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Climate change endangers human health, affecting all sectors of society, both domestically and globally. The environmental consequences of climate change, both those already observed and those that are anticipated, such as sea-level rise, changes in precipitation resulting in flooding and drought, heat waves, more intense hurricanes and storms, and degraded air quality, will affect human health both directly and indirectly. Addressing the effects of climate change on human health is especially challenging because both the surrounding environment and the decisions that people make influence health. For example, increases in the frequency and severity of regional heat waves—likely outcomes of climate change—have the potential to harm a lot of people.
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Executive Summary A Human Health Perspect ive ON CLIMATE CHANGE
A Human Health Perspective
On Climate Change
A Report Outlining
the Research Needs on the
Human Health Effects of
Climate Change
T
In a world of myriad here is abundant evidence that human activities are altering the earth’s
climate and that climate change will have significant health impacts both
domestically and globally. While all of the changes associated with this
“what if” scenarios
process are not predetermined, the actions we take today will certainly help to
shape our environment in the decades to come. Some degree of climate change is
surrounding climate change,
unavoidable, and we must adapt to its associated health effects; however, aggressive
mitigation actions can significantly blunt the worst of the expected exposures. Still,
it becomes very complicated
there will be effects on the health of people in the United States, some of which are
already underway. As great as the domestic risks to U.S. public health are, the global
to create wise health policies risks are even greater.
Climate change and health issues transcend national borders, and climate change
for the future because of the health impacts in other countries are likely to affect health in the United States as
well. Famine, drought, extreme weather events, and regional conflicts—all likely
uncertainty of predicting consequences of climate change—are some of the factors that increase the incidence
and severity of disease, as well as contributing to other adverse health impacts, making
environmental change and it imperative to address climate change-related decision making at local, regional,
national, and global levels. The complicated interplay of these and other factors must
human decisions. The need for be considered in determining the scope and focus of both basic and applied research on
climate change and health.
A Human Health Perspective on Climate Change: A Report Outlining the
sound science on which to base
Research Needs on the Human Health Effects of Climate Change was developed by
an ad hoc Interagency Working Group on Climate Change and Health (IWGCCH).
such policies becomes more
The report identifies relevant federal research and science needs, including research
on mitigation and adaptation strategies. These needs encompass basic and applied
critical than ever. science, technological innovations and capacities, public health infrastructure, and
communication and education. The report is organized around 11 human health
categories likely to be affected by climate change. This approach highlights direct
links between climate change and federal research priorities that are often disease- or
outcome-specific, and enables a holistic approach to exploring climate change-related
health impacts.
www.niehs.nih.gov/climatereport
Human Health Consequences
1 2
Asthma,
Respiratory
Allergies, and
Cancer
3
Cardiovascular
Disease and
4
Foodborne
Diseases
5
Heat-Related
Morbidity and
6
Human
Developmental
Airway Diseases Stroke and Nutrition Mortality Effects
respiratory allergies and Cardiovascular disease Climate change may be the health outcomes of Potential consequences
diseases may become is the leading cause associated with staple food prolonged heat exposure of climate change that
more prevalent because of of death in the united shortages, malnutrition, include heat exhaustion, would affect normal
increased human exposure States. Climate change and food contamination heat cramps, heat stroke, human development
to pollen (due to altered may exacerbate existing (of seafood from chemical include: malnutrition,
growing seasons), molds Many potential direct cardiovascular disease contaminants, biotoxins, particularly during the
(from extreme or more effects of climate change by increasing heat and pathogenic microbes, prenatal period and
frequent precipitation), air on cancer risk, such as stress, increasing the and of crops by pesticides). early childhood as a
pollution and aerosolized increased duration and body burden of airborne research needs in this result of decreased food
marine toxins (due to intensity of ultraviolet particulates, and area include better supplies, and exposure to
increased temperature, (uV) radiation, are well changing the distribution understanding of how toxic contaminants; and
coastal runoff, and understood; however of zoonotic vectors that changes in agriculture and biotoxins resulting from
humidity) and dust (from the potential impact of cause infectious diseases fisheries may affect food and death. extreme extreme weather events,
droughts). Mitigation changes in climate on linked with cardiovascular availability and nutrition, heat events cause more increased pesticide use
and adaptation may exposure pathways for disease. Science that better monitoring for deaths annually in the for food production, and
chemicals and toxins addresses the effects of disease-causing agents, united States than all increases in harmful algal
requires further study. higher temperatures, heat and identifying and other extreme weather
Science should investigate waves, extreme weather, mapping of complex food events combined.
