Health Impacts of Climate Change

Health impacts of climate change – lessons from WA Dianne Katscherian

Charles Darwin University Symposium 14 October 2011

Contents

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Climate Change in Western Australia Climate Change and Health Department of Health activities Other Health sector activities in WA Where are we now?

Some lessons learned

Climate Change in Western Australia  SW WA has experienced reduced rainfall since the 1970s (10 – 20% decrease)  Significant impacts on stream flow, water availability and soil moisture  More intense storm events in SW  NW experiencing more severe cyclones extending further south and inland  Gradual increase in average temperatures

Climate Change in Western Australia  Decreases in rainfall in the south-west since the 70s 500 1976-2003 average: 276 mm

450

mm

400 350 300 250 200 1925-1975 average: 323 mm

150 1925

1935

1945

1955

1965 Year

1975

1985

1995

2005

Climate Change in Western Australia  The Indian Ocean Climate Initiative (IOCI) was established by the WA Government in 1998.  IOCI is a research partnership between the State Government, Commonwealth Scientific and Industrial Research Organisation (CSIRO) and Bureau of Meteorology (BOM).  Research to investigate the causes of the changing climate and develop projections of future climate in WA  4 stages to the program:  Baseline and predictability of WA climate and attribution of climate change  Current and future climate of the North West including extreme events  Very-high resolution climate change projections for the South west  Science leadership and support (current projects)

Climate Change in Western Australia  The IOCI research program projected (yearly averages) that for south-west WA:  by 2030, rainfall will decrease by two to 20 per cent;  by 2030, summer temperatures will increase by 0.5 to 2.1°C;  by 2030, winter temperatures will increase by 0.5 to 2.0°C;  by 2070, rainfall will decrease by five to 60 per cent;  by 2070, summer temperatures will increase by 1.0 to 6.5°C; and by 2070, winter temperatures will increase by 1.0 to 5.5°C.  Sea level rises are also significant (up ~8mm since 1980s)  The changes have obvious implications for people and their activities

WA’s action on Climate Change  WA Greenhouse Strategy (GHS) was finalised in 2004  Committed Government and agencies to respond to measures to address both mitigation and adaptation in WA  Since then:  Climate Change Unit established within the Department of Environment and Conservation responsible for advising Government on government responses to climate change and climate change policy  Formation of the Climate Change Policy Interdepartmental Steering Group (CCPISG) with representatives from all Government agencies

Climate Change and Health  There are many complex interactions associated with potential environmental changes/impacts and human health

World Health Organisation (WHO) 2005 (online) http://www.who.int/globalchange/climate/en/index.html

Climate change and Health  

Climate Change has potential to have significant impacts to health (+ve and -ve) Impacts related to:    

Location of people (work and social environments) Potential environmental changes (arising from changes to climatic conditions) Interaction with the environment (direct impacts – injury, death, diseases) Indirect impacts from existing and future activities and events (loss of communities, livelihood, long term illness etc)

Department of Health and Climate Change

 The GHS committed WA Health to assess impacts of climate change on population of WA  Undertook Health Impact Assessment in 2007 of climate change in collaboration with the WHO Centre for Environmental Health Impact Assessment at Curtin University

The Health Impact Assessment Process  Health Impact Assessment, like other forms of impact assessment, is a formalised collaborative process used to consider potential impacts (positive and negative) from activities during their planning stages  The Process follows the format of:       

Screening Scoping Profiling Risk Assessment Risk Management Decision Making Evaluation

Scenario of Climate Projections for WA in 2030 Climate data from IPCC, CSIRO and IOCI

 Expected average temperature increases of 0.50C to 2.00C  Increases in the number of days over 350C in:  South West of +1 to + 20 days (now 27 in Perth)  North West of +10 to +90 days (now 54 in Broome and156 in Halls Creek)

 Rainfall changes in:  South-West of 2 to 20% reduction in annual rainfall with a 17% reduction in winter rain days and catchment runoff decreases of 5 to 40%  North-West of annual rainfall decreases of 1.5 to 3.5%

