Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States (2015) / Chapter Skim
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Chapter Reviews
Pages 11-36
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From page 11... ...
There are no key findings for this chapter. Generally, the chapter addresses the issues related to Goal 1 very well.
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From page 12... ...
CHAPTER 2 TEMPERATURE-RELATED DEATH AND ILLNESS General Comments and Key Findings Chapter 2 addresses the increases in both average and extreme temperatures and the potential contributions to death and illness, as well as implications of prolonged exposure to high temperature. The authors of this chapter have generally done a thoughtful and careful job of reviewing the major literature in this important area and capturing the key findings that can be drawn from this literature.
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From page 13... ...
The statement of the finding, however, is not consistent with the underlying text and the traceable accounts: the first sentence (and throughout) should refer to "additional premature" rather than "additional" deaths and should read: "Future climate warming could lead to thousands to tens of thousands of additional premature deaths each year from heat in the summer by the end of the century." In addition, this finding is silent on the current state of evidence and understanding of the potential effects of current warming, an issue of considerable public and media interest and debate on which Chapter 1 touches in citing the National Climate Assessment (2014)
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From page 14... ...
Although the first part of this finding, concerning the increases in illness and death related to extreme temperature events, is well documented in the text (e.g., the Chicago 1995 example) , the second part: "mortality effects are also seen for smaller deviations of even a few degrees from seasonal averages, and small deviations from average temperature occur much more frequently than extreme events" does not appear to be supported well in the accompanying text.
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From page 15... ...
CHAPTER 3 AIR QUALITY IMPACTS General Comments and Key Findings This chapter briefly reviews the literature that addresses how global change will likely impact human health via air quality exposure pathways. In this case, the term "air quality" refers to both traditional air pollutants and other airborne materials, in particular aeroallergens.
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From page 16... ...
upon which this conclusion is derived are subject to uncertainties, particularly when applied to estimating future health impacts. Key Finding 2: Worsened Allergy and Asthma Conditions Changes in climate, specifically rising temperatures, altered precipitation patterns, and increasing atmospheric carbon dioxide, are expected to contribute to increasing levels of some airborne allergens and associated increases in asthma episodes and other allergic illnesses, compared to a future without climate change.
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From page 17... ...
While the statement that climate change has impacted ozone is supported by the literature, the authors are advised to better explain the term "climate penalty." Research Needs The authors note that additional research is needed on how air quality and aeroallergens will respond to climate change and on the potential for increased exposure to contaminants indoors. The literature on this issue is not extensive at this time and does not strongly suggest that there will likely be adverse health outcomes from altered exposure to indoor air pollutants.
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From page 18... ...
Similarly, the modeling appears to be well done and is appropriate. CHAPTER 4 VECTORBORNE DISEASES General Comments and Key Findings Chapter 4 discusses the ways in which vectorborne diseases are influenced by climate factors, including the short- and long-term effects on patterns of transmission and infection.
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From page 19... ...
However, the language used for both key findings should be better coordinated with the other chapters to draw attention to the possibility of significantly higher exposure to and impacts of vectorborne diseases on human health in the near future. As implied in Key Finding 1, it seems justified (from the published evidence cited in the chapter)
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From page 20... ...
Key Finding 5 is an important finding that is somewhat lost with the number of other Key Findings of this chapter. The confidence statement comes from the bulk of review papers all suggesting a positive association, but the lack of a likelihood statement is indicative of the limited evidence base.
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From page 21... ...
CHAPTER 5 WATER-RELATED ILLNESSES General Comments and Key Findings This Chapter explores some ways in which climate and weather factors can have an impact on properties of water-related pathogens and toxins as well as impacts on human exposure pathways. In general, this chapter is well-written and does an excellent job of assembling relevant information concerning the likely and possible effects of climate change, especially rising ambient temperature, on selected water-related illnesses.
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From page 22... ...
A breakdown in water infrastructure would contribute to increased risk of exposure to water-related pathogens, chemicals, and algal toxins. Given the decision to focus this chapter on toxin-producing harmful algae and noncholera Vibrios, the three key findings presented appear to be reasonable and supported by the evidence cited.
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From page 23... ...
, should perhaps be reconsidered given the importance of the disease in the United States in terms of the morbidity and mortality that it causes; the clear association of the disease with inhalation of contaminated aerosols of fresh water; the effects of both temperature and the presence of other organisms, such as amoeba, on the growth of Legionella species; the clear link between large scale air conditioning systems (e.g., cooling towers and evaporative conditioners) and the risk of Legionella pneumonia; and the likelihood that increasing ambient temperatures are highly likely to lead to increased need for and use of air conditioning in large parts of the United States.
