International Conference on Sustainable Agriculture and Environment | 27 - 29 June 2013 | Solo, Indonesia.

1. Is Human Health Depends on The Health
of Global Climate?
Perspective on Temperature-related Death
and Communicable Disease

2. Tenri A.Wanahari1, A. Kusumawati2, B. Murthi3, P.
Dirgahayu4, B.A., Mappakaya1
1Faculty of Medicine, Universitas Sebelas Maret
2Center of Biotechnology Study, Universitas Gadjah Mada
3Depatment of Public Health, Universitas Sebelas Maret

3. Conclusion
Climate Change and Health:
Mitigation and Adaptation
The Impact of Climate
Change on Human Health
Climate Change:
Why is It happened?
Climate Change:
The Evidence?

4. Climate Change: The Evidence?

5. What is Climate Change?

6. What is Climate Change?
“Any significant change in measures of climate, such
as temperature, rain fall, wind, and other weather
patterns, lasting for decades or longer”
Intergovernmental Panel of Climate Change (IPCC) 2007

7. Is Global Climate Changing?

8. How do we know?

9. Temperature Change Data
1880-1884
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

10. 1880-18841886-1890
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

11. 1896-1900
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

12. 1906-1910
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

13. 1916-1920
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

14. 1926-1930
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

15. 1936-1940
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

16. 1946-1950
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

17. 1956-1960
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

18. 1966-1970
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

19. 1976-1980
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

20. 1986-1990
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

21. 1996-2000
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

22. 2003-2007
Source: http://svs.gsfc.nasa.gov/vis/a000000/a003400/a003490/index.html

23. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

24. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

25. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

26. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

27. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

28. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

29. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

30. More Evidence?

31. Portage Glacier
1914 2004
• Alaska
Photos: NOAA Photo Collection and Gary Braasch – WorldViewOfGlobalWarming.org

32. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

33. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

34. (Source: The State of the Climate Highlights: National Oceanic and Atmospheric Administration (NOAA), 2009.)

35. Global climate is Changing
Summary:

36. Conclusion
Climate Change and Health:
Adaptation and Mitigation
The Impact of Climate
Change on Health
Climate Change:
Why is It Happened?
Climate Change:
The Evidence?

37. Climate Change: Why is It Happened?

38. Why: Causes of Change

40. How does Green House Effect Works?

41. How does The Greenhouse Effect Works?
Fossil fuels (coal, oil, natural gas)
Carbon Dioxide (CO2)

42. What are The Evidence?

43. What are The Evidence?
The PRIMARY DATA

44. CO2
ppm
Temp
oC
1000 1100 1200 1300 1400 1500 1600 1700 1800 1900 2000
390
370
350
330
310
290
270
250
14.5
14.3
14.1
13.9
13.7
13.5
Correlation between atmospheric carbon dioxide concentration and Earth’s
average surface temperature
Year
CO2
concentration
Earth’s Temperature
Graph from: Hanno, 2009

45. Atmospheric concentrations of important long-lived greenhouse gases over the last 2,000 years. Increases since about
1750 are attributed to human activities in the industrial era. Concentration units are parts per million (ppm) or parts per
billion (ppb), indicating the number of molecules of the greenhouse gas per million or billion air molecules, respectively,
in an atmospheric sample.
(Source: IPCC Fourth Assessment Report: Climate Change 2007)

46. Where does The Green House Gases
Come from?

47. Human-Produced Greenhouse Gas Levels
Global Emissions of Anthropogenic Greenhouse Gases
From 1970 to 2004
(Source: IPCC. Climate Change 2007: Synthesis Report, Summary for Policymakers, Figure SPM3, p.5.)

48. Antrophogenic = from Human*
*According to IPCC (Intergovermental Panel of Climate Change) Summary in 2007

49. Climate changing is human caused, due to due to increases
in greenhouse gases from burning fossil fuel.
Summary:

50. Conclusion
Climate Change and Health:
Adaptation and Mitigation
The Impact of Climate
Change on Health
Climate Change:
Why is It happened?
Climate Change:
The Evidence?

51. How Climate Change affects Health?

52. WEATHER
CHANGES:
- Extreme
weather (heat
wave)
- temperature
- Rain
precipitation
CLIMATE
CHANGE
How Climate Change affects Health?

53. WEATHER
CHANGES:
- Extreme
weather (heat
wave)
- temperature
- Rain
precipitation
- Increase
Temperature
- Increase
Infectious
Disease
Transmission
CLIMATE
CHANGE
How Climate Change affects Health?

