# Presentation: 388081

## CLIMATE INSTABILITY 

**AND **
**PUBLIC HEALTH **
**NREL**
**January 13, 2005**
**Paul R. Epstein, M.D., M.P.H.**
**http://www/med.harvard.edu/chge**

## Algal Blooms 

**Algal Blooms **
**Peru**
**1991**

## United Nations Intergovernmental Panel on Climate Change 

**Third Assessment Report 2001**** **
-  Climate is changing
-  Human activities are contributing
-  Biological systems are being affected      	on all continents
-  Weather is becoming more extreme.** **

** ****All weather = *****f *****(CC + NV)**

## Sea Surface Temperatures: Sept. 2004

**Sea Surface Temperatures: Sept. 2004**

## Since 2001 We Have Learned

**CO****2 ****rise is accelerating: 3ppm/yr, up from 1.8**
**Tropical oceans are warmer & saltier**
**	****   ****surface waters near the poles cooler & fresher **
**	****	*****In August water entering the Arctic Ocean **
**	****	****	****was 1****o ****F warmer than a year ago! **
**3. ****	****Polar and mountain glacial ice is diminishing at ****	****surprising rates**
**4. ****	****Winds around both poles are **
**	****becoming more forceful.**

## 379 ppm

**379 ppm**

##      The Changing Shape of the Curve

**     ****The Changing Shape of the Curve**

**O**
**U**
**T**
**L**
**I**
**E**
**R**
**S**

## Deep Ocean   Warming

**Levitus et al. Science 2000; 287: 2225**** **

- Oceans		18.2 x 1022 J
- Atmosphere	  6.6 x 1021 J

## 			    Precipitation Extremes

- 							 **Past century**** **
**Average annual precipitation  ****	****   ****	****     7%**
**“****Heavy rain events" (>2”/day)  ****	****	****   14%**
**“****Very heavy rain events" (>4”/day)  ****	****   20%**
**Western drought – worst in 500 years**** **

**- Groisman et al. 2004**

## Greenland Ice Sheet

**Geological Survey of Greenland and Denmark**

**	****772,000 square miles of ice **
**	****1.9 miles thick**** **
**Melting ****	**
**  ****1 meter/yr      2000**
**10 meters/yr    2004**

## Slide 11

##     Assessing Climate Stability 

***Rates of Change***
***    ******Variability***
***      ******Gradients***
***        ******Number of Components Changing***

## Epidemiological

**Agent**

**Host**

**Environment**

**Epidemiological**
**Framework**

**Disease**

**Social**

**Ecological**

**Global**

**Ecological-epidemiological**
**Framework**

**Epidemics**

## MODEL PROJECTIONS:HEATWAVES

**MODEL PROJECTIONS:HEATWAVES**

## SURPRISES

- Source: NASA

**2003 Summer Temperatures **
**10****o****C (18****o****F) >30year average **

_**SUMMER 2003 HEATWAVE**_
**FRANCE, GERMANY, ITALY, SPAIN, PORTUGAL**
**21-35, 000 deaths**

**WILDFIRES****	****     CROP FAILURES**

**SURPRISES**

## Slide 16

## INDIA

**INDIA**

**June 2003 ****	****	****T 122****•****F****	**** >1400 deaths**

**July Floods **
**Japanese B encephalitis**

**Andhra Pradesh**

## AIR POLLUTION 

**ASTHMA**
**2-3x**
**  ****Since 1980s**

- _ _
- _ _

**AIR POLLUTION **
**AND CLIMATE CHANGE**

- 	**Indoor pollutants**

**Socio/economic/emotional factors**

**Ground-level ****Ozone**
**&**

**Pollen & CO****2**

**Diesel Particles**
**mold & pollen**

**	****Droughts & ****Fires**

**Floods & ****Fungi**

**Heatwaves**

## RAGWEED POLLEN PRODUCTIONand CO2

**Wayne *****et al., *****2002: *****Annals of Allergy, Asthma and Immunology *****8:279**

- p = 0.005

## CO2 Dome

**CO****2**** Dome**

## VECTORS

***30 “NEW” TO MEDICINE SINCE 1976****** ***
**HIV/AIDS ****	****	****Legionnaires’****	**
***E. coli***** O157:H7****	****MDRTB & others**
**SARS****	****	****nvCJD**
**HPS****	****	*****Vibrio cholerae***** O139**** **
**Nipah  virus****	****	****Ebola**
***Arenaviruses  ******	*****Lyme disease****                **
***RESURGENT & REDISTRIBUTING ***
**Malaria, DF, WNV, Leptospirosis, **
**	****     ****Cholera, Avian Flu**

**VECTORS**
**Mosquitoes**
**Ticks**
**Rodents**
**Bats**
**Tsetse Flies**
**Fleas**
**Lice**
**Snails**
**Algae**

**INFECTIOUS DISEASE**
**A DRIVING FORCE IN HISTORY**
** **
**    *****The Bad News***
***      *****PLAGUE      **
**	****  ****541  AD**
**	****1346  AD****	**
**	****	**
**	****	****     **

