global climate change and health - consortium of …...global climate change could be disastrous for...
TRANSCRIPT
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Global Climate Change and Health
Rosemary Marotta, LLB, LLM, MPA
Lex Chambers & the Al Gore Climate Project Ambassador;
and
Kevin Chan, MD, MPH, FRCPC, FAAP
Assistant Professor, Faculty of Medicine,
and Fellow, Munk Centre for International Studies,
University of Toronto
October 2008
Prepared as part of an education project of the
Global Health Education Consortium
and collaborating partners
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Earth from Space
Page 2 http://images.google.ca/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/6/60/Earth_from_Space.jpg&imgrefurl=http://commons.wikime
dia.org/wiki/Image:Earth_from_Space.jpg&h=4096&w=4096&sz=1887&hl=en&start=6&um=1&usg=__lxiCVPCm0ht5jxLaZItLfQrDisk=&tbnid=eKbgpb1
YI_wHpM:&tbnh=150&tbnw=150&prev=/images%3Fq%3DEarth%2BSpace%26um%3D1%26hl%3Den%26sa%3DN
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Quote “Whoever wishes to investigate medicine
properly, should proceed thus: in the first place to
consider the seasons of the year, and what
effects each of them produces for they are not at
all alike, but differ much from themselves in
regard to their changes. Then the winds, the hot
and the cold, especially such as are common to
all countries, and then such as are peculiar to
each locality. In the same manner, when one
comes into a city to which he is a stranger, he
ought to consider its situation, how it lies as to
the winds, and the rising of the sun; for its
influence is not the same whether it lies to the
north or the south, to the rising or the setting
sun.”
Hippocrates (Airs, waters and places)
Page 3 Source: http://tbhconcepts.com/images/hippocrates.jpg
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Learning Objectives
• Explain how global warming occurs and highlight the
evidence of global climate change
• List major impacts of global climate change
• Outline potential infectious disease problems associated
with global climate change
• Highlight potential weather impacts and the implications
• Highlight possible solutions to climate change
Page 4
In this module, we will look at the relationship between Global Climate Change and
Health. For a more extensive review, please read either the Stern Report or visit the
Intergovernmental Panel on Climate Change website (www.ipcc.ch)
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Case Study
• You are the planning minister of an island country
off the east coast of Africa. You’ve heard that
global climate change could be disastrous for the
country. You are wondering if that’s true … so
you ask for the evidence, and wonder what
impacts this could have for your country.
Page 5
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How does Global Warming Occur?
Page 6
Source:
http://www.grida.no/climate/
vital/03.htm
Greenhouse gases are
essential for the
absorption and retention of
heat from the sun. The
issue with the greenhouse
gas build up is that the
retention of heat is
increasing slowly.
The difficulty with
greenhouse gases is that
this build-up cannot be
reversed quickly or easily.
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How does Global Warming Occur?
Global Climate Change
– Caused by increase in greenhouse gases
• Carbon Dioxide
• Nitrous Oxide
• Methane
• Halocarbons (including CFCs)
– Greenhouse gases absorb earth’s infrared
radiation, solar heat and limit radiant heat
loss
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Why is Global Warming Occurring?
• Burning fossil fuels every year: primarily power plants and
transportation
– 1.2 cubic miles of oil
– 3.5 billion metric tons of coal
– 100 trillion cub feet of natural gas
– 30 billion tons of carbon dioxide
• Decline in carbon intensity reduction and natural sinks
– Forest fires: 22 million acres destroyed each year
• 20% of worldwide carbon dioxide emissions
Page 8
This greenhouse gas build-up continues to occur with increasing burning of fossil fuel, and the
elimination of key carbon dioxide sinks, such as forests and rainforests around the world.
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The Intergovernmental Panel on Climate Change (IPCC)
• Scientific intergovernmental body set up in 1988 by:
– World Meteorological Association
– United Nations Environmental Program
• Does not carry out research or monitor climate data
• 2000 Scientists from 100 countries
– 3 working groups: science; socioeconomic impacts
and adaptation; and mitigation
• Concludes: “HUMANS ARE PLAYING A MAJOR
ROLE IN CLIMATE CHANGE” (IPCC 2004)
Page 9
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Carbon Dioxide Trends
Page 10
CO2 levels are
currently 384 parts
per million
(historical average:
280 ppm)
Methane levels are
1750 parts per
billion (historical
average: 300-700
ppb)
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The Evidence of Global Warming
• 1906-2005: ↑ by 0.56°C
• Next decade: ↑ by 0.28°C
• Top 10 hottest years in the
past 11 years over recorded
temperatures
• Rising sea levels, by about 10
cm over the past century
• Declining snow cover and
glaciers
Source: http://www.ipcc.ch/graphics/graphics/syr/fig1-1.jpg
Page 11
Furthermore, there is evidence of a change in
the ocean currents and also wind patterns
around the world.
