1. Health Effects of Climate Change
Kathy Sykes, Senior Advisor for
Aging and Sustainability
Wayne Cascio, MD
Director, Environmental Public Health Division
Office of Research and Development U.S. EPA
Advisory Committee on National Prevention Strategy
"Remember when atmospheric contaminants were romantically called stardust?" —
Lane Olinghouse
Washington, DC-- Monday, Aug. 31, 2015

2. Disclaimer
Although this work was reviewed by EPA and approved for presentation, it may not necessarily reflect official EPA policy.
Some changes to the climate are unavoidable. Carbon dioxide can stay in the atmosphere for nearly a century, so Earth will continue to warm in the coming decades. The warmer it gets, the greater the risk for more severe changes to the climate and Earth's system. Although it's difficult to predict the exact impacts of climate change, what's clear is that the climate we are accustomed to is no longer a reliable guide for what to expect in the future. 1

3. Science of Climate Change
Human activities, driving, manufacturing, generating electricity, clearing forests all contribute to greenhouse gas emissions
Sources: USGCRP 2008, EPA 2010, EPA 2011
Are warming the planet.
There remains a large degree of uncertainty in much of the science but most recent findings are suggesting it may be even worse. 2

4. 2014 was the hottest year in recorded history
2014 was the hottest year in recorded history, and 14 of the 15 warmest years on record have all occurred in the first 15 years of this century.
And already, the first half of this year has recorded warmer than normal temperatures. 3

5. Sensitivity and Adaptability
Vulnerable populations those most at risk include:
the poor,
elders,
those already in poor health,
the disabled,
and indigenous populations
Source: Climate Change Impacts and Risks Analysis (CIRA) project
climate change could require adaptation on larger and faster scales than in the past, presenting challenges to human well-being and the economy. The more extensively and more rapidly the climate changes, the larger the potential effects on society. The extent to which climate change will affect different regions and sectors of society will depend not only on the sensitivity of those systems to climate change, but also on their ability to adapt to or cope with climate change.
Lyme Disease. Lyme disease is a bacterial illness spread by ticks that bite humans. Tick habitat and populations are influenced by many factors, including climate. Nationwide, the rate of reported cases of Lyme disease has approximately doubled since Lyme disease is most common in the Northeast and the upper Midwest, where some states now report 50 to 90 more cases of Lyme disease per 100,000 people than they did in 1991.
Length of Growing Season. The average length of the growing season in the contiguous 48 states has increased by nearly two weeks since the beginning of the 20th century. A particularly large and steady increase has occurred over the last 30 years. The observed changes reflect earlier spring warming as well as later arrival of fall frosts. The length of the growing season has increased more rapidly in the West than in the East.
Ragweed Pollen Season. Warmer temperatures and later fall frosts allow ragweed plants to produce pollen later into the year, potentially prolonging the allergy season for millions of people. The length of ragweed pollen season has increased at 10 out of 11 locations studied in the central United States and Canada since The change becomes more pronounced from south to north 4

6. Climate Change Impacts and Risk Analysis ---Findings
Extreme heat events -- cause illnesses and death due to heat stroke, cardiovascular disease, respiratory disease, and other conditions.
Increased ground-level ozone --associated with a variety of health problems, including reduced lung function, increased frequency of asthma attacks, and even premature mortality.
Higher temperatures and changes in the timing, intensity, and duration of precipitation --affect water quality, with impacts on the surface water we use.
Source: Climate Change Impacts and Risks Analysis (CIRA) project
Climate change is projected to harm human health in a variety of ways through increases in extreme temperature, increases in extreme weather events, decreases in air quality, and other factors.
CIRA analyzes the potential impacts of climate change on human health by focusing on air quality, extreme temperature mortality, labor, and water quality. Analyses of many other important health effects are not included in CIRA; these include, for example, impacts from increased extreme weather events (e.g., injury or death from changes in tropical storms), air pollution from wildfires, and vector-borne disease (e.g., Lyme disease and West Nile virus). 5

7. Climate Indicators: Health and Society *New Indicators
Heating & Cooling Degree Days*
Lyme Disease*
Heat-Related Deaths
Length of Growing Season
Ragweed Pollen Season
Source: Climate Change Indicators in the United States,
*Indicators added in 2014
some of the ways that climate change is affecting human health and society, including changes in Lyme disease, ragweed pollen season, heat-related deaths, heating and cooling needs, and the agricultural growing season across the United States.
Because impacts on human health are complex, often indirect, and dependent on multiple societal and environmental factors, the development of appropriate health-related climate indicators is challenging and still emerging. It is important for health-related climate indicators to be clear, measurable, and timely to better understand the link between climate change and health effects. 6

