COPING WITH CLIMATE CHANGE
MANIFESTATIONS ON WATER AND
HEALTH
Konstantinos C. Makris and Syam S. Andra
CYPRUS UNIVERSITY OF TECHNOLOGY
Cyprus International Institute
for Environmental and Public Health
in association with the
Harvard School of Public Health
Disruption
What is the cost of avoiding
climate change? If we do
everything we can now to reduce
• Little work has been conducted on
Sb endocrine
global
greenhousedisrupting
gas emissions
effects.
and ensure we adapt to the future
of climate
change,
the
• However, recent evidence suggestseffects
that Sb
may be
at least
average
estimated
cost
2% of
partially responsible for estrogenic
effects.
Choe et
al.is(2003)
the world
gross domestic
reported that antimony chloride has
“highannual
estrogenicity”
in
productdependent
(GDP).
two bioassays. In an estrogen-receptor
transcriptional expression assay using human breast cancer
However, if we do nothing, effects
cells, 1 µM antimony chloride had estrogenic activity that
of climate change could cost 5–
was 61% equivalent to 1 nM 17β-estradiol.
20% of the annual world GDP.
Stern N. The economics of climate change. Cambridge: Cambridge University Press, 2007.
Perception of Cypriot Society on Climate Change
•
•
In the EU, just over half (51%)
of respondents consider climate
change one of the world's most
serious problems (and 20% feel
it is the single most serious
problem).
It is seen as the second most
serious issue facing the world,
after poverty, hunger and lack
of drinking water, and a more
serious problem than the
economic situation.
(Special Eurobarometer report, October 2011)
Chemical Leaching
• Plasticizer molecules like
antimony, BPA and
phthalates from plastic wall
skeleton, could move
through the solid polymer
matrix via the following
mechanisms:
i. Diffusion
ii. Photodegradation
iii. Relaxation
iv. hydrolysis
Climate Change and Health
Reduced Health Risk compared with Tap Water?
A Human Health Perspective on Climate Change: A Report Outlining the Research Needs on the Human Health Effects
of Climate Change April 22, 2010, NIEHS, USA.
How we STORE, TREAT and USE WATER
will be key in adapting to climate change challenges
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
Assess
Adjust
Plan
The Adaptive
Climate Cycle
Evaluate
Implement
Monitor
Hess et al., 2011,EHP
How WE STORE, TREAT AND USE WATER
will be key in adapting to climate change challenges
•Supply Reduction
•Algal Blooms-ToxinsTreatment costs
•Pathogen maturation
rates (Cholera)
•Runoff discharge
•Temperature-driven
volatility, solubility,
biodegradation effects
on POP bioavailability
•Food supply
contamination from
irrigation
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
Bottled
Spring
Water
How WE STORE, TREAT AND USE WATER
will be key in adapting to climate change challenges
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
•Fish productivity-Species
extinction/migration
•Algal bloomsCladophora spp.
•Dissolved O2 reductionHypoxia-Fish kills
•Coral reef bleachingzooplankton reduction
•Shell calcification
reduction-Ocean
acidification
• Coastal flooding by sea
level rise(?)
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
Seawater pollution
with algae and
petroleum
products might
endanger the
quality of
desalinated water,
while treatment
cost may be
exacerbated.
Infrastructure risk
due to sea level for
on-shore plants.
Potable Water in Urban Pipe Networks
Finished water under quality
deterioration (DBP formation,
biofilm/scales release, Legionella
spp. outbreaks).
Stagnation and intermittent flow in
drinking water distribution
systems enhance biofilm growth.
Changes in hydrostatic pressure
within drinking water pipes may
facilitate pipe leakage and
soil/contaminants intrusion.
Wet/dry alterations cause soil
movement (swelling) impacting
pipe physical condition
failures/leakages.
Backflow and wastewater intrusion
into pipes of drinking water
systems poses serious health risk.
How WE STORE, TREAT AND USE WATER
will be key in adapting to climate change challenges
•Low aquifer and river
flow (anoxic zones)
deteriorate water
quality and increase
treatment costs.
