Health Impacts of Global Climate Change International Institute for Global Health (UNU-IIGH) Health Impacts of Global Climate Change Jamal Hisham Hashim, PhD Professor of Environmental Health & Research Fellow Presented at the 16th National Public Health Colloquium, 24-25 November 2009, Kuala Lumpur, Malaysia,

Outline of Talk What is climate change? Greenhouse effect and global warming. Environmental impacts of climate change. Health impacts of climate change. Research needs.

Research Themes of UNU-IIGH Accessibility, Efficiency and Quality of Care in Health System Newly Emerging and Re-emerging diseases and epidemics Control of Non-communicable Diseases IT in Health Climate Change and Health Impact of Globalization on Health Care

Weather and Climate Weather is the fluctuating state of the atmosphere around us, characterized by the temperature, wind, precipitation, clouds and other weather elements. Climate refers to the average weather in terms of the mean and its variability over a certain time-span and a certain area. Statistically significant variations of the mean state of the climate or of its variability, typically persisting for decades or longer, are referred to as “climate change.”

What is Climate Change ? According to the Intergovernmental Panel on Climate Change (IPCC), it refers to any change in climate over time, whether due to natural variability or as a result of human activity. According to the UN Framework Convention on Climate Change, it refers to a change of climate that is attributed directly or indirectly to human activity that alters the composition of the global atmosphere, and that is in addition to natural climate variability observed over comparable time periods.

Source : IPCC 4th Assessment Report, 2007.

IPCC Climate Change Study The Intergovernmental Panel on Climate Change (IPCC) has been established by WMO and UNEP to assess scientific, technical and socio-economic information relevant for the understanding of climate change, its potential impacts and options for adaptation and mitigation. IPCC has come out with the Climate Change 2007 : The IPCC 4th Assessment Report. It is the work of over 2500 scientific expert reviewers, over 800 contributing authors and over 450 lead authors from over 130 countries. It involves 6 years of work in 4 volumes of report.

Greenhouse Effect Greenhouse gases (CO2, CH4, N2O, CFC and O3) trap long-wave radiation from earth from escaping through the atmosphere into space. This produces the greenhouse effect which warms the earth atmosphere. This greenhouse effect leads to the phenomenon called global warming.

Global Warming Global average surface temperature has increased since 1861. Over the 20th century, it has increased by about 0.74 ± 0.18 oC. Since late 1950’s, overall global temperature increase in the troposphere and in surface temperature have been 0.13 oC per decade. 1990’s was the warmest decade with 1998 the warmest year since 1861. Greatest warming effects occur over the tropical and sub-tropical regions.

Mean 1961-1990 Source : Climatic Research Unit, University of East Anglia and the Hadley Centre of the UK Meteorological Office.

Source : IPCC 4th Assessment Report, 2007.

Radiative Forcing Increasing concentrations of greenhouse gases cause positive radiative forcing which tend to warm surface temperature. Increasing concentrations of aerosols cause negative radiative forcing which tend to cool surface temperature.

Source : IPCC 4th Assessment Report, 2007.

Source : IPCC 4th Assessment Report, 2007.

Change in Precipitation Pattern Precipitation has increased by 0.2 to 0.3 % per decade over the tropical (10 oN to 10 oS) land areas. Precipitation has decreased over some areas of central and west Africa. Warm episodes of the ENSO phenomenon which is associated with droughts and warm temperatures in the tropics, have been more frequent, persistent and intense since the mid-1970s, compared with the previous 100 years.

The disappearing Lake Chad : Decreased rainfall in the area since the 1960’s has increased water demand for agriculture.

Rising Sea Level and Ocean Heat Content Tidal gauge data show that global average sea level rose between 0.1 and 0.2 meters during the 20th century. Global ocean heat content has increased since the late 1950.

Source : IPCC 4th Assessment Report, 2007.

How Does Climate Change Affect Human Health ? Thermal stress : * Major increases in the frequency of heat waves with climate change may occur. * In 1995, the week-long heat wave in Chicago caused more than 700 heat- related deaths (Whitman et.al, 1997).

Source : World Health Organization. (2003) Source : World Health Organization. (2003). Climate change and human health – Risks and responses.

