global environmental changes and human healthdata.daff.gov.au/brs/brsshop/data/tmcmichael2.pdf ·...
TRANSCRIPT
Tony McMichael
National Centre for Epidemiology and PopulationHealth
The Australian National University
Global Environmental Changesand Human Health
Can We Detect, Measure and Controlthe Risks?
Proposition 1The great gains in population health overthe past 1-2 centuries have come fromsystemic changes in social and economicconditions, civic infrastructure, foodsupplies, education, and domesticmodernization.
Proposition 2As for animal herds, the healthprofile of a human communityreflects much about the conditions ofthe local environment and nature’s‘goods and services’.
Proposition 3Human pressures – a function ofpopulation size and economicactivities – are now changing variousof the planet’s regional and globallife-support systems (e.g. climate,biodiversity stocks, water supplies).
Challenge to populationhealth researchers
How to identify, attribute,quantify and reduce theresultant, often indirect, risksto human health.
20
25
30
35
40
45
50
55
60
65
70
1950
-55
1955
-60
1960
-65
1965
- 70
1970
- 75
1975
-80
1980
- 85
1985
-90
1990
-95
1995
- 200
0
Kenya
Uganda
Ethiopia
Rwanda
2000
-0520
25
30
35
40
45
50
55
60
1950
-55
1955
-60
1960
-65
1965
-70
1970
-75
1975
-80
1980
-85
1985
- 90
1990
-95
1960
-65
1965
-70
1970
-75
1975
-80
1980
-85
1985
- 90
1990
-95
1995
- 200
0
Zimbabwe
Kenya
Botswana
Uganda
Ethiopia
C
Rwanda
2000
-0535
40
45
50
55
60
65
70
75
80
85
1950
-55
1955
-60
1960
-65
1965
-70
1970
-75
1975
-80
1980
-85
1985
-90
1990
-95
1995
-200
0
Russia
Poland
Denmark
Japan
France
2000
-0535
40
45
50
55
60
65
70
75
80
85
35
40
45
50
55
60
65
70
75
80
85
1950
- 55
1955
- 60
1960
- 65
1965
- 70
1970
- 75
1975
- 80
1980
- 85
1985
- 90
1990
- 95
1995
-200
0
Russia
Poland
Denmark
Japan
France
2000
-05
B A
35
40
45
50
55
60
65
70
75
80
85
1950
- 55
1955
- 60
1960
- 65
1965
- 70
1970
- 75
1975
- 80
1980
- 85
1985
- 90
1990
- 95
1995
- 200
0
Senegal
Tunisia
India
Chile
Mexico
Mali
2000
-0535
40
45
50
55
60
65
70
75
80
85
1950
- 55
1955
- 60
1960
- 65
1965
- 70
1970
- 75
1975
- 80
1980
- 85
1985
- 90
1990
- 95
1995
- 200
0
Senegal
Tunisia
India
Chile
Mexico
Mali
2000
-05
North Korea
NB differentscale of y axis
1950-55 2000-05 1950-55 2000-05 1950-55 2000-05
Lif
e ex
pec
tan
cy a
t b
irth
, in
yea
rsTrends in life expectancy, 1950-now 3 categories: rising, flattening/plateauing, falling
From McMichael et al, Lancet, in press
Year
35 35
Hunter-gatherer
Industrialising
Agrarian
Human CarryingCapacity
Population Demandon Environment
“Over-developed”
1960s 1970s 1980s 1990s0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
One Earth is available(The planet’s total bio-capacity = 1.0)
Number of Earthsused by humanity
Based on Wackernagel et al, 2002
Num
ber
of E
arth
s
From: Steffen et al. 2003
Population Total real GDPForeign direct
investment
Damming of rivers Fertiliser consumption
Motor vehicles
Water use
MacDonalds Restaurants Urban population
From: Steffen et al. In press 2004
Atmos CO2 conc
Domesticated landLoss of trop forest, woodland
Coastal shrimp farmsFully exploited fisheries
Climate disastersAv surface temp (NH)Atmos ozone loss
Atmos CH4 concAtmos N2O conc
Coastal N2 flux
Global biodiversity
Changes in environmental indicators, 1750 - 2000
Climate Change: the “debate”Skepticism is now receding. We know that:
• GHG concentrations are increasing
• GHGs affect the climate system (thankfully!)
• World average temperature has risen relativelyfast over the past 30 years
• Sea-level rise is gradually accelerating
• Many temperature-sensitive systems/processeshave changed over the past two decades
Kilimanjaro 1970
Kilimanjaro 2000
Ice on Kilimanjaro
0
5
10
15
1900 1920 1940 1960 1980 2000 2020
Year
Kilimanjaro 2020?
Are
a (k
m2 )
L.Thompson, in prep.
