1. Christopher J. Portier, Ph.D. Director, National Center for Environmental Health Director, Agency for Toxic Substances and Disease Registry Human Health And Global Climate Change

3. Environmental Change Environmental Change Climate Change Climate Change Human Health Human Health Greenhouse Gas and Other Drivers Adaptation Mitigation

4. Source: NASA

5. Historical and current atmospheric CO 2 (ppm) Source: NASA, IPCC

6. Relative Forcing of Climate Change between 1750 and 2005

7. Integrative Radiative Forcing of Emissions from 2000 20Years 100Years

8. Temperature anomaly (°C) by year 5-year running average Source: NASA Climate Research Unit Twelve of the last 13 years (1995-2007) are the warmest since accurate recordkeeping began in 1850.

9. IPCC Projected changes for Australia

10. Ecological Impacts

11. Melting glaciers and sea ice Source: NSIDC

12. Sea level rise: Historical (∆cm) and current (∆mm) Source: University of Colorado

14. Likely Human Health Impacts

15. Gohlke, Hrynkow and Portier, EHP June, 2008

17. General Remarks  WHO defines “environment” as “all modifiable physical, chemical, and biological factors external to the human host, and all related behaviors that are critical to establishing and maintaining a healthy livable environment”  Susceptible and Vulnerable Populations  “Susceptibility” refers to intrinsic biological factors that can increase the health risk of an individual at a given exposure level certain genetic variants life-stage such as childhood medical history such as a prior history of disease  “Vulnerability” refers to environmental factors that can result in higher risks to human populations people living in earthquake zones in houses made with mud bricks are much more vulnerable to injury from building collapse than those living in structures built with modern techniques and stronger materials displaced populations

18. General Remarks (continued)  Public Health Infrastructure  3,140 counties (or similar administrative units) in the United States and each is likely to have one or more public health agencies  state public health agencies  national public health agencies  WHO, UNEP, …  critical need for research to understand how climate change will alter our public health needs in the United States, and to design optimal strategies to meet those needs  Health Care Infrastructure  more diverse and complicated than the public health infrastructure  not organized or optimized  likely to see changes in the numbers of patients and the spectrum of diseases they present  critical research need

19. General Remarks (continued)  Health related engineering infrastructure  Sea level rise, coastal erosion, and population displacement will create challenges for health-related infrastructure that has been constructed over a period of hundreds of years  coastal routes and harbors threatened by sea level rise will present additional challenges to health care delivery, equipment distribution, and food distribution  sewer and water resources in coastal locations may be threatened directly by sea level rise  Capacities and Skills Needed  skills needed to integrate current and future surveillance activities, retrospective datasets, and weather and climate information  health education and behavioral science

20. primarily asthma, hay fever, rhinitis, and atopic dermatitis for allergies primarily chronic obstructive pulmonary disease (COPD) in adults impact approximately 50 million individuals within the United States management of asthma and other allergic diseases relies on several factors including strict control of exacerbation triggers of the diseases

21. Asthma, Allergies and Airway Disease  Air quality changes  climate variables (temperature, humidity, etc.), CO 2, and other air pollutants may alter the production, distribution, and allergenicity of pollen particles  climate change is likely to alter airborne dust, including indoor dust, and changes in dust composition resulting in asthma exacerbation  wildfires from reduced rainfall will impact asthma and other respiratory diseases, both acutely and over time  COPD is sensitive to air pollution levels which will change in complex ways with the changing climate  Floods and extreme weather  molds and mildew exacerbate existing lung disease and cause others  Oceans  harmful algae blooms which can increase in frequency and intensity with changing weather could exacerbate asthma attacks

22. Asthma, Allergies and Airway Disease  Mitigation and adaptation  Energy and transportation Could increase or decrease certain air pollutants increasing or decreasing lung disease Walking and bicycling can reduce pollution but increase traffic deaths New fuels for cars could create new air pollutants with unknown impacts on lung function Depending on the source for electricity, electric cars could increase air pollution and/or greenhouse gases  Increased air conditioning use could reduce heat-related morbidity and mortality but increase demand for energy and increase pollution levels

23. Plant Hardiness Zone Maps 1990 and 2006 More Pollen

24. Summertime Average Daily Ozone Based on IPCC Predictions

25. Gohlke, Hrynkow and Portier, EHP June, 2008 A comparison of mortality attributable to energy sources using estimates from available models Climate Change Related Deaths Power Generation Related Deaths Oil: 700K Coal: 220K Traditional Biomass: 1500K

26. Woodcock, et al, Lancet, Nov. 2009

27. refers to a group of diseases in which abnormal cells divide without control and are able to invade other tissues more than 100 different types of cancer second leading cause of death in the United States after heart disease, killing over half a million people every year

28. Cancer  Flooding from extreme weather events and sea level rise  storage or from lands containing toxic chemicals such as PCBs, mercury, dioxin and tetrachloroethylene could be released causing increased cancer risks  some pesticides are cancer hazards and runoff could lead to greater exposure  increased arsenical leachates from treated wood products also could lead to greater cancer risks  Altered atmospheric chemistry  increased temperature appears to alter the quantities of pollutants in the lower atmosphere, pollutants that are known to cause lung cancer  the altered atmospheric chemistry may also alter UV-induced skin cancer rates

29. Cancer  Mitigation and adaptation  Reducing our reliance on fossil fuels is likely to reduce current levels of air pollutants that are known to cause lung cancer  Biofuels produce novel air-pollutants and/or differing levels of existing air pollutants that may increase or decrease cancer risks  Changes in agricultural practices might alter exposures to pesticides, herbicides and other contaminants in the human environment, some of which are associated with various cancers  Alternative energy sources such as batteries for electric cars use metals and other chemicals that are known or suspected to cause cancer and their life cycle needs to be carefully evaluated for health risks; truly novel and exotic battery technologies have unknown cancer risks  Photovoltaic systems use a variety of compounds that, in the occupational setting, may alter cancer risks  Increased use of nuclear fuels increases the probability of release; radiation causes a variety of cancers