Fifth Annual International Conference on Environmental and Occupational Medicine

1. Fifth Annual International Conference on Environmental and Occupational Medicine Organized by: Shanghai Municipal Center for Disease Control & Prevention (SCDC) Shanghai Institutes of Preventive Medicine Editorial Board of the Journal of Environmental and Occupational Medicine (JEOM) Sponsored by: Shanghai Municipal Center for Disease Control & Prevention (SCDC) Fogarty International Programs, California Department of Public Health, and Sequoia Foundation Dujiangyan, Chengdu, Sichuan, China, April 7-10, 2010

2. Global Climate Change and Agricultural Security:It’s not the warming, it’s the variability Presented by: John S. Petterson, Ph.D. Director Sequoia Foundation

3. Overview of PresentationIntersection of GCC and Human Behavior • Demographic Context • Population Concentration (rural to urban) • Changes in Production/Consumption Patterns • More people dependent on few producers • Increasing reliance on and fragility of delivery system • Increased exposure to contaminated industrial waste • Regulatory constraints (environmental and occupational regulations) • Global Climate Change • Changes in rainfall regimes • Increase in variability (seasonal/annual) • Unique Local/Regional Influences

4. Population Concentration • Population Concentration (density) • Rural to urban transition • Low rural development rate • High migration toward the coasts with accelerating manufacturing and industrial development • Little movement of industry away from the coasts

5. Employment/Income Disparities • Average rural worker in 2008 earned 30% of the average wage of an urban worker • Educational disparities are continuing to increase • Rural access to doctors and medical facilities inferior to urban areas • Significant disparity in access to capital/loans • Disparities in access to emergency assistance • Disparities in infrastructure, utilities, sanitation, etc.

8. Changing Production Patterns • Fastest growing economy in world history, unprecedented growth driven by external “demand” and precipitous acceleration of domestic consumption • West is a driving “partner” in these impacts, having moved their manufacturing businesses to China for cheap labor, lax environmental regulations, and higher profits. • Structure of Chinese economy increasingly dependent on worst source of environmental pollutants – coal. Push to aggressively pursue alternative renewable energy sources – nuclear, hydro, wind.

9. Changing Consumption Patterns • Increased per capita consumption of environmental amenities: • wheat, rice • fruits, vegetables • cattle, pigs, goats, sheep • wood (construction/fuel) • vegetative cover • Increased contamination of soil, surface, water table, rivers, irrigation supplies

10. Consumption Patterns • In 2003, China fed 20 percent of the world's population with only 7 percent of the world's arable land. • China ranks first worldwide in farm output, and, as a result of topographic and climatic factors, only about 10–15 percent of the total land area is suitable for cultivation. • Of this, slightly more than half is unirrigated, and the remainder is divided roughly equally between paddy fields and irrigated areas. • Nevertheless, about 60 percent of the population lives in the rural areas, and until the 1980s a high percentage of them made their living directly from farming. • Since then, many have been encouraged to leave the fields and pursue other activities, such as light manufacturing, commerce, and transportation; and by the mid-1980s farming accounted for less than half of the value of rural output. Today, agriculture contributes only 13% of China's GDP.

13. Social/Economic Vulnerabilities社会或经济的脆弱性 • Lost crops 农作物的损失 • Less food for families 家庭食物的减少 • Less money for economy 流通货币的减少 • Market decline/collapse市场交易下降或崩溃 • Creation of need to import grain, and the world consequences • Polarization between people in rural and urban China • Forced migration • Linguistic and other social vulnerabilities 语言及其他社会的脆弱性 • Disruptions in access to markets 进入市场的机制被破坏 • Mobility, access to emergency and preventative care 进入应急状态和预防机制的灵活性下降 • Political responses/miscalculations 增加政治回应和错误估算导致决策失误发生率 • Ability to respond to disasters of proportions previously unseen 对以前未见过的不可预见的灾害回应的能力 • Costs of disaster response/management • Costs of subsidies and aid to rural families • Highly vulnerable (poor, elderly, children, handicapped)

14. GCC Alteration of Regional Weather Patterns • Global Climate Change • Alters distribution of rainfall • Alters timing (initial rains, pattern disruptions, early/late final rainfall) • Alters agricultural patterns • Alters natural habitats • Creates land no longer suitable for productive use (desertification) due to shifting isotherms and isohyets • For farmers everywhere: Variability is a BAD thing

15. Southeast China: Percent (%) of 75-year mean

16. Northeast China: Percent (%) of 75-year mean

17. Asia Rainfall Anomalies (blue = increase)

18. GCC Alters Regional Weather Patterns • Increases frequency of droughts • Increases frequency/severity of storm events (flooding) • Alters historic rainfall patterns • Earlier rain • Later rain • Interrupted • Volume/Severity • Timing/Frequency • Location • Retention

19. Effects of Altered Weather Patterns • Results in increased variability of harvest levels • Effects of silt deposition on crop lands • Effects of excess rainfall at sowing/harvest • Effects of prolonged soil saturation of growth and yield • If temperatures are warm during flooding (greater than 77 F), plants may not survive 24 hours in saturated soil • Cold, wet weather favors disease development. • Flooding not required to kill plants, cold, wet weather conditions also favor development of seed rots and seedling blights. • Effects of extended periods of seasonal drought • Seedling development slowed or delayed two to three weeks will allow soil-borne pathogens a greater opportunity to cause damage • The first major impact of soil completely covered with water is a rapid depletion of oxygen required for plant growth and development. • The other major impact of flooding is change in nutrient status either by leaching or changing their availability to the plant. The response to flooding will vary with duration and temperature