***The “Good” News***

**     ****Cholera, TB, Smallpox**

## MONTANE REGIONS

**MONTANE REGIONS**

## WNV

**WNV**
**HUMAN CASES & DEATHS**

**        ****2000         2001      2002****	****2003**
**                            ****25 Nov **

**	****	****       **
**62                        66**
**               ****21**

**       ****4161       **
**                     ****284**** **
**      **
**      **
**     **

** ****9389**
** ****246**

**Jeff Shaman**
** ****Paul Epstein**

**DROUGHT**
**1999, 2002, 2003**

## WNV: A DISEASE OF WILDLIFE

**    ****230 SPECIES ****	****44 STATES, DC, 5 CANADIAN PROVINCES**
**   ****138 Bird *****spp., ******RAPTORS***
***- 37 spp. of mosquitoes***
**   ****HORSES**
** ****  ****ZOO**** ****animals**
**   ****REPTILES**** ****	**

***AVIAN FLYWAYS***

## Ecological Ripples

**INFECTIOUS DISEASES AS FORCES OF GLOBAL CHANGE**
**        ****Raptors****	**** ****	****Rodents** **	****	****	****	****	****	**
**	****	****	****	****	**
**	****	****  ****	****	****	****          ****Lyme disease **
**	****	****	****	****	****	****Hantaviruses**
**	****	****	****	****	****          ****Arenaviruses ****	****	****                  ****	****	****	****	****Leptospirosis ****	****	****	****	****	****	****          Toxoplasmosis**
**	****	****	****	****	****	****Plague**

***Ecological Ripples***

## Slide 27

##            PACIFIC ANOMALIES

**WARM WEST ****	****	****	****	****COLD EAST**

**           ****PACIFIC ANOMALIES**

**Hoerling and  Kumar: *****The perfect ocean for drought.****** Science***** 2003; 299: 691**

**AMERICAS**

**AFRICA**

**AUS**

**ASIA**

## EXTREME WEATHER EVENTS & DISEASE CLUSTERS

**EXTREME WEATHER EVENTS & DISEASE CLUSTERS**

## HURRICANE MITCH

**HURRICANE MITCH 1998**

## HURRICANE MITCH

**     **

**HURRICANE MITCH**
**IMPACTS ON HEALTH**
**AND DEVELOPMENT**

***     ******-- Malaria *****(>30,000 cases)**
***     ******-- Dengue fever (>1,000)***
***     ******-- Cholera (>30,000)***
***     ******-- Leptospirosis ***
**	****      ****Juan Almendares**
***	***

**DISEASE CLUSTER**

## WEATHER ANOMALIES, TRAVEL HAZARDS  

**and TRAUMA **
**Fog, Ice Storms & Road Travel**** **
**Floods & Mudslides**** **
**Ice Instability, Heavy Precipitation & Avalanches****	**
**Infrastructure Damage and Water Q&Q**
**                               ****HEALTH & ECONOMIC IMPACTS**

**Range Expansion of Soybean Rust**
**North America**

_**Crop Pests**_** ****Generations/Year**

**XB Yang, C Rosenzweig, P Anderson**
**R Quiroz, G Baigorria, A Iglesias**

## Drought,

**Drought,**
**Bark Beetles**
**&**
**Fires**

**Respiratory disease**

## Costs of Emerging Infectious Diseases

**Costs of Emerging Infectious Diseases**

**BIO ECONOMIC RESEARCH ASSSOCIATION, Cambridge, MA**

## Costs of Extreme Weather Events

**Costs of Extreme Weather Events**

**UNEP**
**$150B/y w/in this decade**

**Insurance & Reinsurance, Corporations,**
**FEMA, OFDA, NGOs, Nation States, UN Agencies **

**Av. $4 B/y**

**Av. $40 B/y**

## OIL LIFE CYCLE COSTS

- Extraction
- Transport
- Refining
- Transport

- Air Pollution

- Acid Rain

- Climate Change

- Eutrophication
- NOxs

- Warming Oceans
- Coral Reefs
- SLR
- EWEs
- Melting Polar Ice

**Harm  **
**Marine**
**   ****Mammals**
**Shore birds**
**Fisheries**
**Consumers**
**Livelihoods **

**OIL ****LIFE CYCLE COSTS**

- Spills
- &
- Leaks

- Combustion

**MERCURY**

## CLIMATE CHANGE FUTURES: 

**HEALTH, ECOLOGICAL AND ECONOMIC DIMENSIONS**
**Swiss Re, UNDP, JMF**
**Community-building: Scientists, UN agencies, NGOs, Corporations**
**Knowledge-building: Economic evaluation **
**Awareness-building: RISKS and OPPORTUNIIES**

## Harmonizing Adaptation with Mitigation

***Distributed Generation***
**Water****	****	****	****    ****	****Schools**
**	****Purification****	****      ****Clinics**
**	****Pumping****	****	****Homes**
**	****Irrigation****	****    ****	****  ****Computers**
**	****Desalinization****	**** ****	****Cooking**

**	****	****	****	****FOR SUSTAINABLE                       ****	****	****	****	****              DEVELOPMENT**
**	****	****	****	****	**** **

_**THE ENGINE OF GROWTH**_
**for the**_** **_
_**21st CENTURY**_

**    ****Regulatory**

**Institutional**

**  ****EE, RE and DG**
**  “****Green Buildings” & Smart Growth**
**  ****Rationalized Transport & Transit**
**  ****Retrofitting Infrastructure**
**  ****Ecological Reconstruction**

**Funds, subsidies, tax incentives**