1. Health and Climate Change Dianne Katscherian Department of Health

2. Contents Introduction DOH and Climate Change Health Impacts from Climate Change Temperature related health impacts: Extreme events and temperature increases Direct Impacts to health Other Impacts to health Risk Assessments Adaptation responses LG Planning for Health

3. Introduction Changes will affect environmental, human and built systems and alter the way we live The impacts on human health and safety could be of major significance Important we understand the potential health impacts and develop appropriate adaptation responses

4. DOH and Climate Change WA Greenhouse Strategy (GHS) and the Premiers Climate Change Action Statement Making Decisions for the Future: Climate Change committed Government sectors to actions WA Health responses included assessment of impacts of climate change on population of WA Undertook Health Impact Assessment of climate change in collaboration with the WHO Centre for Environmental and Health Impact Assessment at Curtin University

5. Health impacts identified: The impacts from environmental changes were identified as: –Health impacts of extreme events –Health impacts of temperature related events –Water-borne diseases –Vector-borne diseases –Air Quality Health Impacts –Food-borne diseases –Health Impacts from Food Production –Social/Community/Lifestyle Impacts, and –General Principles and Adaptation Measures.

6. Temperature related health impacts: Extreme events and Temperature increases

7. Temperatures in WA WA is likely to become warmer, especially in inland areas, with more hot days and fewer cold nights And has been estimated that the number of days above 35ºC could average: LocationCurrent203020702100 Perth2729-435672 Broome5464-141 Kalumburu140168-214 Halls Creek156168-214 Climate variable20302070 Mean summer temperature (ºC)+0.5 to +2.1+1.0 to +6.5 Mean winter temperature (ºC)+0.5 to +2.0+1.0 to +5.5

8. Direct Impacts to Health from Heat The human body maintains body temperature in ambient temperatures not exceeding 32 degrees. Above this temperature, heat lost through the skin and sweating. Heat-related illness occurs when the body unable to adequately cool. Minimum ambient temperatures are also important –Difficulties cooling when minimum temperatures greater than 22 degrees High humidity reduces effectiveness of sweating and increases the risk of heat-related illness at any given temperature.

9. Relative Atmospheric temperature ( o C) Humidity(%)26283032343638404244 0%25272830323335363738 10%25272830323335373941 20%26272830323437394246 30%26272931333639434752 40%26283032353943485460 50%272831343843495562 60%2729333742485562 70%27313540475463 80%283238445261 90%2834414958 100%28364456 At an apparent temperature, (T a ) of: 32-40 Heat cramps or heat exhaustion possible 41-54 Heat cramps or heat exhaustion likely, heat stroke possible 54-more Heat stroke highly likely Exposure to full sunshine can increase the heat index value by up to 8 o C

10. Heat Illness Heat cramps – muscular pains and spasms. –Are the least severe –Early signal of concerns with heat Heat exhaustion – body fluids are lost through heavy sweating –Typically with heavy exercise or work in a hot, humid place –Blood flow to the skin increases causing a decrease of flow to vital organs. –Results in mild shock with cold, clammy and pale skin together with fainting and vomiting. –If not treated the victim may suffer heat stroke; Heat stroke – is life threatening. –The temperature control system stops working. –If body temperature >39 o C, potential for brain damage and death if cooling does not occur.

11. Vulnerability Those at greatest risk of harm from high temperatures include: –The old, especially >65 years –The young, especially <2 years –The pregnant and breastfeeding –The obese –Those who are not acclimatized to the heat, e.g. new arrivals –Those who have underlying medical conditions, especially cardiovascular disease –Athletes and other participants in outdoor recreational activities –Manual labourers, outdoor workers

12. DOH and Heat Alerts DOH puts out alerts for the public when: –Maximum daily temperatures exceed 35 degrees for 3 days or more –Minimum daily temperatures exceed 23 degrees for 3 days or more Heat wave information on Public Health Website at: http://www.public.health.wa.gov.au

13. Other Health Impacts from Increased Temperatures Water Borne Disease (Gastro- intestinal) –Temperature increase in recreational waters –Change in incidence of water-borne pathogens such as cryptosporidium, campylobacter, amoeba –Increase in toxic algal blooms Water Supply (Increased treatment costs) –Warmer temperatures and thus reduced dissolved oxygen –Reduced water quality –Warmer water from rainwater tanks