the effects of mitigation and changes in air quality webs and sentinel species heat-related illness
and adaptation measures on cardiovascular health that may be vulnerable and deaths are likely
on cancer incidence so is needed. this new to climate change. this to increase in response
that the best strategies information should be research could be used to to climate change, but
can be developed and applied to development prepare the public health aggressive public health
significantly reduce these implemented; for example, of health risk assessment interventions such as
risks. research should research to inform models, early warning heat wave response blooms in recreational
address the relationship understanding of the systems, health plans and heat early areas. research should
between climate change benefits of alternative communication strategies warning systems can examine effects on
and the composition of fuels, new battery and targeting vulnerable minimize morbidity and human development
air pollutant mixtures to voltaic cells, and other populations, land use mortality. additional of adaptations to
produce models to identify technologies, as well as decisions, and strategies science should focus on climate change such as
populations at risk. any potential adverse risks to meet air quality goals developing these tools by agriculture and fisheries
from exposure to their related to climate change. and health care sectors defining environmental changes that may
Allergic components and wastes. Some cardiovascular and for new illnesses, changing risk factors, identifying affect food availability,
Better understanding of stroke risks from climate surveillance needs, and vulnerable populations, increased pesticide use
diseases impact increased incidence of and developing effective to control for expanding
climate change impacts on change could be offset by
approximately the capacity of ocean and reductions in air pollution disease, as well as to risk communication and disease vector ranges,
50 million coastal systems to provide by climate change develop more effective prevention strategies, and prevention of
individuals within cancer curative agents and mitigation. outreach to affected and expanding their use leaching from toxic waste
other health-enhancing communities. in different geographic sites into floodwaters
the United States,
products is also needed. regions. during extreme weather
and are associated Approximately
It is estimated events.
with significant 80 million Americans
Cancer is the second that there are It is estimated that
health care costs have some form
leading cause of 60% of the global About 3% of all
of cardiovascular 38 million cases of
and lost death in the United population will live in children born in
1 disease including foodborne illness
productivity. States, killing more cities by 2030, greatly the United States
hypertension, in the United States
than half a million increasing the total have a birth defect,
coronary artery each year, resulting
people every human population some of which can
disease, heart in over 180,000
year.
2
exposed to extreme be attributed to
attack, or stroke.
3
hospitalizations and
4
heat.
5
environmental
2,700 deaths. 6
causes.
www.niehs.nih.gov/climatereport
of Climate Change
7
Mental Health and Neurological
Stress-Related Diseases and
8 9 Vectorborne
and Zoonotic
10 11
Waterborne
Weather-Related
Morbidity and Crosscutting
Disorders Disorders Diseases Diseases Mortality Issues
By causing or contributing the united States has risk of infectious diseases increases in water increases in the Crosscutting issues
to extreme weather events, seen an increasing trend such as malaria, hantavirus temperature, incidence and intensity
climate change may result in the prevalence of pulmonary syndrome, of extreme weather relevant to preventing
precipitation frequency
in geographic displacement neurological diseases and rabies, and Lyme disease and severity, events such as hurricanes, or avoiding many of the
of populations, damage may increase as a result evaporation-transpiration floods, droughts, and
to property, loss of of climate change due rates, and changes wildfires may adversely potential health impacts
loved ones, and chronic to expansions in vector in coastal ecosystem affect people’s health
stress—all of which can ranges, shortening of immediately during the of climate change include
health could increase
negatively affect mental pathogen incubation the incidence of water event or later following
identifying susceptible,
health, particularly in periods, and disruption the event. research
contamination with
vulnerable communities and relocation of large aimed at improving the vulnerable, and displaced
harmful pathogens and
already experiencing human populations. capabilities of healthcare
social, economic, and deficits such as alzheimer research should enhance and emergency services to populations; enhancing
environmental disruption. disease, Parkinson the existing pathogen/ address disaster planning
research needs include disease, and learning vector control infrastructure and management is public health and health
and understanding how disabilities in children. including vector and host needed to ensure that care infrastructure;
psychological stress acts Climate change, as well as identification; integrate risks are understood and
synergistically with other attempts to mitigate and human with terrestrial that optimal strategies are developing capacities and
forms of environmental adapt to it, may further and aquatic animal health identified, communicated,
exposures to cause adverse increase the number of surveillance systems; and implemented. skills in modeling and
mental health effects and neurological diseases incorporate ecological chemicals, resulting
prediction; and improving
identifying vulnerable and disorders. research studies to provide better in increased human Poor preparedness
populations, identifying in this area should exposure. research risk communication and
and incorporating key focus on identifying and response to
should focus on
mental health outcomes in vulnerable populations understanding where Hurricane Katrina led public health education.
