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Climate Change and Health Presentation 1 Oct 2013
1. Climate Change and Health
Air Pollution and Climate Change Group, Toxicology Department
Centre for Radiation, Chemical and Environmental Hazards
Dr Sotiris Vardoulakis
2. Outline
Global climate change and health
First UK Climate Change Risk Assessment
Health Effects of Climate Change in the UK
Heat and cold effects on health
Air pollution and climate change
Environmental health and sustainability
Climate Change and Health
3. IPCC 5th Assessment Report –
The Physical Science Basis
Climate Change and Health
Available on 30 September 2013
http://www.ipcc.ch/
4. Observed change in average surface
temperature (1900-2012)
Climate Change and Health
oC
IPCC, 4th AR
6. Mitigation is vital, but we need to
prepare for inevitable climate change
observations
projections
2003
2060s
2040s
TemperatureanomalyoverEurope(wrt1961-90)°C
Hadley Centre
We are already
committed to this from
past emissions alone
7. Hughes et al (2011), modified from Capon and Hanna (2009) and Berry et al (2011)
8. Distribution of four climate-sensitive health effects
Relativechangesindiarrhea,malaria,inlandandcoastalflooding,andmalnutritionfrom2000
to2030
(Patz et al., 2008)
9. Climate Change Act
2008
Climate Change Risk
Assessment
January 2012
National Adaptation
Programme
2013
Committee on
Climate
Change
Adaptation
Economic
Assessment
Committee on
Climate
Change
Committee on
Climate
Change
Committee on
Climate
Change
Health Effects
of Climate
Change 2012
UKCP09
UKCIP02
Health Effects
of Climate
Change 2002
Health Effects
of Climate
Change 2008
Legislative Framework: Moving
from evidence to policy
Climate Change and Health
10. CCRA: Sectors and Themes
Sectors (for initial analysis) Themes (for synthesis)Sectors (for initial analysis) Themes (for synthesis)
https://www.gov.uk/government/publications/uk-climate-change-risk-assessment-
government-report
1. Agriculture
2. Biodiversity & Ecosystem
Services
3. Built Environment
4. Business, Industry & Services
5. Energy
6. Floods & Coastal Erosion
7. Forestry
8. Health
9. Marine & Fisheries
10. Transport
11. Water
• Agriculture & Forestry
• Business
• Health & Wellbeing
• Buildings & Infrastructure
• Natural Environment
https://www.gov.uk/government/publications/uk-climate-change-risk-assessment-
government-report
11. CCRA: Key issues for different parts of the UK
Climate Change and Health
12. Health Effects of Climate Change in the UK
(2012)
Climate Change and Health
• Evidence
• Recommendations
• Research gaps
www.hpa.org.uk/hecc2012
13. Current Evidence & Research Gaps
1. Current evidence and climate projections
2. Temperature Effects
3. Air Pollution
4. Aeroallergens
5. Indoor Environment
6. Ultraviolet Radiation
7. Floods
8. Vector borne diseases
9. Food and Water borne Diseases
10. Health Co-benefits of Policies to Reduce Greenhouse Gas Emissions
Climate Change and Health
14. Climate Change and Health
Climate Projections
http://ukclimateprojections.defra.gov.uk/
15. Emissions Scenarios
CO2 emissions under the three IPCC SRES scenarios used in
UKCP09: A1FI (black: High emissions), A1B (purple: Medium
emissions), and B1 (green: Low emissions). (Source: IPCC)
18. Temperature Effects
• Increases in annual mean temperatures of around 2 to 5oC under a
medium emissions scenario (A1B) by 2080.
• Quantification of preventable heat- and cold-related mortality and
morbidity, focusing on vulnerable population groups.
• Understanding the role of the Urban Heat Island in exacerbating the
impact of climate change on mortality rates.
• Improved understanding of the role of planned adaptation strategies
and long-term physiological changes.
• Provision of input to public health plans, and evaluation of their
effectiveness.