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Current Burden of Climate Change
2000: Loss of 150,000 lives and 5,500,000 DALY*
50% caused by malnutrition
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0-2
2-4
4-70
70-120
No Data
Mortality per million
people
Climate change has differential effects. It tends to affect tropical and poor countries more than temperature and wealthy
countries. These impacts and differentials will likely increase as global warming worsens.
Sources: McMichael AJ, Campbell-Lendrum, Kovats S, et al. Global climate change. In Ezzati M, Lopez A, Rodgers A, et al.
(editors). Comparative quantification of health risks: global and regional burden of disease due to selected major risk factors.
Geneva: WHO, 2004. pp. 1543-1649. --- Patz JA, Campbell-Lendrum D, Holloway T, Foley JA. “Impact of regional climate
change on human health.” Nature. 2005; 438: 310-317. *DALY = Disability Adjusted Life Years
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Current Trends
• ↑ temperature by 1.8-4.0 °C by 2100
• ↑CO2 to 500 ppm by 2050. By 2100, the range is 486-1248 ppm.
• 14.9 billion metric tons of carbon emissions in the US, EU, China and India in 2005 will increase to 25.6 billion metric tons in 2030
• Sea levels should rise by 7 to 23 inches and could rise by 20 feet if Greenland, Arctic and western Antarctic sea ice disappears
Page 13 See supplementary note on next slide
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Page 14
Supplementary note
One of the most frightening aspects is that the models done in 2000 for IPCC and
the worse case scenarios for CO2 are being exceeded by the most recent current
data on CO2 emissions. It implies that global climate change is accelerating over
our current worse-case models.
Source: IPCC: summary for policymakers. In: Climate change 2007: the
physical science basis. Contribution of Working Group I to the Fourth
Assessment Report of the Intergovernmental Panel on Climate Change.
Solomon S, Qin D, Manning M, et al, editors. Cambridge: Cambridge University
Press, 2007.
http://images.google.ca/imgres?imgurl=http://www.photosfan.com/images/polar-
bears-on-an-ice-b-erg1.jpg&imgrefurl=http://www.photosfan.com/polar-
bear/2/&h=350&w=500&sz=110&hl=en&start=9&usg=__sdo509Y-p9kYEZy-
siLmis_h5GA=&tbnid=P0ioYRnNI4msbM:&tbnh=91&tbnw=130&prev=/images%3
Fq%3DPolar%2BBear%2BIce%26gbv%3D2%26hl%3Den%26sa%3DG
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Decrease in Arctic Ice
Page 15
There has been a significant decrease in
the arctic ice, especially over the past
decade.
If both the Greenland ice and the western
shelf of the Antarctic disappear, sea levels
would increase by 20 feet, flooding New
York, San Francisco Bay, the Florida Keys,
the Netherlands, Calcutta and Beijing.
There is increasing evidence that there is a loss of arctic ice.
In fact, and increase of 1-2ºF at the equator would be
equivalent to an increase of 12ºF at the poles.
A similar effect could occur in the Antarctic. The potential for
damage and effects on over 200 million people include
putting under water: the Netherlands, New York City, the
Florida Keys, and much of San Francisco’s Bay Area.
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Economic Impact
The risk of climate change would be “equivalent to
losing at least 5% of global GDP each year ... [and that
if] a wider range of risks and impacts is taken into
account, the damage could rise to 20% of GDP each
year.”
-- UK Stern Review (2007)
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What Impacts Will Global Climate Change Have?
• Increase Infectious Disease
• Extreme Weather Events
• Decrease in Fresh Water Supplies and Food;
Desertification
• Increase in Air Pollution
• Decrease Biodiversity
• Impacts on the Economy
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Summary Slide of Climate Change
Page 18
Source: McMichael AJ,
Woodruff RE, Hales S,
“Climate change and
human health: present and
future risks.” Lancet.
