Climate Change and Health Presentation 1 Oct 2013

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Climate Change and Health Presentation from Public Health England

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  • IPCC 5th AR: Warming of the climate system is unequivocal, and since the 1950s, many of the observedchanges are unprecedented over decades to millennia. The atmosphere and ocean have warmed,the amounts of snow and ice have diminished, sea level has risen, and the concentrations ofgreenhouse gases have increased.The total natural RF from solar irradiance changes and stratospheric volcanic aerosols madeonly a small contribution to the net radiative forcing throughout the last century, except forbrief periods after large volcanic eruptions.
  • http://www.bom.gov.au/climate/change/aus_cvac.shtml
  • The plot is for summer (JJA) and for the Mediterranean region (10W-40E, 30-50N) and the timeseries in red come from 7 model runs, using model data submitted for the next IPCC report (AR5). The models are: CNRM-CM5 (Meteo-France); CanEMS2 (Canadian Centre for Climate Modelling and Analysis); HadGEM2-ES (Met Office HC); NorESM1-M (Norwegian Climate Centre); bcc-csm1-1 (Beijing Climate Center, China Meteorological Administration); inmcm4 (Institiute of Numerical Mathematics, Moscow); ipsl-cm5a (Institut Pierre-Simon Laplace). This updated plot uses emissions scenario RCP 8.5, which is a close approximation (but slightly less than) A1FI (high emissions). Fifth Assessment Report (AR5, due in 2014) will put greater emphasis on assessing the socio-economic aspects of climate change and implications for sustainable development, risk management and the framing of a response through both adaptation and mitigation.The term temperature anomaly means a departure from a reference value or long-term average (here 1961-90). A positive anomaly indicates that the observed temperature was warmer than the reference value, while a negative anomaly indicates that the observed temperature was cooler than the reference value.
  • Comparison of year 2000 distribution of carbon dioxide (CO2) emissions (by country) vs. the regional distribution of four climate-sensitive health effects. (a) CO2 emissions (data from Reference 40). (b) The Intergovernmental Panel on Climate Change (IPCC) “business as usual” greenhouse gas (GHG) emissions scenario, “IS92a,” and the HadCM2 general circulation model (GCM) of the U.K. Hadley Center were used to estimate climate changes relative to baseline 1961–1990 levels of GHGs and associated climate conditions. Existing quantitative studies of climate-health relationships were used to estimate relative changes in diarrhea, malaria, inland and coastal flooding, and malnutrition from 2000 to 2030.This is only a partial list of potential health outcomes, and significant uncertainties exist in all the underlying models. These estimates should therefore be considered a conservative, approximate estimate of the health burden of climate change. (Patz et al. 2008)
  • Climate Change Act (2008): A legal framework for reducing GHG emissions. 80% reduction in carbon emissions by 2050. Currently around 27% of total carbon emissions come from homes and 17% from non-domestic buildings.
  • The 11 sectors represent how we are gathering the data and organizing the analysis- they are based on how research tends to be organised so have mainly been chosen for convenience. There are 11 sector reports detailing the outputs of the underlying analysis.Methodology uses a “systematic mapping” technique to look at linkages between the risks/opportunities in different sectors. Some sectors such as flooding have strong links to all other sectors.Once the analysis is complete, we merge these sectors into 5 themes to enable cross-sectoral links to be teased out. The Adapting to Climate Change Programmein Defra is built around these 5 themes.Health Sector: Public (population) health and Health care services and infrastructure
  • Current evidence: geographical variability, vulnerable groups, adaptation effect Methods: quantitative and qualitative
  • UKCP09 provides projections (possible) not predictions (probable)Three emission scenarios (low, medium and high) Probabilistic projections: central estimate and 10% and 90% estimates Variables: Temperature, precipitation, sea level, cloud cover, wind speed, etc.