 Sea-Level increases of 3 to 17 cm by 2030 and 25 to 75 cm by 2100  For Extreme Weather Events the following are generally accepted:      

Heatwaves – more per year Droughts – more frequent and severe Bushfires – increased risk Flooding – increased intensity Storms – increased intensity Tropical Cyclones – increased intensity

Department of Health and Climate Change  Participation by stakeholders from across Government, NGOs and industry  Three significant components:  Identification of health impacts and assessment of current coping capacity  Risk assessments  Development of adaptive responses that could provide Government with the basis for future decision making  Published results in Health Impact Assessment of Climate Change: Adaptation strategies for Western Australia  www.public.health.wa.gov.au

Health impacts identified:  The impacts to health from environmental changes include:      

Health impacts of extreme events Health impacts of temperature related events Air Quality Health Impacts Food-borne diseases Health Impacts from Food Production Social:  Community  Lifestyle  Mental health, etc

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Vector-borne diseases Water-borne diseases

Vulnerability  Vulnerability considered population groups and interactions of people with regions, infrastructure and ecosystems.  People potentially at greater risk of harm from climate change include:      

The old, especially >65 years The young, especially <2 years The pregnant and breastfeeding The obese Those who are not acclimatized e.g. new arrivals Those who have underlying medical conditions, especially cardiovascular disease  People living in higher risk environments  Manual labourers, outdoor workers, outdoor recreation participants  Etc, etc, etc

Risk Rankings Risk Level

Health Impacts arising from:

Extreme

•Extreme events •Heat events •UV exposure •Reduced rainfall and availability of water for food production •Reduced access to health care, food and water •Inability to meet energy demand

Extreme/Hig h

•Fires •Changes to air quality

High

•Flooding •Drinking water contamination •Pathogens in recreational waters •Changes to disease vector distribution and abundance •Exposure to allergens •Food Poisoning •Dislocation •Impacts to Mental Health •Changes to biodiversity •Population reductions and loss of goods and services

Risk Rankings Risk Level

Health Impacts arising from:

High/Mediu m

•Changes to biodiversity •Populations reductions and loss of goods and services •Pathogens in grey-water/non-potable drinking water

Medium

•VOC Exposure •Exposure to Legionnella spp.

•Exposure to Mycotoxins •Exposure to pathogens in food •Exposure to arthropods and other organisms (bites and stings) •Availability and quality of food •Increases in imported foods •Changes to the incidence in crime, accidents, recreational activities, alcohol consumption, self neglect and loss of green space and gardens

Medium/Lo w Low

•Sleep deprivation •Increased pesticide exposure •Increased chemical exposure

Adaptation Responses  Adaptation measures were categorised as:        

Legislative or Regulatory Public Education or Communication Surveillance and Monitoring Ecosystem Intervention Infrastructure Development Technological/Engineering Health Intervention Research/ Further Information

 Extensive range of adaptation responses was identified  Most require changes to the way we live

Adaptation Responses  BUT….  The core business of the health sector is to manage health (mostly by caring for the sick, some protection and prevention)  Does not implement changes to environments  Essential other sectors recognise the role of and engage with Health

Department of Health and Climate Change

 Important that Department engaged with climate change responses  Formation of the Health and Climate Change Steering Group (HCCSG) in February 2008  Chaired by Executive Director Public Health with support from the Environmental Health Directorate

 15 members with representation from all sectors across WA Health

Role of the Steering Group  Provide leadership on climate change mitigation and adaptation across the WA Health sector  Support the development of policies  Develop and implement appropriate governance mechanisms  Raise awareness  Liaise with stakeholders  Respond to new initiatives and strategies

Role of the Steering Group ď&#x201A;§

These roles include consideration of: 1. The implications of climate change on the WA community 2. The ability of the Department to respond to emergencies associated with climate events 3. The preparedness of the health care system to care for people affected by climate events 4. The requirements of the health system to reduce its greenhouse emissions and environmental footprint 5. Responses to state and national policy on climate change

1. Implications of climate change to the WA community  Processes and adaptation strategies for:  Assessment of specific sector vulnerabilities  Formulation of priorities for action  Collaboration in whole of Government responses  Heat strategy

 Working with other sectors to consider social vulnerabilities including:    

FESA Agriculture and Food Fisheries Water

 Raising awareness

2.

