Climate change – reducing the risks to health

Andy Haines

Carbon dioxide measurements since 1957Mauna Loa, Hawaii

• The rise in carbon dioxide is due to our emissions• For every 100t of CO2 emitted now, 15-40t will remain in the atmosphere in1000y• Other long-lived GHGs (methane, nitrous oxide, FCs..) give the equivalent of 20% more CO2

West Antarctic ice sheet

Arctic ice sheets

East Antarctic ice sheet

60myr 50myr 40myr 30myr 20myr 10myr Now

Millions of Years Before Present

12

8

4

0Temp oC (vs 1961-90 av temp)

+3oC+5oC

Earth’s Temperature Chart, since Dinosaur Extinction 65m yrs ago

?

Sea level 25-40 metres higher

than todayTripati et al Science 2009

Paleocene

+1.5oC

last 2m yr = ice-

age

A warming climateIPCC 2013

Surface temperaturechange 1901-2012

Global average sea level change September Arctic sea ice area

Projections of globally averaged surface temperature change from 1986-2005 IPCC 2013

+0.6C for change from pre-industrial

Projections of regional surface temperature change1986-2005 to 2081-2100 for high emission scenario (RCP8.5)

IPCC 2013

Temperature

Precipitation

Projections for other quantities

Global Ocean surface pH

IPCC 2013

+0.2m for change from 1900

An adaptability limit to climate change due to heat stress Steven C. Sherwood and Matthew Huber PNAS 2010

Exceeding peak heat stress for extended periods should induce hyperthermia in humans

‘....It would begin to occur with global-mean warming of about on 7 °C, calling the habitability of some regions into question’

D.S.Battisti and R.L. Naylor . Science 2009

France, August 2003~15000 deaths (~70,000 in Europe) Robine et al 2007

Temperature distribution across Europe on 10 August 2003 at 1500hrs

500 Watts(very heavy work)

400 Watts(heavy work)

300 Watts(medium work)

200 Watts(light work)

28 °C

32 °C

34 °C

0.2

5.5

.75

1

24 28 32 36 40

Prop

ortio

n of

tim

e ne

eded

for r

est

Source: Kjellstrom T et al, Global Health Action 2009. DOI: 10.3402/gha.v2i0.2047

Possible work intensity as a function of temperature

Wet Bulb Globe Temperature (°C)

Baseline 2000

Climate Change and Malaria Potential transmission in Zimbabwe

Climate suitability: red = high; blue/green = low

Highlands

Source: Ebi et al., 2005

Source: Ebi et al., 2005

2025

Climate Change and Malaria - Potential transmission in Zimbabwe

Climate suitability: red = high; blue/green = low

Diarrheal disease and rainfall

Global overview of 36 published reports from LMICs from 1954-2000 (Lloyd, Kovats, Armstrong. Climate Res 2007)

4% (1-7%) increase in diarrhoea incidence in children aged <5 per 10 mm /month decrease in rainfall

Reduced effect of hand washing where rainfall is low?

64

36

20

80

Percentage change in yields to 2050

-50 -20 0 +20 +50 +100

UN Devt Prog, 2009

Plus climate-related:• Flood/storm/fire damage• Droughts – range, severity• Pests (climate-sensitive)• Infectious diseases (ditto)

CLIMATE CHANGE: Poor Countries Projected to Fare Worst MODELLED CHANGES IN CEREAL GRAIN YIELDS, TO 2050

Impacts on malnutritionIncreased numbers of stunted

children

RegionMillions of additional children with stunting in 2050 due to

climate change

NCAR climate scenario

CSIRO climate scenario

South Asia 7 6

Sub-Saharan Africa 9 9

Lloyd S, Kovats RS, Chalabi Z (2011)

Many millions more people are projected to be flooded every year due to sea-level rise by the 2080s

Source: IPCC Wg II, TSI 2007.

2010 – a harbinger of things to come? Pakistan floods ~ 20 m affected Chinese floods ~ 12m displaced Russian drought and fires –wheat harvest down ~ 30% 56,000 extra deaths in Moscow and Western Russia(Munich Re estimate)

Record temperatures in 17 countries.

Deaths Attributable to Climate Change in Year 2000

14 WHO statistical regions are, here, scaled by estimated annual mortality (in 2000) due to change in climate since ~1970. Selected causes of death.

(Patz, Gibbs et al, 2007: based on McMichael, Campbell-Lendrum, et al, 2004)

Estimated annual deaths due to climate change from: malnutrition (~80K), diarrhoea (~50K), malaria (~20K), flooding (~3K)

Physical limits: small low lying islands e.g. Cayman Islands

Behavioural limits: influence where we live and why, e.g. New Orleans

Technological limits: e.g. to the flood defences such as Thames Barrier, London

There are physical, behavioural and technological limits to how much we can adapt

Fossil fuel emissions for the scenariosIPCC 2013

Health co-benefits from the ‘low-carbon’ economyThrough policies in several sectors

e.g.HousingTransportFood and agricultureElectricity generation

lignite

coal

oil

biomassgas

nuclear010

20

30

40

Death

s fr

om

air

pollu

tion

and

acc

idents

/TW

h

0 500 1000 1500

A

lignite

coal

oil

biomassgas

nuclear100

200

30

0

Case

s of

seri

ou

s ill

ness

fro

m a

ir p

ollu

tion /

TW

h

0 500 1000 1500

B

Equivalent CO2 emissions g/kW.hr-

1

0

Air pollution impacts vs CO2 emissions

Source: Markandya A, Wilkinson P. Lancet 2007

GBD estimates for air pollution deaths ( Lim et al LANCET 2012 ;380;) Ambient

particulates ~3.2m deaths p.a.

Household from solid fuels

~3.5 m p.a.Tropospheric Ozone ~ 150 k deaths p.a.

Impacts Reduced exposures e.g. to fine particles, radon, cold, mould, tobacco

smoke

Premature deaths averted ~ 5400/ year

Mt-CO2 saved (vs 1990) 55

Benefits of household energy efficiency in the UK(combined insulation and ventilation control improvements) ( Wilkinson et al 2009

7.0°C

12.5°C

7

8

9

10

11

12

SP01

Modelled health benefits of active travel and low emission vehicles: London and Delhi ( Woodcock et al 2009)

Change in disease burden Change in premature deaths

Ischaemic heart disease 10-19% 1443-2207

Cerebrovascular disease 10-18% 866-1271

Dementia 7-8% 195-250

Breast cancer 12-13% 203-211

Road traffic crashes 19-39% 47-86

Increased active travel in London--- Health effects ( also diabetes, depression , cancer of the breast and bowel)

Food and Agriculture Sector

80% of total emissions in sector from livestock production

Reducing animal source saturated fat by 30 % and replacing it with polyunsaturates could reduce heart disease deaths by ~ 15% (~ 18,000 premature deaths) in the UK

New technologies for clean energy

Building a low carbon,accessible and resilient health system

Design to reduce energy use and GHG emissions.Increase resilience to floods and heatwavesProvide care closer to home Reduce hospital vehicle emissionsEncourage use of public transportation and bicyclesUse locally sourced food and reduce animal product

consumption

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Photos: HCWH, Practice Greenhealth

Climate change has far reaching and potentially catastrophic impacts but many low carbon policies can improve health and the economy.