Climate Trends and Public Health Impacts

Transcription

1 Climate Trends and Public Health Impacts David Grass, PhD, Environmental Health Surveillance Chief Vermont Climate Round Table VCFA, March 31st, 2015

2 Resources Roundtable Dr. Art DeGaetano - Northeast Regional Climate Center Climate-Health tools for temperature extremes Rich Poirot - VT Agency of Natural Resources Air quality and climate extremes Lynn Gilleland - EPA Region 1 Flood resilience guide for water utilities 2

3 The Public Health Imperative Climate change is a local public health issue Climate change amplifies existing health threats Mitigate: Adapt: Respond: To limit health effects To unavoidable climate change impacts To minimize impacts of extreme weather on vulnerable populations Early action will provide the largest benefits Action can have multiple health benefits 3

4 Climate Change and Health Adaptation Vermont Department of Health Climate Change and Health Adaptation Program 4-year grant from the CDC s Climate Ready States & Cities Initiative to: help state and city health departments investigate, prepare for, and respond to the health effects that climate change may have on people 16 states, 2 cities

5 1 Forecasting Climate Impacts and Assessing Vulnerabilities 5 Evaluating Impact and Improving Quality of Activities Building Resilience Against Climate Effects 2 Projecting the Disease Burden 4 Developing and Implementing a Climate and Health Adaptation Plan 3 Assessing Public Health Interventions Climate and Health Program, National Center for Environmental Health

6 1. Review of BRACE Framework Building Resilience Against Climate Effects 1) Forecast climate impacts and assess vulnerabilities 2) Project disease burden 3) Assess public health interventions 4) Develop and implement a climate and health adaptation plan 5) Evaluate impact and improve quality of activities

7 Quantifying the Risks Identified 6 focus areas for quantitative assessment Extreme heat events Air quality impacts Extreme weather events Vector-borne disease Foodborne and waterborne disease Cyanobacterial blooms (blue-green algae) 7

8 Quantifying the Risks Quantify historic dose-response relationship For a change in climate, how much change do we have in a health exposure and/or outcome Project it into the future IF we know the quantitative relationship between climate and health outcome AND how much the climate will change THEN we can calculate the future disease burden 8

9 Extreme Heat Data Used Population-weighted daily minimum and maximum temperatures and heat indices Early Aberration Reporting System (EARS) Emergency Dept. Visits ( ) Vital records for mortality (1999 to 2012) Generalized linear models of temperature/ heat index and various types of mortality:

10 Extreme Heat Exposure variables included: Maximum and minimum daily temperature; Maximum and minimum daily heat index; Average temperature and heat index; All of the above, but lagged from 0 to 4 days; Multi-day averages of all of the above; Interactions among the above; Varying thresholds for the above 10

11 Days per year exceeding 87 F Areas of Concern Extreme Heat Events Preliminary epidemiological analyses suggest that: Temperature threshold for health effects in Vermont may be fairly low (about 87F) Above threshold, emergency department visits and ambulance transports begin to rise, as does daily mortality In addition to the elderly, some relatively young age groups appear to be at risk Days with Temperatures Exceeding 87 F Current B1 A2 11

12 Extreme Heat : 18 hospitalizations 496 emergency department visits (Average annual ageadjusted ED visit rate of 11 /100,000 Annual age-adjusted emergency department visits for heat stress / 100,000 population, over the period 2003 to 2009 State ED visits / 100,000 population Utah 7.6 Massachusetts 11.2 Connecticut 11.3 Maryland 11.3 Vermont 11.4 Minnesota 11.9 Maine 14.8 Missouri 27.9

13 Quantifying the Risks Identified 6 focus areas for quantitative assessment Extreme heat events Air quality impacts Extreme weather events Vector-borne disease Foodborne and waterborne disease Cyanobacterial blooms (blue-green algae) 13

14 Direct and Indirect Health Impacts: Reductionist Framework J Patz et al, Environmental Health Perspectives, 108: (2000). 14

15 Food and waterborne illness Rose et al. Climate Variability and Change in the United States: Potential Impacts on Water-and Foodborne Diseases Caused by Microbiologic Agents. Env. Hlth Perspectives. 2001; 109(2):

16 Food and waterborne illness Sterk A, Shijven J, de Nijs T, et al. Direct and indirect effects of climate change on the risk of infection by water transmitted pathogens. Env Sci Tech 2013; 47:

17 Lyme Disease Modeling

18 Lyme Disease Modeling

19 1. Review of BRACE Framework Building Resilience Against Climate Effects 1) Forecast climate impacts and assess vulnerabilities 2) Project disease burden 3) Assess public health interventions 4) Develop and implement a climate and health adaptation plan 5) Evaluate impact and improve quality of activities

20 Contact information: Principal Investigator Program Chief Epidemiologist

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22 Lyme Disease Modeling Ogden et al. used the previous model in conjunction with historic and projected temperature data to describe the effect of temperature changes on deer tick reproduction Ogden et al Estimated effects of projected climate change on the basic reproductive number of the Lyme disease vector Ixodes scapularis. Environmental Health Perspectives 166(2):

23 Lyme Disease Modeling Data elements Regional Climate Models for temperature input Historical Data - Australian National University Splines (ANUSPLIN) o 10-km gridded daily time-series temperature data, Canadian Regional Climate Model (CRCM) 4 o Special Report on Emission Scenarios (SRES)- A2 GHG emission scenarios o 30-year periods: ,

24 Lyme Disease Degree days >0 o C Projected and historic daily maximum and minimum o 30-year o B2 and A2 emissions scenarios