RESPONSIBILITY OF PUBLIC HEALTH SECTOR ON RISK ASSESSMENT OF CLIMATE CHANGE Prof. Tord Kjellstrom Centre for Global Health Research University of Umea, Sweden and *National Centre for Epidemiology and Population Health The Australian National University, Canberra, Australia This presentation is in the morning of the last day (Friday) of the ICOH conference and 45 minutes has been assigned and it is the last keynote address followed by sub-plenaries and the closing ceremony. Before that, on the first day (Monday) of the conference the sub-committee on Thermal Hazards have a symposium on heat, work and health where I will present a paper on “Comparing different indexes to quantify occupational heat exposure”. The Thermal Hazards sub-committee has its business meeting in the evening of the first conference day. Dr Zayed from Canada has a symposium on Tuesday titled “Impact of climate change on occupational health and safety” (I don’t know the time yet) with a paper by Kjellstrom on “The ‘Hothaps’ program for climate change impact assessment and prevention”. I also have a poster accepted on “Occupational health and productivity loss due to climate change”. Poster session on Thursday. Hopefully this contributions will create justified interest in this part of climate change and health analysis. MoPH seminar, Nr 2, Bangkok, 15 November 2013

The climate change and health panorama Climate change has created new interest in climate conditions and health --- not just change is important, but the current conditions Mitigation reduces extent of ongoing climate change Adaptation reduces impacts on human society and health from climate change we can’t avoid Elderly and children are usually listed as vulnerable groups for climate change, but working age people are also vulnerable, and their health and well-being affects family health and community health ….. the links are important Health Impact and Risk Assessments are an essential component of effective prevention

Projected WBGT in South-East Asia, afternoon, March In shade 1975 In shade 2050 WBGT B A In sun 1975 In sun 2050

Climate change and health in DPSEEA framework

Climate change and health in DPSEEA framework

Climate change will reduce growth in farm production in many poor countries and regions Modelled % change in agricultural production due to climate change, 2080 NA < - 25% LESS -15 to -5% 0 to 5% MORE > + 25% Source: Cline WR, 2007: Global warming and agriculture: Impact estimates by country. Washington, D.C.: Center for Global Development, Peterson Institute for International Economics (cited in von Braun J (IFPRI), 2007

Sources: FAO 2005; WHO 2006; UNICEF 2005 Global Hunger Map, 2005-06 Sources: FAO 2005; WHO 2006; UNICEF 2005 Global Hunger Index Most Least

Mapping of grid data: average Tmax in 1995; 4 months

Average UTCImax in 1995; 4 months

Other examples related to environmental change and social issues, including mental stress 1. Increased suicides among farmers due to drought and agricultural production failures 2. Reduced ice coverage in Arctic areas affecting traditional working life (fishing, hunting) and creating injury and mental health risks 3. Lack of work, loss of income, in forestry when ground is too soft (not ice hard) for machinery use 4. Longer distances to walk and other difficulties in daily household tasks, because climate change has reduced accessibility of certain basic needs 5. Impact of heat on pregnant women and newborn children 6. Increasing heat reducing childrens’ interest in play and physical activities outdoors ….. potentially increasing obesity risks

Public Health Sector focus Health Services (“sick services”) Preventive health programs – needs other sectors Disease and Injury focus (ICD codes): Early childhood diseases, maternity issues, infectious diseases, vector-borne diseases, injuries, respiratory – heart – kidney etc diseases, cancer, special occupational diseases, other ….. Environmental factors: Risk Assessment and Environmental Health Impact Assessment

Climate change and health in DPSEEA framework

Role of Risk Assessment in Prevention Identify climate factors that can affect health Current climate situation; Urban Heat Island; analysis linked to cause effect pathways and timing Potential future climate situation Population size and change in the future Population activities change in the future (e.g. work, active transport, play) Calculate likely impacts for different groups – health equity, environmental justice Identify short-term and long-term prevention approaches and promote the best ones Cooperate with technical expertise to find environmentally friendly cooling and protection systems

Moving forward in Thailand …….. Create links between different sectors: raising awareness Focus on different age groups and consider indirect effects on health and well-being for the family and community: broad Health Impact and Risk Assessment Establish policies and actions for future homes and workplaces …. building design to reduce air conditioning need, urban design (trees for shading, water feature for cooling, etc) Test different approaches in the Thailand context and make epidemiological assessments of prevention and adaptation methods Role of health sector: ….. To discuss …..

Discussion points: Role of health sector: ??? HAZARDS OF CONCERN: make list for different parts of Thailand Risk Assessment; cooperate with other sectors warning systems, emergency preparedness, Specific technical cooling/protection systems health service rapid response teams, expertise and advocacy for future development plans, links to other public health issues (such as obesity prevention)

The End. Thank you Email to HOTHAPS: kjellstromt @ yahoo.com Google: “kjellstrom climate” for all reports on HOTHAPS … and check www.ClimateCHIP.org