Health effects of climate change Heat related impacts Dr Clare Heaviside 1,2,3 1 Air Pollution and Climate Change Group, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell, Oxfordshire 2 School of Geography, Earth and Environment Sciences, University of Birmingham 3 London School of Hygiene and Tropical Medicine Climate change often exacerbates an existing health effect (Source: CDC website) Direct and indirect health impacts of Climate Change McMichael (2009) Temperature changes may modify many of these risks Carbon emissions Health impacts Patz (2007) Health Effects of Climate Change in the UK (2012) 12 HPA authors 10 external authors from 7 UK research institutions 34 internal & external reviewers (12 from overseas) 10 chapters, 240 pages Methods Extensive literature reviews New calculations of health impacts Quantitative estimates (based on UKCP09) where possible Semi-quantitative or qualitative estimates PHE active in research on CC, input into CCRA, National Adaptation Programme and others Global annual mean temperature Combined land-surface air temperature & sea-surface temperature (Met Office) Hottest years (globally) on record Increasing likelihood of extreme events IPCC 2007 Coumou & Rahmstorf (2012) Summer 2003 European Heatwave NASA European mortality during the Heatwave of August 2003 UNEP Data from Baden-Wurttemburg, Germany. Schr & Jendritzky (2004) Highest death toll from Natural Hazards in 50 years for Europe - United Nations Environment Program (UNEP 2004) Temperatures reached 38.5 o C in Kent in Aug 2003 >2,000 excess deaths in England Estimates that between 21 and 38% of the excess deaths were due to the elevated ozone and particulate levels Stedman (2004) max temp 2003 mortality - ozone - PM 10 Daily mortality, London, aged >75yrs Johnson et al (2004) Baseline mortality min temp Quantifying the Health Effects of Climate Change Difficult to quantify health effects relating to Climate Change More likely to study the effects of weather on health Example: time series epidemiology of temperature effects Relate the effects of weather on health to a future climate Temperature-mortality relationship London summer temperature Armstong et al. (2010) A shift in distribution of temperatures will affect mortality Greater risk on very high temperature days Baccini et al. (2008) Presentation title - edit in Header and Footer 1.Projections of temperature related mortality in the UK for the 2020s, 2050s and 2080s 2.Attributing heat related mortality to the Urban Heat Island intensity: a case study for the West Midlands, UK Presentation title - edit in Header and Footer 1.Projections of temperature related mortality in the UK for the 2020s, 2050s and 2080s 2.Attributing heat related mortality to the Urban Heat Island intensity: a case study for the West Midlands, UK Climate change and temperatures in the UK Increase in mean temperatures, heatwaves likely to become more common By 2040, every other year likely to be as hot as 2003 Jones (2008) Towns and cities are usually a few degrees warmer than rural areas Urban Heat Island Effect - Higher population exposure to heat in urban areas (UKCIP) Presentation title - edit in Header and Footer Projections of temperature related mortality in the UK for the 2000s to 2080s Temperature-mortality relationships analysed for each UK region, by age group Mortality estimated for baseline decade (2000s) plus modelled projections Growth and aging of population included in analysis Hajat et al. (2014) Presentation title - edit in Header and Footer Projections of temperature related mortality in the UK for the 2000s to 2080s In the UK, cold deaths outnumber heat deaths (for now and future) The effects of climate change on temperature-related mortality in future are worse for older age groups: Sharp increases in heat related mortality Less dramatic decreases in cold related mortality Public Health implication is that cold will continue to be a problem, particularly with ageing population, however, increasing attention should be given to heat-related impacts. Presentation title - edit in Header and Footer 1.Projections of temperature related mortality in the UK for the 2020s, 2050s and 2080s 2.Attributing heat related mortality to the Urban Heat Island intensity: a case study for the West Midlands, UK The Urban Heat Island (UHI) Why are cities often warmer than the countryside? Urban materials retain heat Buildings stop heat getting radiated to the sky Lack of moisture and vegetation