health impact assessments and understanding the changes in water flow to increased illness
under a range of climate mechanisms and effects Such research will lead
will occur, how water will and death, as well
change scenarios, and of human exposure to interact with sewage in to more effective early
as economic costs of
developing migration neurological hazards such surface and underground
monitoring networks to as biotoxins (from harmful recovery in excess of warning systems and
water supplies as well 11
help ensure the availability algal blooms), metals predictive models; and as drinking water $150 billion.
of appropriate health care (found in new battery improve risk communication greater public awareness
distribution systems,
support. technologies and compact and prevention strategies.
what food sources may of an individual’s or
fluorescent lights),
become contaminated,
An estimated 26.2% and pesticides (used in In the absence of community’s health risk
response to changes in and how to better predict
of Americans over agriculture), as well as the technologies to and prevent human from climate change, which
the age of 18 suffer potentially exacerbating treat or vaccinate exposure to waterborne
effects of malnutrition and and ocean-related should translate into more
from a diagnosable against many VBZD,
stress. pathogens and biotoxins.
mental health some experts successful mitigation and
disorder in a believe, population-
7 Even a single WHO estimates that adaptation strategies.
given year. level mortality from
low-level exposure 4.8% of the global
certain disease
to algal toxins burden of disease
outbreaks could
can result in and 3.7% of all
reach as high as
physiological 9 environment-related
20–50%.
changes indicative of death is due to
neurodegeneration.
8
diarrheal disease,
largely from water
10
contamination.
www.niehs.nih.gov/climatereport
A Human Health Perspect ive ON CLIMATE CHANGE Executive Summary
The Interagency Working Group on
Climate Change and Health
Christopher J. Portier, PhD (Coordinating Lead author)
National Institute of Environmental Health Sciences
Kimberly Thigpen Tart, JD (Coordinating editor)
National Institute of Environmental Health Sciences
Sarah R. Carter, PhD
AAAS Fellow, U.S. Environmental Protection Agency
Caroline H. Dilworth, PhD
National Institute of Environmental Health Sciences
Anne E. Grambsch
U.S. Environmental Protection Agency
Next Steps
Julia Gohlke, PhD
National Institute of Environmental Health Sciences
Jeremy Hess, MD, MPH (Lead author)
Centers for Disease Control and Prevention Recently, the National Research Council
Sandra N. Howard issued a report addressing how federal research and science could be improved to
Department of Health and Human Services
12
George Luber, PhD (Lead author) provide support for decision and policy making on climate change and human health.
Centers for Disease Control and Prevention
Specifically, the report calls for a more complete catalogue of climate change health
Jeffrey T. Lutz, PhD
National Oceanic and Atmospheric Administration
impacts, increasing the power of prediction tools, enhancing integration of climate
Tanya Maslak, MPH (Lead author)
U.S. Global Change Research Program, observation networks with health impact surveillance tools, and improving interactions
University Corporation for Atmospheric Research
Natasha Prudent, MPH
among stakeholders and decision makers. The IWGCCH approached this research needs
Centers for Disease Control and Prevention
assessment with these goals in mind. The next step will be for federal agencies to discuss
Meghan Radtke, PhD (Lead author)
AAAS Fellow, U.S. Environmental Protection Agency the findings of this white paper with stakeholders, decision makers, and the public as they
Joshua P. Rosenthal, PhD
Fogarty International Center work to incorporate and prioritize appropriate research needs into their respective science
Teri Rowles, DVM, PhD
National Oceanic and Atmospheric Administration
agendas and collaborative research efforts. A coordinated federal approach will bring the
Paul A. Sandifer, PhD unique skills, capacities, and missions of the various agencies together to maximize the
National Oceanic and Atmospheric Administration
potential for discovery of new information and opportunities for success in providing key
Joel Scheraga, PhD
U.S. Environmental Protection Agency
information to support responsive and effective decisions on climate change and health.
Paul J. Schramm, MS, MPH
Centers for Disease Control and Prevention
Daniel Strickman, PhD (Lead author) REFERENCES
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ehp ENVIRONMENTAL
HEALTH
PERSPECTIVES
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www.niehs.nih.gov/climatereport
