Presentation on present and future health effects of climate change in California with an emphasis on the San Joaquin Valley (this slide set doesn't yet have speaker notes included)
33. Arsenic
Low Birth Weight
Neonatal Infections
Abnormal Gene Expression
Cancers
Dust Storm
Owens Valley, CA
30 tons arsenic/year
Public Water Systems Violating EPA Standard
48. Aflatoxin Biomarkers and Risk Factors
for Hepatocellular Carcinoma
RISK FACTORS ODDS of CANCER
+ Aflatoxin Biomarker Alone 7
Chronic Hepatitis B or C 7-28
+ Aflatoxin + Chronic Viral Hepatitis 60
Fatty Liver Hepatitis alone 3-16
+ Aflatoxin + Fatty Liver ?
10% OF US KIDS & 40% OF OBESE US KIDS
HAVE FATTY LIVER
Earth can absorb some CO2. ¼ in oceans, ¼ in forests but we are burning twice as much as planet can handle so the other half goes into atmosphere where it stays for hundreds to thousands of years. Every day half the CO2 we create is added to the CO2 from yesterday, the day before, all the way back to the start of the industrial revolution. So by now we have what you can think of as a pretty thick blanket of GHGs around the earth trapping the heat of the sun, and that's why temperatures are increasing.
THE PURPOSE OF THIS TALK IS NOT TO CONVINCE YOU THAT CLIMATE CHANGE IS REAL 97% OF CLIMATE SCIENTISTS agree with that statement as does EVERY MAJOR HEALTH PROFESSIONAL GROUP IN THE UNITED STATES along with the majority of Americans and 73% of Rural nebraskans. If you don't think climate change is happening, my job today isn't to convince you otherwise. What I'd like you to do as you listen today, is ask yourself what you're willing to gamble.
YOUR CHILDREN, YOUR PARENTS, YOUR PARTNER? BECAUSE THATS HOW HIGH THE STAKES ARE AND JUST LIKE THE CASINO OR THE RACETRACK. IF YOU LOSE, YOU DON'T GET it BACK.
Some people like me want to see all the data and some peoples' eyes glaze over as soon as they see the first chart. They just want you to get to the point. If you don't like graphs, you don't have to look and don't try to remember every statistic. If you need them, you can get them later from our website.. Here's what I want you to know when you leave:
1) small changes in climate have big effects on health
2) common sense solutions exist, they're just waiting for us to come to our senses
3) time is short, we'd best do it quickly
4) we can't get it done without you
CASE THREE A 9 year old girl is brought to the doctor by her mother for cough that won't go away. Previously active and athletic, she played soccer and was on swimming team, but now avoids exercise and spends her free time on the phone.
MERCED CO HAS 11TH HIGHEST OZONE IN THE COUNTRY AND IS #2 FOR FINE PARTICULATES, ANOTHER KIND OF AIR POLLUTION MOSTLY FROM VEHICLES
Ozone moves. This map shows location of air quality sensors. As coal burning plants close in the east where they were most common, ozone levels are decreasing. In the west, ozone is increasing and has
Been traced to coal burning plants in asia. Half the time that western air quality exceeds EPA limits,
Asian ozone is what put the numbers over the top. Because it can travel, ozone is not just an urban problem. Air pollutants often collect in valleys, which are home to ag communities. In CA the south central valley has the worst air quality in the US.
Respiiratory irritant. Acute exposure worsens asthma and COPD. SUMMER ASTHMA CAMP STUDY SHOWS MDI USE DOSE RESPONSE AT OZONE LEVELS BELOW EPA LIMITS, increase in er visits
Chronic exposure causes asthma in kids
3 sports=3x risk
ACUTE EXPOSURE KILLS, NO SAFE LEVEL. ABOUT 40% OF AMERICANS LIVE IN AREAS WITH OZONE LEVELS THAT ARE ALREADY ABOVE THE LIMIT ESTABLISHED BY THE EPA BUT THERE IS REALLY NO SAFE LEVEL OF OZONE. INCREASES IN OZONE LEVEL, EVEN WHEN BRIEF AND BELOW THE EPA'S SAFE LIMIT, RESULT IN INCREASED DEATHS
deaths from Climate related increase in ozone in US predicted to triple from 2000 to 2030. .
CO2 acts as fertilizer, increases pollen production and allergenicity, and extends flowering season, spread of allergenic plants. Graph shows pollen production under preindustrial, current and projected future CO2 levels. Pollen levels predicted to double by 2040.