Temperatures in cities can be up to up to 10 o C warmer than surrounding countryside Effect larger for cloud free, low wind conditions, and usually more pronounced at night Why is the UHI important? Over half of the worlds population now reside in cities Impacts include Health respiratory, stroke, heat exhaustion, death Increased energy consumption for cooling Increased greenhouse gases and air pollutant emissions Changes to water quality Most climate change projections dont take into account urban surfaces We may be underestimating future temperature increases in cities urban rural (United Nations) Birmingham and the West Midlands The health impacts of the Urban Heat Island Clare Heaviside Urbanisation across the West Midlands Birmingham is the UKs 2 nd most populous city (~1 million) The West Midlands is the UKs 2 nd most populous urban conurbation Modelling configuration WRF (Weather Research and Forecasting) ARW (Advanced Research WRF) model 4 nested domains (36 km 2, 12 km 2, 3 km 2 and 1 km 2 resolution) Meteorology: ECMWF ERA-interim reanalysis at 1.5 o every 6 hours Land surface data: USGS (United States Geological Survey) land use categories The health impacts of the Urban Heat Island Clare Heaviside BEP (Building Energy Parameterization) scheme (Heaviside et al. 2015) Multilayer surface urban physics scheme 3 types of urban classes Urban classes specially adapted for Birmingham and the West Midlands Simulates the effects of the vertical distribution of heat, momentum and turbulent kinetic energy throughout the urban canopy layer. Modelled Simulations Urban: Model is run using 3 detailed urban land surface categories to best capture the UHI effect using the BEP scheme. Rural: Model is run by replacing all urban categories with rural (grassland/pasture) categories. A comparison of temperature between the 2 simulations gives an indication of the UHI intensity Urban Temperature: urban model simulation The health impacts of the Urban Heat Island Clare Heaviside Snapshot: 11pm, 5 th August 2003 (2 metre temperature) WH Wolverhampton EB Edgbaston BC Birmingham City Centre CH Coleshill CV Coventry UHI Intensity: urban rural experiment The health impacts of the Urban Heat Island Clare Heaviside Difference in 2m temperature between urban and rural model runs, 11pm, 5 th August 2003 WH Wolverhampton EB Edgbaston BC Birmingham City Centre CH Coleshill CV Coventry Urban rural experiment: UHI intensity in city centre The health impacts of the Urban Heat Island Clare Heaviside Birmingham City Centre: T (urban-rural) = 3.2 o C (mean UHI intensity) T (urban-rural) = 5.6 o C (max UHI intensity) (Heaviside et al. 2015) Health Impact Assessment (HIA) methodology Aims: Quantify the effect of the UHI on mortality, and investigate sensitivity of mortality burdens to population weighting of temperature. Estimate the potential health impacts of climate change, by including the UHI intensity as well as the UKCP09 temperature projections. Calculations: Mortality associated with heat during the 2003 heatwave period The effect of population weighting of temperature on mortality burden Mortality associated with the UHI during this period Mortality associated with Climate Change and UHI for future decades The health impacts of the Urban Heat Island Clare Heaviside Health Impact Assessment results HIA based on modelled urban and rural WRF simulations Population weighted temperature is 1 o C higher than geog mean temperature The UHI contributed around half (52%) of the total heat related mortality in the West Midlands during the heatwave of Heaviside et al. (2016) MORTALITY Current climate Future Climate Projections (without pop changes) Temperature metric 2003 heatwave2020s2050s2080s Urban pop weighted (112)184 (143)256 (174) Urban geog mean (92)159 (124)229 (155) Rural 4373 (64)116 (90)180 (122) HIA based on modelled urban and rural WRF simulations, plus climate change projections Population weighted temperature is 1 o C higher than geog mean temperature The UHI contributed around half (52%) of the total heat related mortality in the West Midlands during the heatwave of Heaviside et al. (2016) MORTALITY Current climate Future Climate Projections (without pop growth) Temperature metric 2003 heatwave2020s2050s2080s Urban pop weighted (125)200 (159)278 (192) Urban geog mean (104)173 (138)248 (172) Rural 4379 (72)125 (101)195 (135) Health Impact Assessment results HIA results climate change Estimated mortality based on HIA for 2003 heatwave, and