  • Emissions uncertainty. The description of UKCP09 probabilistic projectionsabove does not discuss the effect of uncertainties in future emissions. Thelatter, though small over the next two or three decades mainly because ofclimate system inertia, will be substantial in the second half of the century. Wetherefore include the effect of emissions uncertainty by presenting separateprobabilistic projections of future climate change for three scenarios of futureemissions. These were decided, following consultation, as the A1FI, A1Band B1 scenarios in the IPCC Special Report on Emission Scenarios (SRES) —renamed for simplicity in UKCP09 as High, Medium and Low respectively. Thesescenarios include a wide range of greenhouse gases and other pollutants; as anexample, the CO2 emissions are shown in Figure 6. (Note that, because futureemissions will be determined by human choices, relative likelihoods cannot beassigned to these scenarios, and we cannot combine emissions uncertainty andother uncertainties to produce a single probabilistic projection covering alltypes of uncertainty.) All scenarios are non-interventionist, that is they assumeno political action to reduce emissions in order to mitigate climate change;differences between them arise purely from different assumptions aboutfuture socioeconomic developments.
  • population growth as this may increase the numbers of people exposed to hazards, such as flooding, or increase the demands for goods and services, such as water and energyUK population is c 62 M rising to 69-86 M (2050s) & 72-113 M (2080s)In some cases the growth in population may be an equal or even greater contributor to risk than climate change
  • Percentage age distribution, United Kingdom, 1971-2085 http://www.ons.gov.uk/ons/dcp171776_237753.pdf
  • IPCC 5th AR: There has been further strengthening of the evidence for human influence on temperatureextremes since the SREX. It is now very likely that human influence has contributed toobserved global scale changes in the frequency and intensity of daily temperature extremessince the mid-20th century, and likely that human influence has more than doubled theprobability of occurrence of heat waves in some locations
  • In England and Wales, there were 2139 excess deaths (16% increase, CI: 14%to 18%) during the August heat wave. The Central England Temperature (CET)peaked at 31.5°C (88.7°F) on 9 August. This coincided with thepeaks in the concentrations of ozone and PM10 in England. The peak in dailydeaths in England and Wales occurred two days later on 11 August. In Englandand Wales, mortality in people over the age of 75 increased by 22% (CI: 20%to 25%), more than the increase seen for other age groups: (11% (CI: 6% to15%) for the 0-64 age group and 3% (CI: -1% to 6%) for the 65-74 agegroup).
  • Thermal comfort zone 12-18 deg C
  • Comparative Assessment Mortality risk associated with heatWhy these differences in vulnerability Draw lessons for public health
  • Current heat-related deaths ~2,000And cold-related deaths ~40,000
  • Quantify the health effects of urban heat islands using regional climate modelling.Understanding the role of the urban heat island in exacerbating the impact of climate change on mortality rates.Improved understanding of the social inequalities in health impacts in this context.West Midlands, 11 pm 5th August 2003
  • What about pollutants other than ozone? The answer is 'We don't really know', and there are many competing potential feedbacks for PM.
  • +5 C increase in temperature applied uniformly for the whole year within the UK ~500 additional premature deaths on a baseline of ~12,000“and the assumption of no threshold for O3 effect”
  • Variations in the potency of aeroallergens (pollen grains).Contain the spread of invasive plants such as ragweed.We need better methods to conduct molecular epidemiology.
  • Increased airtightness of dwellings may have negative effects on human health (indoor air pollution).Promote long-term, energy efficient building design interventions to ensure adequate ventilation in increasingly airtight buildings.
  • Climate change may affect cloud cover and delay the recovery of the stratospheric ozone layer. In a warmer climate, people may spend more time outdoors in the UK, which could increase the risk of non-melanoma skin cancers. Fewer holidays overseas to sunny climates could result in fewer malignant melanomas.
  • Central precipitation estimates show winter rainfall increasing and summer rainfall decreasing.
  • Land use change, wildlife management and agricultural practices.The incidence of Lyme disease transmitted by ticks is likely to increase. Deer populations are likely to have a lager impact on ticks than climate changePossible increase in the number species and abundance of mosquitoes, with implications for transmission of arboviruses (e.g. West Nile virus). The risk from autochthonous transmission of malaria remains low.Effective messages to public health professionals, exposed groups, and general public to reduce vector-borne disease risks.
