A Human Health Perspective On Climate Change
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.
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 U.S. Department of Agriculture, Agricultural Research Service 1 Bytomski, Jr, et al., Curr Sports Med Rep, 2003. 2(6): p. 320-4. Juli M. Trtanj, MES (Lead author) 2 National cancer institute. 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PRINTED ON: New Leaf Sakura | 100% De-iNkeD recycLeD 50% PoSt-coNSumer waSte | ProceSSeD chLoriNe free 12 National Research Council (U.S.). Committee on Strategic Advice on the U.S. Climate Change Science Program., et al. 2009, Washington, GreeN-e ® certifieD | aNcieNt foreSt frieNDLy D.C.: National Academies Press. xii, 254 p. www.niehs.nih.gov/climatereport