Introduce yourself and briefly tell the story of how you came to be doing this presentation
Hot summer days to double or triple. Weat wa
Climate change is causing people to move around more than ever before. In the US since 2005 over 7 million people have been evacuated due to extreme weather events. Lesson from Katrina was that the biggest health impact was not from floods but the 200,000 people with chronic diseases disconnected from their usual source of medical care. Diabetics without insulin, asthmatics without inhalers, people on dialysis, mentally ill people with no meds, etc. Evacuation shelters have large numbers of people in close quarters causing outbreaks of gastrointestinal and respiratory diseases. Aside from physical consequences, these experiences leave psychological scars : after major fires and hurricanes 30% of affected populations have symptoms of Post Traumatic Stress Disorder Globally, environmental events now cause more refugees than war or genocide. Storms, rising sea level, drought, crop failures, and conflict over diminishing resources will result in mass migration of hundreds of millions by 2050. Poorer countries will be the most affected and some of their displaced will come to US and bring diseases with them. TB in US 12x more common in immigrants, cities with high numbers of newly arrived immigrants have higher rates of TB persisting for years after. >80% of MDR (multiple drug resistant) tuberculosis in US occurs in foreign born.
Galen Rupp, US olympic tryouts wearing mask because of high pollen counts. CO2 acts as fertilizer, increases pollen production and the strength of allergens in causing reactions. Graph shows pollen production under preindustrial, current and projected future CO2 levels. Climate change is also increasing the length of ragweed flowering season and increasing the spread of plant species that are common allergens. High pollen causes exacerbations of allergies, asthma, and atopic dermatitis which together are the 6 th most expensive chronic diseases in the US, costing $21 billion annually.
The past two summers have seen the worst drought in 50 years with crop losses of 10 billion in 2011 and a projected 20 billion in 2012. The farmers on the left met in a park in Texas last summer to pray for rain. You can see the condition of their cattle, emaciated due to lack of feed.
Most of what we know about the health effects of dust storms comes from parts of the world where they are more common. In Asia , increased admissions for heart and lung disease are seen lasting up to month afterwards and studies show, decreased lung function in children. In Africa dust storm cause outbreaks of bacterial meningitis. What is in the dust from Aftica and Asia is important to us because half of the airborne dust in the US blows in from other countries, predominently from Asia on our west coast, and from Africa in the east. As climate change converts more of these continents to desert, more of their dust will be carried away on the wind.
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.
Drought has impacts on fresh water as well. Falling water levels in surface and groundwater increase the concentration of contaminants like nitrates and pesticides in drinking water. Nitrate is the most common contaminant and is especially dangerous to infants and pregnant women. It causes miscarriages, birth defects, and a potentially fatal condition in babies called methemoglobinemia, or blue baby syndrome, where the blood is unable to carry oxygen. Long term exposure has been associated with bladder and gastric cancers.
Frequency and size of fires increasing. 32,000 people evacuated Colo Spgs. Wildfire smoke contains many chemicals, some of which are carcinogens. Very fine particulates easily inhaled into lungs and pass into bloodstream causing inflammation. Studies examining hospital records during and after fires show rise in admissions for asthma, bronchitis, pneumonia, heart attacks and strokes. Predicted quadrupling of area burned in western US for every 1 degree rise in temp
This slide is from an EPA study comparing emergency room visits for heart and lung conditions in rural counties exposed to smoke from a peat bog fire (the blue dots) with comparable counties ( the white dots ) that were not affected by the fire. It shows increases in emergency room visits for asthma, copd, pneumonia, heart attacks and congestive heart failure with the elderly most affected.
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.
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.
Mold is a major health hazard in the aftermath of flooding. It will grow on any porous surface that stays wet more than 48 hours. Mold triggers asthma attacks and allergic reactions and also may cause asthma. A medical researcher in Cincinnati has been following a group of children at risk of asthma due to their family history. He found that children exposed to mold in the home as infants had 3x higher rate of asthma by age 7. We will be having more coastal flooding due to sea level rise and increase in severity of storms fueled by warmer ocean temperatures, .. Sea level in US is predicted to rise about 6 inches by 2030, a foot by 2050 . and 3 feet by the end of the century. By 2030 the risk of 100 year coastal floods will double to triple potentially affecting 5 million americans.
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 forms a blanket around the earth trapping the heat of the sun, and that's why temperatures are increasing.
It is coming from human activity. This is a record of CO2 levels going back 600,000 years and CO2 levels are now by far the highest they have ever been.
