Climate Change Distributive Impacts Elizabeth Cullen John Sweeney

Climate Change: Distributive Impacts Elizabeth Cullen & John Sweeney, NUI, Maynooth NUI MAYNOOTH Ollscoil na Éireann Má Nuad IPH, 25 th February 2010

Warming relative to 1961 -90 Mean January figures are predicted to increase by 1. 5 o. C by mid century with a further increase of 0. 5 o. C-1. 0 o. C by 2075. By 2050, the extreme south and south west coasts may have a mean January temperature of 8. 0 o. C. By then, winters in Northern Ireland in the north Midlands will be similar to those presently experienced along the Cork/Kerry coast. July temperatures will increase by 2. 5 o. C by 2050 and a further increase of 1. 0 o. C by 2075 can be expected. Maximum July temperatures of the order of 22. 5 o. C will prevail generally with areas in the central Midlands experiencing maximum July temperatures of 24. 5 o. C.

Rainfall relative to 1961 -90 Overall increases in precipitation are predicted for the winter months of December- February. On average these amount to 11%. The greatest absolute increases are suggested for the north west. Marked decreases in rainfall during the summer and early autumn months across eastern and central Ireland are predicted. Nationally, these are of the order of 25% with decreases of over 40% in some parts of the south-east.

Differences in Seasonal Warming 19612005 Spring Max Spring Min Summer Max Summer Min Autumn Max Autumn Min Winter Max Winter Min Valentia 0. 68* 1. 05* 0. 43 1. 20** 0. 54 0. 87* 1. 17** 1. 34* Shannon 1. 27** 1. 58** 1. 18* 1. 70** 1. 01* 1. 28** 1. 50** 1. 83** Malin 0. 75* 1. 18** 0. 63 1. 13** 0. 47 0. 84** 1. 04* 1. 20** Belmullet 1. 40** 1. 21** 1. 30** 1. 39** 1. 16** 0. 80* 1. 44** 1. 23* Phoenix Park 1. 41** 0. 88* 1. 43** 0. 92** 0. 84* 0. 41 2. 52** 0. 85 Clones 1. 27** 1. 33** 1. 36** 1. 63** 0. 92** 1. 04* 1. 33** 1. 41* Rosslare 1. 06** 1. 28** 1. 12** 1. 19** 0. 97** 1. 02** 1. 62** 1. 32** Claremorris 1. 32** 1. 19** 1. 25** 1. 49** 0. 92* 0. 84* 1. 22** 1. 32* Kilkenny 1. 40** 1. 18** 1. 22* 1. 46** 0. 95* 1. 21** 1. 52** 1. 40** Casement 1. 05** 1. 27** 0. 83* 1. 40** 0. 55 1. 15** 1. 61** 1. 36* Birr 1. 18** 0. 95* 0. 98* 1. 21** 0. 77 1. 44** 1. 14*

HEALTH EFFECTS OF CLIMATE CHANGE Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes 3°C by yr. 2100 40 cm “ “ IPCC estimates Temperature/Heat Stress Cardiorespiratory failure Air Pollution Respiratory diseases, e. g. , COPD & Asthma Vector-borne Diseases Water-borne Diseases 1 2 Water resources & food supply Environmental Refugees Malaria Dengue Encephalitis Hantavirus Rift Valley Fever Cholera Cyclospora Cryptosporidiosis Campylobacter Leptospirosis Malnutrition Diarrhea Toxic Red Tides Forced Migration Overcrowding Infectious diseases Human Conflicts

Temperature-Related Deaths in 11 Eastern U. S. Cities Source: Curriero, et al. , 2002.

LAGGED EFECT

HEAT WAVE EUROPE Heat Index Summer 2003

Ø 35, 000 Excess Deaths in two weeks

Heat Stress: Some Populations Are Particularly Vulnerable

European heat-wave 2003 - 35, 000 died Swiss Temperature Series for June-August 1864 -2003 Analysis shows it likely that most of the risk of the event is due to increase in greenhouse gases - also - by 2050, likely to be average event - by 2100, likely to be a cool event extremely rare event (Schär et al. 2004, Nature, 427, 332 -336, Stott et al 2004, Nature 432 610 -614 )

Climate Change and Air Quality U. S. National Assessment of Climate Change

Health Effects of Ground-Level Ozone § Increased risk of hospital admissions and ER visits for people with asthma (Friedman et al, JAMA, 2001, 285: 897 -905) § 3 X greater risk of DEVELOPING asthma (Mc. Connell et al, Lancet, 2002, 359: 386 -391) Air pollution Climate change

Allergic Illnesses and Aeroallergens • Earlier onset of pollen season • Increased CO 2 and temperature – increase pollen production – Increase length of pollen season • Increased pollen counts • Increase in allergenic (reactive) content of pollen appears likely

Relationship between temperature and malaria parasite development time inside mosquito (“extrinsic incubation period” or EIP). EIP shortens at higher temps, so mosquitoes become infectious sooner.

