Potential Relationships between exposure situations and disease conditions
Health condition of
concern
Exposure situations
Polluted
Air
Acute respiratory
infections
Diarrhoeal diseases
Excreta and Polluted water or
household deficiencies in water
wastes
management
Polluted
food

Malaria and other
vector-borne
diseases
Other infections
Cancer

Cardiovascular
diseases
Mental disorders

Chronic respiratory
diseases
Injuries and
poisonings

Unhealthy
housing




















Global
environmental
change






Source: The World Health Report 1998. Life in the 21st Century – A Vision for All (NB: last column modified )
Health and environment cause-effect framework
Driving
force
Source Activities
Traditional hazards
Modern hazards
Development
activities
Human activities
Natural phenomena
Emissions
Pressure
Environmental Concentration
State
Air
Water
Food
Exposure
Exposure
External Exposure
Dose
Health Effects
Effect
Early/ Subclinical
Moderate/ Clinical
Advanced/ Permanent
Soil
A
c
t
I
o
n
s
DPSEEA: Climate and Health
Driving
forces
Population
growth
Development
policies
Exposure
Effect
Actions
International
agreements;
National
policies
GHG emissions
Pressure
State
Transport, Energy
policies
Global,
national,
monitoring
Climate variability and change
Heatwaves
windstorms,
floods, droughts
Food, watervector-borne
infections
CVD
Infectious
Respiratory diseases
Malnutrition
Food
shortage
Air
pollution
Injuries
Drownings
Mental
health
National,
international
agency
mitigation,
adaptation
strategies
Treatment
Human health impacts and vulnerability
to climate change
Water resources impacts
Impacts on coastal areas
Climate
change
Species and natural areas
Agriculture impacts
Forests impacts
Adaptive
Health impacts
capacity
Pathways by which
climate change
affects health
Regional weather
changes
Climate
Change
•Heatwaves
•Extreme weather
•Temperature
•Precipitation
Health effects
Temperature related
illness and death
Moderating
influences
Extreme weather
related health effects
•Contamination
pathways
•Transmission
dynamics
•Food
availability
•Migration
Air pollution related
health effects
Water and food borne
diseases
Vector and rodent borne
Diseases
Psychological effects
Adaptation
measures
Malnutrition
Research
Adapted from Patz et al, 2000
Causal web: Climate variability and diarrheal disease
Unsafe and limited
water
Drought
Hygiene difficult
Nutritional deficiencies
Contamination from pit
latrines, septic tanks
and sewage systems
Climate
variability
Floods
Debris and carcasses in
rivers
Failure of water
treatment facilities
Temperature
increase
Food spoilage
Algal blooms
Diarrheal
disease
Current and future actions:
•Global, regional burden of disease assessment
•Assessing early health impacts of climate change
•National health impact assessment guidelines
•National adaptation strategies for health
•Pilot warning system projects (e.g. heatwaves)
•Joint WHO/UNEP/WMO activities:
Capacity building
Information exchange
Research promotion
Adaptive actions for the health sector:
primary adaptive measures: actions taken to prevent the onset
of disease arising from environmental disturbances, in an
otherwise unaffected population (e.g. supply of bed nets to all members of a
population at risk of exposure to malaria, early warning systems, integrated
environmental management)
secondary adaptive measures: preventive actions taken in
response to early evidence of health impacts (e.g. strengthening
disease surveillance and responding adequately to disease outbreaks)
tertiary adaptive measures: health-care actions taken to lessen
the morbidity or mortality caused by the disease (e.g. improved
diagnosis and treatment of malaria)
Examples of primary and secondary adaptive measures
to reduce health impacts
Impact
Primary adaptive measures
Secondary adaptive measures
Heat
stress
-Heatwave warning systems
-Urban planning
-Health personnel educated to
detect and treat heat stress
Extreme
weather
events
-Disaster preparedness and mitigation
-Early warning systems
-Disaster protection measures
-Disaster response
Infectious -Integrated environmental
diseases
management
-Disease surveillance and
monitoring
-Control of vector-, food- and
water- borne diseases
Examples of primary and secondary adaptive measures
to reduce health impacts
Impact
Primary adaptive measures
Secondary adaptive measures
Food
security
-International mechanisms of
agriculture, trade and finance
-Seasonal climate forecasting
-Famine early warning systems
-National and local agriculture measures
-Monitoring and surveillance
-Implementation of nutrition
action plans
Water
-Pollution reduction and control policies
-Demand management and water
allocation policies
-Waste water treatment
-Economic and regulatory measures
to increase irrigation efficiency
-Capacity building
-Monitoring and surveillance
-Capacity building
climate Change and Adaptation
Strategies for Human health (cCASHh)
Outreach
V
ulnerability
of
V ector B orn
E pidemiologal
Evaluation
WHO
LSHTM
A
E xtreme W eather E vents ,
D iseases , of W ater F ood born D iseases
ssessment to
E conomic
A ssessment
P olicy
A nalysis
I ntegrated
A ssessment
Feem
WHO
ICIS
dWd
NIPH
SU
dWd
Framework for adaptation
Pik
Current available datasets, Monitoring results
Research results