8. EPA’s Clean Power Plan Reduce Carbon Emissions
By 2030, by 30% below 2005 levels (870 M short tons*)
Equal to
Annual emissions from 166 M cars
(70% USA passenger vehicles) Or
Powering 95% of homes in the USA
*Note Short ton is equal to 2,000 lbs
Under President Obama’s Climate Action Plan, EPA is taking steps to address carbon pollution from the power and transportation sectors, and to improve energy efficiency in homes, businesses and factories. Under EPA’s proposed Clean Power Plan, carbon emissions from the power sector would decrease by 30 percent below 2005 levels and electricity bills would shrink by 8 percent by EPA’s pollution standards for cars and light trucks for model years will save Americans more than $1.7 trillion at the pump. In addition, the agency’s partnerships with industry have prevented more than 365 million metric tons of greenhouse gas pollution, equal to the annual electricity use of more than 50 million homes. 7

9. Cleaner Air Translates into Public Health Benefits
3,600 fewer premature deaths
900,000 fewer asthma attacks for kids
1.4 M fewer days of forced limited activity
300,000 fewer missed school and work days
62,000 fewer respiratory symptoms for kids
Benefits in 2030 of implementing Clean Power Plan 8

10. Wildland Fire Smoke Emissions:
Climate Change, Air Quality, Communities and Health

11. Air Quality, Communities and Health:
Climate & Wildfire Smoke Emissions
Climate Change Predicted to Increase the Risk of Wildfire, Smoke Emissions and Impact on Health
Growing Importance Nationally:
70,000 wildfires annually in US
3-fold increase in acres burned since 1985
Wildfire smoke contributing larger percentage of PM mass
Scientific and Technical Advances:
NASA satellite imaging
NOAA modeling of smoke plumes
EPA’s Advanced exposure modeling
CDC’s syndromic surveillance
URL: airnow.gov/index.cfm?action=airnow.mapsarchivedetail&domainid=53&mapdate= &tab=1

12. 2008 Evans Road Fire Pocosin Lakes National Wildlife Refuge
Public Health Research and Engagement
Meeting the Needs of the EPA, other Federal Agencies and Communities
Quantified Impacts:
Initiated by lightning strike, June ‘08
Burned 40K acres of peat bogs
2 billion gallons of water, 202 days
400 local, County, State and Federal personnel and volunteers
$20 M in suppression efforts
Opportunity to Assess Health Effects and Modifying Effects of SES:
Smoke Affected all SES groups equally
Satellite image showing the location of Evans Road Fire in the Pocosin Lakes National Wildlife Refuge, NC

13. Regional Health Effects
Pocosin Lakes National Wildlife Refuge
Percent change in cumulative RR by discharge diagnosis category for exposed and referent counties in NC during 3-day period of high exposure compared with the entire 6-week study period.
Rappold AG et al. Environ. Health Perspectives 2011

14. Regional Health Effects
Pocosin Lakes National Wildlife Refuge
SES Factors
Education
Employment
Family & social support
Community safety
Income
Percent change in cumulative RR by discharge diagnosis category for exposed and referent counties in NC during 3-day period of high exposure compared with the entire 6-week study period.
Rappold AG et al. Environ. Health Perspectives 2011

15. Reducing Health Impacts to Affected Communities
AirNow Smoke Plume Forecasting
Results:
Evaluated associated health costs
Simulation study
Estimated health and economic benefit of a public health messaging intervention using wildfire smoke forecasting
Impact:
Cost estimates can be incorporated into decision-tools and policy analysis
NOAA’s Hazard Mapping System smoke forecasting might be used with public health intervention to mitigate smoke-related health care utilization and social costs
Modeled smoke plume from current western fires NOAA Hazard Mapping System
URL: airnow.gov/index.cfm?action=topics.smoke_wildfires

16. USFS Wildland Fire Assessment System:
Creating a Community Wildfire Smoke Exposure Vulnerability Index
Current Research:
Community Wildfire Smoke Exposure Vulnerability Index
Integration of maps of –
vulnerability of risk of fire
vulnerability to the health effects of smoke
And with
in vitro and in vivo differential toxicity of fuels
Potential Impact
identify communities of highest risk where outreach programs should be targeted
deliver information needed to by communities to identify resources needed to protect the public
USFS Wildland Fire Assessment System:
Fuel Types
URL:wfas.net/images/firedanger/NFDR_Fuel_Model.png
Make data available to other federal partners, state and local officials

17. EPA Resources
Climate Change in America: Benefits of Global Action Climate Change Indicators in the United States, 2014 (OAR) Individual Actions “What You Can Do” Clean Power Plan Community Page 15