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Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

Appendix A
Compilation of Committee Member Comments

GENERAL COMMENTS

Comment # Page/line Comment
1 Standardize spelling across all chapters:
  • Vectorborne not vector born or vector-borne
  • Mosquitoes not mosquitos
2

Punctuation following [likelihood, confidence statement].

This is neither consistent within the Executive Summary (see Extreme weather versus Waterborne chapters) nor within sections within the Executive Summary (see Food safety).

3 Understandably, the report emphasizes increases in health risks. While reductions are addressed in some passages (e.g., cold extremes), the report does not attempt an overall estimate of harm versus benefit of climate change and does not make an explicit effort to explore all potential health benefits of climate change. This is not necessarily a problem, but some statement of scope on this matter would be useful.
4 It would be helpful to readers if the new quantitative modeling efforts were featured more prominently in the preface.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

CHAPTER 1: CLIMATE CHANGE AND HUMAN HEALTH

Comment # Page/line Comment
5 P2/L13 Do you want “increases” before “diseases” and “stresses” (the prior clause starts with “degraded”, which does not fit here)?
6 P3/L9 Comment states that “research needs” are included at the end of each chapter. These are not in every chapter, and depending on response to other review comments, this sentence should be revised.
7 P23/L28 May need to edit “2007-2014” as the range for the literature search.
8 P26/L20 Authors should consider the possibility that heat waves could become more humid, with subsequent greater impacts on human health.
9 P26/L20-22 It may be helpful to mention dust storms or dust events due to climate change.
10 P27/L24 Suggest adding “behavior” as in “… affect the survival and behavior of mosquitoes, ticks…” Movement sounds like migration, but with mosquito-borne and tick-borne this is also, and more critically, talking about changes in biting frequency, rates, times, hosts, etc. So not movement but behavior.
11 P28/L1 Needs a “.” at the end of this sentence.
12 P28/L7 Use degraded coastal ecosystems rather than altered.
13 P28/L16 “This means areas that already experience…” that areas that reads funny
14 P28/L26-34 It is not clear how the concepts in these few sentences fit together and this needs clarification as to the point being made.
15 P29/L18 How hard would it be to include numbers? For example, “The US
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
population has grown by approximately 103% since 1950 (from ### in 1950 to ### in 2015).”
16 P30 In section 1.3.2, consider adding e-cigarette smoking rates, which is an increasingly important health risk among youth.
17 P30/L37 Change presence to “prevalence”.
18 P31/L1 What does “disease risks have been getting worse” mean here? Increasing prevalence, incidence, poorer health care, etc? This is too vague.
19 P34/L1 Does “related” in this sentence mean “associated with”?
20 P36/L25-31 What about changes in medical care and treatment?
21 P37-38 This may be a standard way in climate change literature, but it is really a qualitative estimate of uncertainty to be associated with a quantitative statement … or vice versa as even though there is a scale, there are not actual probabilities associated with these categories. That i.e., even though the authors are told “very likely” corresponds to “>9 in 10,” they are still making a qualitative estimate of that probability.

CHAPTER 2: TEMPERATURE-RELATED DEATH AND ILLNESS

Comment # Page/line Comment
22 P51/L21 Will human health projections really “reduce but not eliminate the increase in future deaths from heat”? Consider using “predicted increase” instead.
23 P51/L25 When talking about “working age adults”, does it really mean that age group, or does it mean workers in various job categories that put that them at increased risk?
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
24 P51/L25 Try “the socially isolated, economically disadvantaged, and those with chronic illnesses, as well as some communities of color…” The first part of the list refers to individuals, and the latter to communities as a whole.
25 P84 Figure 3: cities or counties? Those look like counties. This needs to be fixed in the text too.

