Health impacts of climate change -

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Health impacts of climate change - major
challenge of the 21st century

• Anna Paldy
• National Institute of Environmental Health,
  Budapest, Hungary

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Changes of the yearly mean temperature in Hungary
(C), 1975-2004.
(Source National Meorological Service, 2006)
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Predicted changes in mean temperature and in
Europe, 2071-2100
Mean temperature

• Figure 1 is based on IPCC
• SRES scenario A2. The projected climate impacts
  are estimated for
• 2071-2100 relative to 1961-1990. The maps are
  based on DMI/PRUDENCE data
• (http//prudence.dmi.dk), and processed by JRC
  within the JRC funded PESETA study
• (http//peseta.jrc.es)

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Predicted ecxess mortality related to heat in
Europe, 2071-2100

• Average annual differences in heat-related deaths
  per 100 000 population, for 2071-2100
• (SRES A2 scenario) compared to 1961-1990, using
  the HS1 climate data, and climate-dependent
  health
• functions (no acclimatisation).

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Emerging evidence of climate change effects on
human health shows that climate change has
altered the distribution of some infectious
disease vectors (medium confidence) altered
the seasonal distribution of some allergenic
pollen species (high confidence) increased
heatwave-related deaths (medium confidence)

• Confalonieri, U., B. Menne, R. Akhtar, K.L. Ebi,
  M. Hauengue, R.S. Kovats, B. Revich and A.
  Woodward, 2007 Human health. Climate Change
  2007 Impacts, Adaptation and Vulnerability.
  Contribution of Working Group II to the Fourth
  Assessment Report of the Intergovernmental Panel
  on Climate Change, M.L. Parry, O.F. Canziani,
  J.P. Palutikof, P.J. van der Linden and C.E.
  Hanson, Eds.,
• Cambridge University Press, Cambridge, UK,
  391-431.

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4 pillars of adaptation strategy of the EU

• 1st Early action in the EU
• 2nd Integrating adaptation into EU external
  actions
• 3rd Reducing uncertainty by expanding the
  knowledge base through integrated climate
  research
• 4th Involving European society, business and
  public sector in the preparation of coordinated
  and comprehensive adaptation strategies

GREEN PAPER FROM THE COMMISSION TO THE COUNCIL,
THE EUROPEAN PARLIAMENT, THE EUROPEAN ECONOMIC
AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE
REGIONS Adapting to climate change in Europe
options for EU action SEC(2007) 849
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Main features of adaptation strategy of the EU
concerning human health

• Adaptation is a key response strategy to make
  sure
• that the potential effects of climate change on
  health are reduced and kept to a minimum.
• The EC recognises that such effects are rapidly
  and dangerously increasing.

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Planned Communication in 2008

• It will establish a framework to tackle the
  impact of climate change on human and animal
  health.
• The Communication is expected to look at
  different aspects of mortality and morbidity due
  to CCh
• including the changes in the means of
  transmission of certain infectious diseases
  affecting human and animals
• changes in the dissemination of airborne
  allergens due to atmospheric changes
• and the risks due to UVR as climate change delays
  the recovery of the stratospheric ozone layer.

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Mortality and morbidity
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Effect of temperature on human health Based on
Budapest data

• The increase of daily mean temperature by 5 oC
• inceases the risk of all cause mortality by 10.
  
• inceases the risk of mortality due to cardio-
• vascular diseases by 12-
• increase the risk of emergency ambulance calls
  due to ill defined symptoms by 15

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Ever strongest heat wave for Central Europe 2007
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Meteorological explanation of the extreme
weather situation of 2007
In a 'normal' summer, the Atlantic jetstream
directs areas of low pressure, which bring cloud
and rain, to the north of the UK. High pressure
systems over Europe and the Atlantic bring warm,
settled conditions. Pressure chart 29/6/06.
Source Met Office-UK
This summer, the jetstream is flowing further
south allowing low pressure systems to sweep
straight over the centre of Britain. It is also
pulling in warmer air from the sub-tropics and
Africa which is sweeping over south-eastern
Europe. Pressure chart 24/07/07. Source Met
Office-UK
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Internatioal Heat wave probability forecast,
issued on 16th of Julay for the coming 10 days
http//www.euroheat-project.org/dwd/index.php
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Heat waves in Hungary, 2001- 2007
2001 2002 2003 2004 2005 2006 2007
No of heat waves 1 2 2 1 1 5 3
Duration of heat waves(No of days) 3 8 11 4 5 30 19
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Number of excess deaths in hospitals and at home
in relation to daily mean temperature in the
Central Region of Hungary, 2007
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Excess mortality during the heat waves in the
Central Hungarian Region in 2007 - in relation to
the mean mortality of days with mean tempgt25 oC
  2nd level of heat alarm 19-23rd June 5 days 3rd level of heat alarm 15-24th July 10 days Warning 23-26. August 4 days
Number of death cases 400 1123 341
Number of excess death cases -22,5 278 3
Daily number of excess cases -4,5 27,8 0,75
of daily excess cases -5.3 32,9 0,9
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Infectious diseases
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Prevalence of TBE
No of TBE cases in Hungary 1989-2005
Increase of incidence of TBE in European
countries 197-2003
Seropositive TBE cases in Hungary 1981-90
www.rivm.nl
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Increased incidence of vector borne diseases
Incidence of Lyme disease in Hungary, 2004 (per
100 000)
In the latest years Hanta virus and West Nile
virus infection was detected. Sand flys, the
vectors of Leishmaniasis are also present in
Hungary
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Hanta virus infection
www.nlm.nih.gov/.../ency/fullsize/17201.jpg
www.osasun.cl/fotos/hanta/2.gif
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www.co.monroe.mi.us
West Nile virus is a mosquito-borne virus
naturally found in bird populations.
Occasionally, the infection can be transmitted to
other animals and humans through the bite of an
infected mosquito
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West Nile virus infection cases in Hungary
Geographical distribution of Hantavirus infection
cases in Hungary
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Leishmaniasis
The insect vector of leishmaniasis, the
phlebotomine sandfly, is found throughout the
world's inter-tropical and temperate regions.
Human infection is caused by about 21 of 30
species that infect mammals. Major types L.
donovani complex with three species (L. donovani,
L. infantum, and L. chagasi)
Spread of leishmaniasis Yellow line prevalence
of cutanoues diseases Yellow dotted line spread
of the vector
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Chikungunya fever
CHIKV infection can cause a debilitating illness,
most often characterized by fever, headache,
fatigue, nausea, vomiting, muscle pain, rash, and
joint pain
The vector, the Aedes albopictus mosquito, has
been detected in metropolitan France and in
northwest Italy, near the borders with France,
Spain and Switzerland
Chikungunya virus (CHIKV) is a member of the
genus Alphavirus, in the family Togaviridae.
www.cdc.gov
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Other problems

• Higher temperatures in summer could considerably
  increase the incidence of food borne salmonella
  infection.
• Climate change might increase levels of
  cryptosporidium and campylobacter in water.

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Allergic plants
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Observed changes in the onset of pollination 4
weeks hazel, birch 8 weeks ash
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Differences in onset of pollination of two
allergic species in Budapest in 2006 and 2007
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Onset and pollen production of 4 allergic spring
trees in Budapest 2005-2007 in relation of TEMP
Aerobiological network of Hungary
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UVB radiation
Source GLOBOCAN 2002
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Spatial distribution morbidity due to melanoma
(ICD-10. C43) and cataract (H25) in relation of
global insolation, Hungary (1997-2001)
melanoma
cataract
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Impact of climate change
warming
So what
EXTREME SITUATIONS
heat waves
Are we ready to adapt to them?