Vector-borne and Zoonotic (VBZ) Diseases • Disease vectors are widely present in temperate regions • Forces underlying VBZ disease risk: –weather/climate –ecosystem change –social and behavioral factors –globalization

Infectious Disease: Dengue Risk • In 1990, almost 30% of the world population, 1. 5 billion people, lived in regions where the estimated risk of dengue transmission was >50% • In 2085, an estimated 50 -60% of the projected global population, 5 -6 billion people, people would be at risk of dengue transmission, compared with 35% (3. 5 billion) if climate change didn’t happen. Hales, de Wet, Maindonald, Woodward, The Lancet, 2002, 360: 830

Dengue along the Texas – Mexico border

How Bad is the Water Problem? • 1/3 of the world’s population, about 2 billion people, currently lives in water-stressed countries (UNEP, IPCC) • By 2025, that number is expected to increase to 5 billion (UNEP, IPCC) • Nearly 1/3 of the world’s land surface may be at risk of extreme drought by 2100 (Burke et. al. Journal of Hydrometeorology, Sept. 2006)

Water Usage • 70% for agriculture globally (90% in some countries) • 10% global food production depends on overpumping of groundwater (India 25%) • 1 Kg of grain requires 1, 000 to 3, 000 litres water • Grain-fed beef requires 20 X more water per calorie than wheat

Extreme Rainfall Events are Unhealthy • 67% of waterborne disease outbreaks in the US were preceded by precipitation above the 80 th percentile (across a 50 yr. climate record), p < 0. 001 • 51% of outbreaks were preceded by precipitation above the 90 th 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*, Rose, Lele, 2001.

Health Effects of Floods • Cause injuries and deaths • Long term psychological and physical effects • Increased risk of infectious disease • Mold • Contaminate water supplies: surface & wells Photo courtesy of FEMA

New Orleans after Hurricane Katrina

Ballinasloe (Credit: Sean Collins)

Athlone (Credit: Paula Murray)

Health Effects of Droughts § § § Concentrate micro-organisms and contaminants in water supplies Crop failures § ~1 billion people hungry § 5 million children die starvation Water shortages for hygiene Increase risk of forest fires Increase risk of infectious disease

Deaths Attributed to Climate Change NOW 150, 000 per year xxx Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on human health. Nature, Vol. 438.

Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on human health. Nature, Vol. 438.

Relative vs Attributable Risk

Water and Food-borne Disease: Climate-Susceptible Pathogens Rising temperatures Increasing rainfall Shifts in reservoir ranges Salmonella X X X Campylobacter X X X Vibrio X X Leptospira X X Enteroviruses X X Naergleria fowleri X Cryptosporidium X X Giardia X X Sea level changes X

Cryptosporidiosis • 405, 000 cases • 100 fatalities • Preceded by heaviest rainfall in 50 years

Mental Health Needs and Hurricane Katrina In the aftermath of Hurricane Katrina, mental health services in New Orleans were challenged by an increased incidence of serious mental illness Nearly half of all survey respondents indicated a need for mental health care with less than 2% receiving professional care (Weisler et al. 2006).

What does climate change mean for environmental health in Ireland?

Temperature/Mortality in Ireland Source: E. Cullen

Maximum temperatures (Kilkenny) and total mortality in Ireland on the hottest day in recent decades (13 th July 1983) Source: E. Cullen

Milder winters Reduced hospital admissions 2 -3% reduction in winter deaths with 2 -2. 5 C increase in temperature (2050)

Impact of hot summers

Increased Heat-related deaths are likely • Hot weather increases daily mortality in Ireland, though less than in most EU countries • Elderly particularly vulnerable – – >80 years Bedridden Heart disease Diabetes • Reduction in winter cold mortality will greatly exceed any increase in summer heat mortality

Some infectious diseases are likely to increase in incidence • Food poisoning • Water borne disease • Malaria? • Tick borne disease?

Salmonella • Approximately 500 cases per annum in Ireland • August maximum 5 times higher than February minimum • Highly significant correlations with maximum temperature

Salmonella incidence in Republic of Ireland (Sources: Kovats, Cullen)

Vector-borne and Water borne Diseases • Local outbreaks of malaria may occur by mid century, though it is considered unlikely that the most dangerous strains are unlikely to become established in Ireland • Tick borne diseases are not likely to become major concerns before mid century • Cholera and typhoid are not likely to become a problem in Ireland • Decreased dilution water in rivers may pose problems for public water quality, however.

Increased UV exposure

Vulnerable Populations Source: Derived from SAP 4. 6, Chapter 2

Environmental Health Actions for Coping with Climate Change in Ireland • Raise awareness of health implications of climate change in Ireland • Raise awareness of potential health benefits of action to reduce impact of climate change • Increased monitoring of food • Health impact assessments to identify and develop adaptation strategies for vulnerable sectors • Interdisciplinary research

Adaptation Strategies to Reduce Climaterelated Health Risks Vectorborne Diseases Waterborne Diseases Air Quality Decision Support Tools Enhance early warming systems based on climate and environmental data for selected diseases Develop early warming systems based on climate and environmental data for conditions that may increase selected disease Technology Development Develop vaccines for West Nile and other vector-borne diseases Develop more rapid diagnostic tests Surveillance and Monitoring Enhance vector surveillance and control programs and monitor disease occurrence Enhance surveillance and monitoring programs for waterborne diseases Infrastructure development Consider possible impacts of infrastructure development such as water storage tanks Consider possible Improve public transit impacts of placement systems to reduce traffic of sources of water and emissions. food borne pathogens Enhance alert systems for high air pollution days Enhance health data collection systems to monitor for health outcomes due to air pollution

Conclusions • Human health is inextricably bound to weather and climate as well as to many complex natural and man-made systems. • There are many uncertainties, but projected changes in climate are likely to impose risks to human health. • Health impacts are multi-factorial with interactions that cascade across a range of confounding and moderating factors. • An extensive suite of adaptation strategies will be key to addressing climate-related health outcomes.