| Human Health Effects of Climate Change: The Evidence & The Knowledge Gaps Francesca Dominici NCAR October 26 2007 |
| Potential Climate Change Impacts |
| Slide 3 |
| Insect-, Tick-, and Rodent-Borne Diseases |
| Changes in weather and vegetation can affect the habitats of organisms such as mosquitoes, rats, and their parasites. | ||
| Ex. Malaria | ||
| Right now: about 45% of the worldÕs population lives in the zone for malaria transmission. Could rise to 60% | ||
| Water-Borne Diseases |
| Heavy rainfall and runoff can damage water quality | ||
| Higher risk from bacteria and infectious viruses | ||
| Especially problematic for combined wastewater systems | ||
| Climate change impact on biogenic emissions |
| Higher temperatures cause increased VOC emissions from trees | |||
| Increase of 10¡C can double biogenic emissions | |||
| Biogenic emissions can be on the same order of magnitude as anthropogenic emissions | |||
| Temperature and Health |
| "Temperature-Related Deaths" |
| Temperature-Related Deaths |
| Slide 9 |
| Not Just Warming More Extreme Events Flooding heatwaves Etc. |
| Slide 11 |
| Heat Wave in Europe |
| Prospective study in an university hospital in Lyon following the French heat wave (August 1-20,2003) | |
| A total of 83 patients presented with heatstroke | |
| 28-day and 2 years mortality rates were 58% and 71% respectively | |
| 14800 heat stroke deaths in France |
| Public health interventions |
| Worse outcomes were derived in setting in which the hospital and the community were not prepared for heat related illness, a situation that is probably similar to most communities in temperate climates | |
| Innovative ways to treat heatstroke (public health interventions) | |
| Identifying individuals at higher risk of heat strokes (susceptibility) |
| Temperature, Air Pollution, and Health |
| Air Pollution Effects |
| Climate changes could affect air pollution levels | |||
| Precipitation, wind speed and direction, temperature | |||
| Higher temperature means | |||
| Faster chemical reaction rates for formation of tropospheric ozone | |||
| More emissions of natural ozone precursors | |||
| Slide 16 |
| Slide 17 |
| Ozone Chemical Reaction Rates Increases with Temperature |
| Climate Change, Ozone, and Health |
| Are changes in climate anticipated to elevate/lower ambient ozone levels? | |
| What are the predicted patterns? | |
| What are the associated impacts on health? | |
| Slide 20 |
| Slide 21 |
| Epidemiological studies using national datasets |
| Slide 23 |
| National Morbidity, Mortality, and Air Pollution Study (NMMAPS), 1987—2000 |
| 108 urban communities | ||
| Cause-specific mortality data from NCHS | ||
| all-cause (non-accidental), CVD, respiratory, COPD, pneumonia, accidental | ||
| Weather from NWS | ||
| Temperature, dew point, relative humidity | ||
| Air pollution data from the EPA | ||
| PM10, PM2.5, O3, NO2, SO2, CO | ||
| U.S. Census 1990, 2000 | ||
| The National Medicare Cohort Study, 1999-2005 (MCAPS) |
| Medicare data include: | |||
| Billing claims for everyone over 65 enrolled in Medicare (~48 million people), | |||
| date of service | |||
| treatment, disease (ICD 9), costs | |||
| age, gender, and race | |||
| place of residence (ZIP code/county) | |||
| Medicare data |
| Nationally inclusive | |
| Availability of hospitalization and mortality | |
| Co-morbidity data available | |
| Uses routinely collected data | |
| Medical bills available for health cost estimation | |
| Encompasses multi-site time series and cohort studies |
| Integrating National
Databases for Monitoring Population Health |
| NCHF: 48 million identification numbers | |
| MCBS: subset of 15,000 Medicare participants with additional information on risk factors | |
| AIRS: air pollution monitoring network | |
| NOAA: weather monitoring network | |
| US Census: location characteristics |
| Slide 28 |
| Daily time series of hospitalization rates and PM2.5 levels in Los Angeles county (1999-2005) |
Estimating temperature-health exposure-response functions |
| Estimating health effects (mortality and morbidity) associated with heat waves |
| A surveillance model to track adverse health effects associated with extreme temperatures |
| Link national data sources on health, environmental exposures, and confounders | |
| Update these data bases to monitor health effects of environmental exposures over time | |
| Use the estimated association between extreme temperature events and health using national data sets and then predict the health impact of future climate change scenarios |