climate change in the great lakes region: key vulnerabilities to public health jonathan patz, md,...
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Climate changeClimate change in the in the Great Lakes Region: Great Lakes Region: Key Vulnerabilities to Key Vulnerabilities to
Public HealthPublic Health
Jonathan Patz, MD, MPHJonathan Patz, MD, MPH Nelson Institute & Dept. Population Health Sciences Nelson Institute & Dept. Population Health Sciences
University of Wisconsin - MadisonUniversity of Wisconsin - Madison
Climate Change Webinar Series Climate Change Webinar Series
Ohio State UniversityOhio State University
Sept. 28, 2010Sept. 28, 2010
CLIMATE
CHANGE
Temperature Rise 1
Sea level Rise 2
Hydrologic Extremes
Urban Heat Island Effect
Air Pollution & Aeroallergens
Vector-borne Diseases
Water-borne Diseases
Water resources & food supply
Mental Health &
Environmental Refugees
Heat StressCardiorespiratory failure
Respiratory diseases, e.g., COPD & Asthma
MalariaDengueEncephalitisHantavirusRift Valley Fever
CholeraCyclosporaCryptosporidiosisCampylobacterLeptospirosis
MalnutritionDiarrheaToxic Red Tides
Forced MigrationOvercrowdingInfectious diseasesHuman Conflicts
1 3°C by yr. 21002 40 cm “ “IPCC estimates
Patz, 1998
HEALTH EFFECTS OF CLIMATE CHANGE
Probabilities of future extremes can be Probabilities of future extremes can be estimated given projections of mean temperatureestimated given projections of mean temperature
Peterson et al., 2007
2057
2007
Heatwave morbidity -Milwaukee
Li, et al. , unpublished (EPA STAR grantEPA STAR grant, J. Patz, PI)
•By 2050, warming alone By 2050, warming alone maymay increase by 68% the increase by 68% the number of Red Ozone Alert number of Red Ozone Alert daysdays across the Eastern US. across the Eastern US. (IPCC, 2007 -Bell et al, (IPCC, 2007 -Bell et al, 2006)2006)
• ““The severity and The severity and duration of summertime duration of summertime regional air pollution regional air pollution episodes are projected to episodes are projected to increase in the Northeast increase in the Northeast and Midwest US by 2045-and Midwest US by 2045-2052 due to2052 due to climate-climate-change-induced decreases change-induced decreases in the frequency of surface in the frequency of surface cyclonescyclones.” .” (IPCC, 2007(IPCC, 2007))
Days per summer (June, July, August) with O3 above the NAAQS limit of 84 ppb. Colored, solid lines reflect the 10-year running mean of exceedances for each model (mean across SDSM ensembles, and across the study sites). Colored dotted lines reflect year-to-year exeedance values (mean across SDSM ensembles, and across the study sites).
Holloway et al. 2009
USA: Combined sewer overflows (CSOs)
Courtesy: Kellogg Schwab
1.2 trillion gal of sewage & stormwater a year discharged during combined sewer overflows
– would keep Niagara Falls roaring for 18 days
Center for Water & Health, JHU Bloomberg School of Public Health
Combined Sewer Systems & Past Combined Sewer Systems & Past Precipitation Trends Precipitation Trends
Source: National Climatic Data Center/NESDIS/NOAA
Past Precipitation Trends
Source: EPA
CSS Communities
770 systems serve around 40 million people
Source: EPA (Courtesy– J. Scheraga)
Sewage overflows in the Great LakesSewage overflows in the Great Lakes
• Intense storm events result in combined sewer Intense storm events result in combined sewer overflows (CSO’s) overflows (CSO’s)
• Great Lakes provides drinking water to 40M people Great Lakes provides drinking water to 40M people and has >500 beachesand has >500 beaches
• Sewage contains human pathogens including viruses, Sewage contains human pathogens including viruses, protozoan, and pathogenic bacteriaprotozoan, and pathogenic bacteria
• The EPA has estimated 140 communities release The EPA has estimated 140 communities release 150 150 billionbillion liters of combined sewage each year liters of combined sewage each year
Bradford Beach
South Shore Beach
Bradford and South Shore Beach on Lake Michigan
E. coli CFU/100 ml
235-999
0-100
100-235
1000-9999
10,000-20,000
RainfallRainfallUrban stormwaterUrban stormwaterSewage overflowSewage overflow
Courtesy: Sandra McLellan
UW-Milwaukee
Reported waterborne diseases, US, from 1948-1994
• 67%67% of waterborne disease outbreaks were preceded by precipitation above the 80th percentile (across a 50 yr. climate record), p < 0.001
• 51%51% of outbreaks were preceded by precipitation above the 90th percentile, p < 0.002
• Surface water-related outbreaks had strongest correlation with extreme precipitation in the month of outbreak; groundwater-related outbreaks lagged 2 months following extreme precipitation.
Curriero, Patz, et al, 2001.
U.S. CCSP, 2008 Globally AveragedGlobally Averaged
Projected Change in the Frequency of 2" Precipitation Events (days/decade) from 1980 to 2055 based on
downscaled climate models (http://www.wicci.wisc.edu)
Courtesy: Steve Vavrus (UW-Madison
Courtesy: Steve Vavrus (UW-Madison)
The Good News about climate change and our health
The opportunity for improving health determinants
We can reduce:
The 1,000,000 annual deaths from urban air pollution
The loss of 1.9 million deaths, and 19 million years of healthy life, from physical inactivity
WHO, 2007
Ten Leading Causes of US Deaths per Year (CDC, 2004)
Friedman et al. JAMA 2001;285:897
Asthma and Air Pollution
• Asthma-related emergency room visits by children decreased 42%decreased 42%
• Children’s emergency visits for non-asthma causes did not change during same period
• Natural experiment during 1996 Summer Olympic games in Atlanta
• Peak morning traffictraffic decreased 23% and peak ozoneozone levels decreased 28%
Comparative Scenario
The Natl. Personal Transportation Survey reports median trip length in urban and suburban areas of the region to be 4-8 km, representing ~20% of VMT for the region. Our alternative scenario thus assumes that all round trips of 8 km or less could be accomplished through alternative modes of (non ICE) transportation.
Grabow et al (in review)
20% fewer car trips:Change in O3 & PM 2.5
Grabow et al (in review)
• hundreds of lives savedhundreds of lives saved
• Thousands of Hospital admissions avoidedThousands of Hospital admissions avoided
• Billions reduction in health care costs Billions reduction in health care costs
Value of co-benefits is large
22
Fig 1 and fig 2
Compare to cost of climate policy: almost always <$30/tCO2
Nemet G F, Holloway T and Meier P 2010 “Implications of incorporating air-quality co-benefits into climate change policymaking” Environmental Research Letters 014007
$2 – 196 /tCO2 with a mean of $49/tCO2
Nemet et al. 2010
Decision Support
• In adapting to climate change, we need to include health co-benefits stemming from mitigation policies; thus far, one-sided discussions of costs
Thank you!Thank you!
www. sage.wisc.eduwww. sage.wisc.edu
Educational website:www.ecohealth101.org