Water, Health, and
Climate Change
Linda Rudolph, MD, MPH
May 27, 2015
Water is essential for life.
Water is a human right.
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2012 California Human Right to Water bill
“…every human being has the right to safe, clean, affordable, and
accessible water adequate for human consumption, cooking, and
sanitary purposes.”
What do we use water for?
• SUSTAIN LIFE
• Stay hydrated
• Grow food, fiber, trees
• Sanitation and hygiene
• Sewer systems
• Wash hands, bodies, food,
homes
• Hydropower
• Transportation
• Aquatic and riparian habitat
• Cultural and spiritual
• Recreation
• Aesthetics
• Landscaping
Water for Life
•
Sufficient: Between 50 and 100 liters of water per person per day are
needed to ensure that most basic needs are met and few health
concerns arise.
•
Safe: free from micro-organisms, chemical substances and
radiological hazards that constitute a threat to a person's health
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Acceptable in color, odor and taste for use
•
Accessible: the water source has to be within 1,000 meters (0.6 mi)
of the home and collection time should not exceed 30 minutes
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Affordable: water costs should not exceed 3 per cent of household
income.
http://www.un.org/waterforlifedecade/human_right_to_water.shtml
:
Sanitation and Safe Drinking Water
• Among the great public
health achievements of
the 20th century
• Chlorination and other
drinking water treatment
• Sewage disposal
• Solid waste disposal
• Food safety
• Public hygiene education
But…..
•
1.1 billion people (1/6) do not have access to a safe and adequate water supply.
• May increase to 2.3 billion by 2025
•
2 – 3.5 million people – mostly children < age 5 in developing nations – die
each year from diseases due to unsafe drinking water, inadequate sanitation, or
poor hygiene
•
Water withdrawals tripled over the last 50 years
• Demand for water for food production is projected to double by 2050 In 2010, nearly
all megacities were facing water scarcity
• Almost half world population will be living in areas of high water stress by 2030
• Climate change increases high water stress
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Global water availability is sufficient to meet the personal and domestic needs
of all human beings. But as demand for water from all sectors exceeds
availability, prioritization of uses becomes all the more important.
http://www.zaragoza.es/contenidos/medioambiente/onu/1048-eng_report_of_special_rppP
rteur_on_human_right_to_safe_drinking_water_and_sanitation.pdf
https://www.facingthefuture.org/IssuesSolutions/FastFactsQuickActions/WaterSecurity/tabid/185/Default.aspx#.VWUHNcbD7Sk
Africa Average
5 gpcd
USA Average
100-176 gpcd
http://www.mercurynews.com/science/ci_25090363/california-drought-water-use-varies-widely-around-state
Climate change impacts on water in California
Drier Dries
Higher Highs
Reduced Runoff
Hotter Hots
Wetter Wets
What are the health impacts of
climate-change impacts on water?
• Water availability and cost
• Water quality
• Water and food production
• Flooding
• Infectious diseases
• Water infrastructure
• Mental health
Drought & Climate Change
• Warming temperatures due to climate change
• Larger fraction of precipitation falls in downpours
• More storm water lost to storm runoff (vs absorbed in soil)
• Larger fraction of mountain precipitation fall as rain rather
than snow
• Snowpack melts earlier due to warming
• Reduced stream flows in late-spring, summer
• Higher evaporation rates
• Losses of water from reservoirs
• Drier soil
• Arctic ice loss may change the jet stream
How bad is this drought?
May 19, 2015
Drought Health Impacts
• Water Quality
• Water Availability and
Affordability
• Food Costs and Insecurity
• Vector-borne disease
• Stagnant pools
• Improper water storage
• Wildfire
• Air Quality
• Increased dust and particulate
levels
• Increased pollen
• Wildfire smoke
• Airborne toxins from freshwater
algal blooms (cyanobacteria)
• Recreational risks
• Unemployment &
economic impacts
• 1/3 CV jobs related to farming
Water quantity
• Most communities in
California not reliant on
a single source of water,
but some are
• Some groundwater
reliant on annual rainfall
• Some small systems
reliant on stream flow
• Some communities
facing acute water
shortages now
Water quality
•
Increase concentration of pollutants and contaminants in groundwater and
surface water
• Toxics and metals
• Bacteria, protozoa, amoeba (warming and concentration)
•
Over 21 million Californians rely on contaminated groundwater as primary
source of drinking water
• Over 4 million people (especially in rural areas) highly vulnerable to groundwater
contamination
•
Use of recycled water for food irrigation/processing may increase risks of
E. coli and Salmonella
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Clean-up of contaminated water very costly
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Reduced stream and river flows can cause stagnation & low O2 levels
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US EPA estimates California will need to spend approximately $40 Billion
on infrastructure improvements to ensure delivery of safe drinking water
over next 20 years
Drought and Food
• Limits in growing season
• Reduced yields due to crop loss or
fallowing
• Conditions that encourage insect and
disease infestation in some crops
• Low crop yields can result in rising
food prices and shortages,
• Food insecurity associated with
diabetes, obesity.
