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WARNING: CLIMATE CHANGE CAN HARM YOUR HEALTH Low-income people and vulnerable groups will be hit the hardest

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This is the ninth in a ​ 10-part series​ about the ongoing global impacts of climate change. These stories will look at the current effects of a changing planet, what the emerging science suggests is behind those changes and what we all can do to
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  WARNING: CLIMATE CHANGE CAN HARM YOUR HEALTH Low-income people and vulnerable groups will be hit the hardest KATHIANN KOWALSKI MAY 2, 2019 Thisistheninthina 10-partseries abouttheongoingglobalimpactsofclimatechange.Thesestorieswill  lookatthecurrenteffectsofachangingplanet,whattheemergingsciencesuggestsisbehindthose changes and what we all can do to adapt to them.  ThecityofBeirawasoverwhelmedwhenCycloneIdaislammedintoMozambiqueonMarch14and 15.Floodssweptacross3,000squarekilometers(1,200squaremiles)ofthenation.Theareaaffectedwas aboutthree-quartersthesizeofthestateofDelaware.Homeswereinundated.Roadsandbridgeswashed away.Morethan1,000peoplediedinthiscountry,MalawiandZimbabwe.Thefulldeathtollmayneverbe known. ThewaterslaidwastetocropsinareasaroundBeira.Thissetthestageforhunger.Floodsshutdown much of the city’s water and sanitation systems. The threat of waterborne disease loomed. AsofApril10,Mozambique’shealthofficialssaidmorethan4,000peoplehadbeeninfectedwith cholera.Bacteriaincontaminatedwatercausethisdisease.Itssymptomsincludeseverediarrhea,violent vomitinganddehydration.Peoplewhodon’tgetprompttreatmentcandie.Clearly,thecountryfaceda major health crisis. Scientistscan’tyetsayexactlywhatroleclimatechangemayhaveplayedinCycloneIdai.Buttheydo knowthatextremestormswillbecomemorecommonwithclimatechange.Theyknow,too,that low-incomecountriesinAfricaandelsewherewillbehitharderthanmorewell-to-donations.Andthey know that there will be a wide range of health impacts — including more waterborne disease. Climatechangeisactinginmanywaysthatcanharmhealth.Between2030and2050,aquarter millionmorepeoplewilldieeachyearthanwouldifclimatechangewerenotafactor,theWorldHealth Organizationnowpredicts.Andthisestimatemaybelow.Itdoesn’tincludeallthemanywaysthatclimate change can affect health. Wedon’thavetowaituntil2030toseeimpacts,either, saysKristieEbi.She’sapublichealthexpert at the University of Washington in Seattle. “Climate change is already affecting our health,” she notes. Extremeheatisoneproblem.Moreintensehurricanes,rainstormsandwildfiresareothers.Such eventscausedirectharm.Theyalsocandisruptbasichealthservicesandpromotethespreadofdisease.But  climatechangewillaltertheplanetinlessobviouswaysthatcanharmhealth.Airandwaterpollutionwill worsen in many places. Infectious diseases will become more common at some sites, or spread to new ones. Themorescientistsandengineerslearnaboutclimatechangeanditsimpacts,thebetterpeoplewill bereadytodealwiththem.“Ifweunderstandthatwearepartofthecause,itgivessomehopethatwecan beapartofthesolution,”saysSarahKew.She’saclimatescientistwithVrijeUniversityAmsterdaminthe Netherlands. CycloneIdaiwasjustthelatestinaseriesofdevastatingstorms,manyofwhichhavebeen intensifiedbyclimatechange.LastSeptemberintheUnitedStates,forinstance,HurricaneFlorenceflooded hugeareasofNorthCarolina.Thewaterssweptsewage,fertilizers,animalwaste,coalashandanimal carcassesintowaterways.Floodwatersalsomessedwithwater-treatmentplantsandsewagesystems.Water systemsshutdowninabouttwodozencommunities.Another20orsowarnedtheirresidentstoboiltheir water before use. Climatechangethreatenswatersuppliesinotherways,too.Stormscanbringcontamination.Sea levelrisecanoverwhelmsewerpipesandtreatmentplants,sweepingmorecontaminationintowaterways. Droughts can take away once abundant water supplies.  