27. Climate Change and Health
1,974
3,281
7,040
12,538
0
5000
10000
15000
20000
2000s 2020s 2050s 2080s
A: Heat deaths
69
114
233
409
0
250
500
750
1000
2000s 2020s 2050s 2080s
A: Heat deaths
UK Wales
Heat deaths (per year for all ages)
28. Climate Change and Health
41,408 42,842 40,397 36,506
0
20000
40000
60000
80000
2000s 2020s 2050s 2080s
B: Cold deaths
2,476 2,472
2,176
1,872
0
1000
2000
3000
4000
2000s 2020s 2050s 2080s
B: Cold deaths
UK Wales
Cold deaths (per year for all ages)
29. Temperature mortality (by age group)
7
94
468
1573
6
85
421
1419
5
69
341
1153
4
56
274
933
0
400
800
1200
1600
2000
0-64 65-74 75-84 85+
Cold deaths /100K (mean)
2000s
2020s
2050s
2080s
0 4
18
79
1 6
26
113
1 11
48
206
2
17
77
327
0
200
400
600
0-64 65-74 75-84 85+
Heat deaths /100K (mean)
2000s
2020s
2050s
2080s
Mean estimates of heat- and cold-related deaths in the UK per year per 100,000
population
(Hajat et al. 2013)
30. Urban Heat Island
West Midlands
O C
Modelledairtemperature
(Heaviside et al. 2013)
Birmingham
11pm 5th
August 2003
Climate Change and Health
31. Air Pollution
Climate Change and Health
• Understanding how climate change interacts with ground level ozone
and other climate sensitive air pollutants.
• Investigation of the range and extent of health effects of ozone,
including those associated with chronic exposure.
• Understanding how vulnerable people (e.g. those with pre-existing
respiratory illness) need to be protected.
32. Annual mean Summer mean
Change in ground level O3 simulated by EMEP4UK for a +5oC increase in
temperature relative to the base simulation for meteorological year 2003.
Ground Level Ozone
(Heal et al. 2013)
Climate Change and Health
34. Aeroallergens
• Climate change may result in earlier seasonal appearance of
respiratory symptoms and longer duration of exposure to
aeroallergens (pollen and fungal spores).
• Changes in plant distribution can expose the population to pollen
from more plants with different flowering seasons.
• Climate change / extreme weather events can change fungal
speciation, distribution and allergenicity.
• Develop integrated system for modelling atmospheric
concentrations of pollen, combining measurements with
numerical forecast models.
35. Indoor Environment
• Climate change may exacerbate health risks
and inequalities associated with building
overheating, indoor air pollution, effects from
flooding, dampness and biological
contamination.
• Characterise the health risks and benefits
associated with current and future building
infrastructure under climate change scenarios.
• Research into how climate change mitigation
and adaptation measures may affect the
indoor environment (e.g. air quality and
biological contamination in buildings).
36. Ultraviolet Radiation
Climate Change and Health
• Climate change may affect ambient levels of UVR, but the critical
factors affecting human exposure are lifestyle and behaviour.
• Understanding the likely changes in ground level UV radiation and
the balance between the risk of skin cancer versus a beneficial
increase in outdoor activity.
• Research into whether warmer summers will encourage more healthy
outdoor activities and increased vitamin D production.
• UVR related public health messages for specific target groups such
as young people and the elderly.
37. Floods (and Droughts)
• Climate change is likely to affect river and
coastal flood risk.
• Some areas are particularly vulnerable to
coastal floods: South Wales, NW Scotland,
Yorkshire and Lincolnshire, East Anglia and
Thames Estuary.
• Understanding how floods (and droughts)
affect both physical and mental health of
populations.
• Development and evaluation of public
health action plans, advice and guidance.
40. Vector Borne Diseases
• It is likely that the range, activity and vector
potential of ticks and mosquitoes will increase
in this century.
• Climate change may act on disease vectors
(and their pathogens) both directly through a
rise in temperature or change in precipitation.
• and indirectly through our adaptation to climate
change, e.g. creation of coastal wetlands and
habitat expansion.
Climate Change and Health
41. Food and Water Borne Disease
• Most water and food-borne pathogens show
seasonal variation, which may be directly or
indirectly influenced by weather.
• Warmer weather will allow pathogens (e.g.
Salmonella) to grow more readily in food, and
will favour pests and fungal mycotoxins that
affect food safety.
• Understanding of how seawater temperature
can affect the risk of people being exposed to
algal blooms and associated marine toxins.
• Climate change is likely to elevate food prices
which may reduce the nutritional status of some
population groups.
42. Health Co-benefits of Mitigation
Climate Change and Health
• Mitigation policies may achieve health, GHG
and economic benefits simultaneously
(‘the triple bottom line’).
• Understanding the health co-benefits of
policies to reduce GHG emissions in
transport, energy generation and food
production.
• Evaluation of the health effects (both positive
and negative) of emerging ‘low carbon’
technologies and biofuel policies.
44. Conclusions
• Climate change is likely to pose significant challenges to public health
in the UK by aggravating existing public health problems.
• Some UK regions (flood risk and densely populated areas) and
population groups (elderly, deprived, ill) are more vulnerable.
• Research needed on current and future interactions between climate,
and environmental and behavioural drivers that affect public health.
