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The Effect of Climate Change on

Human Health
Spring 2012, Lecture 13

Overview of Effects
Climate change is expected to have a major influence
on certain types of disease
Changes in both temperature and humidity will play
an important role
Some of the effects are already being seen
Some increased health risk will be due to extreme
weather events, like the 2010 heat wave in Russia,
but many problems will involve continual climate
modification
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Increased Risk and Benefit


Some climate changes may produce health
benefits, but most will increase risk
The following slides outline a few examples

Increased Heat
Risk - More deaths and increased disease risk
due to very hot days
Benefit Fewer winter deaths and disease
events

Heat-wave Effects
According to the IPCC Fourth Assessment
(2007), by 2100:
o Chicago is projected to experience 25% more
frequent heat waves
o Los Angeles is expected to experience a four to
eight-fold increase in heat-wave days

Those with heart problems, asthma, the elderly,


the very young and the homeless can be
especially vulnerable to extreme heat
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Increased
Heat Stress

Schematic representation of how an increase in average annual temperature


would affect annual total of temperature-related deaths, by shifting distribution
of daily temperatures to the right
Additional heat-related deaths in summer would outweigh the extra winter deaths
averted (as may happen in some northern European countries)
Average daily temperature range in temperate countries would be about 530C.

Food Poisoning
Risk increases due to higher temperatures
Salmonellosis is especially likely to be a
problem

Aero-allergen Production
Risk Increased allergic disorders, including
hay fever and asthma due to longer pollen
seasons
Benefit Reduced exposure to aero-allergrens
in some places due to lower productions or
shorter seasons of pollen circulation
o Higher temperatures and changed humidity may
make the growing seasons shorten for some plants
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Effects of Extreme Temperatures


A European study of hospital admission data for a
dozen major cities found that for every 1C rise in
temperature, hospital admissions for respiratory and
asthma-related illness increase up to 4.5% among the
elderly
The Russian heat wave of 2010 doubled the death rate
in Moscow to 700 people per day during the heat
wave
During the summer 1995 heat wave in Chicago, it is
estimated there were 700 excess deaths due to heat
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Water-borne Infection
Risk - Cholera risk will increase in coastal or
estuarine regions, due to a warming of water
temperatures
Benefit risk will diminish in areas where
heavy rainfalls decrease

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Vector-borne Infections
Risk Both mosquito and tick borne
infections are likely to increase
Benefit In areas of diminished rainfall,
mosquitoes, ticks, and snails may become less
prevalent, and regions of very high
temperatures may also decrease these vectors

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Vector-borne Disease and Climate


Associations
Vector-borne diseases have been shown to be
associated with changing climate conditions,
especially El Nino-Southern Oscillation
(ENSO ) events
o Malaria South Africa, Columbia, Venezuela
o Dengue fever Asia-Pacific
o Ross river virus Australia
o West Nile Numerous places, including the U.S.
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Vector-borne Disease
In epidemiology, a vector is an insect or any living
carrier that transmits an infectious agent
A vector serves two functions:
o It is required for part of the parasite's developmental cycle
o It also transmits the parasite directly to subsequent hosts

Most commonly known vectors consist of arthropods,


domestic animals, or mammals that assist in
transmitting parasitic organisms to humans or other
mammals
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Common Vectors

Mosquitoes serve as
vectors for Malaria,
Dengue fever, Yellow
fever, and Chikungunya

Ticks can serve as vectors for


Lyme disease, Rickettsia, and
Babesiosis

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Climate Effects on Disease Vectors


High temperatures affect both vector and
pathogen
Rainfall effects are more complex
o Heavy rainfall and flooding may trigger outbreaks
of diarrhea in areas where crowding and poverty
are present
o Very high rainfall can reduce mosquito populations
by flushing larvae from their habitat in pooled
water
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Increased Malaria Risk


The IPCC has noted that the global population
at risk from vector-borne malaria will increase
by between 220 million and 400 million in the
next century
While most of the increase is predicted to
occur in Africa, some increased risk is
projected in Britain, Australia, India and
Portugal
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The Effect of Increased Heat


Hotter, more humid weather shortens mosquito
breeding cycles
The incubation of dengue virus is speeded up by
increased temperatures
Milder winters also allow the survival of many
disease related organisms
o Mosquitos, tics and mice
o Lyme disease, Rocky Mountain spotted fever, equine
encephalitis, anaplasmosis, and bebesiosis
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Pesticides and Health


In the decades of the 1950s and 60s, DDT was
widely used to curtail mosquito breeding grounds
In her 1962 book Silent Spring, the late Rachel
Carson pointed out the tremendous environmental
havoc being wrought by DDT and related compounds
Current opinion is that curtailing DDT may have
contributed to the current problem, but todays
problems go well beyond the use of pesticide

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Public Health Opinion


John Balbus, senior adviser for Public Health at the
National Institute for Environmental Health Sciences
siad in an article in the December, 2010 Discover
magazine:
o Climate change will cause a worsening of the common
health problems we already see. There will be incremental
changes in the next 5 or 10 years, but that might not
compare to what were going to see in a matter of decades.
In trying not to be alarmist, scientists have systematically
underestimated the threat.

