Transcript Energy and Health

Energy and Health
Energy Week 2006
Dr Maria Neira, Director
Department for Public Health and Environment
World Health Organization
Energy is good for health, but its production
and use can pose major health risks
There are major opportunities for health gains from:
+ Household energy use - for cooking, water boiling,
space-heating
+ Power generation – from fuel sourcing /extraction to
processing, distribution and waste
+ Transport policies and options
Health risks associated with energy
- Ambient and indoor air pollution
Cardiovascular disease, respiratory disease, lung cancer
- Cold and damp housing
Respiratory diseases, allergies
- Climate change
Extreme weather events, floods, vector-borne diseases
- Accidents/fires
Personal injuries and disability
- Occupational hazards
- Noise, stress
- EMF
Transport and health
•
•
•
•
•
Physical inactivity → 1.9 million deaths
Traffic injuries → 1.2 million deaths
Ambient air pollution → 800,000 estimated deaths in cities
Climate Change → over 150,000 deaths
HIV/AIDS → among truck drivers and road side populations
A disconnected response undermines health
gains from transport investments
HIV / AIDS
TRAFFIC
INJURIES
PHYSICAL
INACTIVITY
CLIMATE
CHANGE
AIR
POLLUTION
Millions of people at risk of transport health
impacts from urbanization and new roads.
• Investments in transport are a unique opportunity to get
this right.
• Transport is a public health issue and health needs to be
part of the transport agenda.
• Governments should act to ensure health is addressed in
transport.
• Why should they act?
1st. To ensure sound economic decisions
Society is unlikely to want to make
sacrifices to eliminate all risks from
transport
Transport Markets fail to deliver socially
optimal patterns as:
• Transport Costs are not all paid for the
user, and the costs borne by others
(external costs) are substantial.
• The overall use of transport, particularly
• The benefits from transport
more polluting modes, is then higher
would be further increased if
than socially optimal
certain journeys were made by
• The right investments and prices (for
different modes, or in the need
pollution, accidents etc.) would correct
to travel long distances to meet
these distortions
basic needs was reduced.
2nd. To protect the health of vulnerable
groups
• Children are especially vulnerable to
injuries, air pollution and noise, their
cognitive and physical development
require exploration of the
neighbourhood and outdoor activity.
• Children and other vulnerable groups
are exposed to risks from traffic but
enjoy few benefits from it.
• These groups often do not have a voice
to influence decisions. Governments
need to be that voice.
3rd. To promote health equity
• Healthy mobility for the poor reduces health risks for those in poverty,
and increases their access to health services, education and jobs
• Need to ensure safety of people using the most common modes of T
• Pedestrians and cyclists do not cause pollution but are exposed to
health risks caused by motor vehicle users
Main mode to work in Mumbai, India
Car
Two-Wheeler
Auto-Rickshaw
Public Bus
Train
Bicycle
On foot
All commuters
0
10
20
30
40
Percent
Low income
50
60
70
WHO's work on transport and health
Knowledge, tools and technical cooperation:
Good practice examples – where transport promotes
health
Cost benefit analysis – health costs and benefits of
transport decisions
Health impacts assessment – in connection with
environment and social assessments
Models for integrated health risk assessment from
transport in urban areas – through air pollution, injuries
and noise.
Support to countries – how to obtain health gain from
transport decisions
Mapping links between climate
change and health
Most expected impacts will be adverse but some will
be beneficial. Expectations are mainly for changes in
frequency or severity of familiar health risks
Modulating
influences
Human exposures
CLIMATE
CHANGE
• Regional weather
changes
• Heat waves
• Extreme weather
• Temperature
• Precipitation
• Contamination
pathways
• Transmission
dynamics
• Agroecosystems,
hydrology
• Socioeconomics,
demographics
Based on Patz et al, 2000
Health effects
• Temperature-related illness and death
• Extreme weather- related health effects
• Air pollution-related health effects
• Water and food-borne diseases
• Vector-borne and rodent- borne diseases
• Effects of food and water shortages
• Effects of population displacement
How does climate impact on health?
Example: Diarrhoeal diseases
Distal causes
Proximal causes
Infection hazards
Temperature
Humidity
Precipitation
Survival/ replication
of pathogens in the
environment
Consumption of
contaminated water
Living conditions
(water supply and
sanitation)
Contamination of
water sources
Consumption of
contaminated food
Contamination of
food sources
Contact with
infected persons
Food sources and
hygiene practices
Rate of person
to person contact
Health outcome
Incidence of
mortality and
morbidity
attributable
to diarrhoea
Vulnerability
(e.g. age and
nutrition)
Does climate change have
a large impact on health?