CHAPTER 3: AIR QUALITY IMPACTS

Comment # Page/line Comment
26 P89 Include PM in the discussion of the harmful effects of poor air quality.
27 P89/L28 Unbold “.” after “…2009)”
28 P91/L11 NOx should be NOx
29 P91/L26 Consider adding “in some areas” after “decrease”, and add citations.
30 P93/L4 The number of premature deaths changes between “perhaps hundreds to thousands” (Page 102, line 32) to “tens to thousands” (page 93, line 4). The latter is probably more appropriate in this case.
31 P94/L15 Would not start this paragraph with “However”.
32 P97/L14 Not sure the term “enter buildings at lower rates” is quite what was intended. Those species are also removed faster after entering. While the former may often be true, the more reactive species and larger particles are also removed faster in the building leading to lower levels. Potentially add “and are removed faster”. There is also an issue with ultrafines, which can be removed quickly.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

CHAPTER 4: VECTORBORNE DISEASES

Comment # Page/line Comment
33 P121 Table of Contents: capitalize “Disease” in “Lyme Disease”
34 P122 Contributing Authors: Suggest changing Mary Hayden and Andrew Monaghan affiliations to their primary affiliations.
35 P123 Key Finding 2: With respect to the text about northward expansion in habitat, is it only expansion, or is the southern limit likely to be bounded in some cases?
36 P123 Key Finding 4: Is this new? That may be ok. What is the difference between “vulnerability to VBD” and “risk for disease”? Should the “influence risk for disease occurrence” be “influence disease occurrence”?
37 P123/L14 What does “infection rate” mean/refer to? Is it the prevalence of infection in the vector?
38 P123/L20 What do “vulnerability to vectorborne disease” and “influence risk for disease occurrence” mean?
39 P124/L4 “carrier”
40 P124 Table: could mortality be included? LD is high on morbidity, but low on mortality. WNV is moderate on Morbidity but, compared with LD high on mortality.
41 P124 Caption: consistency of terms elsewhere “disease agents” is “infective pathogens”
42 P125/L10 Suggest adding “(especially when considering non-human hosts)” after “… relative abundance of disease carrying hosts”
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
43 P125/L18 Replace “carriers” with “hosts”
44 P125/L26 Missing citation that specifically addresses introduction & establishment

Kilpatrick, A.M. and S. E. Randolph, 2012: Drivers, dynamics, and control of emerging vector-borne zoonotic diseases. Lancet, 380(9857):1946-55, doi: 10.1016/S0140-6736(12)61151-9.

45 P126/L5 Standardize VB D vs V-B D vs V B D
46 P128/L7-11 Moore et al 2014 is not the most relevant citation. Replace Moore with:

Falco, R. C. D. F. McKenna, T. J. Daniels, R. B. Nadelman, J. Nowakowski, D. Fish, and G. P. Wormser, 1999: Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans. American Journal of Epidemiology, 149(8):771-6. (See figure 1: http://aje.oxfordjournals.org/content/149/8/771.full.pdf)

47 P128/L15 Replace “transmitted” with “maintained”
48 P131 For consistency with other chapters, the “Research Highlights: Lyme Disease” should be a box.
49 P131/l28 Edit to clarify that Moore (2014) is not the source of the projections. That is, Moore et al. is not driven with downscaled simulations.
50 P133/L1-2 Clarify why the discrepancy.
51 P134/L4 Spelling inconsistency: change “mosquitos” to “mosquitoes”
52 P134/L38 Remove “,” after United States
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
53 P135/L29 Replace “discovered” with “identified”
54 P135/L30 Insert “primarily” as in “… both viruses are primarily transmitted by…”
55 P136/L5-7 Nicely said
56 P136

Section 4.4.3: This section is a bit hard to read and could be clearer. The authors are trying to make a distinction between changes in the vectors and changes in disease. This is a critical distinction and addressed well in most places in this document.

‐      “…range of projections over the next century..” given the context of just this chapter, this is not clear.

57 P137/L6

Question about citations: “…secondary to existing socioeconomic vulnerabilities…” As written this sentence implies that the citations refer to climate change influencing SES.

‐      The Reiter and Gubler are DEN references talking about SES influencing DEN risk, not climate change influencing existing socioeconomic vulnerabilities.