Source: Petit J.R., et al. Climate and atmospheric history of the past 420,000 years fromthe Vostok ice core, Antarctica. Nature 1999; 399: 429-436
10,000 yrsago: farmingbegins
Band of historical climatic variability
20
15
1900 21002000
14
16
17
18
13
19Average GlobalTemperature (OC)
Year205019501860
IPCC (2001)estimatesa 1.4-5.8 oC increase
Low
High
Central estimate = 2.5 oC(plus increased variability)
This presents a rate-of-changeproblem for many naturalsystems/processes
GCM-Modelledincreases intemperatureunder the B2SRES Scenario
(UK Hadley CentreCM3 climatemodel)
2020s
2050s
2080s
GCM-Modelledchanges inprecipitationunder the B2SRES Scenario(UK Hadley CentreCM3 climatemodel)
2020s
2050s
2080s
Sea-level rise over coming centuriesfollowing 70 years of excess greenhouse gas emissions
200 400 600 800 Time from start (years)
0.0
0.5
1.0
1.5S
ea-l
evel
ris
e (m
) Total sea level rise
Ocean Expansion
Ice-melt
Greenhouse gas emissions
IPCC 2001IPCC, 2001
Sea-Level Rise, over the coming millennium
Peaking in 2050
Thank YouAn island of the Maldives, December 2003
Risks to Small Island-States
• Flooding
• Amplified storm surges
• Damaged coastal infrastructure (roads, etc.)
• Salination of island fresh-water
• Impaired crop production
• Population displacement: diverse healthrisks (nutrition, infection, mental health)
Health effects
Temperature-relatedillness and death
Extreme weather-related health effects
Air pollution-relatedhealth effects
Water and food-bornediseases
Vector borne and rodent borne diseases
Health Effects
Temperature-relatedillness and death
Extreme weather-related (floods, storms,etc.) health effects
Air pollution-relatedhealth effects
Humanexposures
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•Precipitation
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•Precipitation
•Sea-level rise
Contaminationpathways
Transmissiondynamics
----rodent
Microbial changes:
Contamination paths
Transmission dynamics
Water and food-bornediseases
Vector borne and borne diseases
Climate ChangeClimate Change
Changes in agro-ecosystems, hydrology
Socioeconomic anddemographic disruption
Effects of food andwater shortages
Mental, nutritional,infectious-disease andother effects
Modulatinginfluences
Daily temperatures and deaths in major Parisian hospitals, July-August 2003
50
100
150
200
250
2 4 6 8 10 12 14 16 1825 27 29 31July August
Max daily temp
Min dailytemp
20
25
30
35
40
15
Deaths Temp oC
(preliminary data from INVS, Paris)
Coexistentozone exposure?
Excess mortality, by department, in France during 1-15 August 2003, vs mean period-mortality in 2000-02
Excess mortalityUp to 25%25-49%50-74%75-100%> 100%
Heat wave, August 2003
• France >11,000 excess deaths• Portugal 1,316 excess deaths• Italy reports 20% more than average in July/Aug• Spain: 100 deaths reported• UK: 900 excess deaths reported
But- No standard method to estimate excess
Vulnerability in heat-waves
• Physiological• Pre-existing disease• Demographic
– Ageing population
• Social– Isolation– Housing quality
Climate change impacts on rain-fedcereal production, 2080
(IIASA: Fischer et al, 2001)
Need to convert estimates of regionalfood yields into estimates of changes in
numbers of malnourished people
What about the small island-states?
VECTOR-BORNE DISEASE
1990
2085
Estimated population at risk of dengue fever under“standard” climate change scenario: 1990, 2085
Source. Hales S et al. Lancet (online) 6 August 2002. http://image.thelancet.com/extras/01art11175web.pdf
Baseline 2000 Courtesy: Kris Ebi
Modelling Malaria Transmissibility in Zimbabwe. I
Baseline 2000 2025 Courtesy: Kris Ebi
Modelling Malaria Transmissibility in Zimbabwe. II
Baseline 2000 2025 2050Courtesy: Kris Ebi
Modelling Malaria Transmissibility in Zimbabwe. III
Prevention Options• Primary prevention
– Must cancel our collective ecological debt; live within thebiosphere’s limits
– Some radical choices needed, to achieve sustainability
• Adaptation (secondary prevention)– Too late to avert all adverse impacts; GEC processes are
prolonged and, sometimes, irreversible– Take action (preferably win-win action) to lessen adverse
impacts now and into the future
• IT MUST BE UNDERSTOOD THAT THE GOALSOF SUSTAINABILITY ARE TO DO WITH HUMANEXPERIENCE, NOT JUST WITH OUR CULTURALAND ECONOMIC ACCOUTREMENTS
The End