2006; 367: 859-869.
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Increase in Infectious Diseases
• Increase in malaria
– Increased rate of reproduction, prolonged breeding
season, and shortened maturation period
– Mosquito migration to higher grounds
• Dengue fever
• Tick-borne disease, including Lyme disease
• Leishmaniasis and trypanosomiasis
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A number of infectious diseases may rise with increase in temperatures. Many insects
have no homeostatic mechanisms, meaning that they do not self-regulate temperature.
Instead, the numbers of insects tend to increase with global warming temperatures . This
will likely lead to an increase in infectious disease.
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Increase in Infectious Disease (con’t)
• Hantavirus and West Nile virus
• With increased flooding: increased
cryptosporidium, norovirus and toxins
• Plague in South America
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Malaria
• Caused by Plasmodium falciparum, vivax,
ovale and malariae
• Carried by Anopheles mosquitoes
• Between 0.7-2.7 million people affected
• Best temperature: 33-39°C
• Minimum temperature: 15-18°C
• Malaria epidemics increase following an
El-Nino event in the South Pacific
• Estimated risk of malaria 16-28% higher
in 2100
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Source: http://static.howstuffworks.com/gif/mosquito6a.jpg
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Dengue Fever
• Caused by Dengue virus
• Carried by Aedes mosquitoes
• 2.5 billion people at risk
• Increased significantly in tropical
developing regions
– Weakened control programs
– Rapid urbanization
– High population densities
– Increased travel
Page 22
Biological models have been made to explore the influence of projected temperature change on the incidence of dengue
fever. The cycle of dengue ranges from 10-40 years, but the current global pandemic has intensified in the past two
decades. This corresponds with an increasing distribution of Aedes aegypti. The current global distribution of dengue fever
risk is 2.5 billion people, which is on par with malaria
Source: http://www.radiobaragua.cu/Palma%20Soriano/noticias/imagen-noticias/aedes-aegypti-2.jpg
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Extreme Weather Events
• Flooding and fire risk
• Increase intensity of cyclones and hurricanes
– Katrina (2005)
– Mozambique, 3 cyclones (2000) in 6 weeks
• Increased malaria: 5-fold
• Heat waves
– Europe (summer 2003): Killed 21,000 - 45,000 additional
people from heat exhaustion/stroke
• Increased tectonic and volcanic activity
• Environmental Refugees
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Katrina (2005)
• This shows Hurricane
Katrina coming to the
Gulf Shore. The
orange/red color shows
the warmth of the Gulf of
Mexico.
Page 24
Source: Epstein PR. “Climate Change and Human Health.” New England Journal of
Medicine. 2005; 353 (14): 1433-1436. Also: Reprinted by permission from Massachusetts
Medical Society. New England Journal of Medicine. Epstein PR. "Climate Change and
Human Health." 353 (14), 1433-1436, 2005
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Decrease in Water Supplies - Food; Desertification
• By 2025: 5 billion persons under severe water stress
• Climate change leads to 1-7% decreases in cereal production
– Developing countries: 9-11% decrease in cereal production
– Developed countries: small increases in cereal production
– 500 million presently at risk from hunger; climate change would
increase the risk by 20 million by 2050, and 80 million by 2080
(this factors in to account the impact of economic and social
development).
• Mitigating climate change, decreases the risk from hunger
Page 25
One of the major concerns of climate change is that in some parts, there could be an increase in famine from significant
droughts. The changing microclimates will lead to some areas getting more food and others less, leading to higher regional
inequality. There may be an associated breakdown in sanitation leading to higher diarrheal disease.
Source: Parry M, Rosenzweig C, Livermore M. “Climate change, global food supply and risk of hunger.” Philosophical
Transaction of the Royal Society of Britain. 2005; 360: 2125-2138.
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Increase in Air Pollution
• Increased Smog and Ozone
– Ozone: Reduces lung function, increases coughing,
aggravates asthma, and worsens symptoms of
emphysema and bronchitis. Increases UV-damage.
• Increase in asthma in US: quadrupled in past 2 decades
• Dust clouds in the Caribbean come from dust clouds in
Africa that cross the ocean via the trade winds
• Increasing levels of plant pollen and soil fungi
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Climate change may also increase ozone levels, leading to a worsening of respiratory problems. Carbon dioxide also leads to
increase in plant pollen, especially ragweed. As well, increased flooding will increase mold and soil fungi.
