Download - Greenhouse Gas Emissions

Warm Climate, Variable Health, Storm Warning

Pierre Gosselin, MD, MPHInstitut national de santé publique du Québec

and Université Laval

CAPE Montreal Conference

26 septembre 2009

Density-Equalling Cartogram. Borders have been adjusted according to the countries’ cumulative CO2-equivalent emissions (1970-2000). Source: Gibbs et al. (2007).

Greenhouse Gas Emissions

Density-equalling Cartogram – WHO Regions scaled according to estimated mortality (per million people) in the year 2000, attributable to the climate

change that occurred from 1970 to 2000. Source: Gibbs et al., 2007.

Mortality caused by Climate Change, 2000

Quebec Data (1960-2003)

Projet #4

Source: Ouranos, 2005.

Projet #4

Source: Ouranos, 2005.

PITTSBURGH ?

MONTRÉAL ?

RIMOUSKI ?

NASHVILLE ?

Quebec Data

In: Évaluation nationale santé et CC 2008

Figure 2 : Nombre de catastrophes naturelles au Canada, de 1900 à 2002

Note : Seules les catastrophes hydrométéorologiques sont associées au climat.Source : D. Etkin et coll., 200417.

Figure 2 shows the number of climate-related and other natural disasters recorded in Canada between 1900 and 2002. According to the estimates published in the World Disasters Report, 2004, the total number of Canadians affected by natural disasters has increased from 79,066 between 1984 and 1993, to 578,238 between 1994 and 2003.

Note : Only hydrometeorological disasters are associated with the climate.

Source : D. Etkin et coll., 2004.

What health impacts

were there in Quebec?

In: Évaluation nationale santé et CC 2008

Question, 2002-2003:

Several studies conducted in Quebec since 2003Researchers: Diane Bélanger PhD (INSPQ, CHUQ) Bernard Doyon PhD (CHUQ) Pierre Gosselin MD MPH (INSPQ, CHUQ, U.Laval, Ouranos)

Contributors:Belkacem Abdous PhD, Pierre Valois PhD (U.Laval), Philippe Poitras MSc (CHUQ), Mélissa Giguère MSc (INSPQ), Marie-France Sottile MSc (Ouranos), Luc Vescovi PhD (Ouranos), Philippe Gachon PhD (Ouranos), Daniel Martin PhD (CHUQ).

Sponsors:Health Canada, Ouranos, MSSS, INSPQPublic Health Agency of Canada, IRSC, GEOIDE, Arcticnet.

Several studies conducted in Quebec since 2003

Other studies: Kosatsky et al. of the Montreal Public Health

Directorate (urban heat islands); Garneau et al. of UQAM (pollens and asthma); Nunavuk studies by Furgal et al. (various

topics); Other Canadian studies including Quebec-

related data.

2005 Assessment

Studies conducted by INSPQ (Quebec’s National Public Health Institute), 2003-2007

4 sectoral assessments (water, zoonotic/vectorial diseases, temperature, EMEs)

General population perceptions, behaviour Public health and municipal managers’

perceptions Mortality modelling and simulation

14 reports available on-line at:http://www.inspq.qc.ca/publications/liste.asp?E=p&Theme=8

Heat wave alert systems (health network) have existed since 2004-2005 for southern Quebec.(93% of the population). Few tests performed.

No systematic review of air conditioning in existing hospitals and shelters, but new standards for new buildings and renovations.

No specific training or recommendations for medical staff regarding health care or medication.

No public awareness/outreach programme. No real prevention or remediation programme for

urban heat islands.

2005 AssessmentTempérature endegrés Celsius

18.3 - 20.9

21.4 - 23.0

23.5 - 26.0

26.5 - 28.0

28.5 - 30.4

30.9 - 32.3

32.8 - 33.8

34.2 - 37.4

Lack of public health emergency training Very good environmental monitoring system

(storms, flooding, dams, rivers, forest fires, etc.)

No follow-up of EME consequences; some short-term psychological follow-up

Some preventive actions regarding flooding and road network, Northern housing and infrastructure.

2005 Assessment

Very good drinking water monitoring system, but infrequent investigation of epidemics

Same for commercial and traditional foodstuffs Poor beach and swimming pool monitoring –

even though Quebec has 50% of Canadian pools!