  • The most important mechanisms to prevent and control food- and water-borne diseases are early detection, surveillance and monitoring, horizon scanning, risk assessment, management, communication and preparedness for potential outbreaks.Warmer weather will allow pathogens (e.g. Salmonella) to grow more readily in food, and will favour flies and other pests that affect food safety.For some pathogens (Salmonella and Campylobacter) there are intervention programmes at relevant stages of food production.Algal blooms are an interesting issue, particularly with dinoflagellate shellfish poisoning, but are a small disease burden, and likely to remain so for the UK. The sea level rise may be less of an issue than salinity, nutrients and temperature when regarding changes in coastal algal populations.
  • Policies to reduce GHG emissions may: Reduced particulate air pollution as a result of reduced coal combustion Reduced dietary saturated fat consumption from animal products Increased physical activity as result of reduced private car use in citiesTaking into account health co-benefits suggests that such policies could offset part of the mitigation costs.
  • Existing public health problems: heat and flood related impacts, air pollution, allergies, and mental healthSome UK regions (flood risk and densely populated areas) and population groups (elderly, deprived, ill) are more vulnerable.National Adaption Programme
  • Public health professionals should capitalise on the potential to reduce GHG emissions and improve public health.
  • Climate Change and Health Presentation 1 Oct 2013

    1. 1. Climate Change and Health Air Pollution and Climate Change Group, Toxicology Department Centre for Radiation, Chemical and Environmental Hazards Dr Sotiris Vardoulakis
    2. 2. Outline  Global climate change and health  First UK Climate Change Risk Assessment  Health Effects of Climate Change in the UK  Heat and cold effects on health  Air pollution and climate change  Environmental health and sustainability Climate Change and Health
    3. 3. IPCC 5th Assessment Report – The Physical Science Basis Climate Change and Health Available on 30 September 2013 http://www.ipcc.ch/
    4. 4. Observed change in average surface temperature (1900-2012) Climate Change and Health oC IPCC, 4th AR
    5. 5. Global annual mean temperature anomaly
    6. 6. Mitigation is vital, but we need to prepare for inevitable climate change observations projections 2003 2060s 2040s TemperatureanomalyoverEurope(wrt1961-90)°C Hadley Centre We are already committed to this from past emissions alone
    7. 7. Hughes et al (2011), modified from Capon and Hanna (2009) and Berry et al (2011)
    8. 8. Distribution of four climate-sensitive health effects Relativechangesindiarrhea,malaria,inlandandcoastalflooding,andmalnutritionfrom2000 to2030 (Patz et al., 2008)
    9. 9. Climate Change Act 2008 Climate Change Risk Assessment January 2012 National Adaptation Programme 2013 Committee on Climate Change Adaptation Economic Assessment Committee on Climate Change Committee on Climate Change Committee on Climate Change Health Effects of Climate Change 2012 UKCP09 UKCIP02 Health Effects of Climate Change 2002 Health Effects of Climate Change 2008 Legislative Framework: Moving from evidence to policy Climate Change and Health
    10. 10. CCRA: Sectors and Themes Sectors (for initial analysis) Themes (for synthesis)Sectors (for initial analysis) Themes (for synthesis) https://www.gov.uk/government/publications/uk-climate-change-risk-assessment- government-report 1. Agriculture 2. Biodiversity & Ecosystem Services 3. Built Environment 4. Business, Industry & Services 5. Energy 6. Floods & Coastal Erosion 7. Forestry 8. Health 9. Marine & Fisheries 10. Transport 11. Water • Agriculture & Forestry • Business • Health & Wellbeing • Buildings & Infrastructure • Natural Environment https://www.gov.uk/government/publications/uk-climate-change-risk-assessment- government-report
    11. 11. CCRA: Key issues for different parts of the UK Climate Change and Health
    12. 12. Health Effects of Climate Change in the UK (2012) Climate Change and Health • Evidence • Recommendations • Research gaps www.hpa.org.uk/hecc2012
    13. 13. Current Evidence & Research Gaps 1. Current evidence and climate projections 2. Temperature Effects 3. Air Pollution 4. Aeroallergens 5. Indoor Environment 6. Ultraviolet Radiation 7. Floods 8. Vector borne diseases 9. Food and Water borne Diseases 10. Health Co-benefits of Policies to Reduce Greenhouse Gas Emissions Climate Change and Health
    14. 14. Climate Change and Health Climate Projections http://ukclimateprojections.defra.gov.uk/
    15. 15. Emissions Scenarios CO2 emissions under the three IPCC SRES scenarios used in UKCP09: A1FI (black: High emissions), A1B (purple: Medium emissions), and B1 (green: Low emissions). (Source: IPCC)
    16. 16. 0 20000000 40000000 60000000 80000000 100000000 120000000 0 2000000 4000000 6000000 8000000 10000000 12000000 14000000 16000000 NE NW YH EM WM EE LN SE SW WA SC NI UK Population Trends UK population is currently 62M rising to 69-86M (2050s) & 72-113M (2080s) Climate Change and Health Wales
    17. 17. Age Distribution (Source: ONS)
    18. 18. Temperature Effects • Increases in annual mean temperatures of around 2 to 5oC under a medium emissions scenario (A1B) by 2080. • Quantification of preventable heat- and cold-related mortality and morbidity, focusing on vulnerable population groups. • Understanding the role of the Urban Heat Island in exacerbating the impact of climate change on mortality rates. • Improved understanding of the role of planned adaptation strategies and long-term physiological changes. • Provision of input to public health plans, and evaluation of their effectiveness.