Ability of the Department to respond to emergencies associated with climate events

 Disaster Preparedness and Management Unit (DPMU) set up in 2004  The Unit has been enhancing WA Health's capability, in terms of equipment, facilities and trained personnel.  Is key member of State Emergency Management Committee  SEMC now considers climate change as key component within planning activities

3.

Preparedness of the health care system to care for people affected by climate events

 Activities include:  Identification of potential improvements to existing practices  Assessment of surge capacity:  “..a health care system’s ability to manage a sudden or rapidly progressive influx of patients within the currently available resources at a given point in time”.  Confident capable of dealing with large (>500 patient) incident.  Participation in activities to enhance the national capability to respond to disasters

4. The requirements of the WA Health to reduce its greenhouse emissions and environmental footprint Review of WA Health practices revealed:  Employs over 37 000 employees  Annual budget of over $6.6 billion (2011)  Accounted for 44% of the government’s stationary energy use and spent over $25 million on energy (2006/2007)  One of the biggest emitters of greenhouse gases, with over 213,000 tonnes of CO2 emitted in (2006/2007)  Hospitals consumed over 1.3 mega litres of water in (2007) and  One of the biggest generators and disposers of single use waste (including single use non-recyclable wastes).

Enhancing Sustainability  Activities include:  Proactive planning for future, for example:  New hospitals/facilities must meet Green Star ratings  Identification through reporting of potential improvements to existing practices

 Appointment of dedicated staff for Energy policy  Developing waste policy reduction/reuse/recycling (already completed clinical waste policy)  Greenhouse gas emissions inventory and reporting

Enhancing Sustainability  Progression of:  Metropolitan travel and transport policy  Sustainable procurement policy

 Formation of Health Environment Awareness Teams (HEAT) in many facilities  Sustainable September activities to:  Raise awareness about environmental, social and economic sustainability in action

 Greening WA Health Intranet

Other activities involving Health sector  Local Government:  Health involved in raising awareness about impacts and providing input to risk assessments  Stakeholder in many regional collaborations  Other research projects at local level

 National responses:  NCCARF  Human Health ARN Management Team (2 WA reps)  Raise awareness within resource sector of risks and co-benefits  Health cluster research project (7 in Aus)  Input to National Adaptation Research Plan

Other activities involving Health sector in WA

National  enHealth and Dept Health and Aging  National Adaptation Action Plan

 AUSAID Pacific program

International  Curtin University WHO Collaborating Centre for EHIA  WHO Climate Change and Health in Pacific program  Assessment of risks, development of adaptation responses and local Action Plans

 UNFCCC V&A training (Africa, Middle East and Latin America)

Where are we now?  Development of Business Case within WA Health for more FTEs to address sustainability  State Gov Policy Steering Group working with Climate Change Unit to :  Develop Climate Change Adaptation and Mitigation Strategy for State (CCAMS)  Plan and implement next Science program for IOCI:  Emphasis on partnerships/collaboration in research projects with Government  Specific Project; Climatologies of heat stress and fire danger indices for WA  Downscaled local projections  Stock-take of WA research in CC

Some Lessons Learned  Climate change is exacerbating existing health issues linked to environmental changes  Addressing health impacts during planning stages of activities can also address CC adaptation  Communities must be involved in local assessments and responsibility for responses must be shared  Health impacts of mitigation activities must also be considered – eg emphasis on air conditioning  Governments have a responsibility to provide leadership in addressing sustainability  Assessments of impacts and development of adaptation responses must be integrated across sectors

Thank You