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Climate Change and Stratospheric Ozone Depletion Early Effects on Our The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its publications programmes. Through its publications, the Organization seeks to support national health strategies and address the most pressing public health concerns. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces some 870 million people living in an area stretching from Greenland in the north and the Mediterranean in the south to the Pacific shores of the Russian Federation. The European programme of WHO therefore concentrates both on the problems associated with industrial and post-industrial society and on those faced by the emerging democracies of central and eastern Europe and the former USSR. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health. Climate change and stratospheric ozone depletion Early effects on our health in Europe This review was prepared with the support of the Swiss Agency for the Environment, Forests and Landscapes. WHO Library Cataloguing in Publication Data Climate change and stratospheric ozone depletion : early effects on our health in Europe / edited by Sari Kovats...[et al.] (WHO regional publications. European series ; No. 88) 1.Climate 2.Environmental health 3.Greenhouse effect 4.Heat – adverse effects 5.Ozone 6.Ultraviolet rays – adverse effects 6.Forecasting 7.Communicable diseases 8.Europe I.Kovats, Sari II.Series ISBN 92-890-1355-9 (NLM Classification: WB 700) ISBN 978-92-890-1355-0 ISSN 0378-2255 Text editing: David Breuer Cover illustration: Paola Chartroux World Health Organization Regional Office for Europe Copenhagen Climate change and stratospheric ozone depletion Early effects on our health in Europe Edited by Sari Kovats, Bettina Menne, Anthony McMichael, Roberto Bertollini and Colin Soskolne WHO Regional Publications, European Series, No. 88 ISBN 92-890-1355-9 ISBN 978-92-890-1355-0 ISSN 0378-2255 The Regional Office for Europe of the World Health Organization wel- comes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Publications unit, WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark, which will be glad to provide the latest information on any changes made to the text, plans for new edi- tions, and reprints and translations already available. © World Health Organization 2000 Publications of the World Health Organization enjoy copyright protec- tion in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concern- ing the legal status of any country, territory, city or area or of its authori- ties, or concerning the delimitation of its frontiers or boundaries. The names of countries or areas used in this publication are those that ob- tained at the time the original language edition of the book was pre- pared. The mention of specific companies or of certain manufacturers’ prod- ucts does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The views expressed in this publication are those of the authors and do not necessarily represent the decisions or the stated policy of the World Health Organization. PRINTED IN DENMARK Contents Page Foreword ...................................................................................................... vii Preface .......................................................................................................... ix Executive summary ..................................................................................... xi Introduction ................................................................................................... 1 Initiatives on climate change and human health ..................................... 3 1. Climate change in Europe ...................................................................... 7 Climate in Europe ..................................................................................... 7 Observed changes in climate .................................................................... 9 Projections of future climate change ...................................................... 13 Rise in sea level ....................................................................................... 14 Impact of climate change on water resources ......................................... 15 Stratospheric ozone depletion ................................................................ 17 2. Effects on health of climate change in Europe ................................... 21 Thermal stress .......................................................................................... 24 Climate change and urban air pollution ................................................. 28 Aeroallergens ........................................................................................... 29 Extreme weather ...................................................................................... 30 Foodborne diseases.................................................................................. 33 Water-related diseases ............................................................................. 34 Vector-borne diseases .............................................................................. 36 Rodent-borne diseases............................................................................. 49 Pest species .............................................................................................. 50 Effects on food supply............................................................................. 50 3. Health effects of stratospheric ozone depletion .................................. 53 Skin cancer .............................................................................................. 53 Damage to the eye ................................................................................... 56 The immune system ................................................................................. 56 4. Early effects of climate change on human health ............................... 59 5. Action to reduce the health effects of climate change ......................... 63 Mitigation to reduce or prevent climate change .................................... 63 Secondary health benefits of mitigation policies .................................. 66 Adaptation strategies to reduce the potential effects on health of climate change in Europe ............................................... 67 Monitoring and surveillance .................................................................. 68 Intersectoral issues................................................................................... 77 Research and policy ................................................................................ 77 6. Conclusions ............................................................................................ 79 References .................................................................................................... 81 Annex 1. Policy document prepared for the Third Ministerial Conference on Environment and Health, London, 16–18 June 1999.......................................................................... 97 Annex 2. Members of the Working Group on the Early Human Health Effects of Climate Change and Stratospheric Ozone Depletion in Europe ....................................................... 115 Foreword Many people in Europe are concerned about the impacts of climate change and stratospheric ozone depletion on human health. A warm- ing trend and stratospheric ozone depletion have been observed in Europe over the last four decades. The European Environment and Health Committee identified the need to assess these topics in 1997, as part of the lead-up to the Third Ministerial Conference on Envi- ronment and Health, held in London in June 1999. This review is the result. It is based on the deliberations of technical experts at two meetings in 1998, a review of current available science on the health effects of climate change and stratospheric ozone depletion within the European Region, and further technical input since the Confer- ence. Understanding what effects environmental changes could have on the health of the European population was the principal driving force behind the review. It clearly points out that there is still sub-
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