WORCESTER MEDICINE
Climate Change
The Science of Climate Change Continued
5. Wang W-C, Yung YL, Lacis AA, Mo T, and Hansen JE. Greenhouse effects due to man-made perturbation of trace gases. Science 1976;194:685– 690. 6. Liousse C, Penner JE, Chuang C, Walton JJ, Eddleman H, and Cachier H. A global three-dimensional model study of carbonaceous aerosols. J. Geophys. Res. Atmos. 1996;101:19411–19432. 7. Hartmann DL, Ockert-Bell ME, and Michelsen ML. The effect of cloud type on Earth’s energy balance: global analysis. J of Climate 1992;5(11):1281–1304. 8. Minnis P, Harrison EF, Stowe LL, Gibson, GG, Denn FM, Doelling DR, and Smith Jr. WL. Radiative climate forcing by the Mount Pinatubo eruption. Science 1993;259(5100):1411–1415. 9. Mitchell Jr, M. A preliminary evaluation of atmospheric pollution as a cause of the global temperature fluctuation of the past century. Singer SF, ed. Global Effects of Environmental Pollution. New York: Springer-Verlag 1970: 139–155. 10. Shaw HR. The periodic structure of the natural record, and nonlinear dynamics. Eos (American Geophysical Union Transactions) 1987;68(50):1651– 1665. 11. Kolbert E. The Sixth Extinction: An Unnatural History. New York: Henry Holt 2014. 12. Barnett TP, Pierce DW, and Schnur R. Detection of anthropogenic climate change in the world’s oceans. Science 2001;292:270–274. 13. Böning C, Dispert A, Visbeck M, Rintoul SR, and Schwarzkopf FU. The response of the Antarctic Circumpolar Current to recent climate change. Nature Geosci 2008;1:864–869. 14.IPCC. First, Second, Third, Fourth, and Fifth Assessment Reports (1990, 1995, 2001, 2007, and 2014, respectively). https://www.ipcc.ch/reports/. Accessed January 13, 2021. 15. NASA Earth Observatory. World of Change: Global Temperatures. https://earthobservatory.nasa. gov/world-of-change/global-temperatures #:~:text=According%20to%20an%20ongoing%20 temperature,2%C2%B0%20Fahrenheit)%20 since%201880. Accessed January 13, 2021.
Climate Change and Human Health Nitin S. Damle, M.D., M.S., M.A.C.P.
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2015, 186 countries signed the paris climate agreement to limit global warming to “well below 2 degrees Celsius” and avoid the harmful impacts on human health. Integral to this goal was to reduce carbon emissions to near zero over the next several decades. Unfortunately, carbon emissions have continued to rise, and the global average temperature has risen by 1.2 degrees Celsius resulting in the five hottest years on record, all since 2015. The environmental impact is well documented and includes sea level rise, ocean acidification, ice melt, and loss of glacier mass. These changes have resulted in a 46% increase (since 1980) in extreme heat waves, flooding, droughts, forest fires, and intense weather events (hurricanes and cyclones). The above weather events and air pollution lead to downstream consequences on human health. This article will focus on five health effects. n
heat waves
The number and intensity of heat waves has increased significantly in the past 20 years. This burden is borne mostly by the elderly, children, and those with cardiovascular and respiratory diseases, outside laborers, homeless, and the poor. There has been a 53.7 % increase in heat-related mortality for people over age 65. Heat waves and temperature rise increase the risk of myocardial infarction, stroke, and acute and chronic renal injury. Studies indicate for each day that the heat index is 95 degrees Fahrenheit (compared to 75 degrees F), emergency department visits increase by 6.6% over the following seven days, heat-related emergency department visits increase by 89% for seven days and death rates increase by 5.8% for each day. Mitigation is essential and includes early warning systems and response plans, increased access to air conditioning, communication by clinical teams to reach vulnerable populations, and education about the risk of heat illness. particulate matter and respiratory diseases
The primary drivers of respiratory diseases are automobile, power plant emissions, and forest fires. Measured particulate matter includes sulfates, nitrates, black carbon, and nitrous oxide. Forty-three million people in the United States and 92% of the world live in areas in excess of the World Health Organization (WHO) particulate limit, and in 2019 there were eight million deaths worldwide attributable to air pollution. Increased CO2 production leads to increased growth of allergen producing weeds, grasses, and trees with rain and floods leading to increased mold and fungal growth. The aeroallergen season has increased from 177 days in the 1970s to 190 days today and is projected
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