1. Потепление климата – новая проблема общественного здоровья приполярного населения Climate warming – new problem of subpolar public health in Russia Профессор Борис Ревич Prof. Boris Revich

7. Аномалии осредненной по территории России среднегодовой температуры воздуха за период 1936-2005 гг. (www.meteorf.ru/klimat05)

8. T –Yakutsk-1950-1995

9. Ожидаемые к середине ХХI века изменения средней годовой температуры воздуха для основных регионов России Expected by 2050 Increments of Annual Average Temperatures in Russian Regions Национальный доклад по проблемам изменения климата Минэкономразвития России, National Report on Climate Change, Ministry of Economic Development, 2003 Регион Region Прогноз увеличения среднегодовой температуры ºС Temperature Increase, ºС Центральный / Central0.5-1.0 Северо-Западный /North-West0-1 Север ЕТС/European North2-3 Арктическое Побережье /Arctic Coast 2-3 Западная Сибирь/West Siberia3-4 Якутия/Yakutia2-3 Дальний Восток/Far East1-2

10. Изменение климата и здоровье в северной России – инфекционные заболевания !!!Геморрагические лихорадки– движение на север !! Деградация территорий вечной мерзлоты – проблемы с инженерными коммуникациями Сокращение площадей на 12-15%, перемещение границы на 160-200 км севернее ОКИ, Якутия, 2001, брюшной тиф !! Паразитозы – дирофиляриатоз – движение на север ! Псевдотуберкулез, листериоз !? Клещевой энцефалит, туляремия

11. Потепление климата- инфекционные заболевания Лихорадка Западного Нила – в 1999 году – вспышки заболевания среди жителей Волгоградской и Астраханской областей, Краснодарского края.

12. Лихорадка Западного Нила в России в 1999 г. Волгоград (> 500 случаев, 38 смертей); Астрахань (> 90 случаев, 5 смертей); Краснодар (> 40 случаев, 3 смерти). Астрахань Волгоград Краснодар Число случаев ЛЗН >5 >35 >500 3215 14 А.Е.Платонов, ЦНИИ эпидемиологии МЗ РФ

13.  Более раннее начало периода нападения клещей на людей (Северо-Запад России)  Рост заболеваемости клещевым энцефалитом - в год заболевает 5-10 тыс. человек  Расширение ареала за счет Северо- Западного и Приволжского регионов. Высокие показатели заболеваемости в Сибири и на Дальнем Востоке  Ixodes Persulcatus – сдвиг теплового барьерав Якутии _!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Клещевой энцефалит

14. Геморрагические лихорадки  Лихорадка Крым-Конго. Южные регионы России, летальные исходы  Омская геморрагическая лихорадка - Природные очаги в Западной Сибири и Казахстане. Тенденция к ее возвращению и распространению на север.

15. Особо опасные инфекции Сибирская язва:  Большое количество стационарно неблагополучных пунктов по сибирской язве.  Возбудитель сибирской язвы в виде спор может десятки лет находиться в почве.  В случае потепления в зонах вечной мерзлоты могут создаться благоприятные условия для вегетации бактерий с высоко вероятным инфицированием восприимчивых животных и опосредованно заражением людей.

16. Наводнения на севере России 1998, майВологодская область г. В. Устюг Эвакуировано 10 тыс. человек 1998, майЛенск, Якутия 172 нас. пункта В зоне затопления 475 тыс. человек, Эвакуировано 50 тыс. человек, t днем +1 +3 °С ночь -10 -12 °С, снег 2001, май 8/06/2006 Ленск, Якутия 172 нас. пункта Таймыр Олекминск, Якутия Эвакуация 23 тыс. человек,больницы ?

17. T and Public Health: Arctic and Subarctic cities, 7 - more 100 thous. peoples 13 - more 20 thous.peoples Urban population -2 2000th

18. Project: Climate, Air Pollution and Mortality in Moscow in 2000-2005 Center of Demography and Human Ecology of Institute of Forecasting, Russian Academy of Science, Moscow Environmental Monitoring Meteorology Observatory of Moscow State University Environmental Defense (USA)

19. Source: Moscow Environment and Climate Reference Book, 2003, vol.1, 173.

21. Summer vs. winter concentrations of РМ10, NO2 and O3 in 2000-05, ug/m 3 (MosEcoMonitoring data) WinterSummer РМ 1030,733,0 NO242,035,4 О319,326,2

22. Regression Equation of Daily Pollution on Daily Temperature Pollution = Const +βT lag + ε

23. Summer (2003 – 2005) Regression coefficients of proportionality between NO2 and T with different time lags in days

24. Summer (2003 – 2005) Regression coefficients of proportionality between PM10 and T with different time lags in days

25. Summer Т and Concentrations wave in August of 2004

26. Winter (2003 – 2005) Regression coefficients of proportionality between PM10 and T with different time lags

27. Number of days with extremely high (in summer) and extremely low (in winter) daily average temperatures in 2000 – 2005 Threshold for temperature anomaly + 20.2+ 21.8+ 20.1- 13.2- 16.4- 14.7 JuneJulyAugustDecemberJanuaryFebruary 2000520030 200142071004 200282181230 20030124063 20043414002 2005378000 20061018

28. Summer Heat Waves: 2001 and 2002. Energy system failure, “Black-out” of May 25th, 2005

29. Heat wave of July’01 and consequent increase of daily mortality from all causes, all ages

30. Moscow, Summer’02 Extremely high temperatures: 16 days with daily Т max above 29 °С, accompanied with smog situation – 27 days with haze, high level of air pollution Low visibility on highways Airports in Moscow Region closed for weather Smell of smoke, “empyreuma” Eye irritation, breathing problems, headache, etc.