    19. 19. © UK Climate Projections 2009 UK (2020s) Climate Change and Health
    20. 20. © UK Climate Projections 2009 UK (2050s) Climate Change and Health
    21. 21. © UK Climate Projections 2009 UK (2080s) Climate Change and Health
    22. 22. Days per year with CET > 20oC Days per year with CET < 0oC
    23. 23. August 2003 heatwave 2003 mortality Baseline mortality 2003 mortality Baseline mortality (Johnson et al. 2005)
    24. 24. Climate Change and Health 0 2000 4000 6000 8000 10000 1 2 3 4 5 -10 -5 0 5 10 15 20 25 30 Aggregatecountofdays Meandailydeaths(per100Kpopulation) Mean Temperature oC England & Wales deaths days Cold effects Heat effects Temperature Effects
    25. 25. 1.00 1.03 1.06 1.09 1.12 UK heat Relative Risks: Heat (all ages) per 1oC increase above temp threshold (93rd %ile) Climate Change and Health
    26. 26. 1.00 1.02 1.04 1.06 UK cold Relative Risks: Cold (all ages) per 1oC decrease below temp threshold (60th %ile) Climate Change and Health
    27. 27. Climate Change and Health 1,974 3,281 7,040 12,538 0 5000 10000 15000 20000 2000s 2020s 2050s 2080s A: Heat deaths 69 114 233 409 0 250 500 750 1000 2000s 2020s 2050s 2080s A: Heat deaths UK Wales Heat deaths (per year for all ages)
    28. 28. Climate Change and Health 41,408 42,842 40,397 36,506 0 20000 40000 60000 80000 2000s 2020s 2050s 2080s B: Cold deaths 2,476 2,472 2,176 1,872 0 1000 2000 3000 4000 2000s 2020s 2050s 2080s B: Cold deaths UK Wales Cold deaths (per year for all ages)
    29. 29. Temperature mortality (by age group) 7 94 468 1573 6 85 421 1419 5 69 341 1153 4 56 274 933 0 400 800 1200 1600 2000 0-64 65-74 75-84 85+ Cold deaths /100K (mean) 2000s 2020s 2050s 2080s 0 4 18 79 1 6 26 113 1 11 48 206 2 17 77 327 0 200 400 600 0-64 65-74 75-84 85+ Heat deaths /100K (mean) 2000s 2020s 2050s 2080s Mean estimates of heat- and cold-related deaths in the UK per year per 100,000 population (Hajat et al. 2013)
    30. 30. Urban Heat Island West Midlands O C Modelledairtemperature (Heaviside et al. 2013) Birmingham 11pm 5th August 2003 Climate Change and Health
    31. 31. Air Pollution Climate Change and Health • Understanding how climate change interacts with ground level ozone and other climate sensitive air pollutants. • Investigation of the range and extent of health effects of ozone, including those associated with chronic exposure. • Understanding how vulnerable people (e.g. those with pre-existing respiratory illness) need to be protected.
