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Biography John Dale Dunn MD JD

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					                Human Health Effects of Global Warming
                     International Conference on Climate Change
                              March 2-4, New York City

                              John Dale Dunn MD JD
                            Emergency Medicine Faculty
                        Carl R. Darnall Army Medical Center
                                 Fort Hood, Texas

Background on warming and health

Public health authorities have asserted that global warming has a detrimental effect on
human health. Officials affiliated with the World Health Organization claimed that
global warming killed 150,000 people in 2000 and that warmer temperatures will put
65 % of the world’s population at risk for insect borne tropical diseases. WHO
scientist Campbell-Lendrum asserted in 2003 that the year 2000 warming death effect
of 150,000 will be doubled by 2030. (Unstoppable Global Warming Singer and
Avery 2007, page 201)

Daily change in temperature in any location on the planet is more than the warming
projection changes of the IPCC: Epidemiologists should know better than to run with
silly “associations” and sky is falling scenarios, given that the human species has
wonderful adaptive mechanism for temperature, and has demonstrated an ability to
live at extremes of temperature far greater than a few degrees from an average.

I assert that warm is good for human health, and that global warming even in the most
extreme estimates will not create heat illness or death increases, and certainly no
changes that are more important than basic public health measures of vector control,
water, nutrition, sewage and housing quality, and the impact of modern medical
measures and technology.

Is warm good for health?

The answer is yes, and most people do what they can to mitigate the effects of
stressful cold weather. People take the hot springs cure, people vacation in warm
places to ease their ills and they move “down south” where the living is easy. As long
as you stay in the warm 1st world you will live better and longer. Older Americans
move to Phoenix in the winter instead of Cleveland, Buffalo or International Falls.
Consider just the risk of falling on the ice in Minneapolis. In Texas we call sensible
retirees snow birds.

People die more often during cold winter months. People of all ages get sick in the
winter more than summer. I get sick in the winter—same for you and your kids. The
WHO proposes we consider warmth as the enemy. Are they goofy or what?

WHO makes heat wave death effects into an argument that global warming will kill
150,000 or twice that number? Warm is good for circulation, arthritis, respiratory
health, and well being.



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Ask a pediatrician what time of year kids are sick. The public health community
would have you believe that global warming is a killer? I say it’s good for the roses,
the trees, the horses, the crocodiles, the snakes, even the polar bears. The issue for
polar bears is food, not temperature. They do quite well in the San Antonio zoo, they
take a dip when they’re hot. A bear’s body temperature is close to ours, so they can
live in moderate climes, just like humans, for cold they have some fat and fur that
protects better than the naked human skin on the ice flows. Bears could still do the
mint julep tour.

Surveillance in the United States Department of Defence shows increases in
respiratory illnesses during the winter months. (MSMR (Monthly Surveillance
Monthly Report) Dec, 2007, published by the Armed Forces Health Surveillance
Center. January is consistently the month of highest mortality rates in the northern
hemisphere. Being born in the winter puts children at higher risk for infectious
disease. Summertime babies have it easy.

A study by Keatinge published September 16, 2000 in the British Medical Journal
showed a tenfold increase in deaths in the elderly (age 65-74) from cold waves versus
heat waves (2000 deaths per million attributed to cold stress, 200 deaths per million
attributed to heat stress.) Cold wave death effects are not only more severe, but last
longer than heat wave effects, probably because of physiological and infectious tails.

The rates of stroke and other cardiovascular events like myocardial infarction are
higher in cold weather, explained by the effects of cold on blood vessels.

Climate has no significant effect on the general health of the population. Period.
Global temperature changes of a few degrees are in the range of human tolerance and
typical of a normal day, not deadly or even stressful.

There are some seasonal and temperature infectious disease patterns, and all of them
are improved with warming. RSV, croup, enteroviruses, Rotovirus, parainfluenza,
and influenza, probably related to close living and transmission. Global warming of a
degree, even up to 5 degrees as predicted by the IPCC fanatics, is not going to change
the seasonal pattern except maybe to moderate it.

Global warming will moderate, not exaggerate temperature extremes. It’s a physical
principle related to air circulation. The pleasant weather without cold snaps blows a
hole in the theory of catastrophe proposed by the WHO.

Heat Illness

So the remaining global warming crusader problem and hobgoblin is heat illness.
Consider the rash of elderly deaths in the 1995 Chicago heat wave or the French
August heat wave and there is the WHO case for panic in a nutshell.

The human organism operates in a controlled, very small range of internal
temperature, regardless of ambient temperature. We are not lizards or snakes. That’s
why the public health global warming panic mongers are off the mark to say human
health would be impacted by global average changes of a few degrees. Humans live
with daily temperature changes of more than 5 degrees and except for the terminally


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ill and dying, we have no problem keeping body temperature in the right range.
That’s what mammals do. People are about 99.6 F rectally , dogs 102 F, horses at
100.5. F. Ambient temperature is not a factor.

The only threat that might produce heat illness is extreme heat waves that exceed 95 F
degrees but that is not the effect of global warming, those things occur for other
reasons. For the ill and debilitated temperature of 95 F or higher is a problem. 100 F
is an emergency if no air conditioning or ventilation is available.

