Climate Change:Global health impacts and local

consequencesMuge Akpinar-Elci, MD, MPH

Director and Associate ProfessorCenter for Global Health

Old Dominion University, VA

Workshop on Mitigation and Adaptation Research in Virginia, August 2015

Why should we care?

http://www.mindmapart.com/climate-impacts-mind-map-jane-genovese/

Perhaps…

http://www.newrepublic.com/article/117799/climate-change-will-force-us-abandon-cities-if-we-dont-prepare-now

Global Injustice

• Climate change effects people around the world – things are a bit hotter, or a bit colder and a bit

more uncertain,– too little or too much water, not enough food, – not safety and security

• It is a survival…

Climate Change and Health• Climate change directly impacts health

– Climate change impacts the weather, air, food supply, water, and economic longevity of humans

– Temperature increases regionally due to climate change has been shown to impact the biological and physical systems of humans worldwide

– Respiratory Health has shown to be a concern!― Increases amount of pollen and allergen― Increases mold― Increases the concentrations of outdoor ozone

and particulate matter

D’Amato, Cecchi, D’Amato, & Annesi-Maesano, 2014

Effects of Sea Level Rise on Health

• Injury• Infrastructure damage• Food and water insecurity and contamination• Release of chemicals, sewage, and pollutants• Allergic and respiratory diseases• Vector born diseases• Impacts on chronic diseases and mental health• Population displacement

Population displacement

Flooding and Health

• Indirect Health effects of flooding:– Damage to water and sanitation infrastructure– Damage to crops and or disruption of food

supplies– Damage/destruction of property– Disruption of livelihood and income– Population displacement– Damage to health care infrastructure

Few & Matthies, 2013

Flooding and Health

• Direct health effects of flooding:– Drowning– Injuries– Vector and rodent borne diseases– Chemical contamination– Skin/eye infections– Mental health– Diarrhoel diseases– Respiratory Diseases

Few & Matthies, 2013

Flooding and Respiratory Health• Lower respiratory symptoms were reported more

frequently in homes with dampness or mold in children and adults

• Allergen levels higher in flooded homes• Flooding leads to loss of electrical power which can

be substituted by petroleum-fuelled equipment― Increases risk of carbon monoxide poisoning― Increases risk of exposure to harmful fumes or

particulate matter

Few & Matthies, 2013, Miller, 2013; Fewtrell et al, 2006

Flooding in U.S.

• “Health effect of exposure to water-damaged New Orleans homes six months after Hurricanes Katrina and Rita”

• Respiratory symptoms were positively associated with exposure to water-damaged homes and respirator use had a protective effect.

• “Schools serving populations already at elevated risk of respiratory illness were disproportionately affected by the flooding of Hurricane Floyd. “

Cummings, 2008

Guirdy et al, 2005

Flooding in Guyana

EM-DAT: The OFDA/CRED International Disaster Database, http://www.emdat.be/

http://www.wondermondo.com/Best/SA/GuyanaFallsList.htmhttp://globalvoicesonline.org/2007/08/23/guyana-georgetown-is-flooded/

Flood date Affected (#people)1988 No data1996 38,0002005 274,0002006 35,0002008 100,000

The case of COVE & JOHN, GUYANA

• The town was flooded in December 2008• To evaluate the prevalence of respiratory symptoms

among occupants of water-damaged houses after the 2008 floods in Guyana

• Out of 185 households, a total of 130 households completed the questionnaire (70%).

The Respiratory health problems and Flooding

• Flooded houses 76.1%– Mould inside the home 37.3% (questionnaire)– Dampness and mould 32.8% (direct observation)

• A statistically significant association was found between flooded houses and “Fever and Chills” (p<0.05)

• A statistically significant association was also found between the presence of mould and runny nose, bronchitis (p<0.05)

S. Rose, M. Akpinar-Elci. ISCOM, 2010

November 2014, Guyana

Sick PopulationAsthma and Saharan Dust

• 200 million tones of dust– Sahara to the Caribbean– Arrives in the Caribbean within one week

• PM 2.5• Reasons to increase

– Climate change (?!)• A wetter or a drier North Africa

– Land use in western Africa

Saharan Dust and the Emergency Room Visits Due to Asthma in Grenada

Mean Monthly Asthma Visits & Dust

R2 = 0.036p< 0.001

Akpinar-Elci et al, 2015

Health care workers’ perspective on Climate Change in the Caribbean

• We conducted focus groups with Caribbean healthcare providers including physicians, veterinarians, nurses, health administrators and technicians who discussed the public health and healthcare impacts of the climate change.

• Participants were recruited from providers lacking any obvious environmental health interest or expertise in Trinidad and Grenada.

• Two countries with markedly – different geographies, cultures, population sizes, industrialization

level, economies, and carbon emissions (in 2009 there were 37.4 metric tons per capita for Trinidad and 2.4 metric tons per capita for Grenada, compared with 17.3 in the USA)

Macpherson and Akpinar-Elci, 2015

Their perspective

• When asked about the local impacts of climate change, participants in both nations agreed that it has already contributed to – the increase of heat stress, – respiratory diseases, – vector borne disease, – mental health problems within their respective communities– availability of drinking water, – climate variability related to floods and droughts, – disaster preparedness,– threats to food security.

Macpherson and Akpinar-Elci, 2015

Women and Single MotherNutmeg and Hurricane Ivan

September 2004, Grenada

http://www.flickr.com/photos/httpwwwsergiocomphotos/542390375/

http://blahblohblog.wordpress.com/2009/09/07/hurricane-ivan-grenada-5-years-ago/

Nutmeg Industry in Grenada

Nutmeg Workers

• 93 workers • 77% female (single mother)• Mean age 47.2±11.4 years

Akpinar-Elci et al, ATS 2011

Respiratory Symptoms

Akpinar-Elci et al, ATS 2011

Adaptation in the developing world Nutmeg industry in Grenada

• Prevent land degradation in Grenada• Implement renewable energy in nutmeg

industry • Build a capacity for nutmeg workers • Reduce the poverty among the nutmeg

industry workers, farmers, and the community

Prevention of Land Degradation

• Activity:– Planting nutmeg trees in land degradation areas

• Outcomes:– Promote and support sustainable land management – Increase nutmeg production– Positive impacts the nutmeg industry, environment, and

Grenada economy

Implementing Renewable Energy in Nutmeg industry

• Activity– Introduction of Solar dryer into nutmeg plant

• Outcomes – Create a more efficient approach to processing the nutmeg

products (shorter time, higher quality)– Improve economic and environmental benefits, – Prevent adverse health effects

Solar Dryer

• End-product quality increased• Drying time reduced from 8 wk to 4 wk• No exposures

– No dust– No mold– No pesticide– No ergonomic problems

UNDP Success Story

Nutmeg Production 500% increase

Virginia and Asthma

Hampton Roads, Sea Level Rise, Flooding

http://www.portsmouthva.gov/dna/Flood_Insurance_Rate_Maps.aspx

http://www.nasa.gov/centers/langley/news/researchernews/rn_climatechange.html

Hampton Roads and Asthma

Behr, Diaz, Akpinar-Elci, 2015

Act Now…

Community-based Adaptation

CARE, 2011, http://www.careclimatechange.org/files/adaptation/CARE_Understanding_Vulnerability.pdf

Thank you

Email: makpinar@odu.edu

http://archive.itvs.org/risingwaters/