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From page 24... ...
The chapter is organized in three main sections: how climate change and changes in weather extremes may increase the risk of selected foodborne illness by increasing the risk of microbiological and chemical contaminants in the food chain, how rising carbon dioxide lowers the nutritional value of foods, and how climate-related extreme weather events affect food distribution and access to safe and quality foods. Important food safety issues and related foodborne diseases caused by the contamination of fish and shellfish with Vibrios, with certain chemical contaminants, and with harmful algal marine biotoxins were covered in Chapter 5.
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From page 25... ...
and hence an associated increased risk of foodborne diseases. Key Finding 2: Chemical Contaminants in the Food Chain Elevated sea surface temperatures and increases in certain weather extremes associated with climate change will increase human exposure to water contaminants in food [Likely, Medium Confidence]
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From page 26... ...
This may continue as atmospheric carbon dioxide continues rising, and could have significant implications for human nutrition. Content Areas Missing There is a critical body of evidence on climate change and associated foodborne and waterborne illness risks, including models developed recently by the European Food Safety Authority and the European Centers for Disease Control, that should be mentioned in this chapter.
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From page 27... ...
Graphics The chapter covers two very different issues: the impacts of climate change on food safety and the impacts of rising carbon dioxide in the nutritional value of food. The title of Figure 1 should reflect this difference (i.e., rising Carbon Dioxide affects nutrient content but does not necessarily affect Food Safety)
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From page 28... ...
Given this mandate, the scope and completeness of the chapter is appropriate, and the authors have captured relevant literature in a balanced manner. That said, the Committee feels that the chapter could be improved in three ways: more specific Key Findings, greater emphasis of the regional character of impacts, and consideration of adaptation.
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From page 29... ...
Key Finding 3: Certain Populations Are More Vulnerable Key risk factors that individually and collectively shape a population's vulnerability to health impacts from extreme events include age, health status, socioeconomic status, race/ethnicity, and occupation. [High Confidence]
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From page 30... ...
Given the importance of adaptation in this context, some consideration of how adaptation mediates health impacts is within the scope and important to include. While literature that specifically addresses the health impacts of adaptation to extremes under climate change might be limited, there is a wealth of relevant analyses on the health benefits of preparedness in the natural disaster literature, including studies on the siting and construction of health infrastructure (e.g., location of generators in flood-prone hospitals)
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From page 31... ...
A general suggestion of the Committee is that all Key Findings should start from health and follow with relevant physical, ecological, or social mediators. Following that model, we suggest that Key Finding 1 be re-ordered to be rephrased with more specificity, "Experiences from climate-related disasters cause stress and serious mental health consequences…" Key finding 3: The Threat of Climate Change The threat of climate change, the perceived direct experience of climate change, and changes to one's local environment can result in substantial adverse mental health outcomes and social impacts for the American public.
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From page 32... ...
CHAPTER 9 CLIMATE-HEALTH RISK FACTORS AND POPULATIONS OF CONCERN General Comments and Key Findings The stated goal of this Chapter is to identify factors that may create or exacerbate the vulnerability of certain groups to the health impacts of climate change. The Chapter also aims to integrate information from the other report chapters to identify specific groups of people that may face greater health risks due to climate change.
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From page 33... ...
Key Finding 2: Climate Factors Interact with Non-Climate Factors to Increase Health Risk Climate change related health risks interact with some of the same non-climate factors that increase the risk of poor health generally. Non-climate factors, such as those related to demographic changes, socioeconomic factors, and pre-existing or chronic illnesses, may amplify, moderate, or otherwise influence climate related health effects, particularly when they occur simultaneously or close in time or space.
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From page 34... ...
Key Finding 4: Mapping Tools and Vulnerability Indices Help to Identify Where and for Whom Climate Health Risks Are Greatest The use of geographic data is allowing more sophisticated mapping of risk factors and social vulnerabilities, to identify and protect specific locations and groups of people. [Medium Confidence]
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From page 35... ...
The inadequate discussion in this section is exemplified in the Traceable Accounts section on page 362. It is only here that the authors note that not all geocoded health data are available in all locations and that, in fact, vulnerable populations such as immigrant populations are more likely to be in the health databases even if they are coded.
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Key Terms
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