Bloomsofharmfulalgaehappenwhensomesingle-celledspeciesgrowoutofcontrol.Someofthem makepoisonsthatcausebreathingproblems.Othersalgaltoxinscanharmtheliver,damagethenervous system or affect the brain (and memories). AbadbloominLakeErieforcedthecityofToledo,Ohio,toshutdownitswatersystemfortwodays in2014.Climatechangewilllikelybringmorebadblooms.Onewaytheycandothis:Climate-intensified stormscanwashmorefertilizerintowaterways.Thosenutrientscanfeedtoxicalgalspeciesinlakesand along coastlines. Warmer waters also are expanding the areas where algal blooms are likely to emerge. ChristopherGoblerisacoastalecologistatStonyBrookUniversityinNewYork.Heandother scientistsfoundthatsince1982,the niche  forharmfulalgalbloomshadgrowninthenorthernAtlanticand Pacificoceans.Thetimingofwhenbloomsmighteruptcouldshiftaswell.Thegroupreporteditsfindingsin 2017 in the Proceedings of the National Academy of Sciences . “Wateristheprimarymediumthroughwhichwewillfeeltheeffectsofclimatechange,”reports UN-Water,aUnitedNationsagency.Watersupplies,watercleanlinessandwater-deliverysystemsareallat risk. Yet the health impacts of climate change don’t stop there. Infolklore,Luciferisanameforthedevil.Butin2017,Lucifertookonanextrameaning.Itwasthe namegiventoaheatwavethatmademanypeoplethinkaboutfiresinhell.InpartsofsouthernEuropethat August,temperaturestopped40°Celsius(104°Fahrenheit).Evenatnight,thosehotspotsdidn’tdipbelow 30°C(86°F).Sopublichealthofficialsissuedwarnings.Findcoolershelter,theysaid.Limitphysicalactivity. Drink extra fluids. Their concern: Heat can kill. Lucifer-likeheatwaveswereoncerare.Now,southernEuropecanexpectthemaboutonceevery10 years.“Weestimatethathuman-causedclimatechangehasincreasedtheoddsofsuchaneventmorethan threefold since 1950,” says Kew. She led the study behind that forecast. These maps show variations from normal summer temperatures in Europe in 2003 and 2015. Redder areas were hotter than normal. On average, areas in the blue boxes were 2.8° C (5° F) warmer than usual. S. Muthers et al/Atmosphere  2017 There’sasimilarforecastfortheUnitedStates.HosmayLopezisaclimatescientistinFloridawith theNationalOceanicandAtmosphericAdministrationandtheUniversityofMiami.“Withouthuman influence,halfoftheextremeheatwavesprojectedtooccurinthefuturewouldn’thappen”inmostofthe UnitedStates,hesays.Andbyhumaninfluence,he’sreferringtotheburningoffossilfuelsandother activities that have been playing a role in warming Earth’s climate.   Climate change will soon be the main factor that drives most heat waves in much of the United States. Or so reports scientists at NOAA and universities in Florida. Graph: NOAA/Climate.gov, Data: Lopez et al/Nature Climate Change  2018 Anincreasedriskofdeathfromheatwavesexistsworldwide,saysYumingGuo.Asabiostatistician, he’sanumbersman.He’salsoanepidemiologist—adiseasedetective—atMonashUniversityin Melbourne,Australia.Heandotherscientistscalculatedtheaddedrisksforheat-wavedeathsin20countries andregions.Theycomparedtherisksthathavebeenforecasttooccurbetween2031and2080tothose seen between 1971 and 2020.   