Transcript 12Aug2016CSIR_Climate Change and Healthx

Climate change and human health
Dr Rebecca Garland
Climate Studies, Modelling and Environmental Health Research Group,
Natural Resources and the Environment Unit,
CSIR
Gauteng Climate Change Forum Meeting
12 August 2016
Introduction: CSIR Climate Studies, Modelling and Environmental Health
Research Group at CSIR
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Perform regional and global climate modelling
– Working towards improving representation of
Africa in global climate model that we run
(CCAM)
– Understanding impacts and risks of climate
projections
– Working across timescales – weather (days
lead time), seasonal (1-3 months lead time),
climate change (until end of the century) 
climate change and health work across these
timescales, today highlight climate change
timescales
First research focus of our health impact work was
on increasing temperatures across Africa
Southern Africa: Temperature anomalies
(departures from 1961-1990 average) since mid1970s most are positive
Rate of increase in max and min temperatures is
also increasing  Temperatures over the
interior regions of South Africa are projected to
rise at about twice the global rate of
temperature increase
Collaborative suite of projects (and plans) with
SAWS, MRC, UCT, CoJ, UP
Model simulated annual
temperature anomalies relative to
the 1971-2005 climatological
average
Blues mean cooler annual
temperature than reference period
Yellows and reds mean warmer
annual temperature than reference
period
Emission Scenarios
and Representative
Concentration
Pathways (IPCC
AR5)
Only RCP 2.6 can safely keep us
well below 2°C above preindustrial, whilst the world is
currently between A2 and RCP 8.5
© CSIR 2007
www.csir.co.za
Highlighting differences in
temperature anomaly for different
emission scenarios
CSIRO-CSIR collaboration: 0.5°
resolution global climate change
downscalings for CORDEX using
CCAM
Downscaling six CMIP5/AR5 global
climate models
© CSIR 2007
www.csir.co.za
Climate change signals may be
classified as…
Plausible
Defensible
Actionable (robust)
…and form the cornerstone for
climate services. The
temperature signal is regarded
as actionable (Engelbrecht et
al., 2015).
Figure: projected changes in
average temperatures (degrees C)
over southern Africa for 2080-2100
relative to 1971-2000 for RCP4.5
(left) and RCP8.5 (right)
CSIR-CSIRO-CHPC
© CSIR 2007
www.csir.co.za
Future climate change over
Tshwane
Warm and dry
Warm and wet
Drastic rises in temperature are
projected – an increase of more
than 4-7°C (compared to
present-day climate ) in annual
average temperature is plausible
under low mitigation scenarios
by the end of the century. Midcentury increases are plausible
to be in the order of 2-3°C.
Extreme temperature events,
number of heat waves and high
fire-danger days are projected
to increase in frequency over
Tshwane.
Cool and dry
Cool and wet
It is plausible for Tshwane to
become generally drier with a
higher frequency of dry-spell
days, but with an increase in
intense thunderstorms.
Health Sector: Critical to understand impacts
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Climate change can impact human health in many ways  Mapping potential health
impacts from climate change turns into a spider web
Many current health risks have climate sensitivity, e.g.,
– Air pollution: formation and transport; allergens
– Malnutrition: food security
– Vector-borne diseases: malaria transmission
– Water: drought, flood and waterborne diseases
IPCC AR5 states that largest risks will be in those populations currently impacted by
climate-related diseases
Strong need for research to understand and unravel impacts, and to develop
adaptation strategies – esp in Africa
Health Impacts of Climate Change
Source: Confalonieri et al. 2007 IPCC AR4
• IPCC AR4 mapped out health impacts from climate change
• “Modifying influence” shown here may impact exposure to climate
change impacts, or change to magnitude of the health effects (e.g.,
overburdened health care system may lead to greater health impacts as
can not treat those who become ill)
What are health impacts from increasing temperatures?