20. Effects of Altered Weather Patterns • Results in increased variability of harvest levels • Depending on “stage” of development, wheat can withstand water-logged soils for up to 24 hours without excessive damage, barley less that this. • Corn is very sensitive to flooding in the early vegetative stage; can survive only 2-4 days of flooded conditions • Soybeans can survive for only 2-4 days under water in anaerobic condition • Increased cost of production/hectare (return on investment decreased); price to consumer

21. Effects of Altered Weather Patterns China's top meteorological official warned that global warming could cut the nation's grain harvest by 5 to 10% by 2030. http://www.time.com/time/world/article/0,8599,1656570,00.html#ixzz0hFWsCwZS

22. Effects of Local/Regional Atmospheric Contamination

26. Flooding 洪涝灾害 • Very high vulnerability • 8% of China located in the mid- and down stream parts of the seven major rivers of the country – all subject to floods. • 50% of China’s population live in these areas • 66% of total agricultural and industrial product value • Large floods occur once every two years • Death by drowning • Lack of food/water缺少食物或饮用水 • Loss of crops/infrastructure • Loss of land/livelihood • Collapse of sanitation, storm-water drainage, and sewage disposal systems • Transmission of waterborne illnesses through unsafe drinking water (increased exposure to waterborne disease vectors (viruses, bacteria, worms, infectious disease, malaria, etc.) (增加对经水传染疾病媒介的暴露（病毒，细菌，蠕虫，传染性疾病，疟疾等) • Added pressure on already overstretched public health services • Higher rates of infection/transmission增高的传染或传播率 China: Flood Management, Hai-lun, Z. (2005)

29. Drought • Northern plains of China • 45 percent of China's population (heart of Han Chinese civilization) • 58 percent of its cultivated land • 19 percent of the nation's fresh water stocks • Principal source of water: the Yellow River • “Dried up during 21 out of the 27 years between 1972 and 1999.” “Drought leaves 18 million thirsty in China,” Xinhua News,August 20, 2006

30. Drought • Decreased fresh water supplies 减少新鲜水源供给 • Less water for irrigation 减少灌溉水源 • Less water for human consumption 减少人类消耗用水 • Less productive harvest 减少农作物产出 • Forced migration • Malnutrition/starvation • Dehydration • Increased exposure to airborne pollutants 增加空气污染的暴露率 • Increased incidence of respiratory ailments 增加呼吸系统疾病的发生率 • Increased exposure to UV radiation 增加对紫外线的暴露 • Skin cancers 增加皮肤癌的发生率

31. Water Quality and Supply • Marine ecosystems • Sea surface temperatures, sea level, salinity, etc.海洋表面温度，海平面，含盐量等 • Changing availability of marine resources • Subsidence and sea level rise • Salt water intrusion into coastal aquifers 盐水侵入造成的沿岸淡水资源的减少 • Runoff/flood pollution 水土流失或水灾造成的污染 • 300 million (25%) people do not have access to adequate drinking water • Pollution “so severe that the Ministry of Water Resources estimates 40 percent of water in the country's 1,300 or so major rivers is fit only for industrial or agricultural use.” (Xinhua News August 20,2006)

32. Direct Human Health 人类因素 • Climate change is expected to have wide-ranging consequences for human health. • Heat waves are linked to cardiovascular, respiratory, and other diseases. • By reducing fresh water supplies, climate change may affect water resources and sanitation. • Any increase in the frequency or intensity of extreme weather events would pose a threat. • Food security may be undermined in vulnerable regions. • Higher temperatures may alter the geographical distribution of species that transmit disease. • Warmer seas could also influence the spread of disease. • People will have to adapt or intervene to minimize these enhanced health risks. • Assessing the potential health effects of climate change involves many uncertainties. UNEP, UNFCCC, Williams, M. (2002). Climate Change Information Kit. Switzerland; 14-14.2.

33. Increased exposure to waterborne disease vectors (viruses, bacteria, worms, infectious disease, malaria, etc.) • Higher rates of infection/transmission • Increased exposure to airborne pollutants • Increased incidence of respiratory ailments • Increased exposure to UV radiation • Skin cancers • Immediate effects of typhoons and droughts • Flooding • Lack of food/water • Spread of waterborne diseases • Decreased fresh water supplies • Less water for irrigation • Less water for human consumption • Less productive harvest

34. Indirect Human Health Consequences • Decreased resources (water and food) • Lost crops • Less food for families • Less money for economy • Human competition for limited resources • Market decline/collapse • Physical disruptions of access to markets • Mobility, access to emergency and preventative care • Political responses/miscalculations • Ability to respond to disasters of proportions previously unseen • Linguistic, cultural, and other socioeconomic vulnerabilities

35. Governmental Action/Inaction 政府作为或不作为 • Weather tracking/prediction 气候跟踪或预报 • Water transfer projects 水源治理项目 • Flood mapping, response 绘制水灾地图，应急反应 • Improved communication between levels of government • Create institutions that allow the central government to convey their decisions and policies to all the local municipalities? • Investing in the rural areas • Keep economic growth under control

36. Conclusions • Global climate change (GCC) will dramatically affect planetary and regional weather patterns • Weather affects everything • Social vulnerability is rapidly increasing and will eventually surpass GCC as principal source of increased morbidity and mortality (the “rich never die”)

37. Conclusions • This presentation argues that the principal mechanism by which global climate change is likely to affect human health is in the distribution, intensity, and timing of rainfall, and that these effects, while geographically pervasive, will be experienced most acutely at the extremes (i.e., floods and drought), and in a predictable regional distribution (i.e., on the geographic margins of pattern changes). • Humans must address the problem by: (1) reducing, and then reversing, the pace of population growth; (2) dramatically reducing human consumption patterns; and (3) implementing national and regional regulatory policies designed to immediately reduce local and regional releases of black carbon.