31. Total mortality of males:Total mortality of males: Yt = 146 + (1.18±0.45)T 0 IHD of males: Yt = 33 + (0.51±0.19)T 0 Results of regression analysis – T-related increase in daily mortality

32. Results of regression analysis – temperature-related increase in daily mortality Cerebrovascular diseases of males: Yt = 23.6 + (0.6±0.2)T 0, Yt = 14.7 + (0.98±0.19)T -1 (T -1 –temperature on previous day ) Mortality of males from external causes: Yt = 18.9 + (0.40±0.19)T 0

33. Health consequences of heat wave in July’02 632 additional deaths as direct result of heat wave

34. Moscow. May 25th, 2005 Warm weather Accident at thermal power station Sharp increase of PM10 concentrations: from average value of 33 ug/m 3 to extreme of 71 ug/m 3, NO2 concentrations within the norm (MosEcoMonitoring data)

35. Cold wave – January’06 Age group 75 +: 142 additional deaths from all causes ( except external), including 61 additional deaths from IHD

36. Т, air pollution and mortality in Moscow in 2002 – 2005 4 causes included in the analysis: All cases, except external IHD (I20-25) Cerebrovascular diseases (myocardial infarction, cerebrovascular accidents) (I 60-69) Chronic lower respiratory diseases (bronchitis, emphysema, asthma, asthmatic status) (J40-47)

37. Seasonal variations of mortality from all causes (except external) in age group 75+. 30-day moving average for 2000 – 2004 summer 2000 summer 2001 summer 2002 summer 2003 summer 2004 Winter 2000 Winter 2001 Winter 2002 Winter 2003Winter 2004

39. Т-mortality curve for Moscow and “T of maximum comfort” (2000-2005)

40. Daily Mortality-T relationship in Moscow, 2000 - 2005 Moscow: linear decrease from -20 to +19 °С [Revich, Golub, Shaposhnikov, 2006] London: linear decrease from 0 to +15 0 C [Keatinge, Donaldson, 2001]

41. Results of regression analysis Relative risks were calculated for: 8 causes of mortality (4 causes and 2 age groups) and time lags 0, 1, …, 6 days … and risk factors: Temperature increase above maximum comfort (+19ºС) Temperature decrease below maximum comfort (+19ºС) Increments of daily average concentrations of PM 10,, NO 2, and O 3 by 10 µg/м 3

42. Examples of relative risks of variation of daily average temperature by 1ºC CasesRR of summer heat (T>20ºC) RR of cold temperatures (T<19ºC) All causes (except external), all ages 2.8% (2.0%; 3.6%) -0.44% (-0.40%; -0.48%) Chronic lower respiratory diseases, all ages 8.7% (0.7%; 16.7%) -1.31% (-1.75%; -0.87%)

44. Relative risks of mortality per 10 µg/м 3 increase of daily average concentration of pollutant CausesAge groupPM 10 NO 2 O3O3 All (except external) All ages0.48-0.57 75+0.960.39- Chronic lower respiratory All ages--4.9 75+--7.8 IHDAll ages0.76-1.10 75+1.11-- Cerebrovas cular All ages0.940.661.55 75+1.391.021.23

45. Low Temperatures as Health Risk Factor in Russia North territories make about 64% of total area of the RF Cold discomfort Cardio-vascular system Respiratory tract Mortality from frostbite In Russia, about 1,500 people die from frostbite every year, predominantly males over 20y.o. There are no deaths cased by frostbite registered in European countries with cold climate (Norway, Denmark, Sweden, Finland, Iceland)

46. Climate Change and Human Health in Russian Arctic Region Infections diseases - Infrastructure break-downs in cryolite zone ! Emergence and new infectious diseases and parasitosis of sea mammals and humans ? Change in food – dietary problems ? Changes in air quality - ? Problems with traditional hunting of northern aborigines - !

47. WWF-Russia climate programme Observations of Climate Change Made by Indigenous Inhabitants of the Coastal Regions of Chukotka

48. Majority of people survived have noticed climate changes

49. Has noticed significant climate changes. Ice breaks up a month earlier than it did before. Old ice no longer exists. Walrus stay longer at haul out sites. Birds depart later. Vladilen Ivanovich Kavry 39 years of age Chukchi Marine Mammal Hunter

50. Required research of climate/health in Russia Infectious diseases and T relationship Mortality and T relationship in different climate zones (North, Siberia, Far East) Climate warming and traditional crafts in Arctic

51. National Climate Health Impact Assessment Scientific Report about Climate change and health at Russian Arctic National Climate Health Action Plan (as French “Plan Canicule”, UK, Germany, Spain, Finland, etc.) The following documents should be prepared:

55. Спасибо за внимание ! Thank you for attention!!