‐      Ramos should not be included here. They only speculate about possible SES associations “The only factor found to be associated with recent dengue infection in Brownsville was smaller lot size. This finding could [emphasis added] reflect denser concentration of people or could be related to socioeconomic factors.18,26”

58 P137 Add Yuma/San Luis to update DEN outbreaks in US
59 P139 “… reservoirs; however, the influence of climate change on the timing, prevalence, …” remove “however,” it is grammatically redundant of the “;” and diminishes the significance of the second clause.
60 P140

Description of evidence missing additional earlier literature. For example Moore et al., 2014 is not the most relevant citation. Replace Moore with:

Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

Falco, R. C. D. F. McKenna, T. J. Daniels, R. B. Nadelman, J. Nowakowski, D. Fish, and G. P. Wormser, 1999: Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans. American Journal of Epidemiology, 149(8):771-6. (See figure 1: http://aje.oxfordjournals.org/content/149/8/771.full.pdf)

61 P140/L28 “There is low confidence that climate change will influence human incidence of LD.” Is it low confidence that it will influence or it is low confidence on how it will influence?
62 P141/L5 “landscape” use a clearer term for the audience?
63 P141/L33 “There is low confidence that climate change will influence human cases of WNV.” As with LD, is it low confidence that it will influence or it is low confidence on how it will influence? This is an important distinction. As written, the CDC is saying that climate change will not influence these diseases. One could argue that this is more a lack of evidence of how it may.
64 P142/L15 Remove “will”
65 P142/L19-20 “… which may disproportionately affect certain populations.” This feels a little out of the blue.
66 Figure 2 Remove the empty circle “insignificant”?

CHAPTER 5: WATER-RELATED ILLNESS

Comment # Page/line Comment
67 Possible omissions from the discussion of water-related illness include: (1) the importance of regional variability associated with climate driven hydrological impacts and, in turn water-related illness, and (2) impacts associated with alterations to annual snowpack and snowmelt (e.g. water availability/quantity and quality). Highly
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
regionalized variations in water-related illness should be discussed (or at least mentioned) in Section(s) 5.2 and/or 5.3, and a discussion of climate change-induced shifting patterns in snowpack/snowmelt (and possibly glacial mass balance) should be addressed. The Committee notes, however, that the primary category of disease for which this issue is relevant may be vectorborne diseases, especially arbovirus encephalitis (e.g., West Nile, Western equine, St Louis, etc.) and Lyme disease. See, for example, Reisen et al., 2008 and references therein. Thus, report authors may wish to include information about this in Chapter 4 instead.
68 P163/L4 Will warming expand seasons for all species?
69 P164 Table 1, Vibrio species: “blood poisoning” is not typically used by the medical profession; better might be “bloodstream infections.”
70 P165 Table 1, Chemical Contaminants: it is not clear that inclusion of mercury and other chemicals in this table makes sense, despite the fact that ingestion of food containing such metals and compounds is a cause of “foodborne” illness.
71 P166/L1-4 “Our understanding…is complicated by limited case data”: is vague. Given what follows, one can assume it is meant to refer to underreporting or incomplete reporting of reportable (and even more so non-reportable) conditions; if so, this should be re-written. In addition, the sentence that begins “All other reporting is voluntary…” is misleading-data concerning many legally reportable conditions are incomplete because the reporting, while legally mandated, depends on both correct diagnosis and willingness of providers and labs to report to passive surveillance systems. Data concerning conditions that are not “reportable” by law typically must and do come from special studies and surveys, not from “voluntary reporting.”
72 P168/L8-10 The sentence that begins “The majority of drinking water outbreaks…” may imply that Legionella infections/Legionnaires’ disease cases are the result of ingestion of contaminated drinking water. While there is disagreement about the relative importance of inhalation of contaminated aerosols versus aspiration of contaminated water in the causation of Legionella pneumonia, few experts in the field would refer to outbreaks of legionellosis as “drinking water outbreaks.”
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
73 P170/L27 While the Committee does not dispute the statement that “… contamination of marine waters is a significant risk for illness,” a statement that is more specific with regard to what types(s) of illness this statement refers to should be included.
74 P171/L4 Wrong degree symbol
75 P172/L1-7 The first part of the first two sentences clearly refers to the effects of higher sea surface temperatures on “seasonal window” and “geographic range,” while the second sentence is clearly referring to “higher levels” of Vibrios; these are not equivalent, and one does not, necessarily, imply the other.
76 P172/L5 Note that Urquhart et al. (2014) found that projections of Vibrio increase at high SSTs are highly sensitive to the structure of the statistical model (Urquhart, E. A., B. F. Zaitchik, D. W. Waugh, S. D. Guikema, and C. E. Del Castillo, 2014: Uncertainty in Model Predictions of Vibrio vulnificus Response to Climate Variability and Change: A Chesapeake Bay Case Study. PLoS ONE 9(5):e98256, doi: 10.1371/journal.pone.0098256).
77 P172/L25, 27 It is not clear that “intestinal” is the correct word in either of the lines; “enteric” might be closer to what is intended.
78 P178 Section 5.6 (Emerging Issues): much of the concern about ingestion of mercury, pesticides, etc. relates to the risk of “chronic” health outcomes, such as endocrine disorders, autism, cancer, etc. rather than acute illnesses, such as gastroenteritis, hepatitis A, shellfish toxin-related illness, etc. Some explanation/discussion of the differences between acute illnesses caused by a single exposure and with an incubation period of minutes/hours to days and weeks versus chronic diseases in which repeated exposure can/may lead to an increased risk of a “chronic condition” years or decades later might be helpful to include here.
79 P181/L20 Is the word “actual” really helpful here?
80 P181/L25 The word “issues” is vague and unhelpful.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
81 P184/L2 Missing a period after “…(Zamyadi et al 2012)”