54. HEALTH EFFECTS
Heat-related
illness, death
Flood, storm-
related health
Mals
Air pollution effects
Water- and food
borne diseases
Vector-borne
disease
CLIMATE
CHANGE
How Climate Change affects Health?
WEATHER
CHANGES:
- Extreme
weather (heat
wave)
- temperature
- Rain
precipitation
- Increase
Temperature
- Increase
Infectious
Disease
Transmission

55. HEALTH EFFECTS
Heat-related
disease/death
Flood, storm-
related health
Mals
Air pollution effects
Water- and food
borne diseases
Vector-borne
disease
CLIMATE
CHANGE
How Climate Change affects Health?
Malaria and Dengue
WEATHER
CHANGES:
- Extreme
weather (heat
wave)
- temperature
- Rain
precipitation
- Increase
Temperature
- Increase
Infectious
Disease
Transmission

56. What kind of Research
to Asses The Impact of
Climate Change on Health?

57. past Future
2020s, 2050+
NOW
Learning
From The Past Disaster
Detection
of Health Impact
Predictive
Modelling
Research Strategy
Research using Statistics Tools

58. Case Studies

59. Case Studies: Temperature related-Death

60. What Kind of Variable do We need
for doing this Research?

61. Case Study: Temperature related-Death
Source: World Health Organization, Climate Change and Health

63. Heatwave:
August 2003
34,000 extra
deaths over a
two-week period
http://earthobservatory.nasa.gov

65. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June

66. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June
July

67. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June
July
August

68. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June
July
August
September

69. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June
July
August
September
Temperature

70. Mortality in Paris during 2003 Heat Wave
Source: Institute de Vieille Sanitaire, France
June
July
August
September
Temperature
Number of Death

71. Can we Predict the Future Temperature?

72. Seeing The Future: Projection
20
15
1900 21002000
14
16
17
18
13
19
Temperature (OC)
Year
2.5oC
Best
estimate
Low
High
IPCC estimates
(2007): increasing
1 to 4.5oC
1.2oC
2050

73. Climate Change: Temperature
Distribution Shift to More Heat
IPCC, 2007b

74. Are there more studies reported?

75. Urban area Health
outcome
measure
Model Climate
scenario
Non-climate
assumptions
Results ref
UK Heat- and
cold-
related
mortality
and
hospital
admissions
.
Empirical-
statistical
model,
derived
from
observed
mortality.
UKCIP
scenarios
2020s,
2050s,
2080s
No population
growth. No
acclimatization
assumed.
Medium-high climate
change scenario would
result in an estimated
2800 heat deaths per
year in the UK in the
2050s (250%
increase). Greater
reductions in cold-
related mortality.
Keatinge et al.
(Department
of Health,
2002)
Lisbon,
Portugal
Heat-
related
death
Empirical-
statistical
model,
derived
from
observed
summer
mortality.
2xCO2
emissions
RCMs:
PROMES
and
HadRM2
SRES population
scenarios.
Assumes some
acclimatization.
Increases in heat
related mortality, by
2020s, to range 5.8-
15.1 deaths per
100,000, from baseline
5.4-6 deaths per
100,000
(Dessai, 2003)
Six cities in
Australia
[Adelaide,
Brisbane,
Hobart,
Melbourne,
Perth,
Sydney]
Two cities in
New Zealand
[Auckland,
Christchurch]
Heat- and
cold-
related
mortality
in over 65s
Empirical-
statistical
model,
derived
from
observed
monthly
mortality.
High,
medium
and low
emissions.
CSIROMk2,
ECHAM4
Population
growth, and
population
ageing.
No
acclimatization.
Increases in heat-
related mortality in
over 65s, increases
large in temperature
cities. Less reductions
in cold related
mortality.
(McMichael et
al., 2003)

76. Climate Change increase the risk of Death
Heat-related Death incidence tend
to Increase in the future
Summary:

77. Case Study: Vector-borne Disease

78. Vector-borne Disease
Susceptible
population
• Migration (forced)
•Vector environment
Vector
•Survival, lifespan
•Reproduction/breeding patterns
•Biting behavior
Pathogen
•Survival
•Transmission
•Replication in host