• Affects health of livestock and cost of
feed
• Herd culling can increase meat and
dairy prices
• Impacts on fisheries
http://www.motherjones.com/environment/2014/02/wheres-californias-water-going
http://www.motherjones.com/environment/2014/02/
wheres-californias-water-going
Nutritional recommendations
Drought and Mental Health
• Drought stress may be different than stress in other disasters
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extended event with no single moment of impact
anxiety builds over time and becomes chronic
less noticeable to self and others
may not be viewed as seriously because damage not as visible
• Impact is worst for already stressed farm families and
communities
• May be greater for young farmers, farmers with second off-farm job,
women in farm families
• Drought and suicide
• Australia
• U.S. Mid-west
http://www.health.vic.gov.au/pcps/downloads/planning_practice_guide.pdf
Warmer Water Temperatures
Coastal and Inland Water Bodies
• Naturally occurring pathogens and
toxin-producing harmful algae
• Expand seasonal windows of growth
• Expand geographic range
• Expansion northward of invasive species
• Changes in fish populations
• Increase mercury contamination in fish
• Reduce dissolved oxygen, incomplete mixing
• Increase vectors
Extreme Precipitation & Flooding
• Warmer air holds more
moisture
• Rain falling in more
concentrated episodes
• Risk: overwhelm capacity of
• Combined sewer systems
• Water treatment facilities
Orange County Hospital, 1938
Anaheim, 1938
Public Health Issues - Precipitation
Extreme Precipitation
Sewage
overflows
Physical injuries
and destruction
of property
Increased runoff:
sediment,
contaminants,
nitrate, etc.
Contamination
of surface and
groundwater
Waterborne disease outbreaks from drinking
water or recreational contact (beachgoers):
Giardiasis, E coli, Cryptosporidium
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Flooding Health Effects
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Acute injuries & fatalities
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Contamination
• Drowning, trauma
• Increase pathogen loads from urban, agricultural, and wildlife sources
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Impacts drinking water/waste water/sewage treatment and storm water
•
Mental Health
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Disruption social networks & support
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Respiratory illness
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Chronic disease, dermatitis, arthritis
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Disruption in medications
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Soil erosion/loss
• Increased risk failure/damage
• Water infrastructure breakdown exacerbates risk (especially aging infrastructure)
• PTSD, depression, anxiety, access to mental health services
• Asthma, respiratory infection, mold
• Agriculture and aquatic habitat impacts
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Waterborne Disease Outbreaks in U.S.
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Inadequate, interrupted, or intermittent water treatment associated with waterborne
disease outbreaks
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Number of pathogens in the source water
Age of the distribution system
Quality of the delivered water
Climatic events that tax treatment plant operations
½ of waterborne disease outbreaks from 1948 – 1994 associated with extreme
precipitation
• 1993 Milwaukee Cryptosporidium Outbreak
• 1.61 M people were affected; over 400,000 w/ significant symptoms; 100 people died
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1971 to 2002: 764 documented waterborne outbreaks associated with drinking water
• 575,457 cases of illness, 79 deaths
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Estimated number of waterborne illnesses/year: 19.5 M/yr. all health outcomes
• GI illness only: estimates 12M – 16M/year
http://www.ncbi.nlm.nih.gov/pubmed/18020305
Transportation
Impacts
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Sea Level Rise & Storm Surge
• LA region sea level rise
projected:
• 5 – 24 inches) from 2000 to
2050
• 17 – 66 inches from 2000 to
2100.
• Roads, water systems, health
facilities at risk
• Saline intrusion
• Sacramento-San Joaquin Delta
http://c-change.la/sealevelrise/
Displacement and
Migration
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Public Health Role
• Educate the public about water, climate change, and
health
• Advocate for health, equity, and sustainability in water
policies and programs
• Protect our precious water resources from further
contamination
• Support actions to enhance water supply sustainably,
mindful of health concerns
• Increase monitoring for water-related health risks and
outcomes
Public Health Role
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Ensure access to adequate supplies of safe and clean drinking water, water for
sanitation and hygiene, and water for healthy food production
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Educate the public about water, climate change, and health
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Advocate for health, equity, and sustainability in water policies and programs
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Protect our precious water resources
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Support policies, programs, funding, and infrastructure to enhance water supply
sustainability
• Source protection, pollution protection, replenishment
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Water conservation and efficiency
Water recycling and reuse (e.g. gray water)
Repaired and expanded infrastructure (green and gray)
Water and soil management
Safety net systems (e.g. lifeline water rates)
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Increase monitoring for water-related health risks and outcomes
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Enhance public health preparedness for water impacts of climate change
Public Health has an important role.
Join the webinar series to learn more!
http://phasocal.org/water-initiative/
http://climatehealthconnect.org/climate-and-health-alliance/
Linda Rudolph, MD MPH
linda.rudolph@phi.org
http://www.phi.org/uploads/application/files
/h7fjouo1i38v3tu427p9s9kcmhs3oxsi7tsg1fovh
3yesd5hxu.pdf
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