Transcript NCEH/ATSDR All Hands Meeting - Yale School of Public Health

Human Health And
Global Climate Change
Christopher J. Portier, Ph.D.
Director, National Center for Environmental Health
Director, Agency for Toxic Substances and Disease
Registry
Human
Health
Climate
Change
Greenhouse Gas
and Other Drivers
Mitigation
Adaptation
Environmental
Change
Source: NASA
Historical and current atmospheric CO2 (ppm)
Source: NASA, IPCC
Relative Forcing of Climate Change between 1750
and 2005
100Years
20Years
Integrative
Radiative Forcing
of Emissions from
2000
Temperature anomaly (°C) by year
5-year running average
Twelve of the last 13 years (1995-2007) are the warmest since
accurate recordkeeping began in 1850.
Source: NASA Climate Research Unit
IPCC Projected changes for Australia
Ecological Impacts
Melting glaciers and sea ice
Source: NSIDC
Sea level rise: Historical (∆cm) and current (∆mm)
Source: University of Colorado
Likely Human Health Impacts
Gohlke, Hrynkow and Portier, EHP June, 2008
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
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
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
• 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
Asthma, Allergies and Airway Disease

Air quality changes
 climate variables (temperature, humidity, etc.), CO2, 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
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
Plant Hardiness Zone Maps 1990 and 2006
More Pollen
Summertime Average Daily Ozone Based on IPCC Predictions
A comparison of mortality attributable to energy
sources using estimates from available models
Climate Change
Related Deaths
Oil: 700K
Coal: 220K
Power Generation Traditional Biomass: 1500K
Related Deaths
Gohlke, Hrynkow and Portier, EHP June, 2008
Woodcock, et al,
Lancet, Nov. 2009
• 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
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
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