Ingeneral,poorercountriesinwarmregionswillbehithardest,theyfound.Ifpeopledonothing aboutclimatechange,forexample,ColombiainSouthAmericacouldhaveroughly20timesmoredeaths fromheatwaves.MoldovainEasternEuropewouldhaveabout50percentmoredeaths.Theteamsharedits results in PLOS Medicine  on July 31, 2018. “Climatechangeaffectsallofus,”MadeleineThomsonsays,“exceptsomeofushavealotmore resources[moneyandexperts]tobeabletotackleit.”She’saninsectbiologistandenvironmentalhealth scientist at Columbia University in New York City. Climatechangeisn’tjustwarmingtheair.It’salsomakingthatairhardertobreatheformany people. Some of the reasons include rising levels of pollen, pollution and other air quality problems. Plantpollencancausehayfever.Itsmiseryincludessneezes,runnynoses,sorethroats,headaches anditchyeyes.Pollenalsocantriggerasthmaattacks,makingithardtotakeabreath.Climatechangemay lengthenthegrowingseasonforthepeskysourcesofpolleninmanyareas.Higherlevelsofcarbondioxide may also promote more plant growth. “Ipersonallysufferfromspring-timeallergiesandfearalongerandpotentiallyworsepollenseason,” saysMichaelCase.He’saclimatescientistattheUniversityofWashingtoninSeattle.Caseandecologist KristinaStinsonlookedathowsneezezonesforragweedpollencouldshiftintheeasternUnitedStates.She worksinMassachusettsattheUniversityofAmherst.Theduosharedtheirworkin PLOSONE   onOctober31, 2018. Climatechangewillbringwarmingandashiftinrainfallpatterns.Thatwillpushragweedfarther northintonewplaces,suchasthenortheasternUnitedStates.Theplantalsocouldspreadnorthwestinto Wisconsin,MinnesotaandCanada.Meanwhile,partsofFloridaandtheAppalachianmountainsmaybecome   lessragweed-friendly.“Thesechangeswillhaverealeffectsonpeople’shealth,”Casesays,“makingitworse in some areas and potentially better in other areas.” The map on the left shows current places in the eastern United States where ragweed pollen can pose allergy problems. Blue areas on the map on the right show where the plant’s distribution will likely expand by the 2050s due to a moderate increase in greenhouse-gas emissions. Brown areas show where there may be less ragweed by then. M. Case and K. Stinson/ PLOS ONE   2018 Trees,too,cantriggerallergiesandasthma.PatrickKinneyisanepidemiologistatBostonUniversity inMassachusetts.Hewaspartofateamthatlookedathowchangesinwhenoaktreesreleasetheirpollen willaffectasthmasufferersintheeasternUnitedStates.Oakpollenledto21,000emergencyroomtrips thereforasthmain2010.Severeclimatechangecouldupthatbyanother5to10percentby2050to2090, the team reported in the May 2017 issue of GeoHealth . Abiggerconcern,though,maybepollution.LastyearKinneylookedintoresearchonthe interactionsofclimatechange,pollutionandhealth.Burningoffossilfuelsandotheractivitiesrelease chemicalscalled nitrousoxides  and volatileorganiccompounds ,orVOCs.Sunlighttriggerschemicalreactions   inbothtypesofchemicals.Thatbrewsupground-levelozone.Andozoneisatriggerforasthmaattacksand other breathing problems. “VOCemissionsgoupasthetemperaturegoesup,”Kinneynotes.“Andthatpromotesozone formationbecausethere’smoreofthatstuff”intheair.Also,peoplewillneedmoreairconditioningduring hotspells.Butburningfossilfuelstomakeelectricitywillendupreleasingevenmoreozone-forming chemicals. Theburningoffossilfuelsalsofillstheairwithteeny,tinypollutantparticles.Moreof  these  particulates  canformassunlightbreaksdownotherairpollutants.Particulatepollutioncancauselung disease.Butthat’snotall.“There’sallsortsofgunkintheparticlesthatgetsabsorbedintothe bloodstream,”Kinneynotes.Studiesshowthosetinybitscancause heartandcirculation problems.They alsomaymesswithhormonelevelsandsome brainfunctions.KinneysharedhisfindingsintheMarch 2018 Current Environmental Health Reports . Wildfires spewparticulates,too,alongwithotherpollutants.Badairqualityaffectedvastareasof  thewesternUnitedStates,wherewildfiresragedlastyear.Andthereare moretocome.From2046to2051, 440westernU.S.countieswillhaveatleastonehigh-pollutionsmokeday.Thetotal5-yearincreaseacross allthosecounties:almost5,000morehigh-smokedaysthanhadplaguedthemduringthe5-yearspanof    2004to2009.That’sbecausebiggerfireswillaffectmultiplecounties.Soconcludesa2016study in Environmental Research Letters . Evendroughtscanmakebreathingharder.Dryspellsmakethegrounddusty.Windscankickthat