People who are at risk of heat illness or effects can avoid the risk by being quiet,
drinking fluids and staying in a well ventilated place. That’s why heat didn’t kill off
the primitive tribes in the first few thousand years of man’s existence on this planet.
It’s not rocket science. Take a break, take a drink of water when you’re thirsty. Live
under the shade of the coconut tree and relax when the temperatures seem pretty high,
even if you don’t have a thermometer. The WHO seems to think that people who live
in hot places are on a chain gang, but they are drinking water in the shade of the tree
and waiting for it to cool down.

Let’s eliminate right off the bat heat stress for the healthy active person, since
acclimatization and adjusting work schedules and activities can circumvent the heat
stress problems of the seriously active player. Heat deaths are of the isolated
innocents who are ill, who get into trouble without attention. Otherwise only rarely
does heat stress cause illness or death.

Extreme heat waves occur for various reasons, and are not affected by slight changes
in average global temperature. The heat shock does cause an initial surge in deaths,
particularly in high density populations where people live in buildings without air
conditioning or ventilation, but those deaths quickly dissipate, and research shows a
successive period with a much lessened death effect.

General improvements in heat wave deaths in Germany and United States studies and
across the 1st world countries are due to awareness, prevention, and most important,
air conditioning.

Evaporation of sweat, the most important mode of “wet” heat dissipation, and air
convection, the most effective “dry” heat loss mechanism are affected by hydration
status, ventilation, and cardiovascular conditioning as well as medication effects.
High humidity and ambient temperature are the most serious factors for producing
heat illness.

The various stages of heat illness are fatigue, cramps; progressing to exhaustion and
then, when core temperature increases to more than 102 F, heat confusion and
“stroke” or progressive brain dysfunction. Heat illness in the otherwise healthy is
purely a thermoregulatory failure, do to imbalance of energy production and the lack
of cooling from convection, radiation or evaporation, producing dehydration and core
temperature increase. The core temperature rise causes diffuse organ heat damage
and progressive dehydration that produces circulatory failure and death.

The typical high risk range for the healthy human is temperature and heat index
factors in excess of 100 with the margin at 105 F, humidity 10% or more. In the


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tropics temperature rarely rises to heat index danger levels because of limits on
temperature rise caused by humidity. It’s hot and humid in the tropics but the heat
index is less than dangerous.

Dry desert produces the extremes of heat. The desert summer temperatures of Iraq, at
more than 120 F, are an excellent laboratory for heat illness in the healthy American
soldier. Heat illness is a risk when ambient temperatures are above 100 degrees and
subjects have a compromise of adaptive fluid intake, ventilation, and no opportunity
for heat loss, or an increase in core heat production because of activity.

American Soldiers in training in the Southeast United States repeatedly undergo heat
stress challenges with heat illness limited to a few cases every year. At Fort Hood the
last two years training of thousands of soldiers, has produced less than 50 cases of
heat illness per year in 2006 and 2007.

In Iraq where summer daytime temperatures can reach 130 F, American soldiers in
full battle gear, including Kevlar body armor, helmet, 50 pound burdens of arms
equipment and munitions, are operating in the full sun, walking and running or closed
up in heavily armored vehicles. They survive and function with proper fluid intake,
conditioning and training with no significant losses, down time, or removal for heat
illness.

Acclimatization is the key to heat stress. Lack of physiological accommodation and
confinement or lack of ventilation and fluid intake is the reason for heat illness in the
elderly without air conditioning.

Heat stress and severe heat conditions are not the product of global warming, but local
conditions, and there is no reason for the WHO to project thousands of deaths from a
change in average temperature on the planet—one, because any warming is moderate
and distributive and doesn’t create extremes; and two, because heat illness and deaths
are not about the temperature as much as failure to acclimatize and address the special
needs of the infirm and debilitated.

Proper prevention and modern adaptations make warm weather beneficial, only
extreme heat events are a risk at all, and such conditions are not the result of any
global warming trends.

Conclusion

The Copenhagen Consensus group placed basic public health as high priority and
global warming as low priority for addressing the problems of the planet. I am
outraged at the attitude of the European and American snobs who place global
warming on the top of their list of priorities over the welfare of the poor and deprived
of the third world.

Here we are fussing and worrying about whether one, two or three degrees of global
warming is a catastrophe, when we can see serious problems for innocent people
dying or suffering from water borne diseases, poor nutrition, and parasites. The WHO
and the international public health community are pathetic debating societies; they
should be ashamed that they can’t get the basics right on humanitarian needs.


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Biography John Dale Dunn MD JD

Dr. Dunn is a civilian emergency medicine faculty physician at Carl R. Darnall Army
Medical Center, Fort Hood, Texas. Fort Hood is the largest United States Army base
and the home of the 1st Cavalry and 4th Infantry Divisions. Dr. Dunn served as public
health authority for Brown County, Texas for more than ten years and is the Brown
County Sheriff’s Medical Officer. He has lectured and written on environmental and
public health issues for more than ten years. He is a policy advisor for the Heartland
and the American Council on Science and Health.




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