• Exposure to extreme
temperature increase mortality
and morbidity
• Ballester et al. (2011) studied
health impacts in Europe
– Relationships of cold and hot
weather to health different  hot
end of curve increasing more
rapidly and non-linear
– Note relationship across
parameters
• In general, those that are
especially vulnerable to heat
stress are
Source: Ballester et al. Nature Communications, 2011
– Elderly
– In urban areas (pollution and
urban heat island effect)
– With pre-existing cardiovascular
and respiratory disease
– With compromised coping
capacities
Heat waves – when heat impacts become obvious
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August 2003 heat waves across Europe – hottest summer in over 500 years, 3.5°C above
normal, estimates up to 45 000 heat-related deaths
Some of those at higher risk of mortality – over 75 yrs old, being female or being an
unmarried man
Source: Confalonieri et al. 2007 IPCC AR4
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Climate Change and Human Health Research
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Looking at “those who are vulnerable”, many people in South Africa fit those
characteristics AND modelled temperature projections show increases as great as 46˚C for region by 2100
 Will increasing temperatures from climate change be a health risk? And if so,
where? Where are the hotspots?
This project: Analyzed the risk to human health from increases in temperature over
Africa – from current to 2100 under business as usual scenario (A2 scenario for
IPCC AR4)
Additional factors not taken into account yet, such as
• Background health
• Acclimatization – not well understood how quickly populations can
acclimatize. Also, technological interventions (e.g. AC, may not be practical
for many populations)
Dearth of data on response in Africa to extreme temperatures
Limited studies in Africa to document impacts and understand
temperature-health relationship
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Most epidemiological studies to understand the association between temperature
and health have been in industrialized countries in temperature climates  few
studies from Africa
An example of recent research on developing this relationship for Africa
Study used “75th percentile temperature” as a threshold value to discuss
increases in mortality risk
Very few data available for this type of analysis across the continent – South
Africa is not different – however heat is a public and occupational health risk
Informal settlements in Nairobi
Egondi et al., 2012
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Use Apparent Temperature to describe health impacts
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Apparent Temperature (AT) describes “how hot it feels”
– Combines Temperature, Relative Humidity and wind speed
AT can then be related to health impacts through Symptom Bands
We used a symptom table developed by US National Weather Service  potential
limitations as relationship has not been tested in southern Africa
Symptom Band AT (˚C)
Health Impact/Symptom
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27-31
Fatigue possible with prolonged exposure and/or physical activity
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31-41
Sunstroke, heat cramps and heat exhaustion possible with prolonged
exposure and/or physical activity
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41-54
Sunstroke, heat cramps, or heat exhaustion likely and heatstroke
possible with prolonged exposure and/or physical activity
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>54
Heatstroke/sunstroke highly likely with continued exposure
Source: “Heat Index” http://www.crh.noaa.gov/pub/heat.php
Number of days where AT>27˚C (Hda2)
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The maximum AT for these time
periods were used:
• Number of days within a
band for reference period:
1961-1990
• The projected change in
number of days relative to
the reference period
• Results shown as an average
projected change in days per
year for three time periods
• Joburg Example: 34.5 (ref) +
37 (2011-2040) = 71.5
average projected days per
year with AT>27˚C
No decreases projected: largest
increases in southern Africa and
East Africa highlands.
Ref:1961-1990
Change: 2011-2040 vs. Ref
Change: 2041-2070 vs. Ref
Change: 2071-2100 vs. Ref
Garland et al., 2015
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• Also, analyzed AT ≤ 27 ˚C  decreases across whole region for all time
periods
Focusing on South Africa
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Maps highlight present day
climate (A), and then change
in hot days
Gauteng projected to see
large increases in hot days
Graph – avg. hot days per
year (10th, median and 90th
percentile  show spread in
projections)
This study the focus was on
Africa and utilized global runs
 tailored regional climate
modelling for decision support
can be performed at higher
resolution
CCAM seamless system
across timescales – e.g.
seasonal timescale for
planning for hot seasons
Importance on Non-climate factors
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With respect to climate change, health sector focuses on adaptation
– In a changing climate, what are we going to do to protect the health
of South Africans?
