pollution
Infrastructure development
Consider possible impacts of infrastructure development such as water storage tanks
Consider possible impacts of placement of sources of water and food borne pathogens
Improve public transit systems to reduce traffic emissions.
Adaptation Strategies to Reduce Climate-Adaptation Strategies to Reduce Climate-related Health Risksrelated Health Risks
ConclusionsConclusions• 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.