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TRANSCRIPT
David Grass, PhD, Environmental Health Surveillance Chief
Vermont Climate Round Table – VCFA, March 31st, 2015
Climate Trends and Public Health Impacts
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
The Public Health Imperative
3
Climate change is a local public health issue
Climate change amplifies existing health threats
Mitigate: To limit health effects
Adapt: To unavoidable climate change impacts
Respond: To minimize impacts of extreme weather
on vulnerable populations
Early action will provide the largest benefits
Action can have multiple health benefits
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
1
Forecasting Climate Impacts and Assessing
Vulnerabilities
2
Projecting the Disease Burden
3
Assessing Public Health Interventions
4
Developing and Implementing a
Climate and Health Adaptation Plan
5
Evaluating Impact and Improving
Quality of Activities
Building
Resilience
Against
Climate
Effects
Climate and Health Program, National Center for Environmental Health
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
Quantifying the Risks
7
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)
Quantifying the Risks
8
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
Extreme Heat – Data Used
Population-weighted daily minimum and
maximum temperatures and heat indices
Early Aberration Reporting System (EARS) –
Emergency Dept. Visits (2003-2012)
Vital records for mortality (1999 to 2012)
Generalized linear models of temperature/ heat
index and various types of mortality:
Extreme Heat
10
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
Areas of Concern
11
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
0
10
20
30
40
Current 2021-2050 2041-2070 2070-2099
Day
s p
er
year
e
xce
ed
ing
87°F
Days with Temperatures Exceeding 87°F
B1
A2
Extreme Heat
2003-2009:
18 hospitalizations
496 emergency
department visits
(Average annual age-
adjusted ED visit rate
of 11 /100,000
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
Annual age-adjusted emergency department visits for heat stress / 100,000 population, over the period 2003 to 2009
Quantifying the Risks
13
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)
14
J Patz et al,
Environmental Health
Perspectives, 108: 367–
376 (2000).
Direct and Indirect Health Impacts:
Reductionist Framework
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): 211-220.
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: 12648-1266.
Lyme Disease Modeling
Lyme Disease Modeling
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
Contact information: [email protected]: Principal Investigator
[email protected]: Program Chief
[email protected]: Epidemiologist
Lyme Disease Modeling
Ogden et al. 2014. Estimated effects of projected climate change on the basic reproductive number of the
Lyme disease vector Ixodes scapularis. Environmental Health Perspectives 166(2): 631-638.
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
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: 2011 - 2040, 2041 - 2070
Lyme Disease
Degree days >0o C
Projected and historic daily maximum and minimum
o 30-year
o B2 and A2 emissions scenarios