PM2.5 From
Energy
Alternatives
Hill, PNAS, 2009
• diseases that pertain to the heart
or blood vessels
• cardiovascular disease is the
leading cause of death in the
United States, with 631,636 deaths
in 2006
• stroke is the third leading cause,
with 131,119 deaths in 2006
• approximately 80 million
Americans have some form of
cardiovascular disease
– hypertension
– coronary artery disease
– heart failure
– stroke
Cardiovascular Disease and Stroke

Air pollution
 Basically the same as for lung-related diseases
 Novel fuels may be a bigger problem here than for cancer

Heat and extreme weather events
 Direct morbidity and mortality in people with cardiovascular
disease
 Cardiac dysrhythmias are associated with temperature and other
environmental exposures

Changing climate
 There are cardiovascular complications from some vector-borne
and zoonotic disease which are expected to increase
Congestive Heart Failure and Temperature
Ebi, et al., Int. J. Biometerol., 2004
• Nutrition
– the diet humans eat
– failure to obtain sufficient calories
and the right amounts of vitamins,
minerals, fats, and other food
components can result in illness
and death
• Foodborne illness
– results from ingesting food that is
spoiled or contaminated
• microbes,
• chemical residues such as
pesticides
• other toxic substances
• 38 million cases of foodborne
illness in the United States each
year
• 180,000 hospitalizations
• 2,700 deaths
Nutrition and Foodborne Illness

Climate Changes
 Will alter food production, in some cases decreasing it for populations
already experiencing malnutrition
 May alter the outbreak incidence, habitat range, growth cycles, and human
toxicity of pests, fungi/molds, weeds, viruses, and other microbes that can
infect food crops and cause disease
 Food production and distribution systems may be at higher risk of
contamination increasing the risk of foodborne disease
 Even without altering food quantity, climate may alter food quality and
nutritional value

Drought and water availability
 Regional and local impacts of water shortages during droughts, especially
when combined with broader changes in land use and in precipitation
may alter food production and water quality
 Changes in agriculture and aquaculture due to droughts could alter food
supply
Nutrition and Foodborne Illness

Extreme weather events
 Food contamination increases during extreme weather events and
may lead to more foodborne illness
 Changes can occur in subsistence foods (especially marine and
freshwater species) during extreme weather events including
contaminant accumulation and toxicity

Mitigation and adaptation
 Reducing the use of beef to mitigate the release of methane gas
may improve health in some countries and increase it in others
Extreme Events and Invasive Species
Largest Impact
• small farmers
Soybean rust
PCR positives
Hurricane Ivan (2004) and
Soybean Rust (predicted model
versus data)
Changes between 1992 and 2002 in the three
earliest observations of potato late-blight in
Finland
Days after Planting
Gregory et al., JXB, 2009
Food Poisoning in England
Lake et al., Epidem Infections 2009
Nutrition and Foodborne Illness
McMichaels et al., Lancet 2008
Irrigation water consumption
Vibrio parahaemolyticus infection in Alaska and
mean daily water temperature
McLaughlin et al, NEJM Oct. 2005
Projected change in Australian gross value of
wheat
Without Adaptation
With Adaptation
(changed planting dates and varieties)
• health outcomes of prolonged
heat exposure include heat
exhaustion, heat cramps, heat
stroke, and death
• in the United States, an average of
688 persons succumb to heatrelated death per year
• prolonged exposure to heat may
also exacerbate preexisting
chronic conditions such as various
respiratory, cerebral, and
cardiovascular diseases due to the
body’s impaired
thermoregulation, resulting in
additional illness and death
Heat-Related Morbidity and Mortality

Heat waves and rising temperatures
 Many illnesses are closely tied to rising and falling temperatures
on both a short-term and long-term basis
 Heat and air pollution combine to increase both morbidity and
mortality of a number of diseases

Mitigation and adaptation
 Designs of cities to reduce local heat could also reduce
greenhouse gases and improve health
• humans develop in a predictable fashion,
growing from a fertilized egg to fetus,
newborn, toddler, child, adolescent, and
adult in a way that is fairly well
understood
• environment can be a potent modifier of
normal development and behavior
• examples
– subtle changes such as small reductions in
IQ from exposure to lead
– changes in onset of puberty from exposure
to endocrine disrupting chemicals
– birth defects such as cleft palate due to
dioxin-like compounds
– fetal loss through exposure-related
spontaneous abortion
• 3% of all children born in the United
States have a birth defect
• birth defects are a leading cause of death
in children, accounting for almost 20% of
all infant deaths
Human Development (continued)

Extreme weather events
 Toxic wastes sites contain many agents known or suspected of causing
birth defects and altering reproduction, especially leading to release of
agents that biaccumulate like mercury
 Pesticide runoffs could become a problem

Climate change
 May alter presence of microorganisms to digest toxic chemicals making
them harmless or metabolize them into more harmful compounds (eg
organic mercury)
 Improper nutrition (due to inadequate climate for food production) is
linked to developmental deficits