79. What Kind of Variable do We need
for doing this Research?

80. Case Study: Vector-borne Disease
Source: World Health Organization, Climate Change and Health

81. Case Study: Dengue

82. (World Health Organization, 2012)
Equator Line

83. DENGUE FEVER: Estimated geographic region suitable
for A. aegypti vector, an also transmission:

84. DENGUE FEVER: Estimated geographic region suitable
for A. aegypti vector, an also transmission:
Climate conditions now and in alternative scenarios for 2050

85. NCEPH/CSIRO/BoM/UnivOtago, 2003
DENGUE FEVER: Estimated geographic region suitable
for A. aegypti vector, an also transmission:
Climate conditions now and in alternative scenarios for 2050
Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome
.
.
Brisbane
.
.
.
.
.
.
.
Current risk region, for
dengue transmission
Global statistical model (Hales), applied to
Australia: mosquito survival in relation to
water vapour pressure (rainfall, humidity).

86. NCEPH/CSIRO/BoM/UnivOtago, 2003
DENGUE FEVER: Estimated geographic region suitable
for A. aegypti vector, an also transmission:
Climate conditions now and in alternative scenarios for 2050
2050 risk region:Medium GHG
emissions scenario
Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome
.
.
.
.
.
.
.
.Carnarvon.
Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome
.
.
Brisbane
.
.
.
.
.
.
.
Current risk region, for
dengue transmission
Brisbane
Global statistical model (Hales), applied to
Australia: mosquito survival in relation to
water vapour pressure (rainfall, humidity).

87. NCEPH/CSIRO/BoM/UnivOtago, 2003
DENGUE FEVER: Estimated geographic region suitable
for A. aegypti vector, an also transmission:
Climate conditions now and in alternative scenarios for 2050
2050 risk region:Medium GHG
emissions scenario
Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome
.
.
.
.
.
.
.
.Carnarvon.
Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome
.
.
Brisbane
.
.
.
.
.
.
.
Current risk region, for
dengue transmission Darwin
Katherine
Cairns
Mackay
Rockhampton
Townsville
Port Hedland
Broome.
.
.
.
.
.
.
.Carnarvon. 2050 risk region: High GHG
emissions scenario
Brisbane
Brisbane
Global statistical model (Hales), applied to
Australia: mosquito survival in relation to
water vapour pressure (rainfall, humidity).

88. Case Study: Malaria

89. (World Health Organization, 2012)
Equator Line

90. (Ex)trinsic
Incubation
Period
(In)trinsic
Incubation
Period

91. (Ex)trinsic
Incubation
Period

92. “extrinsic incubation period” shortens at higher
temps, so mosquitoes are infectious sooner.
Relationship between Temperatute and Malaria Parasite Development
In Mosquito

93. TRANSMISSION POTENTIAL
0
0.2
0.4
0.6
0.8
1
14 17 20 23 26 29 32 35 38 41
Temperature (°C)
Plasmodium
Incubation time
0
10
20
30
40
50
15 20 25 30 35 40
(days)
Biting frequency
0
0.1
0.2
0.3
10 15 20 25 30 35 40
Temp (°C)(perday)
Survival probability
0
0.2
0.4
0.6
0.8
1
10 15 20 25 30 35 40
(perday)
Temp (°C) Temp (°C)
Malaria Transmissibility: Temperature and Biology
P.vivax
P.falciparum
Based on Martens
WJM, 1998
---------------- Mosquito ------------------

94. TRANSMISSION POTENTIAL
0
0.2
0.4
0.6
0.8
1
14 17 20 23 26 29 32 35 38 41
Temperature (°C)
Plasmodium
Incubation time
0
10
20
30
40
50
15 20 25 30 35 40
(days)
Biting frequency
0
0.1
0.2
0.3
10 15 20 25 30 35 40
Temp (°C)(perday)
Survival probability
0
0.2
0.4
0.6
0.8
1
10 15 20 25 30 35 40
(perday)
Temp (°C) Temp (°C)
Malaria Transmissibility: Temperature and Biology
P.vivax
P.falciparum
Based on Martens
WJM, 1998
---------------- Mosquito ------------------

95. TRANSMISSION POTENTIAL
0
0.2
0.4
0.6
0.8
1
14 17 20 23 26 29 32 35 38 41
Temperature (°C)
Plasmodium
Incubation time
0
10
20
30
40
50
15 20 25 30 35 40
(days)
Biting frequency
0
0.1
0.2
0.3
10 15 20 25 30 35 40
Temp (°C)(perday)
Survival probability
0
0.2
0.4
0.6
0.8
1
10 15 20 25 30 35 40
(perday)
Temp (°C) Temp (°C)
Malaria Transmissibility: Temperature and Biology
P.vivax
P.falciparum
Based on Martens
WJM, 1998
---------------- Mosquito ------------------

