As far as Nepalese people are concerned, they are very bad in their food habits. Disease like ulcer and diabetes are rampant along Nepalese people. Moreover, there are areas in the country where there is a severe malnutrition. Factors influencing food habits •Individual Preferences Every individual has unique likes and dislikes concerning foods. •Cultural Influences A cultural group provides guidelines regarding acceptable foods, food combinations, eating patterns, and eating behaviors. •Social Influences Members of asocial group depend on each other, share a common culture, and influence each other's behaviors and values.

1. Health effects of climate change
Ramanand Pandit

2. Types of health effects
• Direct health effect of climate change
• Indirect health effect of climate change

3. Direct health effects of climate change
• The direct impacts of climate change depend
mainly on exposure to heat or cold waves or
extreme weather events.
• Studies done by IPPC in temperate and
subtropical countries have shown increases
in daily death rates associated with extreme
outdoor temperatures.

4. Direct health effects of climate change
Mortality increases much more steeply with
rising temperatures than with falling
temperatures (Kalkstein, 1993).
The lowest mortality occurs within a range of
intermediate comfortable temperatures
(between 21°C and 26°C) and humidity
(relative humidity below 60%).

5. Direct health effects of climate change
Extrapolation of investigations performed in
cities in the United States, China, Netherlands,
and the Middle East indicates that morbidity
and mortality also could increase in this region
as a result of the expected increase in the
number of days with high daily temperatures.
(i.e., the persistence of days with higher-than-
normal maximum and minimum temperatures)

6. Direct health effects of climate change
The impacts would be make worse by high
humidity rates, intense solar radiation, and
weak winds.
All of these factors affect the physiological
mechanisms of human adaptation.

7. Direct health effects of climate change
High temperatures and air pollutants,
especially particulates, act synergistically to
influence human mortality.
This effect is occurring in large cities where
such conditions enhance the formation of
secondary pollutants (e.g., ozone)

8. Direct health effects of climate change
Global warming could increase the number and
severity of extreme weather events such as
storms, floods, and droughts, and related
landslides and wildfires.
Such events tend to increase death and
pathology rates-directly through injuries or
indirectly through infectious diseases, as well as
through social problems that stem from the
dislocation of people, adverse psychological
effects, and other stresses.

9. Direct health effects of climate change
A number of slums and isolated towns located on
hills, as well as human settlements located in
flood-prone areas, are subject to periodic
natural disasters that adversely affect human
health.
These overcrowded and poorly-serviced semi-
urban settlements also provide a potential
breeding ground for disease hosts (e.g., rats,
mice, cockroaches, flies) and disease organisms,
increasing the population's vulnerability.

10. Direct health effects of climate change
Communities surrounded by these poverty
belts also become more vulnerable to
periodic disease outbreaks (WHO
Commission on Human Health and
Environment, 1992).

11. Direct health effects of climate change
Climate change also may intensify diseases
resulting from water contamination.
For example:
Increases in Salmonella infections following a
flood was observed in Bolivia.

12. Indirect health effects of climate
change
Some infectious diseases are more common in
tropical and subtropical areas than in temperate
or cold areas.
Therefore, global warming would tend to extend
their area of influence or increase the
importance of outbreaks.
Some of these diseases are food or water related
infections; after they are introduced into a
region, they show a tendency to spread over the
whole region.

13. Indirect health effects of climate
change
Viral, bacterial, and protozoan agents of
diarrhoea can survive in water-especially in
warmer waters-for long periods of time and thus
spread at increased rates in rainfall periods,
enhancing their transmissibility among people.
This disease and other diarrhoeas and
dysenteries are associated with the distribution
and quality of surface water, as well as with
flooding and water shortages.

14. Indirect health effects of climate
change
These conditions alter the population
dynamics of organisms, slow down personal
hygiene, and make worse local sewage
systems.
Increases in coastal algal blooming also may
amplify the increase and transmission of
Vibrio cholerae.
Algal blooming also may be associated with
bio-toxin contamination of fish and shellfish.

15. Indirect health effects of climate
change
With ocean warming, temperature-sensitive
toxins produced by phytoplankton could
cause contamination of seafood more often,
resulting in an increased frequency of
poisoning.
Thus, climate-induced changes in the
production of aquatic pathogens and bio-
toxins may put at risk seafood safety.

16. Indirect health effects of climate
change
• Some viruses have had unexpected outbreaks-such
as arenaviruses in Argentina and Bolivia (PAHO,
1996) and hantaviruses in the south of Argentina;
their relationship to climate change is not yet well
understood.
• Fungi such as Paracoccidiodes brasiliensis-which
require high humidity and generally are associated
with rainfall regimes of 500-2,000 mm/yr and
average temperatures of 14-30°C-are found in
some areas of South America (e.g., Brazil,
Venezuela, and northern Argentina) (Restrepo et al.,
1972), where this mycosis is becoming endemic.

17. Indirect health effects of climate
change
• It may spread if climate change provides
adequate conditions to start the epidemiological
chain.
• In this connection, increasing surface traffic that
has resulted from commercial activity stemming
from the new regional common market may call
for the development of appropriate sanitary
barriers (e.g., disinfection of vehicles and their
contents to block transport of harmful fungi) at
borders.

18. Indirect health effects of climate
change
A special category of infectious diseases-a
group known as vector-borne diseases
(VBDs)-could expand their geographic and
elevational ranges because conditions would
be more favorable for viruses and other living
agents, reservoirs, and vectors as a result of
global warming.

19. Indirect health effects of climate
change
The most important VBDs are listed below,
with indications of some of their main vectors:

20. Indirect health effects of climate
change
Malaria: Vectors are several species of the
mosquito genus Anopheles. Malaria's
incidence is affected by temperature, surface
water, and humidity.
Dengue: Vectors are Aedes and other
mosquito species. High temperatures,
particularly in winter, promote the spread of
this disease.

21. Indirect health effects of climate
change
Yellow fever: Several species are vectors.
Yellow fever has an urban epidemiology
similar to dengue, but it also has cycles that
develop in the wild.

22. Indirect health effects of climate
change
Other viruses also affect human beings in this
region. One produces Venezuelan equine
encephalitis; it is transmitted by several
mosquito species, and cases have been reported
in Colombia and Venezuela (WHO, 1996).
Its relation to climate change has not yet been
demonstrated; however, warming could affect
the geographical distribution and dispersion, as
well as some behaviors and patterns, of
vertebrate reservoirs (mammals and birds) and
vectors.

23. Indirect health effects of climate
change
• Infective agents and vectors are sensitive to
environmental changes, especially those
conditioned by temperatures and humidity.
• Vectors also are sensitive to wind, soil
moisture, surface water, and changes in
vegetation and forest distribution (Bradley,
1993).

24. Indirect health effects of climate
change
• Temperatures and humidity influence the geographical
and elevational dispersion of vectors (Burgos et al.,
1994; Curto de Casas et al., 1994), as well as their
population dynamics and behavior.
• Precipitation is an important factor for vectors with
aquatic stages, such as mosquitoes and black flies,
because breeding places are increased and maintained
by rainfall.
• Winds may contribute to the dispersion of some flying
insects, such as mosquitoes, black flies, and sand flies
(Ando et al., 1996).