14. Other Health Impacts from Increased Temperatures Food borne Disease (Food Poisoning) –May increase proliferation of bacterial pathogens including Salmonella, Campylobacter and Listeria spp. –May increase mycotoxins and aflatoxins in seafood Food Production (Dietary and nutritional changes) –Changes in crop yields and protein levels (+/-) –Effects on feed intakes and animal reproduction –Changes to pests, weeds and diseases –Changes to use of agrochemicals

15. Other Health Impacts from Increased Temperatures Air Quality (Respiratory Effects) –Increased production pollen, aeroallergens, dust, increased off-gassing of VOCs –Increased risks from particulates associated with bushfires or controlled burning –Increased use of evaporative air conditioners and water conserving products (mulch) with links to Legionnaire's Disease –Increased exposure to pesticides UV Exposure (Skin cancers, eye disease) –increase time spent outdoors and thus increase UV exposure

16. Other Health Impacts from Increased Temperatures Vector Borne ( Ross River Virus, Barmah Forrest Virus, Dengue, Murray Valley Encephalitis, Other exotic diseases) –Impacts on: Complex ecological cycles of the diseases, Ability for systems to respond Lifestyle/behavioural –Increases in crime - particularly involving aggression, –Accidents - workplace and traffic, –Decline in physical health –Hot nights cause sleep deprivation

17. Other Health Impacts from Increased Temperatures Lifestyle/behavioural –Recreational opportunities - changes to exercise patterns, –Changes in alcohol consumption, –Stress –Lack of cold water – reduced ability to cool down Economic –Loss of income and/or assets, –Reduction of goods and services, –Higher costs of insurance, food, water, energy –Financial strain for LGs.

18. Risk Assessments and Heat RiskHealth Impacts arising from: Extreme Heat events UV exposure Reduced access to health care, food and water Inability to meet energy demand Extreme/High Fires Changes to air quality High Flooding Drinking water contamination Pathogens in recreational waters Changes to disease vector distribution and abundance Exposure to allergens Food Poisoning Impacts to Mental Health

19. Adaptation Responses Health sector not responsible for implementation of actions to mitigate the effects of heat (and other aspects of climate change) Requires consideration by sectors tasked with planning for and responding to changes LGs have key role in many areas

20. Adaptation Responses Must be formulated to cope with the effects of unavoidable climate change Can be broken down into measures similar to those used for public health: –primary adaptive measures: actions taken to prevent the onset of disease arising –secondary adaptive measures: preventive actions taken in response to early evidence of health impacts, and –tertiary adaptive measures: health-care actions taken to lessen the morbidity or mortality caused by the disease Most LG involvement in Primary and Secondary measures

21. Adaptation Responses Adaptation measures were categorised as: –Legislative or Regulatory –Public Education or Communication –Surveillance and Monitoring –Ecosystem Intervention –Infrastructure Development –Technological/Engineering –Medical Intervention –Research/ Further Information

22. LG Planning for Health Input to regulatory changes: –Minimum energy efficiencies in homes –Limiting power use in high demand/emergency periods –Energy for essential services and communal cooling centres –Protection of vulnerable groups –Periodic reassessment of building codes –Other infrastructure requirements –Funding requirements

23. LG Planning for Health Local public health response mechanisms: –Heat Event Response Plans –Air quality improvement plans –Raising awareness locally and increasing community engagement Communication to aged care facilities, refuges for homeless, day-care centres, schools Communication for difficult to reach groups – remote, non- English speaking tourists, mobile population Education campaigns on heat management and avoidance procedures Local information (websites, newspapers, etc) Local partnerships

24. LG Planning for Health –Integrated vulnerability assessments –Incorporation of adaptation measures into long term planning and policies –Monitoring and surveillance programs –Community response mechanisms

25. LG Planning for Health Input to local infrastructure change requirements: –Housing and public buildings (eg, insulation, guidelines, passive-solar) –Air conditioning unit design –Preventative measures other than air conditioning –Urban design to reduce urban heat island effect –Costs associated with vegetation loss in development –Local green space –Water efficiency and building material improvements –Alternative energy use and diversification of power supplies

26. For further information For WA Government publications –Office of Climate Change WA http://dec.wa.gov.au For WA Health Climate Change Publications –Public Health Division http://public.health.wa.gov.au

27. Thank you