1. Climate Change Adaptation: Progress on the E3 Network Bertrand Sudre - Office of the Chief Scientist European Centre for Disease Prevention and Control 5 th EIONET workshop on Climate Change Impacts, Vulnerability and Adaptation 30 June 2011

2. European Environment and Epidemiology E 3 network Improved population health Integrate environmental and epidemiological data Essential information Increased under- standing Public health action 2

3. E3E3 Inte- grate Inter- pret AnalyseMerge European Environment and Epidemiology : E 3 network Epidemic intelligence and surveillance ( ECDC, WHO ) Environmental and land-use data (EEA, SEIS, EDEN,...) Demographic and socioeconomic data (Eurostat,...) 3

4. Specific aims of the E 3 network 1)Enhancing analytic capability: link environmental data to surveillance data for trends and forecasts / for long-term adaptation to climatic and ecologic changes. 2)Enhancing and accelerating response capability: link environmental data to outbreak scenarios for efficient response. 3)Disseminate information: guide policy, practices, and other interventions. 4)Support public health research: relationship between disease and the environment. 5)Promote advance collaborations: EU agencies and other governmental and non-governmental organizations. 6)Inform and strengthen Member States: activities in preparing for the health impacts of climate change. 4

5. E3E3 Inte- grate Inter- pret AnalyseMerge Epi intelligence Water quality Air quality Flora Fauna Geography/geology Satellite data SES data Demography Agriculture Land use etc. ID surveillance Meteorology Entomology Features of the E 3 network Infectious diseases epidemiology Determinants Socio economic 5

6. Features and challenges of the E 3 network Provide rapid / easy access to environmental and epidemiologic data Increase use of available data sets (long term view) Analyze data across geographic and political boundaries and recognize disease trends Link exposure-disease data : quantify magnitude of risk Promote European standards for environmental / epi data Provide quality control 6

7. 7

8. Improving EDEN Re-structure Re-organise

9. E3 Metadata Tools Data providers Metadata BuilderMetadata TranslatorMetadata Compiler E3 metadata processing Inspire directive march 2007 9

10. Disseminate information E3 Geoportal: prototype 10

11. 11 CategorySub-Category Administrative Country datasets (EDEN project & Eurostats) European datasets (EDEN project) Populated places Bioclimatic data Evapotranspiration Temperature Other eco-climatic variables Vegetation indices Climate predictions CRU Scenario A1 CRU Scenario A2 CRU Scenario B1 CRU Scenario B2 CRU Derived data CRU Observed baseline data WCLIM Estimates Demography and population Demography and Population Eden sub-project Hydrology Land-Cover use Landsat bands (GeoCover initiative) Forest species distribution Non Forest species distribution Landsat bands (restricted projects) Global and regional Land cover projects Land cover-use (others) Livestock Meterorological data Precipitation Temperature Other climatic variables Geological and soil dataGeology Topography and elevation Topography and Elevation Hosts and vectors Distributions of species (reservoirs) E3 GeoData: Examples of Eco-Climatic determinants

12. E3 Data: Examples of socio-economic determinants CategorySub-category HealthChildhood mortality Health care staff (nurses, physicians,...) Hospital beds Infant mortality Life expectancy Maternal mortality... Total Infrastructure indicatorsElectricity Roads/transport (air / maritime transportation) Waste water treatement and capacities Water sanitation (Proportion of population using improved drinking-water sources / sanitation facilities) Total PopulationDensity Country-level population and downscaled projections based on the SRES A1, B1, B2 and A2 Scenarios, 1990-2100 Gridded Global Population based on the SRES B2 Scenario, 1990 and 2025... Number Country-level population and downscaled projections based on the SRES A1, B1, B2 and A2 Scenarios, 1990-2100 GPWv3... Total WealthAccess to information, TV Radio. Education Pupils and students in upper secondary and post-secondary non-tertiary education (ISCED 3-4) % of 15-24yo), by NUTS 2 regions Share of women among tertiary students... Annual Gross Domestic Product in euro Country-level GDP and downscaled projections based on the SRES A1, A2, B1, and B2 marker scenarios, 1990-2100 12

13. E3 Geoportal: prototype 13

14. E3 Proof Of Concept ( EPOC ) Studies Objectives Illustrate how existing or future E3 archive/geo-data can be used in the areas of disease risk study, disease vector mapping and early warning. Different potential uses of disease and environmental data. On going assessment of selected diseases : Leptospirosis Salmonellosis Vector BD : Mosquitoes Tick borne disease : Tick borne encephalitis 14

15. EPOC: Mosquitoes maps Vector distribution maps, using data held within the E3 archives, are being refined and reprocessed to assess new ways of identifying areas (ecological niche) into which Aedes albopictus may spread from current distributions. 15 Predicted future routes of spread of Aedes albopictus : Details of Mahalanobis distance of Global model (Mahalanobis distance = the environmental distance between the two sets of points adjusted for the covariance of the variables). The MD images are stretched over a range of values to reveal areas of greatest similarity to presently occupied areas. River systems are the likely major spread routes in Europe.

16. EPOC: Tick-borne encephalitis (TBE) The risk maps for southern Sweden (held within the E3 archives) are being used to investigate whether independent meteorological and other data sets can provide a basis for predictions. 16 WILD BOAR

17. Spring temperatures above certain thresholds promote disease transmission between ticks, which is one of several factors increasing disease risk. Cumulative measures of spring temperatures between 7 and 10 degrees (cumulative day degrees, CCD) have been shown to differentiate between locations that are at high and low risk in the summer and autumn. Ongoing development : evaluation of satellite estimations - prospective validation (intra-annual validation), and this model may have the potential to be used for warning system. E3 pilot study: TBE Risk and Increase in Spring Temperatures 17

18. Red areas are predicted TBE presence (>+75% probability) NLDA for 1986-2007. Circles are cumulative day degrees values: green =low; yellow=medium; red=high 18 E3 pilot study: TBE Risk and Increase in Spring Temperatures

19. It is a prototype forecasting disease model for Europe and climate sensitive diseases Apply risk model to other members states in EU Promote direct use of risk maps in public health (currently underutilized) knowledge – capacity – expertise building Promote network of excellence : collaboration with external partners and it is an example of interface/application for other projects E3 pilot studies : ? Added values 19

20. Others related projects Decision-making tool for climate change and food and waterborne diseases Decision-making tool is based on mathematical models / different climate scenario Risk assessment framework : quantitative approach based on a priori model (= combination of successive modules describing the transmission pathway) DG CLIMA Clearinghouse website 20

21. DG CLIMA Clearinghouse 21

22. Others related projects Decision-making tool for climate change and food and waterborne diseases Decision-making tool based on mathematical models / different climate scenario : Risk assessment framework : quantitative approach based on a priori model (combination of successive modules describing the transmission pathway) DG CLIMA Clearinghouse website Health indicators for Climate Change report EEA 2012 Health indicators i.e : Aedes albopictus suitability map Tick borne disease : Borreliosis (Lyme disease) Food and water borne diseases... 22

23. 23 ECDC : Office of chief scientist Health Impact Section Jan Semenza Bertrand Sudre Jonathan Suk E3 : ECDC – EDEN project EPOC studies : ECDC sections - Oxford university – ERGO – AVIA GIS Impact of Climate Change on Food- and Water-borne Infectious Diseases in Europe Decision-making tool : RIVM (NL) – DG Clima Clearinghouse - EEA Health indicators for Climate change report EEA 2012 : ECDC experts – Health Impact Section