Review these in detail. Points: in best case, CO2 levels stabilize, they don't go down for 200 years. Temp keeps rising but hopefully tops out at 4-6 degree increase. Pre heat oven analogy. in worst case, emissions, levels, and temps increase for 7-12 degree total temp increase
We are following worst case scenario and facing a public health emergency. Public health- affects whole populations Emergency- not because everyone will drop dead right away but because if we don't lower our CO2 emissions NOW the GHGs we put into atmosphere will stay for hundreds of years and it will be too late to do anything to prevent the resulting disease and death.
JUST BECAUSE WE CAN'T REVERSE CLMATE CHANGE, DOESN'T MEAN ITS TOO LATE TO DO ANYTHING ABOUT IT. Chronic disease analogy (diabetes) can't cure but can control. Control has to be early to avoid irreversible damage WE ARE AT A CRITICAL POINT IN HISTORY.
You may have noticed that over and over, certain groups are more affected. Old, young, asthmatics and people with allergies most affected, because most sensitive. They are like the canaries coal miners used to take into the mines to signal when the air was becoming poisoned and it was time to come up. But when our canaries, if we could call our children and our parents such a thing, when our canaries get sick, we can't come up like the miners for fresh air and clean water. We have nowhere else to go. These are the symptoms, the warning signs, of a sick planet. And whats the diagnosis? Carbon dioxide pollution. What's carbon dioxide? Carbon is the building block of life. when we burn things that were once alive carbon combines with oxygen to form CO2.
i How many of you have ever not done what the doctor told you to do? Or done what doctor told you not to do? People don't change because we tell them to. Even if they did, the amount of CO2 reduction and the short time to do it mean that individual consumer choices are not enough to meet our CO2 lowering target. Difference between individual health treatment and public health treatment.. This is a picture of an old water pump in London made famous by John Snow, the father of public health. It was the 1800s, before the germ theory of disease and there was a Cholera epidemic in London, which Dr Snow traced to the neighborhood served by this pump. The pump was bringin water from the Thames River, where, after heavy rains, the city happened to be dumping raw sewage. What did he do? Did not go door to door telling people not to drink the water. Took the handle off the pump. Thats how you respond to a public health crisis. We need federal policy and investment to take the handle off the fossil fuel pump. To change the game and make it easy and economical to do the right thing, expensive and difficult to keep adding to our carbon dioxide pollution.
A move to active transportation yields even more health benefits. Cities with higher rates of biking and walking to work have lower rates of obesity diabetes, and high blood pressure. . People who live in walkable neighborhoods are twice a likely to get recommended levels of exercise and weigh an average of 10# less than residents of more dispersed areas. Mass transit is also active transit because one has to walk to and from the station. Charlotte light rail before and after study: rail commuters lost 7# in first 18 months, lowered risk of obesity by 80%. 10 lb weight loss is medically very significant, cuts risk of diabetes, heart disease, and breast cancer in half. I've given you a lot of numbers but its not all about quantity. Addressing climate change means improving our quality of life too. We are a nation addicted to speed, living faster than we were ever meant to go. We know its bad for us and it doesn't make us happy but we can't seem to stop. Turning away from the path of destruction to live within our ecological means is also turning toward a better way of life.. Its more time with families, more vibrant communities, reconnection with nature, and bringing our lives back into line with our values. That kind of medicine isn't bitter, its better.
Or we can choose to do nothing. If we continue business as usual. by the end of the century Milwaukee will be like Charlotte,NC Detroit like Memphis, Columbus OH like Las Vegas. 180 of our cities will be partly underwater, our farms will be dustbowls, our forests charred wastelands, we'll be teetering on the brink of total social, economic and environmental collapse. And as our planet gets sicker, we'll get sicker too, All the health consequences I've told you about are happening now with a temperature increase of less than 1.5 degrees. Multiply that by 7 or by 12 and remember that once we burn the fuel and release that CO2 in the atmosphere, we've chosen our future and we can't take it back.
Introduce a local climate activist who invites the audience to take action.
CLIMATE AND HEALTH IN NEW ZEALAND- For Medical Audiences
Health Effects of Climate Change CLIMATE AND HEALTH
NEW ZEALAND IS WARMINGDeparture from Historic Average 1860-2010
Beta agonist Use in Asthmatic Children Increases with Ozone LevelSummertime haze air pollution and children with asthma.Thurston GD Am J Respir Crit Care Med February 1, 1997 vol. 155 no. 2654-660
Less dust mite antigen needed to drop FEV1 20% following inhalation of ozoneAssociation of ambient ozone exposure with airway inflammation and allergyin adults with asthma. Khatri, SB 2009 Oct;4 J Asthma 6(8):777-85.