SEASON EXTENDING MOST IN HIGHER LATITUDES.
NE HAY FEVER SEASON NOW 10D LONGER
Active wildfires emit large quantities of fine particulates, enter deep into lungs and pass into bloodstream. Fires are associated with PM2.5 levels as high as the smog in Beijing. Compared with pregnancies before and after the wildfires, moms exposed to wildfire smoke in CA 2003 gave birth to babies with lower birth weight up to 3-9 gms depending on trimester of exposure.
Dioxin in smoke, deposited on range and farmland resulting in human ingestion and accumulation in fatty tissues. 80% of dioxin exposure is from beef and dairy
In SW United States we are seeing increases in Valley Fever, a fungal lung infection (coccidiodomycosis) caused by inhaling dust from disturbed ground.. Not everyone who is infected gets sick. Older people, minorities, and people with diabetes or low immune function are more likely to become ill. Studies show that years with increased cases follow a grow and blow pattern. spring rain followed 6-24 mo later by drought and wind yields higher concentration of dust particles and increased cases of lung fungus.This slide shows the match of a predictive model based on spring rain and winter dust levels ( black line) and actual cases of lung fungus in Arizona.
Steve and Sue Smith rush their 1 month old daughter Chelsea from their rural farmhouse to the local hospital when she's starts turning blue. Chelsea has had diarrhea and vomiting for the past 2 days and was breastfeeding poorly. Her parents started giving her powdered infant formula made with boiled tapwater so dad could help with feedings.
In the ER, the doctor notes an irritable infant with rapid breathing and heart rate, but no fever. Her lips have a bluish tinge and her mouth is dry indicating mild dehydration but her lungs are clear. IV fluids and 100% oxygen are administered without improvement.
Nitrates in well water (and some public water systems as well) can cause Blue Baby Syndrome in babies under 6 months. The nitrate binds to hemoglobin in red blood cells and impairs its ability to carry oxygen. Consumption of too much nitrate in pregnancy reults in miscarriages and neural tube defects
The nitrate from fertilizer and manure, percolates down into groundwater.
Drought contributes to nitrate contamination because crops that are not growing well don't use the fertilizer. When the rain finally comes, there is a big spike in groundwater nitrate.
Dry lake beds contain high levels of minerals left behind when the water evaporates. Owens Lake emits about 300,000 tons of PM-10 per year: 30 tons of this is arsenic and 9 tons is cadmium. Aerosols sampled from Owens dust storms commonly contains significant amounts of arsenic concentrated in the <10 micron fraction. levels can be as high as 400 ng/m3
About 25% of airborne arsenic in SE US comes in dust from Africa
The health department of a mid sized city was notified by schools and employers of unusually high rate of absenteeism.
Sick workers and students complained of vomiting, diarrhea, abdominal cramps lasting 1-2 wks. By the time cause found and eliminated over 400,000 people affected. Clue; began during month of record rainfall.
Ccmbined sewer overflow is a type of urban sewer system where the same pipes that carry away storm runoff also carry away raw sewage. When there is heavy rain, these systems are overwhelmed and the water, mixed with sewage, overflows: into streets, rivers and lakes. 700+ cities in US with 40 million people have CSOs. In NYC 1/20 inch of rain is enough to provoke overflow dumping an annual 27 billion gallons of raw sewage into New York Harbor.
In Milwaukee in 1993, during a period of record rainfall, a city water plant with its intake near a CSO outlet in Lake Michigan contaminated the city's drinking water with cryptosporidiosis.
Socal and Central Valley 40-70% increase in heavy rains (decrease in NoCal). This slide shows how childrens visits to the emergency room for gastroenteritis (black line) match up with a model based on heavy rainfall (blue line). Majority of drinking water contamination cases in urban watersheds and nearly 70% of all gastroenteritis outbreaks occur after heavy rainstorms. Hospital admission of kids with diarrhea triples after heavy rain.
Rates have doubled in dogs and humans, from occupational to recreational
Mixture of excess nutrients from runoff and warm water temperature. Hepatotoxic, 1000x higher at water's edge.
Big problem in midwest, 2007 30% OF US LAKES, 100% of midwest lakes HAD detectable MICROCYSTINIn NE, dog, wildlife and livestock deaths, and in one year more than 50 accounts of human illnesses were attributed to HABs in lakes. Numerous health alerts and advisories.