CHAPTER 6: FOOD SAFETY, NUTRITION, AND DISTRIBUTION

Comment # Page/line Comment
82 P215/L23 Move “.” to end of sentence.
83 P224/L2 Remove “a” from “lead” so that it says “… rain led…”

CHAPTER 7: EXTREME EVENTS

Comment # Page/line Comment
84 P261/L36 Johnson and Fonseca 2014’s study on the effect on reproductive success under conditions of forced egg retention (by removing water sources in the lab) is an inappropriate citation. Suggest looking at the literature they cite in the introduction, including, at a minimum, the Shaman article that everyone cites for WNV and drought: Shaman, J., J.F. Day, and M. Stieglitz, 2005: Drought-induced amplification and epidemic transmission of West Nile virus in southern Florida. Journal of Medical Entomology, 42 134–141.
85 P263 Is C. gatti an example of impacts of climate extremes?
86 P266/L33 Remove everything after “..increase infectious disease risk.” This is inaccurate and not supported by the citation “Patz & Uejio.”
87 P290 Figure 2—Pregnant women and newborns are not additional risk factors.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

CHAPTER 8: MENTAL HEALTH AND WELL-BEING

Comment # Page/line Comment
88 Key Finding—punctuation not consistent with other chapters “…[].” not “….[]”
89 P299/L16 Can “most” be quantified?
90 P299/L31-38 It also seems that the prior paragraph could largely be included in the heat chapter rather than here, since it is largely about issues other than mental health. If the authors would like to expand the scope of the chapter to well-being more generally, which is reflected in this paragraph, there are many other issues that might be included throughout the chapter.
91 P300/L1-6 The characterization of increased crime and violence due to heat is a bit lopsided. The literature is more nuanced than this. In addition, there is literature that addresses the relationship between heat, stress and interpersonal conflict that would helpful to mention in that section and also in the overall chapter.
92 P300/L20 Replace West Nile virus with WNV
93 P300/L27-30 Move to previous paragraph on WNV
94 P301/L9 Remove “.” after “…future.”
95 P301 Third paragraph: describe hybrid risk in more detail.
96 P302 Under populations of concern, farmers are called out, but no detail is given. Since farmers are not discussed in Chapter 9 as a vulnerable population, a few sentences regarding occupational groups who will be most economically affected by climate change (fishermen, farmers) would be helpful.
97 P303 The section on Children should include the research out of the Colorado Center on Disasters regarding the creation of resilience and
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
post-disaster recovery that improves childhood outcomes. There may also be other research in this arena to include. Again, it is important to make sure that research showing answers, not just the impacts and problems, is included in order to address the interests of broad audiences who might be reading this report.
98 P305 In the first paragraph on economically disadvantaged, need to discuss that this population may lack access to care for mental health issues.
99 P305 In the second paragraph, any discussion of emergency workers and first responders should be expanded to include health care workers and public safety workers who often become first responders in acute climatic events.
100 P305 The issue of access is particularly important to include in the section on Low Income populations, as it is a problem that generally affects this group more than others.
101 P306/L12-14 Remove line “Those who sleep outdoors at night…” or find appropriate citation. Ramos and Svoboda are citing a non-peer-reviewed source and the link is no longer valid—could not be verified.
102 P308/L26 “With regards to…” remove “s”
103 P309 Research needs. In reading this section, there is a much more realistic discussion of the limitations of current data systems and monitoring. Much better than the discussion in Chapter 9 that has a specific section on monitoring vulnerable populations. The chapters need to cross reference each other on this important topic.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