Sources: EPA. Ozone and Your Health. United States Environmental Protection Agency. Washington DC, USA. EPA-
152/F99-003, 1999. -- Epstein PR. “Climate Change and Human Health.” New England Journal of Medicine. 2005; 353
(14): 1433-1436. -- Watson RT, Patz J, Gubler DJ, Parson EA, Vincent JH. “Environmental health implications of global
climate change.” Journal of Environmental Monitoring. 2005; 7: 834-843.
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Increase in Air Pollution (con’t)
• Ragweed, with double the
ambient carbon dioxide, grow
10% taller, but have 60% more
pollen
• Diesel particles deliver
allergens deeper into our
alveoli (in our lungs)
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Decrease Biodiversity
• 60% of resources and life-
support systems are in decline
or used in unsustainable ways
(Millennium Ecosystem
Assessment, 2005)
• Decline in coral reefs: decline
protection for fish, loss of
potential medicines
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Do We Need More Evidence?
• Is there uncertainty in climate change, and is more research
required?
– Overwhelming scientific evidence that climate change is being
caused by human beings.
• Management of environmental and public health risks should use
a “precautionary principle”
– We should not take undue risks when there is the potential for
serious and perhaps irreversible environmental and human
damage.
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Possible Solutions
• Carbon Capture and Storage
• Renewable Energy Sources
• Changing Transportation
Methodologies
• Create Carbon Emission Caps
• Mitigation and Adaptation
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Carbon Dioxide Capture and Storage
Store CO2 from large sources of fossil-fuel combustion
(three methods)
1. Post-combustion capture: Separation of CO2 from flue
gases derived from combustion of fuel in air; uses
organic solvent to capture CO2
2. Pre-combustion capture: Primary fuel is mixed with
stem and air/oxygen to give CO and hydrogen; more
steam to give CO2 and hydrogen at lower volumes
3. Oxyfuel: Uses 90-95% O2 to produce CO2 and water.
Gas dried and compressed; stored in ground, deep
ocean water or used for mineral carbonation.
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Renewable Energy Sources
• Hydroelectric: constant source and store of energy
– Problems with CO2 and methane emission from
anaerobic fermentation in static water
• Solar: expensive, large requirements for land, and
intermittent, but can be used locally
• Biomass: cleaner technology, but impacts food prices
• Wind, wave and geothermal
• Nuclear fusion: theoretical potential to provide lots of
energy with less radioactivity than fission, safer
Page 32
Markandya A, Wilkinson P. Energy generation and health. Lancet. 2007; 370: 979-990.
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Changing Transportation Methodologies
• Reducing or avoiding travel: using information and
communication technologies (e-mail, teleconferencing)
• Increasing energy efficiency and alternative fuel
sources in vehicles
• Decreasing trip distances
• Group traveling (buses and car pooling)
• Improve access for walking and cycling, especially in
inner cores of cities
Page 33
Source: Woodcock J, Banister D, Edwards P, Prentice AM, Roberts I. Energy and transport. Lancet.
2007; 370: 1078-1088.
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Create Carbon Emission Caps and Taxes
• Create a greenhouse gas inventory
– Create carbon emission targets and credits
– Force companies to pay for overuse with the need to
purchase carbon emission credits
• Create a carbon tax
– Implemented in Sweden and British Columbia
(Canada), on the value of carbon dioxide produced
• Proceeds can be used in part to reduce impacts on
poor or generalized across the board, so as to be
revenue neutral
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Mitigation and Adaptation
• Protecting water and sanitation impacts
– Especially in the Middle East and North Africa
• Providing support for environment health emergencies
– Increasing training in complex humanitarian emergencies
• Developing strong infectious disease surveillance systems
– Build capacity to monitor new disease and outbreaks
• Building human health capacity
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As water and sanitation becomes an increasingly pressing matter from climate change
impacts, it will be important to place an emphasis on protecting existing water sources and
reducing the burden of disease caused by poor water protection and sanitation.