•Seawater intrusionBrackish waters
•Salting-out effect for
increased
bioavailability of POPs
•Deeper water table
pumping—higher costs
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
How WE STORE, TREAT AND USE WATER
will be key in adapting to climate change challenges
•Increased
demand
•Treated water
quality reduction
(xenobiotics)
•Urban storms
may increase the
contaminant load
in treatment
plants.
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
How WE STORE, TREAT AND USE WATER
will be key in adapting to climate change challenges
Desalinated
Water
Surface
Water
Recycled
Water
Hydrogeologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
•Increased withdrawalSpring capacity issuesShift to bottled water
•Water quality
reduction-Brackish
waters
•Plasticizer leaching
Neglected Water Compartment—URBAN STORMWATER
Desalinated
Water
STORM
Water
Surface
Water
Recycled
Water
Hydrologic
Cycle
Ground
Water
Coastal
Water
(Bottled)
Spring
Water
Extreme Rainfall-Induced Health Hazards
EXTREME WEATHER EVENTS
URBAN STORMAWATER MANAGEMENT
More than 50% of waterborne disease outbreaks
were preceded by intense rainfall events in the
USA above the 90th percentile (Curriero et al.,
2001, AJPH). In need of stormwater urban
collection ponds and deployable portable filters
for contaminants
1. Erosion-Sedimentation
2. Increase downstream pollution from
Brownfields’ contaminant release
3. Unwanted mixing of freshwater with sewage
during floods and downstream runoff
4. Pump station failure, power outage, possible
loss of water supply
Venice, IT, summer 2006
Kris Snibbe/Harvard Staff Photographer, Harvard Gazette, October 27, 2011
Αccess to improved water source, GDP and infant mortality
Hunter et al., 2010. Water Supply and Health. PLoS Med 7(11): e1000361
Sea Rise and SaltWater Intrusion
• Average estimated sodium intakes from drinking water ranged from 5 to
16 g day-1 in the dry season, compared with 0.6–1.2 g day-1 in the rainy
season. The annual hospital prevalence of hypertension in pregnancy was
higher in the dry season (OR = 12.2%; 95% CI, 9.5–14.8) than in the
rainy season (OR = 5.1%; 95% CI, 2.91–7.26) (Khan et al., 2011, EHP).
• Increases in water salinity may increase POP/pesticide bioavailability due
to salting out effect.
Water and Health -- Adaptation Measures
1. Climate change effects on water sectors before hitting hard our
economy need to be classified and hierarchically addressed by pertinent
agencies
2. Interdisciplinary efforts need to be initiated by engaging plethora of
expertises, ranging from engineers, economists, health scientists,
biologists, environmental scientists, and others as needed
3. Coastal infrastructure sustainability and maintenance, Sea level rise?
4. Disaster management and preparedness plans
5. Climate change and public health education and learning
Acknowledgement
• We would like to thank the Harvard-Cyprus
program of the Harvard School of Public
Health for partially funding and supporting of
this study.
Extended Heat Periods and Heat Waves
1. Heat Stress may be overwhelming
for patients suffering with
cardiovascular or respiratory
disease, diabetes, and other chronic
diseases.
2. Need to estimate heat related
mortality and compare it with the
increased air pollution mortality
due to the use of air conditioning in
Peak demand seasons (summer).
Example of the impact of the average air temperature on daily
mortality in humans. These data represent the mortality (324.7
deaths per day) in The Netherlands from 1979 to 1987.
The size of each block is proportional to the sample size. Data and
graph modified from Kunst et al. (1993).
Shortened Gestational Age with Heat Stress Periods
•Gestational age at delivery determines fetal maturity at birth.
•Shorter gestational age at delivery was documented to be the
primary cause of perinatal mortality, both in Europe and US.
•Risk increases with decrease in gestational age.
•A 5-day reduction in gestational age was observed when
subjects were exposed to 32 °C (Heat Index) on the day before
delivery (p = 0.03)
Dadvand et al., 2011. Climate Extremes and the Length of Gestation. Environmental Health Perspectives.
