1. ERIC AMSTER MD MPH Climate change and Health

2. Climate change Human-induced emission of greenhouse gases into the lower atmosphere is increasingly contributing to the warming of the earth's surface Global warming will increase the frequency of extreme weather conditions such as heat waves, droughts, heavy rainfall, hurricanes, etc. The change in climate is likely to have a major impact on the environment

3. Environmental Public Health Exposures  Outcomes ?

6. CO2 and temperature 2010 concentration = 390 ppm

7. 3 MAIN EFFECTS Gradual increase in temperature Temperature extremes Extreme climate events (storms, floods)

8. 1. Gradual increase in temperature  Raise in sea-level  water supply becomes salinated  Tropical region increases  malaria, dengue, etc  Worsening air pollution  cardiopulmonary morbidity and mortality

9. 2. Temperature extremes  Heat waves  dehydration, heat stroke  Drought  decrease in crop, drinkable water  ↑ Fires  burn injuries, air pollution  Cold events  frost bite, hypothermia

11. August 4, 2010

13. 3. Extreme climate events  Drowning, displacement  Decrease in drinkable water  Infectious diseases

14. 16”/40cm rain in 2 days

15. ISLAMABAD—The number of people suffering from the massive floods in Pakistan exceeds 13 million -- more than the combined total of the 2004 Indian Ocean tsunami, the 2005 Kashmir earthquake and the 2010 Haiti earthquake, the United Nations said Monday. UN: Pakistan flood misery exceeds tsunami, Haiti By Sebastian Abbot Associated Press Writer / August 9, 2010

16. Who’s most vulnerable Homeless Poor Nomadic populations (Bedouin) Coastline communities Children Elderly Chronic disease

17. State of research Very new and active area of research Lack of good research  Poor exposure assessment  Poor outcome assessment Multiple confounders Delayed effect: need to observe population for decades