Preventive watershed-based approach in place but poorly financed.

2005 Assessment

Quantitative water management is poorly implemented (outdated

infrastructure, standards, swimming pools…)

No quality control for small water sytems and private wells (20% of population)

Poorly organized public awareness/outreach

2005 Assessment

75% of adults take action to protect themselves from the heat

The proportion of air-conditioned dwellings has doubled since 1997; now at 35,8%.

The most significant factor limiting access to air conditioning is household income.

Public Perceptions and Behaviour

Projet #2

0

5

10

15

20

25

30

35

40

1972 1976 1980 1984 1988 1992 1996 2000 2004

Année

Po

urc

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tag

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es m

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ag

es p

osséd

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cli

mati

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Percentage of households with air conditioning in Quebec, 1972 to 2005

Source: ISQ (2005b) and Bélanger et al. (2006a).

Access to air conditioning in 2005, in relation to the mean temperature warming trend (1960-2003) in southern Quebec

Source: Bélanger et al. (2006a), Yagouti et al. (2006)

“Living alone” is an excellent predictor for low income, chronic health problems and “age over 65”; these are the people who are most at risk in case of an Extreme Meteorological Event

Two-thirds of people using walking aids or wheelchairs are unable to go shopping for groceries during a heat wave.


Apartment dwellers and low-income people make great use of public parks and beaches during heat waves.


Projet #2

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Est duQuébec

Nord duQuébec

Région deQuébec

Centre duQuébec

Sud deMontréal

Nord deMontréal

Montréal etLaval

Région de résidence

tous les jours pas tous les jours sans chauffage au bois

Po

urc

en

tag

e

Percentage of domestic wood heating, per region

Source: Bélanger et al. (2006)

Link Between Mortality And Climate

Mortality and Climate – Relative to Tº

Historical Mortality Rate Modelling and Future Simulations

ANNUAL

Bonus:

Heat

Waves

Deaths

Other questions, 2005:

Where does the public stand? What changes are people ready for?

Very high recognition of environmental problems (water, air); some linkage to CC

Same recognition level regarding existing vulnerabilities (poverty, unemployment, aging population) and their link with health conditions

Most managers consider that CC adaptation will be a regional and provincial priority for the next 10 years, with varying importance depending on the region.

Study of Public Health / Municipal Managers

Both manager categories (public health and municipal) are very aware of the negative impacts on infrastructure and economy, and on physical and mental health.

Collectively, their appreciation of these impacts is clear, detailed and balanced.

Results

Most managers believe that their regional institutions, in partnership, share the responsibility for CC adaptation.

However, there is little field work, mostly limited to heat wave emergency plans.

Most managers say they need (in this order): • More practical information; • Regional climate data; • More political and institutional support; and • Financial and human resources to move ahead.

Results

Municipalities rely more on government information sources, less on scientific sources (Ippersiel & Morissette, 2004)

More municipal (6+) than public health (1+) laws and regulations

Little money tagged for prevention at the municipal level.

Discussion

There is no unanimous certainty that a period of climate change has started, notably because of the media-peddled controversy on the causes of the warming trend – natural vs anthropic.

Discussion

Public’s Intentions Regarding Certain Actions

(2005)

Figure X: TRANSPORT : Solutions pour réduire les effets nuisibles des CC sur la santé et le bien-être des Québécois

18,2

58,0

59,5

57,9

58,4

69,5

19,3

30,5

25,2

24,5

29,5

24,4

26,6 19,7

9,7

7,6

6,9

3,5

6,8

2,7

7,7

6,7

4,0

2,3

0% 20% 40% 60% 80% 100%

Taxer davantage l'achat desautomobiles

Augmenter le nombre d'abribus

Aider financièrement l'achatd'automobiles "vertes"

Rendre obligatoire l'inspectiondes automobiles (> 7 ans)

Diminuer l'utilisation de l'autodans les grandes villes

Augmenter le transport encommun (covoiturage, autobus)

Tout à fait d'accord Plutôt d'accord Plutôt en désaccord Tout à fait en désaccord

Figure XX: LOGEMENT : Solutions pour réduire les effets nuisibles des CC sur la santé et le bien-être des Québécois

37,1

62,5

63,1

27,4

21,6

30,6

19,6 14,1

4,2

9,6

1,7

5,8

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Empêcher le chauffage au boislorsqu'il y a du smog, l'hiver

Empêcher la construction desmaisons, chalets ou logementsdans les zones à risque (e.g.

inondations)

Améliorer les exigences surl'isolation des maisons et des

logements

Tout à fait d'accord Plutôt d'accord Plutôt en désaccord Tout à fait en désaccord

Assessment Summary

Action on housing and infrastructure will be crucial; standards must take CC into account

Availability of shaded and cool areas in cities will have to increase; trees planted today will be useful around 2040…Not cutting them is a lot smarter.

