1 Climate change and health Dr Bettina Menne WHO Regional Office for Europe

2 Source: WHO, WMO, UNEP: Climate Change and Human Health – Risks and Responses; Summary; 2003

3 Content What are the observed climatic changes? Has population health been affected? What are future potential changes, and How could health be affected? What actions are needed?

4 Source : KNMI 2005 Temperature deviation, compared to 1961- 1990 averages

5 Source : KNMI 2005 Rate of change since 1850

6 What is the trend and rate of change in the European annual and seasonal temperature ? Source : KNMI 2005

7 Change in frequency of days with temperatures above 25°C in Europe, in the period 1976-1999 Source : KNMI 2005

8 Lengths and start of growing season Length of growing season, Finland Carter, 1998

9 Similar patterns in other biological systems Northward movement of range of plankton and fish in Northsea; Upward shift of the tree line in mountains, Invasion of laurophylous evergreen species in forests and upward shift of pine mistletoe in Alps; Disappearance of palsa mires in Lapland ; Increased species richness and frequency at altitudinal margin of plant life in Fennoscandia; Change in high mountain vegetation types and new occurrence of alpine vegetation on high summits in high mountain; Increased in growing season wine-grape and changes in wine quality in France; Advance in the beginning of growing season for fruit trees in Germany; Decrease in thickness and areal extent of permafrost in Northern Russia. Sources Brander and Blom, 2003; Kullman, 2002; Camarero and Gutiérrez, 2004; Shiyatov et al., 2005; Walther, 2004; Dobbertin et al., 2005; Luoto et al. 2004 ; Klanderud and Birks, 2003; Klanderud and Birks, 2003; Peñuelas and Boada 2003; Petriccione, 2003; San Elorza and Dana, 2003; Duchene and Schneider, 2005; Jones and Davis, 2000; Chmielewski, et al., 2004; Mazhitova et al., 2004; Frauenfeld et al., 2004

10 Evidence is growing that climate change is already affecting health

11 Spread of Ixodes ricinus was observed in higher latitudes (Sweden: milder winters, early arrival of springs)(Lindgren et al) altitudes (the Czech Republic: shift from 700 to 1,100 m) (Daniel et al, 2003) Leishmania New endemic areas have been detected in northern Italy, North Croatia, Switzerland and Germany.(Lindgren and Naucke, 2005) Species in higher latitudes or altitudes Source: adapted from Lindgren, 2001; Daniel, 2003 and 2004; Lindgren and Naucke, 2006)

12 In Europe the pollen season is expanding: on average it has increased by 10–11 days over the last 30 years (Menzel, 2001). An earlier onset followed by a prolonged exposure implies a longer and possibly heavier period of symptom occurrence; The introduction of new aeroallergens into an area, increases sensitization; The introduction of new invasive plant species with high allergenic pollen, in particular ragweed (Ambrosia artemisiifolia), present important risks to human health. Earlier start of pollen season Source: adapted from Behrendt H et al. Allergotoxicology - A research concept to study the role of environmental pollutants in allergy. ACI international, 2001, 13:122–128.

13 The risk of dying in heat is increasing UTC 13:00 Heat Stress Cold Stress light extreme high moderate light comfortabel moderate high extreme 14,80 2 † 1,410 † Baden- Wuertte mberg 3,166 † 2,091 † 650 † 9,702 † 1,854 † 960 † Perceived temperature on 8 August 2003 and August heat mortality

14 Mortality changed with degree increase of temperature The effect is expressed in terms of % variation in mortality associated to 1°C increase in exposure. PHEWE, forthcoming City-specific and pooled estimates of the effect of high apparent temperatures on mortality for all causes

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16 Confounding with air pollutants in summer Percent increase in the total daily number of deaths for an increase of 10μg/m3 in various pollutants in the warm season (March-October) All air pollutants have statistically significant main effects on the daily total number of deaths. An increase of 10μg/m3 in these pollutants is associated with a 0.5- 1.0% increase in the daily number of deaths. Phewe, forthcoming

17 Temperature influences the transmission in 35% cases in England, Poland, the Netherlands, Czech Republic, Switzerland and Spain (Kovats et al). In some countries salmonella cases are decreasing, which shows that measures and policies can be effective These diseases show seasonal variations. Salmonella cases raise for each 1-degree increase in weekly temperature Photo by FreeFoto.com Czech R UK Switzerland Spain

18 Floods affect health in Europe Source: EM-DAT database, May 2005 1992: 1346 killed in Tajikistan 1993: 125 died in Yekaterinburg, Russia 1996: 86 died in the Biescas campsite, Spain 1998: 147 died in Sarno, Italy 2002: 120 died in Central Europe Source: Source: "EM-DAT: The OFDA/CRED International Disaster Database, www.em-dat.net - Université Catholique de Louvain - Brussels - Belgium" Created on: May-23-2005. - Data version: v05.05

19 20 15 1900 21002000 14 16 17 18 13 19 Temperature ( O C) Year 2.5 o C Best estimate Low High IPCC estimates (2001): c. 1-5 o C 1.2 o C 2050

20 Increase in vulnerability? Data-source: EEA, 2006 EEA, 2005 2.5 milion people at risk annually Average sea levels are rising about 1.7mm/yr globally 9% of all European coastal zones are below 5 m elevation

21 Data source: Henrichs and Alcamo, 2001. Hadley Centre HadCM3 model, baseline scenario Some projections are strong

22 Europe is aging Lutz, 2002

23 Will inequalities further increase? WHO Euro, 2005

24 Scenario studies on heat United Kingdom (Donaldson et al. 2001) –Medium-high climate change scenario results in an estimated annual 2800 heat deaths in the UK in the 2050s (250% increase). Greater reductions in cold-related mortality. Lisbon, Portugal (Dessai 2003) –Increases in heat related mortality by 2020s to range of 5.8-15.1 deaths per 100,000, from baseline of 5.4-6 deaths per 100,000

25 Contraction and expansion? European Climate Change Programme - Working Group II - Impacts and Adaptation 3. Human Health Brussels, 2.May.06

26 Change in population at risk = + 25 mill Predicted change by 2050

27 What mix of mitigation/adaptation is possible? No action All mitigation All adaptation Mix of mitigate/ adapt/ impact Cost of adaptation lessmore Cost of mitigation lessmore Cost of impacts lessmore (Holdridge diagram)

28 The costs of inaction are high For the city of Rome the monetized mortality damages in the absence of adaptation programs are estimated to be €281 million for the year 2020 (2004 Euro) Alberini and Chiabai, 2005

29 In summary Climate change affects health and will affect health Anticipatory thinking is needed to link the multiple global change exposures to anticipate risks to human health Adaptation strategies are needed to anticipate, detect and prevent the health effects Without the reduction of greenhousegases in the long run adaptation will not be suficient

30 The WHO EURO Global change and health programme http://www.euro.who.int/globalchange

31 Climate change and adaptation strategies for human health http://www.euro.who.int/globalchange dgr@ecr.euro.who.int bme@ecr.euro.who.int WHO Regional Office for Europe European Centre for Environment and Health