How Does Climate Change Affect Human Health ? Decreased precipitation : * Leads to drought which triggers forest fires causing respiratory problems (Brauer & Jamal, 1998). * Drought also reduces surface water flow, thus degrading water quality leading to waterborne disease. * Droughts may reduce food production leading to diseases of malnutritions.

How Does Climate Change Affect Human Health ? Increased precipitation : * Populations in developing countries are vulnerable to floods because of their habitation of high-risk areas like flood plains and coastal zones. * Deaths from drowning and physical injuries from accidents among victims. * Mixing of flood water with sewage and wastes leads to waterborne diseases, especially among the malnourished. * Increase opportunity for pest breeding which leads to vectorborne and zoonotic diseases (eg. Leptospirosis).

Tropical storm Ketsana hit Manila in September 2009

How Does Climate Change Affect Human Health ? Increased sea level : * Leads to flooding. Mixing of flood water with sewage and wastes leads to waterborne diseases. * Increase opportunity for pest breeding which leads to vectorborne and zoonotic diseases. * Salt water intrusion affecting groundwater and breeding of certain disease vector (A. sundaicus).

How Does Climate Change Affect Human Health ? Vectorborne diseases : * Modeling work suggest a 5% to 7% potential increase in malaria distribution through increased altitudinal reach and a 16% to 28% exposure risk due to prolonged transmission season in Africa in this century (Tanser et.al, 2003). * Increase temperature may increase Dengue virus replication in Aedes aegypti leading to potential epidemics (Patz et. Al, 1998).

Health Effects of Global Climate Change Global cooling Greenhouse gases Health impacts Environmental impacts Environmental modifications Negative radiative forcing Positive radiative forcing Increase surface temperature Thermal stress Extreme weather Injury & death Global warming Melting of polar ice Ocean warming Altered wind patterns Respiratory diseases Increase sea level Decrease precipitation Increase precipitation Aerosol pollution Coastal flooding Drought Vector breeding Flooding Forest fires Population displacement Mudslide Water pollution Poor food production Vectorborne diseases Rodent-transmitted diseases Waterborne diseases Malnutrition Jamal HH (2007)

Research Needs Quantifying change in disease burden associated with climate change, especially in developing countries. Identifying population groups susceptible to health effects of climate change (the elderly, poor and homeless). Predicting the impacts of intervention policies (eg. improved fuel efficiency, promotion of renewable energy). Disaster management during extreme weather events (eg. cyclones, floods and forest fires). Countries’ preparedness in dealing with the effects of climate change.

and Ecosystem Integrity Connecting Environmental Changes, Impacts and Responses in the Mekong Delta to Human Wellbeing and Ecosystem Integrity A planned collaborative research with UNU-INWEH, UNU-EHS, UNU-ESD, UNU-IEGL, UNU-IIST and UNU & GIST. To study the health impacts of deteriorating water quality in the Mekong Delta, as a consequent of environmental and climate change. Preliminary work has begun and now seeking bigger fund.

Health impacts of environmental and climate change in the Mekong Delta Government policies Climate change Economic development Urbanization Sea level rise Extreme weather Salt water intrusion Surface temperature change Change in rainfall pattern Industrial pollution Population growth Soil salinization Mangrove destruction Flood Drought Sewage pollution Water pollution Agriculture & aquaculture Fertilizer use Water-related diseases Vector habitat change Waterborne diseases Food security Eg. schistosomiasis & leptospirosis Pesticide use Eutrophication Eg. cholera, typhoid, hepatitis A, etc. Vectorborne diseases Chemical -related illnesses Malnutrition Eg. dengue & malaria Trigger of change Risk factors Eg. pesticide & heavy metal poisoning Environmental drivers Health outcomes

Global Vulnerability to Disease (VyGIL) - Developing an Interactive Global Vulnerability Tool A collaborative research project between 3 UNU institutes (UNU-IIGH, UNU-INWEH and UNU-EHS) and 13 other institutions. To develop an interactive GIS tool to map vulnerability indices of water-related diseases. A proof-of-concept study on Dengue and Chikungunya in Malaysia will be initiated early next year.

Thank you

Source : World Health Organization. (2003) Source : World Health Organization. (2003). Climate change and human health – Risks and responses.