• The environmental public health sector needs to respond to these
challenges by:
strengthening modelling, monitoring and surveillance systems
improving the resilience of public health infrastructure
improving the assessment & communication of climate related risks
developing the evidence on health benefits of climate change
adaptation and mitigation
45. Acknowledgements
• Climate change and associated research in PHE/CRCE
• Department of Health
• Department for Environment, Food and Rural Affairs
• NHS Sustainable Development Unit
• UK Climate Impacts Programme
• UK Met Office
Climate Change and Health
Health Effects of Climate Change in the UK (2012)
report available online
www.hpa.org.uk/hecc2012
IPCC 5th AR: Warming of the climate system is unequivocal, and since the 1950s, many of the observedchanges are unprecedented over decades to millennia. The atmosphere and ocean have warmed,the amounts of snow and ice have diminished, sea level has risen, and the concentrations ofgreenhouse gases have increased.The total natural RF from solar irradiance changes and stratospheric volcanic aerosols madeonly a small contribution to the net radiative forcing throughout the last century, except forbrief periods after large volcanic eruptions.
The plot is for summer (JJA) and for the Mediterranean region (10W-40E, 30-50N) and the timeseries in red come from 7 model runs, using model data submitted for the next IPCC report (AR5). The models are: CNRM-CM5 (Meteo-France); CanEMS2 (Canadian Centre for Climate Modelling and Analysis); HadGEM2-ES (Met Office HC); NorESM1-M (Norwegian Climate Centre); bcc-csm1-1 (Beijing Climate Center, China Meteorological Administration); inmcm4 (Institiute of Numerical Mathematics, Moscow); ipsl-cm5a (Institut Pierre-Simon Laplace). This updated plot uses emissions scenario RCP 8.5, which is a close approximation (but slightly less than) A1FI (high emissions). Fifth Assessment Report (AR5, due in 2014) will put greater emphasis on assessing the socio-economic aspects of climate change and implications for sustainable development, risk management and the framing of a response through both adaptation and mitigation.The term temperature anomaly means a departure from a reference value or long-term average (here 1961-90). A positive anomaly indicates that the observed temperature was warmer than the reference value, while a negative anomaly indicates that the observed temperature was cooler than the reference value.
Comparison of year 2000 distribution of carbon dioxide (CO2) emissions (by country) vs. the regional distribution of four climate-sensitive health effects. (a) CO2 emissions (data from Reference 40). (b) The Intergovernmental Panel on Climate Change (IPCC) “business as usual” greenhouse gas (GHG) emissions scenario, “IS92a,” and the HadCM2 general circulation model (GCM) of the U.K. Hadley Center were used to estimate climate changes relative to baseline 1961–1990 levels of GHGs and associated climate conditions. Existing quantitative studies of climate-health relationships were used to estimate relative changes in diarrhea, malaria, inland and coastal flooding, and malnutrition from 2000 to 2030.This is only a partial list of potential health outcomes, and significant uncertainties exist in all the underlying models. These estimates should therefore be considered a conservative, approximate estimate of the health burden of climate change. (Patz et al. 2008)
Climate Change Act (2008): A legal framework for reducing GHG emissions. 80% reduction in carbon emissions by 2050. Currently around 27% of total carbon emissions come from homes and 17% from non-domestic buildings.
The 11 sectors represent how we are gathering the data and organizing the analysis- they are based on how research tends to be organised so have mainly been chosen for convenience. There are 11 sector reports detailing the outputs of the underlying analysis.Methodology uses a “systematic mapping” technique to look at linkages between the risks/opportunities in different sectors. Some sectors such as flooding have strong links to all other sectors.Once the analysis is complete, we merge these sectors into 5 themes to enable cross-sectoral links to be teased out. The Adapting to Climate Change Programmein Defra is built around these 5 themes.Health Sector: Public (population) health and Health care services and infrastructure
Current evidence: geographical variability, vulnerable groups, adaptation effect Methods: quantitative and qualitative
UKCP09 provides projections (possible) not predictions (probable)Three emission scenarios (low, medium and high) Probabilistic projections: central estimate and 10% and 90% estimates Variables: Temperature, precipitation, sea level, cloud cover, wind speed, etc.
Emissions uncertainty. The description of UKCP09 probabilistic projectionsabove does not discuss the effect of uncertainties in future emissions. Thelatter, though small over the next two or three decades mainly because ofclimate system inertia, will be substantial in the second half of the century. Wetherefore include the effect of emissions uncertainty by presenting separateprobabilistic projections of future climate change for three scenarios of futureemissions. These were decided, following consultation, as the A1FI, A1Band B1 scenarios in the IPCC Special Report on Emission Scenarios (SRES) —renamed for simplicity in UKCP09 as High, Medium and Low respectively. Thesescenarios include a wide range of greenhouse gases and other pollutants; as anexample, the CO2 emissions are shown in Figure 6. (Note that, because futureemissions will be determined by human choices, relative likelihoods cannot beassigned to these scenarios, and we cannot combine emissions uncertainty andother uncertainties to produce a single probabilistic projection covering alltypes of uncertainty.) All scenarios are non-interventionist, that is they assumeno political action to reduce emissions in order to mitigate climate change;differences between them arise purely from different assumptions aboutfuture socioeconomic developments.