for potentially similar heatwave events projected for 3 future decades, (medium emissions, with population growth). Summary of HIA results The health impacts of the Urban Heat Island Clare Heaviside According to simulations, the effect of urbanisation in the West Midlands was on average ~3 o C, with max T of 7 o C during the 2003 heatwave (daily mean T) Population weighting of temperature data resulted in +1 o C for the region The 1 st -10 th August 2003 heatwave was associated with 90 additional deaths in region Around half (47) of these were associated with the UHI intensity Climate projections suggest a similar heatwave in 2080 could result in ~280 deaths Calculations include population growth but assumes no adaptation to heat in future Implications for HIA methodology: A HIA based on geographic mean temperature underestimated mortality by 20% A HIA without urban surfaces (no UHI) underestimated mortality by 52% To account for all future effects: include population weighting and UHI as well as climate and population projections Thank you The health impacts of the Urban Heat Island Clare Heaviside Bibliography 1/2 Armstrong, B.G., Chalabi, Z., Fenn, B., Hajat, S., Kovats, S., Milojevic, A. and Wilkinson, P. (2010) Association of mortality with high temperatures in a temperate climate: England and Wales. Journal of Epidemiology and Community Health. Baccini, M., Biggeri, A., Accetta, G., Kosatsky, T., Katsouyanni, K., Analitis, A., Anderson, H.R., Bisanti, L., D'Iippoliti, D., Danova, J., Forsberg, B., Medina, S., Paldy, A., Rabczenko, D., Schindler, C. and Michelozzi, P. (2008) Heat effects on mortality in 15 European cities. Epidemiology 19(5), Coumou and Rahmstorf (2012) A decade of weather extremes. Nature Climate Change 2, 491496 Hajat, S., Vardoulakis, S., Heaviside, C. and Eggen, B. (2014) Climate change effects on human health: projections of temperature-related mortality for the UK during the 2020s, 2050s, and 2080s. Journal of Epidemiology & Community Health. 68 (7), Heaviside C., Cai, X.-M., Vardoulakis, S. (2015). The effects of horizontal advection on the Urban Heat Island in Birmingham and the West Midlands, UK during a heatwave. Quarterly Journal of the Royal Meteorological Society. 141, 14291441. Heaviside C., Vardoulakis, S., Cai, X.-M.(2016) The contribution of the Urban Heat Island to heat related mortality during the 2003 heatwave and for projected future climate in the West Midlands, UK. Journal of Environmental Health. In press IPCC (2007). Summary for Policymakers. In: Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA.,. The health impacts of the Urban Heat Island Clare Heaviside Bibliography 2/2 Johnson, H., Kovats, R.S., McGregor, G., Stedman, J., Gibbs, M., Walton, H., Cook, L. and Black, E. (2005) The impact of the 2003 heat wave on mortality and hospital admissions in England. Health statistics quarterly / Office for National Statistics(25), Jones, G.S., Stott, P.A. and Christidis, N. (2008) Human contribution to rapidly increasing frequency of very warm Northern Hemisphere summers. Journal of Geophysical Research D: Atmospheres 113(2). McMichael, A. and Wilcox, B. (2009) Climate Change, Human Health, and Integrative Research: A Transformative Imperative. EcoHealth 6(2), Patz, J.A., Gibbs, H.K., Foley, J.A., Rogers, J.V. and Smith, K.R. (2007) Climate change and global health: Quantifying a growing ethical crisis. EcoHealth 4(4), Schr, C., Vidale, P.L., Lthi, D., Frei, C., Hberli, C., Liniger, M.A. and Appenzeller, C. (2004) The role of increasing temperature variability in European summer heatwaves. Nature 427(6972), Stedman, J.R. (2004) The predicted number of air pollution related deaths in the UK during the August 2003 heatwave. Atmospheric Environment 38(8), UNEP (2004) United Nations Environment Program. Impacts of Summer 2003 Heat Wave in Europe, Environmental Alert Bulletin. Vardoulakis, S. and Heaviside, C. [eds.] (2012) Health Effects of Climate Change in the UK 2012 Current evidence, public health recommendations and research gaps. Health Protection Agency, Centre for Radiation, Chemical and Environmental Hazards, UK. ISBN: Temperature related mortality in future Heat deaths Sharp increases in heat related mortality in future decades, especially for older age groups Cold deaths Decreases in cold related mortality in future decades, although reductions not as sharp as increase in heat related mortality Temperature related mortality in future See also Hajat et al. (2014)