Stress-Pollution Interactions
• Temperature effects may be acting
as an effect modifier towards the
toxicity of a pesticide during an
animal study (Gordon C.J., 2003,
Environ. Res.). For example,
toxicological experiments with
rodents for a pesticide showed noeffect level at 5 mg/kg at relatively
warm ambient temperatures when
literature showed 75 mg/kg as a noeffect level.
(Gordon C.J., 2003, Environ. Res.)
Heat-Related Interventions-Dilemmas
• Identification of elderly and children
while provisioning them with access to
air conditioning. Could increased use
of air conditioning serve as a costeffective intervention measure when
their use leads to air pollution and risk
for power outage in the summer?
• Both health (exposure and toxicologic)
and economic-based risk assessment
plans.
• Socioeconomic status and the built
environment may be extremely
important factors of susceptibility to
heat waves and heat stress on
morbidity/mortality in Cyprus.
Microplastics in the marine environment and
Climate Change
•
•
Physiological effects on marine biota
induced by bioavailable compounds
desorbed from ingested plastics are being
investigated, since mass of ingested plastic
in Great Shearwaters (Γλάροι) was
positively correlated with PCBs in their fat
and eggs.
There is also potential danger to marine
ecosystems from the accumulation of plastic
debris on the sea floor. The accumulation of
such debris can inhibit gas exchange
between the overlying waters and the pore
waters of the sediments, and disrupt
inhabitants of the benthos
Laysan albatross chick, Kure Atoll, 2002, photo: Cynthia Vanderlip, AMRF.
(Moore, C.J., 2008, Environ. Res.).
High Air and Water Temperatures
• Solvent Switching is defined as
contaminant partitioning into different
phases towards thermodynamic equilibrium.
Temperature-driven effects on Henry
constant for various organics.
Concentrations of contaminants may not
exceed thermodynamic constraints.
• Solvent Depletion is an energy-intensive
process that increases fugacity since solvent
concentrations decrease. Food web
alterations, organic carbon changes,
biomagnification). Concentrations of
contaminants may exceed thermodynamic
constraints.
(McDonald et al., 2002, ES&T)
T
Greenhouse gases + sunlight
Secondary PM and photodegradation
O3
Harmful and Nuisance Algal Blooms
Cyanobacteria (blue-green algae)
produce toxins (microcystins,
nodularins, saxitoxins, anatoxin-a,
anatoxin-a(s) , cylindrospermopsin)
whose health effects range from
liver damage, including liver cancer,
to neurotoxicity.
Nuisance algal blooms like those of
Cladophora spp. are expected to
grow in frequence in Cyprus coasts.
CLIMATE CHANGE IN A NUTSHELL
Manifestations
Melting
Cap
Factors
•Transportation
•Industry
Ice
•Ocean Circulation
•Water Temperature
•Salinity
Processes
Temperature
Rise
•Agriculture
Rainfall
Variations
•Heating
Land Use Changes
CO2
CH4
Greenhouse
Effect
Consequences
N2O
Disasters
•Floods
Fossil Fuel Burning
Sea Level
Rise
•Cyclones
•Urbanization
•Heat Waves
•Deforestation
•Droughts
Outcome
•Casualties
•Famines
•Diseases Spread
•Biodiversity Losses
•Economic Losses
Reference: Modified from UNFCCC 2007.
CLIMATE CHANGE – BROADER IMPACTS
• WATER, AIR, WEATHER, ECOSYSTEMS, OCEANS
Reference: 1) USEPA , 2) UNEP/GRID-Arendal, Potential climate change impacts ,
UNEP/GRID-Arendal Maps and Graphics Library,
http://maps.grida.no/go/graphic/potential-climate-change-impacts (Accessed 13 October 2011)
Cyprus-Specific
Synoptic Plan
•
•
•
•
•
•
•
•
Current and foreseeable climate change
(CC) environmental manifestations
Water-Related, but not visually observed
CC Environmental Manifestations
CC-Impacted Health Categories and
Water
Hydrologic Cycle Alterations due to CC
Water-Related CC Health Impacts
Water-Mediated CC Heath Impacts
Synthesis and Adaptation Plans
What is Next for Cyprus
2 9 2 | N AT U R E | VO L 4 7 2 | 2 1 A P R I L 2 0 1 1
Climate Change and Health Effects
Heat Periods and Waves, Storms/Hurricanes, Floods, Drought,
Nutrition, Food Safety, Air Pollution, Aerosolized Allergens, Infectious
Diseases, Occupational Health, UV Radiation.
