1. Dr Alan Abelsohn A/ Prof Grant Blashki Climate change and health Climate Change Conference 2010 Alan Abelsohn, University of Toronto

2. Addressing the Health Effects of Climate Change: Family Physicians are Key http://www.ocfp.on.ca

3. Climate change related to global warming is the world’s most urgent public health problem (Stott BMJ 2006) Climate change has been called the defining issue for public health in the 21st century. (Chan, 2007) Climate change related to global warming is the world’s most urgent public health problem (Stott BMJ 2006) Climate change has been called the defining issue for public health in the 21st century. (Chan, 2007)

5. Health Impacts of Climate Change Direct impacts Temperature related Extreme weather events Indirect impacts Air pollution related Water and food borne contamination Vector borne and zoonotic diseases Socio-economic impacts on communities

6. The French Heat Wave 2003 Daily Mortality in Paris Source: INVS, 2003

7. Number of hot days above 30  C Heat Waves in Canadian Cities Environment Canada 2005

8. Heat Related Impacts Heat related illness Vulnerable populations Elderly Chronic Illnesses Medications Housing Isolated/ Homeless Occupational Adaptation: Heat alert programs

9. Heat, Air Pollution and Weather Related Mortality in Toronto Air Pollution Acute air pollution related elevated mortality # Days with temp >30 0 C Heat alerts Heat related elevated mortality Cold related mortality Annual mean # (1954- 2000) 82282.5120105 Predicted 2080 (based on a 3 fold increase in CO2) Substantial increase in high pollution days (esp Ozone related) 25-30% increase, to 1070 4 fold increase 4 fold increase in hot weather warnings 3 fold increase (360) 60% decrease Derived from Toronto Public Health. Influence of Weather and Air Pollution on Mortality in Toronto: Summary Report (Pengelly et al., 2005)

10. Forest Fire – Air Pollution

11. Allergies Length of Season Increased Pollen Counts Synergism with Ozone

12. Storms, floods, drought Less developed countries: more vulnerable Direct injuries Indirect Damage PTSD, anxiety, depression Socio-political unrest and Population Displacement Drought Water scarcity Malnutrition, infant mortality Fires

13. Drought in Australia

14. Vector Borne Diseases (Zoonoses) Dengue Lyme Disease Malaria

16. Potential Spread of Lyme Disease From Ogden International Journal for Parasitology 2006

17. Malaria Rate of development and biting rate Increased egg survival Increased puddles where mosquitoes breed Increased range of survival Altitude Latitude

18. Baseline Ebi et al. 2005 Vector-Borne: Malaria in Zimbabwe 2000

19. 2025 Ebi et al. 2005

20. 2075 Ebi et al. 2005

21. Impact in Developing Countries By 2000, climate change since the 1970s was causing over 150,000 additional deaths per year (WHO, 2002) Malnutrition; Gastro-enteritis; malaria Sea level rise

22. Indirect impacts on international health Water Food security Extreme climatic events Shelter and human settlements Population displacement and migration The challenge of poverty and inequality (MDGs) Costello A et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet. 2009;373:1693-1733.

23. Costello. Lancet 2009