Supporting the poor, handicapped or chronically ill will be decisive to avoid social disasters…

Neighbourhood solidarity.

Assessment Summary

The ground is fertile but it is necessary to continue tirelessly explaining the links between the actions that need to be taken, their causes and the climate…

Our major information effort: 22 reports, summaries, articles and book chapters (several thousand copies distributed); some 100 conferences and media events; hyperlinks on 6 websites…

Assessment SummaryChapter 6 deals with Quebec; it summarizes all studies conducted in Quebec and includes recommendations.

See http://www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2008/2008_122-fra.php

and for the online version: http://www.sindark.com/2008/08/03/human-health-in-a-changing-climate/

Several applied health research projects are being concluded within Ouranos (cyanobacteria, rural gastroenteritis, atlas of vulnerabilities, links between heat and air pollution, historical and future hospitalization modelling)

Advice on guidelines being prepared for doctors and healthcare workers.

Ouranos Health Research Programme

2006-2009

Température endegrés Celsius

18.3 - 20.9

21.4 - 23.0

23.5 - 26.0

26.5 - 28.0

28.5 - 30.4

30.9 - 32.3

32.8 - 33.8

34.2 - 37.4

In development Important support for adaptation work New issues: urban heat islands and

mortality, UV, zoonotic and vectorial diseases, strokes, high risk group characterization, housing, health impacts of Extreme Climatic Events, geosimulation of Lyme’s Disease…

Ouranos Health Research Programme

2009-2014

Température endegrés Celsius

18.3 - 20.9

21.4 - 23.0

23.5 - 26.0

26.5 - 28.0

28.5 - 30.4

30.9 - 32.3

32.8 - 33.8

34.2 - 37.4

Reinforced health monitoring (for ECEs, infectious zoonotic and vectorial diseases, real time mortality) will be in place by 2012

Platform in development

There will be studies, recommendations and demonstration projects on how to improve climate-related health care and services (institutional and home-delivered)

Adaptation of health care–related buildings and lands (1,700 buildings) according to new standards (demonstration projects)

Health Action Plan 2007-2013


Support demonstration projects for the creation of «cool islands» and for the prevention of EME risks to vulnerable, non-health care clients (schools, day care facilities, low cost housing, etc.)

Training programme planned for network and non-network staff (pending needs identification)


First health programme of this kind in Canada – yet incomplete and imperfect

Not much done yet on behaviour and its follow-up (and continuing reinforcement)

Links need to be established with other existing health-related initiatives (UV, physical conditioning, sustainable development, transportation, etc.)

Planned funding: $30 million, including 50% for demonstration projects – initiated last year.

LESSONS LEARNED

LESSONS LEARNED Need to start to change our thinking and words on

the need for innovation for CC adaptation. The necessary technologies have been around for more than a century: bicycles (1817), railways (1804), tramways (1832), planning (~10,000 years), boats (~10,000 years), tax (~1,600 years) and walking (~2,000,000 years)

What is needed instead is a strenghtening of public institution mandates, infrastructure and legal requirements.

LESSONS LEARNED It took 10 years to get ready to act, so we might

as well start now, because… When the money comes, we’d better be ready to

spend it wisely; It is essential to broadcast, explain and repeat

the concepts, solutions, impacts and avoided costs, since human behaviour remains… human.

LESSONS LEARNED

What will be lacking is the few billion dollars needed to offset the advertising drive to consume and emit GHGs

Last year, the world automobile industry alone spent $70 billion on advertising and incentives… out of a total world advertising budget of $450 billion

Reducing GHG emissions remains the Number 1 adaptation measure, one which we owe our descendants.

Thank you for your attention