    32. 32. Annual mean Summer mean Change in ground level O3 simulated by EMEP4UK for a +5oC increase in temperature relative to the base simulation for meteorological year 2003. Ground Level Ozone (Heal et al. 2013) Climate Change and Health
    33. 33. Ozone Mortality Burdens (no threshold) (Heal et al. 2013) Wales: 677 700 782 815 765
    34. 34. Aeroallergens • Climate change may result in earlier seasonal appearance of respiratory symptoms and longer duration of exposure to aeroallergens (pollen and fungal spores). • Changes in plant distribution can expose the population to pollen from more plants with different flowering seasons. • Climate change / extreme weather events can change fungal speciation, distribution and allergenicity. • Develop integrated system for modelling atmospheric concentrations of pollen, combining measurements with numerical forecast models.
    35. 35. Indoor Environment • Climate change may exacerbate health risks and inequalities associated with building overheating, indoor air pollution, effects from flooding, dampness and biological contamination. • Characterise the health risks and benefits associated with current and future building infrastructure under climate change scenarios. • Research into how climate change mitigation and adaptation measures may affect the indoor environment (e.g. air quality and biological contamination in buildings).
    36. 36. Ultraviolet Radiation Climate Change and Health • Climate change may affect ambient levels of UVR, but the critical factors affecting human exposure are lifestyle and behaviour. • Understanding the likely changes in ground level UV radiation and the balance between the risk of skin cancer versus a beneficial increase in outdoor activity. • Research into whether warmer summers will encourage more healthy outdoor activities and increased vitamin D production. • UVR related public health messages for specific target groups such as young people and the elderly.
    37. 37. Floods (and Droughts) • Climate change is likely to affect river and coastal flood risk. • Some areas are particularly vulnerable to coastal floods: South Wales, NW Scotland, Yorkshire and Lincolnshire, East Anglia and Thames Estuary. • Understanding how floods (and droughts) affect both physical and mental health of populations. • Development and evaluation of public health action plans, advice and guidance.
    38. 38. Changes in Precipitation – Winter
    39. 39. 39 Changes in Precipitation – Summer
    40. 40. Vector Borne Diseases • It is likely that the range, activity and vector potential of ticks and mosquitoes will increase in this century. • Climate change may act on disease vectors (and their pathogens) both directly through a rise in temperature or change in precipitation. • and indirectly through our adaptation to climate change, e.g. creation of coastal wetlands and habitat expansion. Climate Change and Health
    41. 41. Food and Water Borne Disease • Most water and food-borne pathogens show seasonal variation, which may be directly or indirectly influenced by weather. • Warmer weather will allow pathogens (e.g. Salmonella) to grow more readily in food, and will favour pests and fungal mycotoxins that affect food safety. • Understanding of how seawater temperature can affect the risk of people being exposed to algal blooms and associated marine toxins. • Climate change is likely to elevate food prices which may reduce the nutritional status of some population groups.
    42. 42. Health Co-benefits of Mitigation Climate Change and Health • Mitigation policies may achieve health, GHG and economic benefits simultaneously (‘the triple bottom line’). • Understanding the health co-benefits of policies to reduce GHG emissions in transport, energy generation and food production. • Evaluation of the health effects (both positive and negative) of emerging ‘low carbon’ technologies and biofuel policies.
    43. 43. Public Health Response
    44. 44. Conclusions • Climate change is likely to pose significant challenges to public health in the UK by aggravating existing public health problems. • Some UK regions (flood risk and densely populated areas) and population groups (elderly, deprived, ill) are more vulnerable. • Research needed on current and future interactions between climate, and environmental and behavioural drivers that affect public health. • The environmental public health sector needs to respond to these challenges by:  strengthening modelling, monitoring and surveillance systems  improving the resilience of public health infrastructure  improving the assessment & communication of climate related risks  developing the evidence on health benefits of climate change adaptation and mitigation
    45. 45. Acknowledgements • Climate change and associated research in PHE/CRCE • Department of Health • Department for Environment, Food and Rural Affairs • NHS Sustainable Development Unit • UK Climate Impacts Programme • UK Met Office Climate Change and Health Health Effects of Climate Change in the UK (2012) report available online www.hpa.org.uk/hecc2012
    46. 46. Climate Change and Health

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