FREMONT lake 2005-2006 microcystin in nearby groundwater and in fish
water treatment can remove microcystin but it is a doubled edged sword, decomposed algae increases dissolved organic carbon which combines with chlorine to form carcinogenic disinfection by products. Exposure during pregnancy can cause miscarriages, low birth weight, birth defects, Adult exposure causes cancer.
Another consequence of warmer water is a BRAIN INFECTION CAUSED BY AN AMOEBA called Naegleria. Inactive in cold water, only reproduces in water over 77 degrees. Rare but tragic, affects healthy kids, almost always fatal. Result of swimming, Amoeba enters thru nose, follows olfactory nerve to brain, then eats brain. The little girl is Annie Bahnemann, the first child ever to die of PAM in Minnesota, in 2010. 2 years later another boy died after swimming in the same lake. Last year, in 2 public water systems in Louisianna.
Historically in southern tier states, now occuring further north and more frequently. 2001-2010 32 cases
The green diamonds on this map show where corn crops had aflatoxin levels higher than FDA standards in 2012-13, . As you can see, the area has moved northward in latitude, to include the eastern edge of NE
TERATOGENIC, DECREASED BIRTH WEIGHTS. PLACENTA CONCENTRATES, found levels 6x higher in cord blood than maternal
INCREASES RISK OF LIVER CANCER ABOUT 7 TIMES HIGHER BUT WHEN COUPLED WITH CHRONIC INFLAMMATION LIKE HEP B OR C OR ALCOHOL, RISK IS 60 TIMES HIGHER.
NAFLD increasingly common risk factor for HCC in US. Childhood obesity increases risk of adult liver cancer 12-20%. currently affects 30% of US population, predicted to double by 2050
Biomarkers detected in Texas community with high prev HCC, related to corn tortillas and riceFDA allowed blending for feed in 4 states.
1999 national nutritional survey blood samples analysed last year for aflatoxin. 1% detectable. Higher in younger, Latinos, males, and immigrants.
Drought increases male suicide rate in farming communities. Also increases hunger in families and causes switch to cheaper less healthy foods. Kids from these families have 8-11x higher rates of iron deficiency anemia, resulting in impaired learning.This year there will be increase in cost of produce. CA, experiencing severe drought, grows half of nation's produce, over 90% artichokes,cauliflower, broccoli, celery, grapes strawberries. Half asparagus a nd bell peppers, 1/3 of carrots and tomatotes. CA Farmers will not get any irrigation water from state or federal water projects.
800,000 acres usually irrigated won't be planted (20% of total) losses 3.5 billion dollars to farmers and 10-13% increase in consumer prices. This really underlines the importance of crop diversity everywhere in the US as insurance against regional extreme
HABs in ocean are also the result of ag drainage of nutrients and warmer water.
Toxins concentrate in clams, mussels, oysters and cause human illness
Poisoning events are increasing, closures by PHDs are becoming more frequent. Triangles are ASP
VIBRIO INFECTIONS MORE THAN DOUBLED 1998-2010.
Joe Tenerelli is a 68-year-old man brought to the ER by his wife. He has had rapidly progressive weakness in both legs following a few days of fever, rash, neck stiffness, fatigue and aching muscles. In ER had fever, disoriented to date and place, paralysis of both lower extremities and absent reflexes at knees and ankles. after one week in the hospital, his strength began to return. After one month in the hospital his strength continued to improve but was not back to full strength so he was transferred to rehabilitation facility.
2 weeks before he got sick he found one of these in his yard
NE had 3rd highest rate of WNV after the Dakotas. Infection spread from birds to people by mosquitos. Began in NY in 1999, spread across US in 5 years. Climate implicated, 13,000 cases correlated with weather reports, strong relationship between temperature and risk of infection. Usually no sx, 1/150 cases invade the nervous system causing inflammation of brain (encephalitis) or spinal cord (myelitis) .
THIS SLIDE SHOWS THE SPREAD OF DENGUE FEVER IN RECENT YEARS FROM THE HOTTEST AREAS AROUND THE EQUATOR TO THE NORTH AND SOUTHlso transmitted by a mosquito called the Yellow Fever mosquito because it also causes Yellow Fever, although not anymore in the US. Dengue is a severe flu like illness, sometimes called “breakbone fever” due to intense joint pain. If you are unlucky enough to catch it again, you get hemorrhagic fever which is 50% fatal without intensive treatment. Dengue was eradicated, now back. 2005 Brownsville 25% seropositive in never travelers. 75% + overall. FL 2009 5% sero+. Since 1980 7 outbreaks TX, 1 HI, 4 FL. 2000-2007 hospital admissions for dengue tripled. In addition to effects on breeding and biting of mosquitos mentioned for WNV, climate change is increasing the mosquitos' geographic range. The most effective transmitter can't survive freezes, range expanding northward with warmer winters.