Burden of disease by region: Climate change and urban air pollution
Disability Adjusted Life Year per million. World Health report 2002.
Climate change
Air pollution
•Cardiopulmonary
diseases
•Respiratory
infections
•Trachea/
bronchus/
lung
cancers
Africa region
South-East Asia region
Eastern Mediterranean region
Latin America and Caribbean region
Western Pacific region
•Diarrhoeal diseases
•Malaria
•Unintentional injuries
•Protein-energy malnutrition
Developed countries
3000 2500 2000 1500 1000 500
0
500 1000 1500 2000 2500 3000
Household energy,
indoor air pollution and health
• Some 3 billion people rely on solid fuels
(e.g. dung, wood, agricultural residues,
charcoal, coal) for their basic energy
needs.
• Cooking and heating with solid fuels
leads to high levels of indoor air pollution
(IAP), a complex mix of health-damaging
pollutants (e.g. PM, CO).
• Women and young children, who spend
most time at home, experience the
largest exposures and health burdens.
Who is most affected?
Health impacts of indoor air pollution
Health outcome
Evidence
Population
Acute infections of the
lower respiratory tract
Strong
Children aged
0–5 years
2.3
1.9–2.7
Chronic obstructive
pulmonary disease
Strong
Women aged
≥ 30 years
3.2
2.3–4.8
Moderate I
Men aged ≥
30 years
1.8
1.0–3.2
Strong
Women aged
≥ 30 years
1.9
1.1–3.5
Moderate I
Men aged ≥
30 years
1.5
1.0–2.5
Lung cancer (biomass)
Moderate II
Women aged
≥ 30 years
1.5
1.0–2.1
Asthma
Moderate II
Children aged
5–14 years
1.6
1.0–2.5
Moderate II
Adults aged ≥
15 years
1.2
1.0–1.5
Cataracts
Moderate II
Adults aged ≥
15 years
1.3
1.0–1.7
Tuberculosis
Moderate II
Adults aged ≥
15 years
1.5
1.0–2.4
Lung cancer (coal)
Relative
risk
Relative risk (95%
confidence interval)
S
U
F
F
I
C
I
E
N
T
I
N
S
U
F
F
I
C
I
E
N
T
Highly
Neglected
Issue!
1.6 million annual deaths
• in the poorest countries
• mostly among young children
Available interventions
Changing the source
of pollution
Improved cooking devices
 Improved stoves
Alternative fuel–cooker
combinations
 Briquettes and pellets
 Kerosene
 Liquefied petroleum gas
 Biogas
 Natural gas
 Producer gas
 Solar cookers
 Modern biofuels
Reduced need for fire
 Retained heat cooker
 Efficient housing design
 Solar water heating
 Pressure cooker
Improving the living
environment
Improved ventilation
 Smoke hoods
 Eaves spaces
 Windows
Kitchen design and
placement of the stove
 Kitchen separate from house
 Stove at waist height
Modifying user
behaviour
Reduced exposure by
changing cooking practices
 Fuel drying
 Pot lids to conserve heat
 Food preparation to reduce
cooking time
 Good maintenance
Reduced exposure by
avoiding smoke
 Keeping children away from
smoke
The link between household energy and the
Millennium Development Goals?
"We will spare no effort to free our fellow men, women and children
from the abject and dehumanizing conditions of extreme poverty, to
which more than a billion of them are currently subjected."
United Nations Millennium Development Declaration, signed by all 191 Member States of
the United Nations in September 2000
MDG 1: Eradicate extreme poverty and hunger
MDG 3: Promote gender equality and empower women
Household
Energy
MDG 4: Reduce child mortality
MDG 7: Ensure environmental sustainability
WHO’s Programme on
Household Energy and Health
• Document the health burden of indoor
air pollution and household energy.
• Evaluate the effectiveness of technical
solutions and their implementation.
• Act as the global advocate for health
as a central component of
international/ national energy policies.
• Monitor changes in household energy
habits over time.
Conclusions
 We must ensure energy health risks are reduced, so
that society can reap the related benefits.
 The health sector (including WHO) have the
knowledge, tools and partners to contribute to the
understanding of energy health risks, including identifying
energy solutions
that effectively contribute to health.
w
 Thereemis a need to expand that work in partnership to
the range
u of countries and settings with the greatest need.
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 The World
Bank can enhance health gains from energy
t
e
investments
by including health issues as a key
n
consideration
for its energy lending operations, and its
s
technicalu support to countries.
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