1. Climate Change & Public Health NJDEP Clean Air Council 2009 Leonard Bielory, M.D. Chairman - NJDEP Clean Air Council Professor Medicine, Pediatrics, Ophthalmology and Visual Sciences UMDNJ - New Jersey Medical School Leonard Bielory, M.D. Chairman - NJDEP Clean Air Council Professor Medicine, Pediatrics, Ophthalmology and Visual Sciences UMDNJ - New Jersey Medical School

2. 2008: Melting Icebergs

3. How it threatens your health But the polar bear might not be the only threatened species

4. Climate change and air pollution Climate change and air pollution have, to a large extent, a common cause –emissions from fossil fuel burning. The combustion of fossil fuel leads to emissions of greenhouse gases (GHGs) (CO 2, methane, nitrous oxide) GHGs accumulate in the atmosphere, warming its lower layers and causing knock-on effects in the Earth System Increase temperature has a direct effect on air pollutant in particular O 3 formation Climate change and air pollution have, to a large extent, a common cause –emissions from fossil fuel burning. The combustion of fossil fuel leads to emissions of greenhouse gases (GHGs) (CO 2, methane, nitrous oxide) GHGs accumulate in the atmosphere, warming its lower layers and causing knock-on effects in the Earth System Increase temperature has a direct effect on air pollutant in particular O 3 formation

5. Climate Change Source: NASA Source: geology.com

6. Global change factors 13 1900 2100 2000 20 15 14 16 17 18 19 Earths Average Surface Temp ( O C) Year 2050 1950 1860 IPCC (2001) estimate: + 1.4-5.8 o C by 2100 IPCC (2001) estimate: + 1.4-5.8 o C by 2100 Central estimate: 2.5 o C increase Central estimate: 2.5 o C increase Band of historical climatic variability Band of historical climatic variability

7. WHO estimated mortality (per million people) attributable to climate change by the year 2000 Nature 2005;438:310-317.

8. CLIMATE CHANGE CLIMATE CHANGE Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes Urban Heat Island Effect Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees Urban Heat Island Effect Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees Heat Stress Cardiorespiratory failure Asthma, COPD, Allergies Dengue, Malaria Encephalitis, Hantavirus Rift Valley Fever Cholera, Campylobacter Cyclospora, Cryptosporidiosis Leptospirosis Diarrhea, malnutrition Toxic Red Tides Overcrowding, Forced Migration Infectious diseases Human Conflicts Heat Stress Cardiorespiratory failure Asthma, COPD, Allergies Dengue, Malaria Encephalitis, Hantavirus Rift Valley Fever Cholera, Campylobacter Cyclospora, Cryptosporidiosis Leptospirosis Diarrhea, malnutrition Toxic Red Tides Overcrowding, Forced Migration Infectious diseases Human Conflicts 1 3°C by yr. 2100 2 40 cm 2 40 cm IPCC estimates 1 3°C by yr. 2100 2 40 cm 2 40 cm IPCC estimates Patz, 1998 Health Effects of Climate Change

9. Climate Change and Respiratory Health Increased number of deaths and acute morbidity due to heat waves Increased frequency of cardio-respiratory events due to higher concentrations of ground level of O 3 Change in frequency of respiratory diseases from transboundary long-range air pollution (e.g related to fires, aerosols) Altered spatial and temporal distribution of allergens and some infectious disease vectors Increased number of deaths and acute morbidity due to heat waves Increased frequency of cardio-respiratory events due to higher concentrations of ground level of O 3 Change in frequency of respiratory diseases from transboundary long-range air pollution (e.g related to fires, aerosols) Altered spatial and temporal distribution of allergens and some infectious disease vectors Source: Environment and human Health Committee of the European Respiratory Society ( ERS) Climate change and respiratory disease: a position statement

10. Climate Change & Allergic Airway Disease

11. Stafoggia M, 2008 Risk of dying on days with temperature of 30°C (lag 0-1) vs of 20 °C in people age 65+ 4 italians cities 1997-2004

12. The severity and duration of summertime regional air pollution episodes are projected to increase in the Northeast and Midwest US by 2045- 2052 due to climate- change-induced decreases in the frequency of surface cyclones. (IPCC, 2007) By 2050, warming alone may increase by 68% the number of Red Ozone Alert days across the Eastern US. (IPCC, 2007 -Bell 2006 The severity and duration of summertime regional air pollution episodes are projected to increase in the Northeast and Midwest US by 2045- 2052 due to climate- change-induced decreases in the frequency of surface cyclones. (IPCC, 2007) By 2050, warming alone may increase by 68% the number of Red Ozone Alert days across the Eastern US. (IPCC, 2007 -Bell 2006

13. 95 US communities 1987-2000 Bell ML, 2004 95 US communities 1987-2000 Bell ML, 2004 Percentage change in daily mortality for a 10 ppb increase in ozone

14. Medina-Ramon M, 2006 Percentage change in respiratory hospital admissions and air pollution across 36 US cities 1996-1999 Change per 5 ppb O3 ( 8-h) and 10 ug/m3 PM10 (24-h)

15. 50 eastern US cities, summer months Bell ML, 2007 50 eastern US cities, summer months Bell ML, 2007 Hospital admissions Mortality Ozone effect: increase (%) from 1990 to 2050 in cause specific hospital admission and total mortality

16. Potential human health benefits from reductions in ozone and particulate matter air pollution associated with implementing GHG mitigation measures (2001-2020) (Source: Cifuentes et al. 2001) Potential human health benefits from reductions in ozone and particulate matter air pollution associated with implementing GHG mitigation measures (2001-2020) (Source: Cifuentes et al. 2001)

17. Is this the solution?

18. Climate Change & Public Health NJDEP Clean Air Council 2009 Leonard Bielory, M.D. Chairman - NJDEP Clean Air Council Professor Medicine, Pediatrics, Ophthalmology and Visual Sciences UMDNJ - New Jersey Medical School Leonard Bielory, M.D. Chairman - NJDEP Clean Air Council Professor Medicine, Pediatrics, Ophthalmology and Visual Sciences UMDNJ - New Jersey Medical School Improving Air Quality & Reducing Climate Change