朱明若

报告提纲

1. 简介：气候变化对全球健康的挑战2. 气候变化与健康的研究空白 : 综合多学科方法于气候变化和适应

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Future temperature changes

CSIRO Climate change: the latest science

Global warming by 2100: 450 ppm:0.8 – 2.1 °C

550 ppm:1.1 – 2.7 °C

No mitigation:2.4 – 6.4 °C

Sources: WHO 2003

Variations in Earth's average surface temperature, over the past 20,000 years

Ice Age

I. 介绍 : 气候变化对全球健康的挑战从 90’s 早期 WHO 气候变化警告WHO 的一项研究估计，在亚洲及太平洋，气候变化每年直接或间接导致大约 77 000 人死亡—

气候变化导致了全球半数的死亡

10 年后 , Dr Shigeru Omi, World Health Organization Regional Director for the Western Pacific, warned:

“我们现在已经进入了全球气候变暖严重影响生活和身体健康的关键阶段，如果我们现在不采取行动，这一问题将在未来几十年对人类 . 带来更大的威胁”

全球变暖的潜在影响 :以前没有蚊子的地方出现了蚊子 :- 增加了虫媒疾病的威胁，如疟疾和登革热 .

有些地区可能降雨量减少了，导致水资源短缺，引起水源性疾病的发生 .

耕地面积减少导致数百万人面临营养不良和饥饿

Dr Shigeru Omi, WHO 西太平洋区域主管 , 对气候变化和人类健康发出警告 :

从 90’s 早期 WHO 气候变化警告

Research on climate change and health were limited相比气候研究的投资，必要的投入是非常小的

Why should an extra degree or two (or 4) matter?

Global mean temperature is likely to rise by 1.4-5.8°C between 1990 and 2100 with associated changes (IPCC, 2007)

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Thornton & Jones. 4 degrees and beyond 2009. Projected climate change will shorten growing seasons in equatorial regions and increase the risk of hunger where communities depend on local agriculture

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D’Souza et al., 2003

Food-borne infections are more common when

temperatures rise – 5 major Australian cities

Significant collective work informing policy direction for climate change, health and environment

March 8, 2014

政府间气候变化专门委员会（ IPCC ） The Final Report of the Working Group II contribution to the IPCC’s Fifth Assessment Report (WGII AR5), titled Climate Change 2014: Impacts, Adaptation, and Vulnerability (31 March 2014.)

Lancet, 2012

2009

The latest: what science tells us about climate change

Is it global warming or just the weather?

Indeed, heat waves and cold spells, increasing incidences of floods, droughts, typhoons and rise in sea level are just some of the many examples around us of a changing climate.

加上气候变化有关的极端天气事件，海平面上升，超级灾害，和环境污染有关的用水安全，食品安全问题… .

Rising atmospheric

temperature

Rising sea level

Reductions in North Hemisphere

snow cover

Climate change is Unequivocal

• 1900-2100 年，全球平均气温很可能上升 1.4-5.8°C (IPCC, 2007)

• 海平面上升 0.18 - 0.79 米 (IPCC, 2007)

• 洪水是发生最频繁的自然灾害 (EM-DAT, 2006)

• 气候变化影响全球食物产量

气候变化是 21 世纪全球健康的最大威胁(The Lancet Commissions, 2009)

Types of disasters in the world in 2011 (EM-DAT, 2011)

Increasing flood risks (EM-DAT, 2011)

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Water Security

Desertification

Searching for water

Extreme weather and climate change related disasters:Water crisis

用水安全和水源性疾病

• 亿人得不到干净的水， 220 万5 岁以下的儿童由于水源污染而死亡。• 在发展中国家，腹泻、周围环境温度与降水总量明显相关。

Source: UN

Multiple impacts of food shortage: hunger & starvation, human suffering, malnutrition, lower immunity, increased morbidity and mortality!!

