Key Vulnerabilities to Public Health - Jonathan

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Climate change in the
Great Lakes Region:
Key Vulnerabilities to
Public Health
Climate Change Webinar Series
Ohio State University
Sept. 28, 2010
Jonathan Patz, MD, MPH
Nelson Institute & Dept. Population Health Sciences
University of Wisconsin - Madison
HEALTH EFFECTS OF CLIMATE CHANGE
Urban Heat Island
Effect
CLIMATE
CHANGE
Temperature Rise 1
Sea level Rise 2
Hydrologic Extremes
Air Pollution &
Aeroallergens
Vector-borne Diseases
Water-borne Diseases
1
2
3°C by yr. 2100
40 cm “ “
IPCC estimates
Water resources & food
supply
Mental Health &
Patz, 1998
Environmental
Refugees
Heat Stress
Cardiorespiratory failure
Respiratory diseases, e.g.,
COPD & Asthma
Malaria
Dengue
Encephalitis
Hantavirus
Rift Valley Fever
Cholera
Cyclospora
Cryptosporidiosis
Campylobacter
Leptospirosis
Malnutrition
Diarrhea
Toxic Red Tides
Forced Migration
Overcrowding
Infectious diseases
Human Conflicts
Probabilities of future extremes can be estimated
given projections of mean temperature
2057
2007
Peterson et al., 2007
Heatwave morbidity -Milwaukee
Li, et al. , unpublished (EPA STAR grant, J. Patz, PI)
•By 2050, warming alone
may increase by 68% the
number of Red Ozone Alert
days across the Eastern US.
(IPCC, 2007 -Bell et al,
2006)
• “The severity and
duration of summertime
regional air pollution
episodes are projected to
increase in the Northeast
and Midwest US by 20452052 due to climatechange-induced decreases
in the frequency of surface
cyclones.”
(IPCC, 2007)
Days per summer (June, July, August) with O3 above the NAAQS limit of 84 ppb. Colored,
solid lines reflect the 10-year running mean of exceedances for each model (mean across
SDSM ensembles, and across the study sites). Colored dotted lines reflect year-to-year
exeedance values (mean across SDSM ensembles, and across the study sites).
Holloway et al. 2009
USA: Combined sewer overflows
(CSOs)
Courtesy: Kellogg Schwab
1.2 trillion gal of sewage & stormwater a year
discharged during combined sewer overflows
– would keep Niagara Falls roaring for 18 days
Center for Water & Health, JHU Bloomberg School of Public Health
Combined Sewer Systems & Past
Precipitation Trends
CSS Communities
770 systems serve around
40 million people
Past Precipitation Trends
Source: EPA
Source: EPA (Courtesy– J. Scheraga)
Source: National Climatic Data Center/NESDIS/NOAA
Sewage overflows in the Great Lakes
• Intense storm events result in combined sewer
overflows (CSO’s)
• Great Lakes provides drinking water to 40M people
and has >500 beaches
• Sewage contains human pathogens including viruses,
protozoan, and pathogenic bacteria
• The EPA has estimated 140 communities release 150
billion liters of combined sewage each year
Rainfall
Urban stormwater
Sewage overflow
Bradford Beach
E. coli CFU/100 ml
0-100
100-235
235-999
1000-9999
10,000-20,000
South Shore Beach
Courtesy: Sandra McLellan
UW-Milwaukee
Bradford and South Shore Beach on Lake Michigan
Reported waterborne diseases, US, from 19481994
• 67% of waterborne disease outbreaks were preceded by
precipitation above the 80th percentile (across a 50 yr.
climate record), p < 0.001
• 51% of outbreaks were preceded by precipitation above
the 90th percentile, p < 0.002
• Surface water-related outbreaks had strongest correlation
with extreme precipitation in the month of outbreak;
groundwater-related outbreaks lagged 2 months following
extreme precipitation.
Curriero, Patz, et al, 2001.
Globally Averaged
U.S. CCSP, 2008
Projected Change in the Frequency of 2" Precipitation
Events (days/decade) from 1980 to 2055 based on
downscaled climate models (http://www.wicci.wisc.edu)
Courtesy: Steve Vavrus (UW-Madison
Courtesy: Steve Vavrus (UW-Madison)
The Good News about climate
change and our health
The opportunity for improving
health determinants
We can reduce:
The 1,000,000 annual deaths from
urban air pollution
The loss of 1.9 million deaths, and
19 million years of healthy life,
from physical inactivity
WHO, 2007
Figure 1: Ten Leading Causes of US Deaths per year (CDC, 2004)
600,000
500,000
400,000
300,000
200,000
100,000
Cause of Death
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Number of people
700,000
Ten Leading Causes of US Deaths per Year (CDC, 2004)

Sedentary Lifestyle

Air Pollution

Motor Vehicle Crashes

Non Transport Related
Asthma and Air Pollution
• Natural experiment during
1996 Summer Olympic
games in Atlanta
• Peak morning traffic
decreased 23% and peak
ozone levels decreased 28%
• Asthma-related emergency room visits by
children decreased 42%
• Children’s emergency visits for non-asthma
causes did not change during same period
Friedman et al. JAMA 2001;285:897
Comparative Scenario
The Natl. Personal Transportation Survey
reports median trip length in urban and suburban
areas of the region to be 4-8 km, representing
~20% of VMT for the region. Our alternative
scenario thus assumes that all round trips of 8
km or less could be accomplished through
alternative modes of (non ICE)
transportation.
Grabow et al (in review)
20% fewer car trips:
Change in O3 & PM 2.5
• hundreds of lives saved
• Thousands of Hospital admissions avoided
• Billions reduction in health care costs
Grabow et al (in review)
Value of co-benefits is large
$2 – 196 /tCO2 with a mean of $49/tCO2
Fig 1 and fig 2
Compare to cost of climate policy: almost always <$30/tCO2
Nemet G F, Holloway T and Meier P 2010 “Implications of incorporating air-quality co-benefits into
climate change policymaking” Environmental Research Letters 014007
22
Nemet et al. 2010
Decision Support
• In adapting to climate
change, we need to
include health cobenefits stemming from
mitigation policies; thus
far, one-sided
discussions of costs
Educational website:
www.ecohealth101.org
Thank you!
[email protected]
www. sage.wisc.edu
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