Tracking the Health Effects of Global Climate Change:

1
Tracking the Health Effects of Global Climate
Change A Preliminary Agenda Brad
Whorton Barbara Toth
2
La Bajada Tornado of 2007
3
Record snow amounts in northern New Mexico,
2006-2007
4
Extreme Pollen Spike in New Mexico, Spring 2007
5
Categories of Anticipated Health Effects

• Temperature-related morbidity mortality
• heat waves blizzards (increase in frequency
  intensity)
• Health risks related to extreme weather events
• floods storm surges, tornadoes, hurricanes,
  droughts, and fires (increase in frequency
  intensity)
• Air pollution-related (Respiratory and
  Cardiovascular diseases)
• Water- food-borne diseases
• Vector- rodent-borne diseases

6
Vector-borne Zoonotic Diseases

• Excess cases of vector-borne disease
• West Nile Virus
• Equine encephalitis
• Dengue
• Malaria
• Hantavirus
• Lyme disease
• Plaque
• Tularemia
• Q Fever
• Etc

7
A recent Harvard Medical School study argues that
the asthma epidemic among inner-city children is
due in part to global warming.
8

• Global warming results in a longer growing
  season for allergy producing plants that trigger
  asthma.
• Pollen season arrives 10-15 days earlier than it
  did 30 years ago.

9
Elevated CO2 stimulates some molds (e.g.,
symbiotic soil fungi) to grow faster and produce
more spores (Klironomos et al. 1997, Wolf et al.
2003). Molds are a trigger for many asthma
sufferers.
10

• Direct health care cost for asthma is more than
  11.5 billion annually.
• Asthma causes approximately 24.5 million missed
  work days for adults each year.

11
A major component of Climate Change is Global
Warming. The number of Excess Heat Events
(EHEs) will increase with climate change.

• 2003 European heat wave
• 2006 California heat wave

In France, there were an estimated 15,000 EHE
deaths alone in the summer of 2003.

• At-risk Persons
• Over age 65
• Infants
• The poor
• Socially isolated
• Mobility restricted
• Mentally impaired

12
Europe saw crop failures and massive forest
fires. France had no plans on what to do for a
heat wave.

• 1) Deaths due to Exposure to excessive natural
  heat (X-30) as either an underlying or
  contributing cause gives an extremely
  conservative estimate.
• Average of 182 deaths in U.S. annually.

• From 2001-2005, there were 11 heat deaths as
  an underlying cause and
• 100 deaths as a contributing cause in New
  Mexico.

X-30 deaths coded only if core body temperature
exceeds 105F.
13

• Methods used by Kalkstein and Greene (1997) and
  Davis
• et al. (2003).

EHE-attributable deaths based on differences in
daily deaths on EHE days compared to longer-term
averages.

• Average of 1,700 to 1,800 deaths in U.S.
  annually.

Need to come up with a measure of EHE days that
fits specific locations in New Mexico.
We are currently participating with other states
in a SEHIC workgroup in order to come up with
national standards.
14
The map shows the estimated excess mortality rate
per 100,000.
15
Global warming will increase the level of
OZONE. Ground-level OZONE pollution comes from
emissions. Their levels increase in the summer
due to the presence of hot and stagnant air. As
summers get hotter, there will be more
ozone. Exposure to OZONE increases mortality
and results in reduced lung function. Ozone
levels in San Juan County are among the highest
in the Southwest (Sather 2004).
San Juan Power Plant, San Juan County, NM
16
Major Coal-fired Power Plants in New Mexico
Total population within a 30 mile radius 192,702
San Juan
Raton
Four Corners
Number of children 60,926
Escalante
Children in poverty 25,019
Children with asthma 3,539
(American Lung Association Website)
17
OZONE EPHTN Surveillance Projects

• San Juan Asthma and Air Quality Study (2000-2003)

• Ozone, PM2.5, PM10, NO2, SO2 air quality data
  from NMED
• Emergency Department and Urgent Care Asthma data
  from San Juan Regional Medical Center.

• Findings
• OZONE (2 day lag) was associated with increased
  odds of asthma-related medical visits.
• PM2.5 was associated with increased odds of
  asthma-related medical visits.

• Albuquerque Asthma and Air Quality Study
• Los Alamos Asthma and Air Quality Study

• NASA Satellite Asthma/MI Air Quality Study of
  Region 4

18
Whats Going On in Lea County?
With the refineries (and large feedlots and dairy
industry) in Lea County, there may be important
environmental factors involved and a connection
to climate change. More study is needed.
19
HERE ARE SOME OF THE SURVEILLANCE PROJECTS WE ARE
WORKING ON

• San Juan County Air Quality Study
• Albuquerque Air Quality Study
• Los Alamos Air Quality Study
• NASA Satellite Air Quality Study

HEAT ? OZONE? ASTHMA

• NASA Satellite Air Quality Study
• 2007 New Mexico Pollen Spike and Days
• of Work Missed Study

HEAT CO2
? POLLEN ? ASTHMA

• Albuquerque Air Quality Study
• Los Alamos Air Quality Study
• NASA Satellite Air Quality Study

HEAT ? OZONE? MI
HEAT ? EXCESS HEAT MORTALITY

• NM Excess Heat Mortality Study

WET ? WATER-BORNE DISEASES (Cryptosporidium) HE
AT VECTOR-BORNE DISEASE (West Nile Virus,
Malaria, Dengue Fever)
RODENT-BORNE DISEASE (Hantavirus)
20
Strategies

• Mitigation (primary prevention)
• Reducing emissions of greenhouse gases
• Analyze health impacts of different strategies
• Adaptation public health response to climate
  variability change
• Data collection tracking (e.g., temperature
  trends, climate-sensitive diseases, etc)
• Modeling forecasting
• Define vulnerable populations
• Partnership development with all relevant sectors
• Educating communicating
• Workforce development
• Curriculum development
• Develop evaluate action plans

21
All will come again into its strength The fields
undivided, the waters undimmed, the trees
towering and the walls built low. And in the
valleys, people as strong and varied as the
land.
--Rilke