Mitigation
 Pesticides, like DDT, and their metabolites are known or suspected of
altering reproduction and development
 Metals and other chemicals likely to be used in battery production are
known or suspected to cause developmental disorders
Global spread of malaria in a future, warmer
world
Rogers et al., Science, Sept., 2000
Human Development (continued)
Law et al, A. J. Epidemiology 2005
• Mental health disorders refers to a broad
class of illnesses
–
ress-Related
isorders
mild disorders, such as social phobias and fear
of speaking in public
– very severe diseases including depression and
suicide
– can also lead to other chronic diseases and
death
• Stress-related disorders derive from
abnormal responses to anxiety or prolonged
anxiety
– examples
• obsessive-compulsive disorder
• post-traumatic stress disorder
• 26.2% of the American population (1 in 4
people) over the age of 18 suffer from a
diagnosable mental health disorder
– 9.5% suffer from mood disorders
– 6% suffer from serious mental illness
Mental Health and Stress-Related Disorders

Heat and extreme weather events
 Both heat and weather emergencies increase stress levels which
are associated with increased risk of chronic diseases, like
cardiovascular disease and diabetes, as well as increased morbidity
and mortality in people with existing disease conditions
 Displaced populations have a much higher incidence of mental
health issues than people in stable communities
Climate Change and Instability
UK Ministry of Defense - slide courtesy of T. McMichaels
• all categories of disease
involving the central,
peripheral and autonomic
nervous system including
their coverings, blood
vessels and all effector
tissue, such as muscle
• Examples
– Alzheimer Disease
– Parkinson Disease
– learning disorders in children
Neurological Diseases and Disorders

Heat and climate
 Harmful algal blooms and bacterial proliferations are likely to increase with
increasing water levels releasing neurotoxins that humans can inhale from water in
the air or eat from fish and other seafood

Extreme weather events
 Flooding can overwhelm toxic dump sites and other storage facilities releasing
neurotoxic metals and other agents into the environment

Mitigation and adaptation
 Many pesticides used for agriculture and vector control cause neurological damage
including reduced IQ and possible Parkinson’s Disease
 Increased use of fluorescent bulbs will put a greater amount of mercury into homes
increasing potential exposure
 Many metal and metal compounds being used to improve battery performance
may cause neurological damage
 Reducing use of fossil fuels should reduce exposure to arsenic, mercury and other
neurotoxic metals
Costello et al, AJE,
March, 2009
• infectious diseases whose transmission
cycles involve animal hosts or vectors
• vectorborne diseases
– organisms, typically blood-feeding
arthropods (insects, ticks, or mites),
carry the pathogen from one host to
another, generally with amplification in
the vector
• zoonotic diseases
– diseases that can be transmitted from
animals to humans by either contact
with animals or by vectors that can
carry zoonotic pathogens from animals
to humans
• 247 million cases of malaria in 2006
and 881,000 deaths
Vectorborne and Zoonotic Diseases

Heat and climate
 Endemic areas will likely see range expansion leading to increased
incidence of VBZD
 Changes in temperatures hold the potential for expansion of VBZD
transmission in ocean, coastal, and Great Lakes environments
Probability of Dengue fever transmission (1990)
Hales et al., 2002
Probability of Dengue fever transmission (2085)
Hales et al., 2002
• diseases caused by a wide variety of
pathogenic microorganisms found in
water
– protozoa that cause cryptosporidiosis
– parasites that cause schistosomiasis
– bacteria that cause cholera and
Legionellosis
– viruses that cause viral gastroenteritis
– amoebas that cause amoebic
meningoencephalitis
– algae that cause neurotoxicity
• in the US, mostly gastrointestinal
disease
• 12.8% of global mortality attributable
to the environment is due to diarrheal
disease
• more serious symptoms and greater
risk of death in children and pregnant
women
Waterborne Diseases

Extreme weather events
 Sewage overflow from extreme weather events and flooding due
to other weather-related issues can contaminate water sources

Heat and climate
 Melting of tundra can damage infrastructure releasing raw
sewerage increasing risks of a number of waterborne pathogens –
so can extreme weather events
Waterborne Diseases
Patz et al, 2008
Waterborne Diseases
Patz et al, 2008
Waterborne Diseases
Mackenzie, 1994
Waterborne Diseases
400,000 total
cases estimated
Mackenzie, 1994
Waterborne Disease Outbreaks in US Following
Heavy Rainfall (1948-1994)
Newtok, Alaska in Spring, 2007
• hurricanes, floods, blizzards, droughts,
tornadoes, etc.
• from 1940 to 2005, hurricanes caused
about 4,300 deaths
• from 1940 to 2005, flooding caused
7,000 deaths, primarily from injuries
and drowning
• over the past 100 years, heavy rainfall
events have increased by as much as
100% in the midwest and northeast
Weather-Related Morbidity and Mortality

Extreme weather events
 The frequency and and maybe intensity of extreme weather
events is predicted to increase – these can result in death and
injury above and beyond the issues mentioned earlier
 Extreme weather events destroy medical and public health
facilities leading to a greater loss of life
New Orleans Pre- and Post-Katrina
Charity Hospital and LSU Medical School
Science News, Aug. 2007
Interaction Network: Our Environment and Our Health
Gohlke and Portier (2007)