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West Nile Virus


Another vector borne disease is West Nile virus
It first occurred in Uganda in 1937, with later
outbreaks in Israel in the late 1950s, and
Romania in 1996
It has since spread to the U.S., appearing in
New York in 1999
The vector is Culex pupiens, a common house
mosquito
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Conditions for Spreading West Nile


West Nile becomes a threat after periods of hot,
dry weather
In New York in 1999, there was a period of ten
days with temperatures over 100F, followed by
heavy rains
The resulting floods created mosquito breeding
grounds, and populations increased rapidly
Birds drinking in stagnant pools of water were
infected
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Bronx Zoo
Birds at the Bronx Zoo became infected, with
deaths of several species
o Crows
o Flamingoes
o Bald Eagles

More than 30,000 West Niles cases have


occurred in the U.S. since 2002, with over
1000 deaths
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Infectious Diseases
Many infectious agents, vector organisms, non-human
reservoir species, and rate of pathogen replication are
sensitive to climatic conditions
Salmonella and cholera bacteria, for example,
proliferate more rapidly at higher temperatures,
salmonella in animal gut and food, cholera in water
In regions where low temperature, low rainfall, or
absence of vector habitat restrict transmission of
vector-borne disease, climatic changes could tip the
ecological balance and trigger epidemics
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Dengue Fever in the United States


Dengue fever was thought to be eradicated in the
U.S., but has been making a comeback
There are two forms
o Classic dengue fever has been present in northern
Mexico (Matamoros) and is occurring in
Brownsville, Texas
o Dengue Hemorrhagic Fever was seen in
Brownsville, for a resident who contracted the
disease in the U.S., in 2005, and has been spreading
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Dengue Hemorrhagic Fever


The appearance of Dengue Hemorrhagic Fever
in the United States was of great concern
o There is no vaccine to protect against it
o There is no medicine to cure it

The patient in Brownsville recovered, but


those people who have other health problems
would probably not be so lucky

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Flooding
Floods are classified as low-probability, high
impact events
For the decade 1992-2001, there were nearly
100,000 flood related deaths, and 1 to billion
people were affected by flooding

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Increased Risk of Floods


More injuries and deaths due to flooding
Increased risk of infectious disease due to
flooding, and mental health disease brought on
by flood-related stress

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Short Term Flood Effects


Some health consequences arise during or
soon after the flooding
These include injuries, communicable
diseases, or exposure to toxic pollutants
Excessive rainfall facilitates entry of human
sewage and animal wastes into waterways and
drinking water supplies, increasing the risk of
water-borne diseases
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Longer Term Flood Effects


Other effects of flooding may appear later
These include malnutrition, caused by crop
loss, and mental health disorders resulting
from the stress of flood-related problems

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Droughts
Droughts represent the other extreme of weather related
precipitation problems
Globally, disaster effects are greatest for droughts (and
associated famines) because of their regional extent,
which are usually much larger than flood-related regions
Another pollutant of concern is "particulate matter," also
known as particle pollution or PM
Climate change may indirectly affect the concentration of
PM pollution in the air by affecting natural or biogenic
sources of PM such as wildfires and dust from dry soils

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Particulate Matter
PM is a complex mixture of extremely small particles
and liquid droplets
When inhaled, these particles can reach the deepest
regions of the lungs
Exposure to particle pollution is linked to a variety of
significant health problems
Particle pollution also is the main cause of visibility
impairment (haze) in the nations cities and national
parks
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Poverty and Disease


Susan Fisher-Hoch, an epidemiologist at the
University of Texas School of Public Health said,
o If dengue moves into a population that hasnt experienced
it and has no natural immunity, we are going to see more
severe disease
o The way we live hermetically sealed in our houses with
screens on the windows and air-conditioning protects us
enormously. But what about those who dont live well the
people in trailer parks sitting on their porches surrounded
by mosquitoes?

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Additional Problems
According to a paper by McMichael et al.
(2006) in The Lancet, IPCC modeling
indicates a future increase of 5-10% in the
number of malnourished people
Conflicts over food, together with migrant and
refugee flows likely to result from these widerranging effects would create additional
problems
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Anticipated Consequences
These additional effects include:
o Increase in infectious disease cases
o Malnutrition
o Mental health problems
o Injury and violent death from conflict

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The Effects of Climate Change

The video shows a report that resulted from a collaboration


between the British medical journal, The Lancet, and University
College London
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