CHAPTER 9: CLIMATE-HEALTH RISK FACTORS AND POPULATIONS OF CONCERN

Comment # Page/line Comment
104 The structure of this chapter is fairly redundant. It is not always clear why a section is a section and how it repeats a previous section.
105 The treatment of VBD is not consistent and seems to be trying to make distinctions where there may not be evidence to support a distinction.
106 Suggest replacing the term Hispanic with the word Latino (as we are largely referring to persons from North, Central, and South America and the Caribbean, rather than from Spain).
107 P338/L36 Fix font of comma after hazard.
108 P339/L6 Figure 2 does not explain what the text says it is supposed to explain (it does not appear to be related to the description of the framework given in the text).
109 P339/L30 Add “and other air pollutants” after aeroallergens.
110 P340/L6 Condition of Infrastructure should include reference to “access” to infrastructure. For example, access to communication infrastructure can influence a person’s vulnerability.
111 P341/L6 Should read “see Section 9.3.2.” There is no section 9.2.2.
112 P342/L11 Insert “inadequate” before “access to health care.”
113 P342/L18 Insert “lack of access to emergency communications” after “poor quality housing.”
114 P342/L21 Insert “such as” after “adaptation measures” and give an example.
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
115 P343/L8-10 “Because of poor housing conditions and other SE factors, some populations of color and low-income populations may be at risk for exposures to disease carried by vectors such as fleas, ticks and mosquitoes Ramos et al 2008 (See also Chapter 4 VBD).”
(1)    Not a valid interpretation of Ramos (DEN on the TX-MX border). From Ramos: “The only factor found to be associated with recent dengue infection in Brownsville was smaller lot size. This finding could reflect denser concentration of people or could be related to socioeconomic factors.18,26”
(2)    Not sure a DEN paper can be extrapolated to all vectors
(3)    Doubt Chapter 4 would support this statement
(4)    Making statements like this without support leads to spurious conclusions, and an assumption that we know more than we actually do about VBD in the United States
116 P343/L11 The first sentence (on nutritional content) is unclear and it would be helpful to the reader to include a short explanation. Consider adding information to connect the remainder of the paragraph to climate change.
117 P343/L18 Stress-related mental health impacts are also due to greater vulnerability, not just access to mental health care.
118 P344/L15 The sentence on mercury exposure should be strengthened. Mercury also affects all life stages as it is a potent neurotoxin. Perhaps add a reference to salmon in the western and northwestern U.S.
119 P346/L29 Add space between “Impacts). Children”
120 P347/L7-10

“Climate change is potentially driving the increasing prevalence and exposure to diseases spread by ticks and mosquitoes [note: add an “e” here], as the length of warm seasons and the habitat suitability …”

-    This is consistent with Chapter 4 VBD

-    Given the paucity of data on children and pregnant women, perhaps this piece needs to pull international studies/data? Usually think of a lot of the mosquito borne disease effecting children (usually because of first exposure).

-    In this section of “Children and Pregnant Women” should pregnant women at least be addressed in so much as a statement that

Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
we do not know? Rather than an omission, explicitly stating that this is a gap in the literature may be important especially since part of this document’s goal is to inform policy and research priorities.
121 P347/L16 Insert “increasing costs” after “affecting supplies.”
122 P347/L23 “Pregnancy, the developing fetus, and newborns are considered.. vectorborne diseases…“
Unfortunately, given the literature cited in the preceding section, there is little to no evidence to support this. Suggest that VBD be pulled out of this sentence and given its own sentence, for example: “Given the paucity of U.S. based literature regarding VBD and these risk populations, we cannot estimate the effect, however, it is known that these populations tend to be more severely affected and, until there is literature to support it, we can assume that they will disproportionality experience negative impacts.”
123 P349/L31-37 This paragraph is well written and could be duplicated in other sections for better clarity.
124 P350/L9-15 Older Adults “VBD pose a greater …” Citation?
125 P350/L25 Is urban heat island a ‘Non-Climate Stressor”?
126 P350/L28 Housing stocks? What is that?
127 P351/L23 This section speaks only about outdoor workers, who may be at great and most obvious risk, but warehouse workers, for example, with no air conditioning and demanding workloads are also at high risk for heat related illness, especially in cases where employers manage from air conditioned offices. Management’s awareness of changes in conditions in the workplace as a result of climate change will influence the level of exposure of employees to extreme conditions, both indoors and outdoors.
128 P352/L27-29 This is more consistent with the language in Chapter 4
129 P352/L34-36 U.S. vs United States
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
130 P353/L4

Military and VBD—the literature shows that military are currently at risk for VBD in a very different way than most U.S. citizens, but Chapter 4 does not say anything about Military. The reference to Chapter 4 is inappropriate.

‐      Similarly, L 14 Lyme disease and military? That does not seem like the best example of VBD risks to military ppns. LD is Northeast and Upper Mid-west, most military bases are South. Spotted fevers may be a better example, or even leishmaniasis (Old World Leishmaniasis: An Emerging Infection among Deployed U.S. Military and Civilian Workers, Weina, ClinID, 2004: 39(11)) or, if it needs to be U.S. acquired, WNV.

‐      LD gets reported at bases all over the United States—this disconnect between where the vector is (Chapter 4) and where the reports are coming from seems like something the CDC should look into in a DOD-CDC collaboration.

‐      Question whether valley fever might not need to be included here. Historically in the United States this has been a problem and it somewhat continues to be.

‐      Try “Coccidioidomycosis in the U.S. military—A review” Crum-Cianflone, Ann NY Acad Sci 2007

‐      Suggest a little bit of a literature review to support these statements about military and VBD.

131 P354/L27 Change “introduction chapter” to “chapter on Climate Change and Human Health” here and in line 30.
132 P355/L8 Change punctuation as follows “… Nordone t al 2009; See also Ch.8: Mental Health and Well-Being). In…”
133 P357 Emerging Issues?
134 P387 Figure 3. “Young children are particularly sensitive to … death,” suggest removing “and death” so that it reads “Young children are particularly sensitive to … heat-related illness,”
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×

APPENDIX: TECHNICAL SUPPORT DOCUMENT

Comment # Page/line Comment
135 SPAs are listed but never explained or referenced.
136 Exposure Response modeling: The form of the relationship (e.g., linear or non-linear) is another major source of uncertainty that is not mentioned here.
137 P404 Figure 3 is not that useful. Also the panels do not show “model output.”
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page41
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page42
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page43
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page44
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page45
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page46
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page47
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page48
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page49
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page50
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page51
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page52
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page53
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page54
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page55
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page56
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
×
Page57
Suggested Citation:"Appendix A: Compilation of Committee Member Comments." National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press. doi: 10.17226/21787.
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Page58
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The U.S. National Climate Assessment identified a number of ways in which climate change is affecting, and is likely to affect, people, infrastructure, natural resources, and ecosystems. Those impacts, in turn, are increasingly having important current and potential future consequences for human health. There is a need to probe more deeply into how climate change impacts on the environment can create environmental stressors that, in turn, are having and/or have the potential to have significant impact on human health in a number of dimensions. In response to this need, the U.S. Global Change Research Program (USGCRP) has initiated an interagency Scientific Assessment on the Impacts of Climate Change on Human Health in the United States. The Assessment is intended to inform public health authorities, other planning and policy entities, and the general public.

Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States evaluates the scientific basis, findings, and key messages of the USGCRP Draft Assessment. This report offers a number of overarching suggestions on how the USGCRP report authors can enhance their identification and assessment of the science and better communicate their conclusions to all of their target audiences. These recommendations this help the Assessment to play a significant role in continued efforts to examine and explore the impacts of climate change on human health.

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