population growth as this may increase the numbers of people exposed to hazards, such as flooding, or increase the demands for goods and services, such as water and energyUK population is c 62 M rising to 69-86 M (2050s) & 72-113 M (2080s)In some cases the growth in population may be an equal or even greater contributor to risk than climate change
Percentage age distribution, United Kingdom, 1971-2085 http://www.ons.gov.uk/ons/dcp171776_237753.pdf
IPCC 5th AR: There has been further strengthening of the evidence for human influence on temperatureextremes since the SREX. It is now very likely that human influence has contributed toobserved global scale changes in the frequency and intensity of daily temperature extremessince the mid-20th century, and likely that human influence has more than doubled theprobability of occurrence of heat waves in some locations
In England and Wales, there were 2139 excess deaths (16% increase, CI: 14%to 18%) during the August heat wave. The Central England Temperature (CET)peaked at 31.5°C (88.7°F) on 9 August. This coincided with thepeaks in the concentrations of ozone and PM10 in England. The peak in dailydeaths in England and Wales occurred two days later on 11 August. In Englandand Wales, mortality in people over the age of 75 increased by 22% (CI: 20%to 25%), more than the increase seen for other age groups: (11% (CI: 6% to15%) for the 0-64 age group and 3% (CI: -1% to 6%) for the 65-74 agegroup).
Thermal comfort zone 12-18 deg C
Comparative Assessment Mortality risk associated with heatWhy these differences in vulnerability Draw lessons for public health
Current heat-related deaths ~2,000And cold-related deaths ~40,000
Quantify the health effects of urban heat islands using regional climate modelling.Understanding the role of the urban heat island in exacerbating the impact of climate change on mortality rates.Improved understanding of the social inequalities in health impacts in this context.West Midlands, 11 pm 5th August 2003
What about pollutants other than ozone? The answer is 'We don't really know', and there are many competing potential feedbacks for PM.
+5 C increase in temperature applied uniformly for the whole year within the UK ~500 additional premature deaths on a baseline of ~12,000“and the assumption of no threshold for O3 effect”
Variations in the potency of aeroallergens (pollen grains).Contain the spread of invasive plants such as ragweed.We need better methods to conduct molecular epidemiology.
Increased airtightness of dwellings may have negative effects on human health (indoor air pollution).Promote long-term, energy efficient building design interventions to ensure adequate ventilation in increasingly airtight buildings.
Climate change may affect cloud cover and delay the recovery of the stratospheric ozone layer. In a warmer climate, people may spend more time outdoors in the UK, which could increase the risk of non-melanoma skin cancers. Fewer holidays overseas to sunny climates could result in fewer malignant melanomas.
Central precipitation estimates show winter rainfall increasing and summer rainfall decreasing.
Land use change, wildlife management and agricultural practices.The incidence of Lyme disease transmitted by ticks is likely to increase. Deer populations are likely to have a lager impact on ticks than climate changePossible increase in the number species and abundance of mosquitoes, with implications for transmission of arboviruses (e.g. West Nile virus). The risk from autochthonous transmission of malaria remains low.Effective messages to public health professionals, exposed groups, and general public to reduce vector-borne disease risks.
The most important mechanisms to prevent and control food- and water-borne diseases are early detection, surveillance and monitoring, horizon scanning, risk assessment, management, communication and preparedness for potential outbreaks.Warmer weather will allow pathogens (e.g. Salmonella) to grow more readily in food, and will favour flies and other pests that affect food safety.For some pathogens (Salmonella and Campylobacter) there are intervention programmes at relevant stages of food production.Algal blooms are an interesting issue, particularly with dinoflagellate shellfish poisoning, but are a small disease burden, and likely to remain so for the UK. The sea level rise may be less of an issue than salinity, nutrients and temperature when regarding changes in coastal algal populations.
Policies to reduce GHG emissions may: Reduced particulate air pollution as a result of reduced coal combustion Reduced dietary saturated fat consumption from animal products Increased physical activity as result of reduced private car use in citiesTaking into account health co-benefits suggests that such policies could offset part of the mitigation costs.
Existing public health problems: heat and flood related impacts, air pollution, allergies, and mental healthSome UK regions (flood risk and densely populated areas) and population groups (elderly, deprived, ill) are more vulnerable.National Adaption Programme
Public health professionals should capitalise on the potential to reduce GHG emissions and improve public health.