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Jon Ayres Institute of Occupational & Environmental Medicine University of Birmingham, UK

The effects of global warming on pulmonary health. Jon Ayres Institute of Occupational & Environmental Medicine University of Birmingham, UK j,g.ayres@bham.ac.uk. The effects of global warming on pulmonary health. Climate change Possible effects on patients with lung disease

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Jon Ayres Institute of Occupational & Environmental Medicine University of Birmingham, UK

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  1. The effects of global warming on pulmonary health Jon Ayres Institute of Occupational & Environmental Medicine University of Birmingham, UK j,g.ayres@bham.ac.uk

  2. The effects of global warming on pulmonary health • Climate change • Possible effects on patients with lung disease • Heat, cold and weather changes • Pollution • Allergic responses • Infections • What can be done • Mitigation • Adaptation • Advocacy

  3. John Tyndall 1820-93 Recognised the greenhouse effect and identified the relative radiative forcing of the different greenhouse gases. "The waves of heat speed from our earth through our atmosphere towards space. These waves dash in their passage against the atoms of oxygen and nitrogen and against molecules of aqueous vapour. Thinly scattered as these latter are, we might naturally think of them meanly as barriers to the waves of heat."

  4. Temperature trends in central England

  5. GHG emissions have increased by 70% over the last four decades (IPCC 2007). Energy and transport are the biggest emitters. Transport emissions projected to increase by about 50% by 2030 compared to 2000 (EEA 2007). Projected temperature increase by the end of the 21st century is 2.3 - 6°C(IPCC 2007). Greenhouse gas emissions are warming the earth

  6. How climate change can affect health

  7. Key respiratory conditions • COPD • Prevalence • Severity • Disease progression and exacerbations • Mortality • Asthma • Prevalence • Severity • Respiratory infections • Pneumonia • Rhinitis and other allergies • Prevalence • Severity To what extent? Which interventions? What advice? > to Governments > to our patients

  8. Climate change and respiratory disease • 1 Extreme temperature events • both heat and cold • 2 Changes in air pollution • ozone (sulphates, PM) • 3 Flooding • 4 Damp housing • Thunderstorms • Infections • 7 Changes in allergen disposition • and consequent allergies • 8 Forest fires • 9 Dust storms ERS position statement Ayres et al Eur Respir J 2009;34:295-302

  9. Temperature

  10. Phewe EU Project Max temperature and hospital admissions Michelozzi et al, AJRCCM, 2009

  11. Place of death and heat-related mortality Stafoggia et al, JECH, 2008

  12. Thanks to Mercedes Medina-Ramon

  13. Thanks to Mercedes Medina-Ramon

  14. Temperature, PM10 and Mortality Stafoggia et al, AJE in press

  15. Wild fires San Diego October 2007

  16. With thanks to Bert Brunekreef

  17. Saharan dust storms

  18. With thanks to Bert Brunekreef

  19. Thunderstorms and asthma • Will likely increase in some areas • Effects in asthma • Temperature drop • Grass pollen Packe & AyresLancet 1985;ii:199-203

  20. But…cold weather still affects Europe • Cold outdoor and indoor temperatures can cause cardio-pulmonary problems. • These effects may be most serious for poorer households. • Most European countries suffer from 5-30% excess winter mortality (IPCC 2007). • Health risks may arise from the use of solid fossil fuels and biomass Photo: WHO HOW TO REDUCE HEALTH EFFECTS Ensure health systems preparedness by • adapting health care infrastructures; • advocating access to clean, affordable and reliable energy with other sectors; • promoting energy efficiency

  21. What we need to know….. • More about the effects of CC • on those with existing lung conditions • on the incidence of new disease • Monitoring respiratory disease indicators • Improve basic research into respiratory disease aetiology/mechanisms in the context of CC • Assess interventions • e.g. warning systems for heat waves • targeted housing design

  22. Be aware! Press for continued downward pressure on air pollution by Governments Home insulation/air conditioning Advise the susceptible Warning systems for heat waves Cost-benefit….. What we can do immediately…..

  23. What we can do as individuals • Inform our professional colleagues • Set an example • Tensions when it comes to international conferences! • Advocate • Ensure our own Governments and the EU are aware of the legislative options • Evaluate the interventions

  24. Thank you for your attention

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