Large focus needs to be on non-climate factors: Non-climate factors are
everything else that can increase vulnerability or protect
people’s/community’s health
This are critical as we can control these  we can’t always eliminate
increased risk to health from climate change, but we can aim to
decrease the impact
– Temperature: heat-health action plans and early warning systems
with public health advice
– Air pollution: decrease emissions, early warning systems with public
health advice
– Water-borne diseases: Continuous supply of clean drinking water,
even in floods/droughts/etc.
Early warning systems, climate and health surveillance, and on the
ground action are key needs to adapting to climate change in
health sector
Heat Alert and Response Systems (HARS)
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Heat Alert and Response Systems (HARS) have been successful in mitigating health
impacts – few in tropical and sub-tropical countries  necessary for South Africa
communities
HARS is set of measures that will be enacted when “high temperatures” are forecast 
need effective forecasts (and what is “high temperature”) and effective management and
intervention system
Health Canada has created a framework for the development and implementation of
HARS, through assessment of existing HARS across countries. The core elements are
– community mobilization and engagement through a lead organization to prepare
community for the upcoming heat season, as well as to identify any needs in the
community
– an alert protocol that will be followed, which begins with identification and forecasting
of weather conditions that may have an impact on health, and the communication of
when this will happen (i.e. through weather forecasts) to key leading organizations
and stakeholders
– a community response plan that implements the agreed upon interventions and
actions that will be implemented to mitigate health impacts during a heat alert period
– communication plan that provides advice on individual actions that can protect health
from high temperatures
– an evaluation plan, to assess the HARS and its performance..
Summary
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Climate change is expected to have large impacts on health, but little is known what
impacts have already happened and what might happen in future area where
local observations and information are needed
Warming has already been happening
Many current health issues are climate-sensitive and thus may be impacted by
climate change  adding an additional stressor to health field (public and
occupational)
Important to include assessment of non-climate factors into understanding what
might be health impact
Projections of hot days for South Africa show large increases in “Hda2” for Gauteng
Province. Moving forward need to quantify potential risk – need local relationships of
temperature and mortality. Also, on-going work on heat wave projections.
Current critical needs are in local studies of impact of climate on health (past present
and future)  DATA
Recent articles on heat-health
Bidassey-Manilal, S., Wright, C.Y., Engelbrecht, J.C., Albers, P.N., Garland, R.M. and Matooane, M.
“Students’ perceived heat-health symptoms increased with warmer classroom temperatures in
Johannesburg, South Africa” International Journal of Environmental Research and Public Health, 13,
2016.
Garland, R.M., Matoaane, M., Engelbrecht, F.A., Bopape, M.J., Landman, W.A., Naidoo, M., van der
Merwe, J. and Wright, C.Y. “Regional projections of high temperature days in Africa and the related
potential risk to human health” International Journal of Environmental Research and Public Health, 12,
12577-12604, 2015.
Engelbrecht, F, Adegoke, J, Bopape, M.J., Naidoo, M., Garland, R.M., Thatcher, M., McGregor, J.,
Katsfey, J., Werner, M., Ichoku, C. and Gatebe, C., “Projections of rapidly rising surface temperatures
over Africa under low mitigation” Environmental Research Letters, 10, 2015.
Upcoming SARVA Hard Copy Atlas Health Chapter, case study on heat-health and HARS
Thank you!
Rebecca Garland
[email protected]
Extra Slides
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Top Hda3 = Days where ATmax ≥32 ˚C
Middle Hda4 = Days where ATmax ≥39 ˚C
Bottom Hda5 = Days where ATmax ≥51 ˚C
Reference on left, change in 2071-2100 on right
Highlights the different thresholds where
projected increases in hot days begin – different
for different areas
Below – can use projections to analyse the
projected rate of increase  acclimatization
possible?
Garland et al., 2015
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City of Tshwane – Current Climate
• Tshwane is located in the
summer rainfall region of
eastern South Africa,
an annual average rainfall of
about 670 mm
• Isolated heat thunderstorms
and wide-spread rainfall occur
frequently during the warmer
months.
• Experiences storms frequently
associated with hail, damaging
winds and flash floods;
occasionally experience
drought and heat waves
• The Figure shows the annual
cycle in rainfall (mm, top) and
temperature (°C, bottom)
over Tshwane