Malnutrition population distribution

食物短缺和饥饿

Land Degradation, Food Insecurity, Poverty, Starvation, and human suffering

• 8 亿人得不到足够的食物• 每年至少有 350 万儿童死亡，其中 1 / 3 的儿童在 5岁以下，其根本原因是营养不良。 • 营养不良容易引发疾病(2002 数据 )

食品安全和营养不良

极端气候事件

全球变暖

WHO 2007 Climate change & human health-risks and responses新的传染病

Displacement & Refugees 迁移

洪水

• 疾病模式的改变 , • 水和食物的不安全 , • 脆弱的住房和人类住区• 极端气候事件• 生态迁移和难民• 虫媒疾病将影响更多的地区，并导致更多人死亡，尤其是脆弱群体，如老年人• 气候变化对政府尤其是卫生部门是一个直接的挑战 –包括急性医疗和公共卫生体系

气候变化相关的健康威胁的趋势直接或间接增加死亡、疾病和伤害--The Lancet Commissions--

气候变化是 21 世纪全球健康的最大威胁(The Lancet Commissions, 2009)

1Climate Change and Health

Hisashi OgawaWHO Regional Office for the Western Pacific

9 August 2011

Pathways by which climate change affects human health

Sources: WHO 2003

Future effects of climate change on human health, IPCC 4th AR, 2007

Climate change and Health

More droughts, floods, typhoons

Effects on water and food shortage; on water and food borne disease

More Extreme Weathers

Confidence in: Malaria distribution changes – mixed effects (some contractions and

some expansion in geographic range and change in seasonality)

Less confidence in dengue fever impacts, though WHO and scientists around the world estimated that around 3 billion

people globally will be at risk from Dengue fever due to climate change, urbanization, and world trade (ESSP 2006: 10)[1].

Dengue fever is recognised as a serious threat to the world’s population as there is not yet a proven effective treatment.

Confalonieri, U and McMichael, A (ed) 2006) Global Environmental Change and Human Health. Earth System Science Partnership Report No. 4.

Climatic Changes and Mosquito-born diseases

Emergence of DEN/DHF

Prior to 1970, only 9 countries had experienced cases of dengue haemorrhagic fever (DHF); since then the number has increased more than 4-fold and continues to rise  

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Lancet 2006;368:2194

Global dengue cases reported each year to WHOGlobal rise in dengue cases reported each year to WHO

Countries at risk of dengue transmission

Current global dengue distribution; 35% of the global population is exposed.

The dengue distribution will be 50-60% of the population by 2085.

Hales et al., 2002

Global Model for Dengue Distribution

Zika: a serious threat for pregnant women and their foetus

European heat waves – summer of 2003 and again in 2006

Figure depicts 2003 temperatures compared to same time in 2001

2003 Heat wave responsible for 35,000 deaths across Europe, 3000 deaths in France alone

Excess mortality density (1990s and 2090s)in East Asia

1990s

2090s10-4 10-3 10-2 10-1 100

(persons/km2) Honda, Y. Presentation at IEEE, September 2010

Desertification, dust and sand storm, forest fires

Effects on water and food shortage and on air pollution

Impacts of climate change and air pollution

Children with cancer are comforted by a charity worker.Of the estimated 11,700 deaths from cancer in Guangzhou each year, the biggest killer is lung cancer, and there are no prizes for guessing why that is.

LUNG CANCER THE LEADING KILLER IN GUANGZHOUThe Guangzhou CDC has reported that cancer is the leading cause of death in the city, causing 25% of all deaths, Nanfang Daily reports.

Increases in Lung Cancer in Beijing and Guangzhou

Hurricane Katrina 2005 – around 1800 deaths

80-90% of disasters during 2001-2011 have resulted from floods, droughts, tropical cyclones, heat waves and severe storms. In 2011, 332 disasters in 101 countries, causing 30770 deaths, affecting 244 million people, damages amounted to over US$366 billion. (2012 Atlas of Health and Climate

by WHO and World Meteorological Organisation)

disasters

Health and Emergency Services Health and Emergency Services being stretched to the limitbeing stretched to the limit

The UN warns that the number of people forced to leave home due to pollution, rising sea levels and expanding deserts could soar from 25 million in 2005 to 50 million in 2010 (Newsweek October 24, 05)

Climate change-- the multiplier of risks: climate change related extreme weather

events, heat waves, droughts, sea level rises, and environmental pollution related water

security, food security problems….