Key Population Health Terms
Susceptibility: Intrinsic biological
factors that can increase health risk
of individual such as medical
history genetic variants and stage
in life.
Vulnerability: Human populations
at higher risk due to environmental
or personal-socioeconomic factors.
Both susceptible and vulnerable
populations are called sensitive.
J. Estrin, NY Times, March, 2010
Sea Level Rise Between 1870-2006
http://maps.grida.no/go/graphic/trends-in-sea-level-1870-2006
Climate Change and Aflatoxins
Reference: 1Patterson and Lima, 2010. How will climate change affect mycotoxins in food? Food Research International 43 (2010) 1902–1914;
2CAST. (2003). Mycotoxins: Risks in plant, animal, and human systems. Ames IA, Council for Agricultural Science and Technology.
Climate change affects fisheries industry
http://maps.grida.no/go/graphic/vulnerability-of-national-economies-to-potential-climate-induced-changes-in-fisheries
Ocean Acidification and Climate Change
http://maps.grida.no/go/graphic/acidification-due-to-climate-change-impacts-for-oceans-and-coral-reefs
High Air and Water Temperatures
•
•
•
•
•
•
•
•
Decrease dissolved oxygen levels
Increase contaminant load to water bodies (both chemical and microbial)
Reduce stream and river flows
Foster algal blooms
Increase the likelihood of saltwater intrusion near coastal regions
Increase disinfection by product formation in potable water supplies
Ozone formation
Enhance ice/snow melt and possible release of POPs, e.g., PAH, PCB,
Dioxins, EDC
• Volatility, Solubility, Biodegradation
• Increase incidence cases of Legionella spp. outbreaks due to prevailing of
thermophila bacteria in higher ambient temperature environments
Reference by Noyes et al., 2009, Environ. International
Recycled Water
Tremendous pressure on
increased recycled water
production
in light of climate change
effects.
Xenobiotics in recycled water
need to be treated prior land
application.
Concentrations of target compounds (ng L-1) and minimum reporting
levels (MRL) in wastewater samples from Larnaca, CY (Makris and
Snyder, 2011).
Atenolol
Atorvastatin
Atrazine
Benzophenone
Caffeine
Carbamazepine
DEET
Diazepam
Dilantin
Fluoxetine
Iopromide
Meprobamate
Primidone
Sulfamethoxazole
TCEP
TCPP
Trimethoprim
BHA
Bisphenol A
Diclofenac
Gemfibrozil
Ibuprofen
Musk Ketone
Naproxen
Octylphenol
Triclosan
Influent
Concentration
Effluent
Concentration
Influent
MRL
Effluent
MRL
3900
100
< MRL
< MRL
82000
580
1500
< MRL
< MRL
< MRL
< MRL
310
< MRL
240
< MRL
< MRL
110
< MRL
< MRL
1400
3800
4300
< MRL
1400
< MRL
480
< MRL
< MRL
< MRL
410
26
390
400
3.4
61
< MRL
120
14
20
7.7
420
3000
< MRL
< MRL
< MRL
< MRL
88
33
< MRL
< MRL
< MRL
5.7
200
100
50
10000
1000
100
200
50
200
100
2000
50
100
50
2000
20000
50
200
1000
100
50
200
5000
100
5000
200
1.1
0.53
0.26
53
5.3
10
20
0.26
20
0.53
11
0.26
0.53
0.26
11
2000
0.26
1.1
5.3
0.53
0.26
1.1
26
0.53
26
1.1