Climate Change, Air Quality and Health: a Mexican Perspective. MSc. Magali Hurtado Díaz Environmental Health National Institute of Public Health

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1 Climate Change, Air Quality and Health: a Mexican Perspective MSc. Magali Hurtado Díaz Environmental Health National Institute of Public Health April 2008

2 Potential Relationships between exposure situations and disease conditions Health condition of concern Polluted Air Acute respiratory infections Excreta and household wastes Polluted water or deficiencies in water management Exposure situations Polluted food Diarrhoeal diseases Malaria and other vector-borne diseases Unhealthy housing Climate Change Other infections Cancer Cardiovascular diseases Mental disorders Chronic respiratory diseases Injuries and poisonings Source: The World Health Report Life in the 21st Century A Vision for All (last column modified )

3 Climate Change Pathways by which climate change affects health Regional weather changes Heat waves Extreme weather Temperature Precipitation Moderating influences Contamination pathways Transmission dynamics Health effects Temperature related illness and death Extreme weather related health effects Air pollution related health effects Water and food borne diseases Vector and rodent borne diseases Research Adaptation measures Nutrition Mental health Source: Adapted from Patz et al. 2000

4 Climate change and human health Needs of Research Needs assessment Identification of research needs and knowledge gaps Health impacts research Development of quantitative estimates of health risks associated with climate change Assessment and adaptation/decision support Development of information and tools that help public health officials ameliorate global change health impacts

5 Climate change and variability Health impacts research Retrospective Studies Prospective Studies Associations climate and Health County Analysis Climate Change Scenarios by Region Impact of climate variability on the incidence of malaria in Chiapas's municipalities Vulnerability for ecological regions: case studies Diagnostic study of climate change effects in Mexican population health Impact of climate variability on the incidence of dengue in Veracruz's municipalities Scenarios to evaluate the impact of climate change on human health in Mexican territory Characterization of the vulnerability associated with climate change in Mexico and it s local health effects Health risk scenarios associated with climate change in the Olmeca region of Veracruz

6 Diagnostic study of climate change effects in Mexican population health Objective To make a national diagnosis of the potential impact of climate change in human health, selecting diseases and death causes that [in the scientific literature] had reported any association with climate and are relevant [in terms of public health] in Mexico

7 Acute respiratory diseases in large cities Many large cities have high levels of air pollution, which interact with high temperatures increasing mortality and morbidity Health effect assessment for air pollution and climate Epidemiologic studies

8 Metropolitan Areas ZM Juárez (Pop ,817) ZM Monterrey (Pop ,302) 11 municip ZM Valle de México (Pop ,677) 16 deleg. and 59 municip. ZM Guadalajara (Pop ,136) 8 municip. ZM Toluca (Pop ,801) 12 municip Source: INEGI, CONAPO, SEDESOL, 2000

9 Basic study designs in climate and air pollution epidemiology Exposure Acute Chronic Time Series (counts): Ecological (rates): Mortality, Mortality Unit of observation Aggregated Hospital Admissions Emergencies Episodes, interventions Morbidity Cross-sectional Panel studies: Cohort studies: Symptoms/Diseases Mortality Individual Lung Function Symptoms/Disea se Cohort studies Lung Function Cross-sectional

10 Ozone formation and temperature Ozone is the primary component of smog Ozone formation: Heat/light NO 2 + VOCs ozone Warmer temperatures favor ozone formation

11 O 3 (daily data, Maximum 1-h), Mexico City: Month average, period Completeness daily data: at least 75 % of the hours from 6:00 to 19:00 (above 10 hours) Concentration (ppm) LAG TAC EAC SAG AZC TLA XAL MER PED CES PLA HAN UIZ BJU TAX CUA TPN CHA TAH SUR Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Source: ESCALA Project

12 O 3 (daily data, Maximum 1-h): Month average, period Completeness daily data: at least 75 % of the hours from 6:00 to 19:00 (above 10 hours) Mexico City Concentration (ppm) LAG TAC EAC SAG AZC TLA XAL MER PED CES PLA HAN UIZ BJU TAX CUA TPN CHA TAH SUR Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec ESTANDARD Toluca Monterrey Concentration (ppm) OX CE MT SL SM AP SC Concentration (ppm) SE NE CE NO SO Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Source: ESCALA Project

13 O 3 (daily data, Maximum 8-h moving average), Mexico City: Month average, 2000 Completeness daily data: at least 75 % of the hours from 6:00 to 19:00 (above 10 hours) Concentration (ppm) LAG TAC EAC SAG AZC TLA XAL MER PED CES PLA HAN UIZ BJU TAX ESTANDARD CUA TPN CHA TAH SUR Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Source: ESCALA Project

14 O 3 (daily data, Maximum 8-h moving average), Mexico City: Week average, 2000 Completeness daily data: at least 75 % of the hours from 6:00 to 19:00 (above 10 hours) Concentration (ppm) LAG TAC EAC SAG AZC TLA XAL MER PED CES PLA HAN UIZ BJU TAX CUA TPN CHA TAH SUR Sunday Monday Tuesday Wednesday Thursday Friday Saturday Source: ESCALA Project

15 Health effects of ozone Known to cause inflammation in respiratory tract (Devlin et al., 1997) Reduces ability to breathe (lung function) for some people (Kleinman et al., 1989, Kulle et all) Increases hospitalization for asthma, other lung diseases (Burnett et al., 1994, Thurston et al., 1997 ) New US study finds Ozone mortality effects* (Domenchi et. al 2004)

16 Health effects of ozone and interactions with climate Increase in the occurrence of asthma attacks respiratory infections and with changes in lung function Short-term effects on children with mild-to-moderate asthma (Just J. et all; 2002) Ozone concentrations associated with daily deaths in the warm months (Schwartz 2004)

17 Relative risk of all causes all ages for O3 in MCMA, Monterrey and Toluca ( ) MCMA Monterrey Toluca Relative risk for 10 units variation of the pollutant Relative risk for 10 units variation of the pollutant Relative risk for 10 units variation of the pollutant Relative risk Relative risk Relative risk Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3 Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3 Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3

18 Relative risk of Cardiovascular causes all ages for O3 in MCMA, Monterrey and Toluca ( ) MCMA Monterrey Toluca Relative risk for 10 units variation of the pollutant Relative risk for 10 units variation of the pollutant Relative risk for 10 units variation of the pollutant Relative risk Relative risk Relative risk Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3 Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3 Lag 0 Lag 2 Lag 4 MAv 0 to 1 MAv 0 to 4 Exposure Pollutant: O3

19 Decision support Greenhouse gas emissions scenarios Global climate modelling: Generates series of maps of predicted future climate Time 2080s 2050s 2020s Health impact model: Estimates the change in relative risk of specific diseases 2020s 2050s 2080s Conversion to a single health measure Level Age group (years)

20 Climate change and human health Gaps and problems Lack of data of required resolution and quality at county level Many social-economic data are inaccessible for analysis Highly technical and complex Beyond anyone s experience Misinformation actively disseminated