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Climate Change and human health

Source: CDC, 2015. Retrieved on 25th March 2016 from http://www.cdc.gov/climateandhealth/effects/default.htmClimate change will continue to exacerbate health problems that

already exist (IPCC, 2014a), new health threats will emerge (CDC, 2015)

报告提纲

1. 简介：气候变化对全球健康的挑战2. 气候变化与健康的研究空白 : 综合多学科方法于气候变化和适应

3. 公共卫生关注点及主要概念 : 健康不平等性、脆弱性、适应和适应能力

4. 从范围界定到适应规划的渐进式问题解决步骤5. 健康和气候变化应用研究的路线图6. 未来的方向：气候变化和全球研究伙伴关系

急需一个能阐明气候变化的不良健康效应的综合的多学科的方法

至关重要的是需要建立跨学科的研究能力，关注最容易受到气候变化对健康影响的和研究基础最为薄弱的低收入国家相比目前气候研究的投资，必要的投入是非常小的，与适应和减缓决策的经济意义相比则是边缘化的，与未管理的气候变化或设计不良的气候政策对健康的潜在后果相比则是微不足道的 .

学科间的、综合的方法，包括气候变化适应的多个部门和利益相关方卫生部门必须发展适应性策略以使由气候变化引起的健康危害最小化。

对脆弱人群的需求给予更多的关注。

评估和提高公共卫生系统反应能力。 实施适应性措施。

气候变化、脆弱性和卫生系统应对能力气候变化对公众健康是一个重要的并且是新出现的威胁，改变了我们必须考虑保护脆弱人群的方式 .

http://www.who.int/globalchange/climate/en/

现有的全球健康问题已经拉伸了许多发展中国家的资源，使他们更容易受到气候变化影响… ..

评估不均等影响的脆弱性、公共卫生体系的应对能力和开展适应性战略都是非常重要的 !

对健康影响的研究仍然很有限

许多研究已经关注气候 - 健康关系，通过模型估计未来健康风险

The role of international experts in the Adapting to Climate Change in China

(The ACCC project)Sponsored jointly by DFID/SWISS/CHINA

Example one

DFID-Swiss-China ProjectJune 2009-June 2012

Guangdong project team with International Health Experts

Scoping

Vulnerability

Assessment (VA)

Scenario development & testing

Adaptation planning

Spiral Steps to climate change adaptation research

Building research

team

Risk Assessment

(VA)

ACCC in progress:Policy brief from learning thus far

ACCC Policy Brief: Climate change and Impact on Agriculture in China

ACCC Policy Brief on CC Impact on Agriculture in China

ACCC Policy Brief: Climate Change and its impact on population health in Southern China(Heat waves, cold spell, foot and mouth diseases, and risk perception & heat stroke)

Three examples of translational research:

3. Conduct stakeholder engagement workshops in Hangzhou to inform, consult, gain feedback, and invite inputs on the revision of the brooklet to better meet their needs;

Revise the booklet, conduct another stakeholder engagement workshop in Guangdong intensive heat;

Revise the booklets Provide the booklets to research

partners and stakeholders group as a basis for designing the next phase of the action research focussing on local area adaptation strategies for prioritised target group.

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将来研究的优先领域包括 :

–区域风险的鉴定 (Risk Assessment )

– 当地基本保健服务和职业健康服务的准备 ;– 初级、二级、三级卫生服务气候相关健康数据的整合– 发展适应性策略– 实施适应性措施。

澳大利亚—国家气候变化适应研究设施气候变化和健康知识和研究的空白未来的方向

气候变化与人类健康 气候变化引起的健康效应的管理需要政府和民间团体所有部门的参与，学术学科间的合作以及国际合作 .

当地政府社区和相关部门参与监测、讨论、倡导和支持适应过程是非常关键的 !

-Lancet and University College London Institute for Global Health Commission vol 373, May 16, 2009

Thanks you

朱明若Thanks you!