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Mitigation and Adaptation
• Air conditioning, to reduce risks from heat waves and help
control pollution exposure
• Improve architecture design to cope with heat waves and
extreme weather events
• Public education about various risks
– Winter anomalies, increased pollution, droughts/floods
• Strengthen and increase heights of sea walls and levees
• Strengthen pollution controls
• Stop deforestation and restore forests
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Climate Change Affects Global Health and Development
• With increasing temperatures we can expect more
infectious disease, especially in the tropical and peri-
tropical areas
• Increased droughts, floods, and natural disasters will make
large populations poorer
• Water supplies and lower food yields could affect the poor
• Increased problems with air pollution
• Energy solutions are required that balance the need for
development with environmental impacts
• Poor populations have the lowest ability to cope
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Quiz Introduction
• Now we invite you to take the module quiz and
test your recent learning.
• This quiz has 5 multiple choice questions.
• Write down the letter code for each of your
answers on the next 3 slides and then check
the answers on the slides that follow
• After completing your quiz, come back for the
summary of this module presentation.
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1. What is the cause of global warming? A. Earth is wobbling closer to the sun.
B. An increase in greenhouse gases
C. There are more forest fires today
D. There is more volcanic activity in the Atlantic Ocean
2. What is the current level of carbon dioxide in the atmosphere? A. 280
B. 320
C. 380
D. 500
E. 750
Quiz questions
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Quiz questions
4. Climate change will lead to which of these conditions? A. Improved food yield in developing countries
B. Decreased food yield in developed countries
C. Less famine around the world
D. Less respiratory problems in children
E. Decline in coral reefs
3. How high will the sea rise if the Arctic and western shelf of
the Antarctic melt away? A. 1 foot
B. 2 feet
C. 5 feet
D. 10 feet
E. 20 feet
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Quiz questions
5. Which are possible solutions for climate change? A. Carbon capture and storage
B. Hybrid technology
C. Creating carbon emission caps
D. More wind power
E. All of the above
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1. What is the cause of global warming? A. Earth is wobbling closer to the sun. - Incorrect
B. An increase in greenhouse gases - CORRECT
C. There are more forest fires today – True but not main cause
D. There is more volcanic activity in the Atlantic Ocean – True but not
main cause
2. What is the current level of carbon dioxide in the atmosphere? A. 280 – Historical average in history
B. 320 – Approximate level in 1960
C. 380 - CORRECT
D. 500 – Projection for the year 2050
E. 750
Quiz answers
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4. Climate change will lead to which of these conditions? A. Improved food yield in developing countries – Estimated 9-11% decline
B. Decreased food yield in developed countries – May be a small increase
C. Less famine around the world – Climate change will increase hunger
D. Less respiratory problems in children – There will be more air pollution and
probably increased levels of asthma
E. Decline in coral reefs – CORRECT. Warmer climates more leeching of
reefs and reduced fish stocks
3. How high will the sea rise if the Arctic and western shelf of
the Antarctic melt away? A. 1 foot
B. 2 feet
C. 5 feet
D. 10 feet
E. 20 feet - CORRECT
Quiz answers
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5. Which are possible solutions for climate change? A. Carbon capture and storage – Although correct there is a better
answer
B. Hybrid technology – Although correct there is a better answer
C. Creating carbon emission caps – Although correct there is a better
answer
D. More wind power – Although correct there is a better answer
E. All of the above - CORRECT
Quiz answers
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Summary
• Global warming and climate change are caused by the
production of greenhouse gases such as CO2
• Uncontrolled climate change will lead to greater
incidences of ill health and morbidity.
• Ignoring these health impacts will lead to economic
consequences.
• The result will be an increase in infectious disease,
extreme weather events and a shortage of clean water
and food.
• Solutions are available, but the political will is required.
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Credits
Rosemary Marotta, LLB, LLM, MPA
Lex Chambers & the Al Gore Climate Project Ambassador;
and
Kevin Chan, MD, MPH, FRCPC, FAAP
Assistant Professor, Faculty of Medicine,
and Fellow, Munk Centre for International Studies,
University of Toronto
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Acknowledgement
We would like to acknowledge the "Al Gore
Climate Change Project" for its
contribution to this module.
For more information you can go to:
http://www.theclimateproject.org/
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Sponsors The Global Health Education Consortium gratefully acknowledges the
support provided for developing these teaching modules from:
Margaret Kendrick Blodgett Foundation
The Josiah Macy, Jr. Foundation
Arnold P. Gold Foundation
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0
United States License.