Transcript Key Vulnerabilities to Public Health - Jonathan
Climate change
Public Health
in the Great Lakes Region:
Key Vulnerabilities to Climate Change Webinar Series Ohio State University Sept. 28, 2010
Jonathan Patz, MD, MPH
Nelson Institute & Dept. Population Health Sciences
University of Wisconsin - Madison
HEALTH EFFECTS OF CLIMATE CHANGE Urban Heat Island Effect
Heat Stress Cardiorespiratory failure
CLIMATE CHANGE
Temperature Rise
1
Sea level Rise
2
Hydrologic Extremes
1 2
3
°
C
by yr. 2100
40 cm
“ “ IPCC estimates
Patz, 1998
Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees
Respiratory diseases, e.g., COPD & Asthma Malaria Dengue Encephalitis Hantavirus Rift Valley Fever Cholera Cyclospora Cryptosporidiosis Campylobacter Leptospirosis Malnutrition Diarrhea Toxic Red Tides Forced Migration Overcrowding Infectious diseases Human Conflicts
Probabilities of future extremes can be estimated given projections of mean temperature
2057 2007 Peterson et al., 2007
Heatwave morbidity -Milwaukee
Li, et al. , unpublished (
EPA STAR grant
, J. Patz, PI)
•
By 2050, warming alone may days
2006)
increase by 68% the number of Red Ozone Alert across the Eastern US.
(IPCC, 2007 -Bell et al, •
“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 cyclones climate change-induced decreases in the frequency of surface .”
(IPCC, 2007 )
Days per summer (June, July, August) with O3 above the NAAQS limit of 84 ppb. Colored, solid lines reflect the 10-year running mean of exceedances for each model (mean across SDSM ensembles, and across the study sites). Colored dotted lines reflect year-to-year exeedance values (mean across SDSM ensembles, and across the study sites).
Holloway et al. 2009
USA: Combined sewer overflows (CSOs)
Courtesy: Kellogg Schwab
1.2 trillion gal of sewage & stormwater a year discharged during combined sewer overflows – would keep Niagara Falls roaring for 18 days
Center for Water & Health, JHU Bloomberg School of Public Health
Combined Sewer Systems & Past Precipitation Trends
CSS Communities
770 systems serve around 40 million people
Past Precipitation Trends Source: EPA Source: EPA (Courtesy– J. Scheraga) Source: National Climatic Data Center/NESDIS/NOAA
Sewage overflows in the Great Lakes
•
Intense storm events result in combined sewer overflows (CSO’s)
•
Great Lakes provides drinking water to 40M people and has >500 beaches
•
Sewage contains human pathogens including viruses, protozoan, and pathogenic bacteria
•
The EPA has estimated 140 communities release 150 billion liters of combined sewage each year
Rainfall Urban stormwater Sewage overflow
E. coli
CFU/100 ml 0-100 100-235 235-999 1000-9999 10,000-20,000
Courtesy: Sandra McLellan UW-Milwaukee
Bradford Beach South Shore Beach
Bradford and South Shore Beach on Lake Michigan
Reported waterborne diseases, US, from 1948 1994
•
67% of waterborne disease outbreaks were preceded by precipitation above the 80th percentile
(across a 50 yr. climate record), p < 0.001
•
51% of outbreaks were preceded by precipitation above the 90th percentile,
p < 0.002
• Surface water-related outbreaks had strongest correlation with extreme precipitation in the month of outbreak; groundwater-related outbreaks lagged 2 months following extreme precipitation.
Curriero, Patz, et al, 2001.
Globally Averaged
U.S. CCSP, 2008
Projected Change in the Frequency of 2" Precipitation Events (days/decade) from 1980 to 2055 based on downscaled climate models (http://www.wicci.wisc.edu)
Courtesy: Steve Vavrus (UW-Madison
Courtesy: Steve Vavrus (UW-Madison)
The Good News about climate change and our health
The opportunity for improving health determinants
We can reduce:
The
1,000,000 annual deaths
urban air pollution from The loss of 1.9 million deaths, and
19 million years of healthy life, from physical inactivity
WHO, 2007
700,000
Figure 1: Ten Leading Causes of US Deaths per year (CDC, 2004)
Ten Leading Causes of US Deaths per Year (CDC, 2004) 600,000 500,000 400,000 300,000 200,000 100,000 0
He ar t D M is ali ea se gn an t N eo pla Ch sm ro Ce nic s re L br ow ov er as R cu es la pir r at or y D is ea Un se in te nt io na l In ju ry Di ab et es M ell itu s Al zh eim Cause of Death er In 's D flu is en ea za se a nd Pn eu m on ia
Ne ph rit is S ep tic em ia
Sedentary Lifestyle Air Pollution Motor Vehicle Crashes Non Transport Related
• • • •
Asthma and Air Pollution
Natural experiment during 1996 Summer Olympic games in Atlanta Peak morning decreased 23% and peak ozone traffic levels decreased 28% Asthma -related emergency room visits by children decreased 42% Children’s emergency visits for non-asthma causes did not change during same period Friedman et al. JAMA 2001;285:897
Comparative Scenario
The
Natl. Personal Transportation Survey
reports median trip length in urban and suburban areas of the region to be 4-8 km, representing
~20% of VMT
for the region. Our alternative scenario thus
assumes that all round trips of 8 km or less could be accomplished through alternative modes of (non ICE) transportation.
Grabow et al (in review)
•
20% fewer car trips: Change in O
3
& PM
2.5
hundreds of lives saved
•
Thousands of Hospital admissions avoided
•
Billions reduction in health care costs
Grabow et al (in review)
Value of co-benefits is large $2 – 196
/tCO 2 with a mean of $49/tCO 2
Fig 1 and fig 2
Compare to
cost
of climate policy: almost always <$30/tCO 2
22 Nemet G F, Holloway T and Meier P 2010 “Implications of incorporating air-quality co-benefits into climate change policymaking”
Environmental Research Letters
014007 Nemet et al. 2010
Decision Support
• In adapting to climate change, we need to include health
co benefits
stemming from mitigation policies; thus far, one-sided discussions of costs
Educational website:
www.ecohealth101.org
Thank you!
www. sage.wisc.edu