Fastest growing infection in the world.
Spread of Lyme related to effect of climate change on survival and food sources for mammals which carry it.
Extreme heat causes more deaths than any other type of extreme weather event,, variability kills more over 10,000/ year
LETHAL Heat wave in Europe 2003- 70,000 deaths.
2006 2 weeks, 600 deaths, 1600 hospitalizations, 16000 ER visits.
AGRESSIONincreased rates of assault, murder, domestic violence, suicides and psychiatric holds for danger to others
In US avg annual heat deaths in hundreds, Medicare study on summer variability showed 10,000 deaths/yr in elderly with diabetes, heart failure, chronic lung disease
IN UTERO EFFECTS low birth weight
2011 206 DEATHS ENTIRE US
, deaths related to exertional heat stroke (EHS), the most severe form of EHI, appear to be on the rise [2]. STUDENT ATHLETE DEATHS from EHS were higher during the period from 2005 to 2009 than any other five year period over the past 35 years. CDC 9,000 PER YEAR
1991-1999- 17 child deaths/yr from being left in hot car
2002-2012 40/yr
CA Office of Env Health Hazard Assessment looked at 60,000 birth records and found that a 10°F (5.6°C) increase in weekly average apparent temperature (T and H) resulted in 8.6% increase in preterm delivery. Greater associations were observed for younger mothers, blacks, and Asians. independent of air pollutants
AGRESSION increased rates of assault, murder, domestic violence, suicides and psychiatric holds for danger to others
UC Berkeley metaanalysis of 60 studies- for each SD of increased temp
or decreased rainfall 4% increase in individual/small group violence,
14% increase in major conflicts
We are facing a public health emergency. Public health- affects whole populations
Emergency- not because everyone will drop dead right away but because greenhouse gases are almost forever,
if we stopped now, it would take 300 hundred years for the ocean to absorb 60% CO2 because once the surface water gets saturated, have to wait for deep water to cycle up. Then the ocean is full. Removal of the next 10% takes 1000 years to react chemically with rock to become bicarbonate and get taken up into seashells, fall to the floor and get turned into limestone. The remaining 20% has to go back underground to coal and oil, which will take 10,000 years. Meanwhile, CO2 from natural sources is still being emitted and adding to what's there. If you add faster than you can remove, it keeps building up.
What happens to T? Global warming is like weight. Its easier to gain than lose. T would keep increasing for decades and then plateau. It wouldn't go down for 1000 years.
By 2030, 40% of adults will be obese, 44% will have cardiovascular disease, 1 of 5 will have DM
1/3 of the cases of America's top 10 killers result from physical inactivity.
1/3 OF COLON CANCERS, 1/3 OF POSTMENOPAUSAL AND RECURRENT BREAST CANCERS, 1/3 OF HEART DISEASE AND DIABETES CASES PREVENTABLE BY PHYSICAL ACTIVITY
HALF ENDOMETRIAL CANCERS, 1/3 ESOPHAGEAL AND PANCREATIC CANCERS ATTRIBUTED TO OBESITY WHICH IS RELATED TO INACTIVITY
Agriculture focused on meat and feed production is water, fuel, and fertilizer intensive. Worldwide, increased demand for meat is decimatling forests, which are an important sink for CO2.
Ruminants produce methane.20X more powerful than CO2 over 100 years, but 100x more powerful in the first 20 years, which is the critical time for responding to climate change. Fertilizer produces nitrogen oxides 300X
Overconsumption of meat and corn sugars leads to CVD, cancer, obesity and diabetes.
3 IN NE: Belleview, Lincoln, and Omaha.
Cities across the country have almost a decade of experience and many successful projects to decrease energy waste and lower emissions.
So we know what to do and we know how to do it, but we don't have the political will in Washington to scale them up and get them done.
32 TEXAS, 50 FLA, 33 IOWA,
SO WHAT'S IN THE DOCTORS' PRESCRIPTION?