96. TRANSMISSION POTENTIAL
0
0.2
0.4
0.6
0.8
1
14 17 20 23 26 29 32 35 38 41
Temperature (°C)
Plasmodium
Incubation time
0
10
20
30
40
50
15 20 25 30 35 40
(days)
Biting frequency
0
0.1
0.2
0.3
10 15 20 25 30 35 40
Temp (°C)(perday)
Survival probability
0
0.2
0.4
0.6
0.8
1
10 15 20 25 30 35 40
(perday)
Temp (°C) Temp (°C)
Malaria Transmissibility: Temperature and Biology
P.vivax
P.falciparum
Based on Martens
WJM, 1998
---------------- Mosquito ------------------

97. Baseline 2000 2025 2050
Ebi et al., 2005
Climate Change and Malaria
Potential transmission in Zimbabwe
Bulawayo
Climate suitability:
red = high; blue/green = low
High probability
Medium probability
Low probability
Harare
Highlands

98. Ebi et al., 2005
Bulawayo
Harare
Baseline 2000 2025 2050
Climate Change and Malaria
Potential transmission in Zimbabwe
Climate suitability:
red = high; blue/green = low

99. Ebi et al., 2005
Bulawayo
Harare
Baseline 2000 2025 2050
Climate Change and Malaria
Potential transmission in Zimbabwe
Climate suitability:
red = high; blue/green = low

100. Malaria in India
Bhattacharya et al. 2006
2050’s1980 to 2000

101. Vector-borne Disease (Malaria and Dengue):
Tend to increase in range of transmission and incidence
in the Future, depend on regional weather change
Summary:

102. Conclusion
Climate Change and Health:
Adaptation and Mitigation
The Impact of Climate
Change on Health
Climate Change:
Why is It happened?
Climate Change:
The Evidence?

103. Climate Change and Health:
Mitigation and Adaptation

104. What we can do Facing
The Climate Change?

105. Mitigation and Adaptation
Managing The Cause:
Green House Gas
Managing the
Impact: The Health

106. Climate Change and Health
Mitigation and Adaptation (The Concept)
Based on: McMichael et al., Brit med J, 2008
Climate - changes

107. Climate Change and Health
Mitigation and Adaptation (The Concept)
Human society:
• Population size
• Economic activity
• Culture, governance
Human pressure
on environment
Based on: McMichael et al., Brit med J, 2008
Adaptation: Reduce
health impacts/risks
Human impacts:
•Health
Unintended
health effects
Mitigation of Climate
Change: Reduce
GHG emissions
Climate - changes
Risks to
humans better
understood
Natural
environmental
processes
Need for local
prevention
Causes Impact

108. Disaster
Preparedness
Public Education
& Risk Communication
Enhanced Early
Warning System
& Monitoring
Strategies for Adaptation (The Concept)
World Health Organization, 2012

109. Mitigation & Adaptation
• Mitigation: Need policies to reduce greenhouse gas
emissions
• Adaptation: We need to educate the public
(the health risk), Improve early warning system
& monitoring, and making strategy for disaster
preparedness

110. Reducing Health Impacts
of Climate Change
Disease burden
now 2050 2100
Baseline burden

111. Reducing Health Impacts
of Climate Change
Disease burden
Mitigation begins
emissions reduction (etc.)
now 2050 2100
Baseline burden
Health impact
change by mitigation

112. For mitigation, we need more policy to reduce green house gases emission
For adaptation, we need to educate the public (the health risk),
Improve early warning system & monitoring,
and making strategy for disaster preparedness
Summary:
Earlier we do the prevention, better the outcome

113. Conclusion
Climate Change and Health:
Adaptation and Mitigation
The Impact of Climate
Change on Health
Climate Change:
Why is It happened?
Climate Change:
The Evidence?

114. Conclusion

115. Global climate is Changing,
poses significant public health threats
Climate changing is human caused, due to due to increases
in greenhouse gases from burning fossil fuel.
Heat related-death incidence
tend to increase in the future
Vector-borne Disease (Malaria and Dengue):
Tend to increase in range of transmission and incidence
For mitigation, we need more policy to reduce green house gases emission
For adaptation, we need to educate the public (the health risk),
Improve early warning system & monitoring,
and making strategy for disaster preparedness
Summary:
Earlier we do the prevention, better the outcome

117. Thank You