dustintotheair.Breathingitincanirritate lungs.Drysoilalsokick-startsthegrowthofaharmfulfungus.It causesadiseasecommonlyknownasvalleyfever.Ateamofscientistsfoundalinkbetweenthenumberof  valleyfevercasesinCaliforniaandArizonaandsoil-moisturelevelsthefallandwinterbefore.Theirreport was in GeoHealth  in 2017. Scientistsdescribeanorganismthatcanspreaddiseaseasavector.Insects,ticksandvariousother animalscanbeculprits.Climatechangewillaffectwheresuchvectorsthrive,notesAnna-SofieStensgaard. She’s a disease ecologist at the Natural History Museum of Denmark in Copenhagen. Forinstance,sheandhercolleagueslookedathowclimatechangemightaffectthreetypesof  parasiticworms.Thesewormscauseschistosomiasis(Shis-toh-so-MY-uh-sis).Thediseaseaffectsmorethan 200millionpeopleworldwide.Infectedchildrengrowweakandpoorlynourished.Theyalsomaydevelop learning problems. Theteamexaminedclimatedataandexperimentalevidenceonhowtemperatureaffectsthesnails thathosttheseparasites.And,shenotes,“Itisnotjustamatterofwarmerequalsmoredisease.”For instance,warmingmightbringsomeareasofAfricafewercasesofschistosomiasis.Butthatwarmingmight alsospreadtheseinfectionstoplacesthathadn’tseenthediseasebefore.Thosenewsiteswillmainlybeat theedgeofcurrenthigh-riskregions.RecentcasesthatpoppedupinsouthernEuropecouldbethefirstsign of this spread, Stensgaard suggests. Her team’s study appeared in the February 2019 issue of  Acta Tropica . Manyinsectscarrydisease.That’swhy“anychangetoclimateisexpectedtohaveabiginfluenceon theimportanceanddistributionofinsect-bornediseases,”saysJenniferLord.She’sabiologistatthe LiverpoolSchoolofTropicalMedicineinEngland.Oneofherrecentstudieslookedathowthatwilllikelyplay outfortsetseflies.Theseinsectscarrytheparasitesthatcausesleepingsicknessinpeopleandnaganain cattle. Both diseases can be deadly.   Lordandotherscientistsbuilta computermodel   basedonthefly’sbiology.Theyalsoanalyzed27 yearsofclimatedataandtsetse-flycountsfromManaPoolsNationalParkinZimbabwe.Thisparkisina valley,soit’swarmerthanhigher-altitudeareasnearby.Themodelpredictedtemperaturestoclimboverthe nextseveraldecades.Italsoprojectedthepark’sflypopulationwoulddrop.Theteamexpectsthattrendwill continue. Butwhatcouldhappenoutsidethepark,athigherelevations,isworrisome.“Risingtemperatures mayhavemadesomehigher,coolerareasofZimbabwemoresuitablefortsetse,”Lordsays.Manyofthose placesdon’thavethefliesnow.Buttheydohavemanymorepeopleandcattlethanthevalleydoes.So,she notes, “Any arrival of tsetse there may increase disease.” Awarmerclimatealsomaydrivedisease-carryingmosquitosintonewregions,includinghigher elevationsthatusedtobetoocoolforthem.Someofthosemigratingmosquitosarelikelytospreadmalaria to those higher-altitude sites. That’s the conclusion of one 2014 study in Science . Malariaparasitesattacktheliverandbloodcells.Peoplewithmildcasessufferwithfevers, headachesandchills.Inworsecases,thebloodcan’tcarryenoughoxygen.Sometimesmalariaalsoattacks thelungsandbrain.Roughly435,000peoplediedfromthediseasein2017,notestheWorldHealth Organization. Mosquitoescanalsocarrydengue(DEN-gay)intonewareas.Thisviruscausesfeversandseverejoint pain.Mostnewareasarelikelytobenexttoorneartoplaceswherethemosquitoeslivenow.Thisshift wouldpresentriskstopeopleonallcontinentsexceptAntarctica,noteEbiattheUniversityofWashington and a colleague. They published their 2016 study in Environmental Research . Similarshiftsmayoccurforotherdiseasesaswell.Butthere’snoone-size-fits-allforecast.That’s becausedifferentspecieswillnotallrespondthesamewaytochangesintheirenvironment.Ingeneral, though,low-incomecountrieswillbehitthehardest.Andwithinthoseplaces,women,childrenandthe elderly are expected to fare worst.
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