LUCKILY, ITS NOT THAT DIFFICULT. THE SOLUTIONS ARE COMMONSENSE, PAY FOR THEMSELVES IN FUEL AND HEALTHCARE SAVINGS, AND IMPROVE THE QUALITY OF LIFE. BUT OF COURSE THERES A CATCH,
Not problem deniers, solution deniers.
BUYING A PRIUS WON'T HELP
JOHN SNOW BECAME THE FATHER OF EPIDEMIOLOGY BY STOPPING A CHOLERA EPIDEMIC IN LONDON BEFORE THE GERM THEORY OF DISEASE WAS EVEN ESTABLISHED. DID HE DO IT BY GOING AROUND THE NEIGHBORHOOD TELLING EVERYONE NOT TO DRINK WATER? HEWENT TO HIS LOCAL GOVERNMENT AND GOT THEM TO TAKE THE HANDLE OFF THE PUMP. “The pestilence was stayed.”
Take the handle off the pump is not something you do at your own house,
ZERO ENERGY HOME SEATTLE, MAKES UP USE WITH SOLAR. 75% CONSERVATION AND 25% GENERATION.
Atlanta Olympics- traffic decreased 20%, ozone decreased almost 30%, and kids ER visits for asthma down over 40%.
The health cost of fossil fuel addiction is enormous. Globally 400,000 people a year die as a result of climate change (90% are children) but 2.5 million die from lung disease, CVD and cancer from carbon related air pollution. We spend more on the health consequences of fossil fuel than we do on fossil fuel itself.
Closing all coal burning power plants in the US would save 13,200 lives and prevent nearly 10,000 hospitalizations and more than 20,000 heart attacks each year with an annual health savings of more than $100 billion per year
For every ton of CO2 emissions we eliminate, even counting the cost to do it, we come out economically ahead.
WE NEED TO GET CITY PEOPLE OUT OF THEIR CARS.
FOCUS ON 40% of daily trips are under 2 miles.
EVERY CITY SHOULD HAVE EXCELLENT PUBLIC TRANSIT
SAFE BIKING AND WALKING INFRASTRUCTURE
Put the things we need within walking distance, separate the people from the cars. Only 1% of fed transportation dollars for active, needs to be increased.
Increased average daily time spent on active transport from 4 to 22 minutes/d SF bay area
Decrease
14% heart disease, stroke, and diabetes
6-7% dementia and depression
5% breast and colon cancer
1.4 -22 billion dollars/year saved
Midwestern metrop areas- 50% short trips by bike save over $5 billion in health spending per year: $3.8 billion/year saved due to health benefits of exercise and $2.5 billion due to benefits of cleaner air.
Nutritionally in the US we get what we pay for. We're subsidizing corn for feed and ethanol and that's what we get. !% of crop subsidies goes for produce. First step in right direction, produce growers included in crop insurance this year. People eat more if its cheaper. Align subsidies with federal dietary recommendations.
40% of food is wasted. Revising use by labelling
Tax credits for farmers who donate cosmetically unsellable food. Lets make energy out of waste instead of methane.
Heavy meat eaters eat an avg 700 cal more/d
Decrease cancers by 10%, heart disease by 20%, diabetes 25%
Man in flood: Car, canoe, motorboat, helicopter. God will save me. floods, droughts, mosquitos. Solutions are there but God helps those who help themselves. We have to put them into action.
WHEN IT COMES TO CLIMATE CHANGE, THERE ARE NO RED AND BLUE STATES, ONLY GREEN STATES.
While a STRONG MAJORITY OF US CITIZENS WANT CLIMATE ACTION NOW, even if other countries don't act, and even if it costs us some money, our government doesn't
Climate change as cosmic test. Test of our wisdom to understand a global problem needs global solutions, ability to think beyond immediate self interest: future, communities, responsibilities as stewards
Test of our democracy:
25% of Americans are willing to join a campaign to move Congress to climate action.That's one of every 4 people in this room. They're waiting for someone in their community to step forward. Make yourself a promise to do something outside your comfort zone. Write a letter, make a phone call, join a protest, talk to your friends, visit your congressperson, go to a candidates forum and ask the question: what are you going to do about climate change? A healthy high quality future is within our reach but it won't come to us. We have to reach out and get it.
The future is up to people like you and me but we've got to act now because its about to slip through our fingers.
Please take some cards to share with friends. Website has If you go to our website, you will find links to a variety of organizations. Find the one that sounds right for you and get involved. You can download my slides and give this talk again in your community. I'm happy to answer any questions.