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Health Effects of Climate Change in the UK HEALTH EFFECTS of CLIMATE CHANGE in the UK PREFACE

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Health Effects of Climate Change in the UK HEALTH EFFECTS of CLIMATE CHANGE in the UK PREFACE Health Effects of Climate Change in the UK HEALTH EFFECTS OF CLIMATE CHANGE IN THE UK PREFACE There is growing and widely accepted evidence that the climate of the earth is changing, in part due to human activity. It is also becoming clear that climate change will affect health.This effect will be felt more strongly in some countries than others but there is a clear need to understand the likely effects in the UK in order to develop strategies to mitigate such effects and to understand the extent of adaptation that may occur. In addition, the increased burden likely to be imposed on the National Health Service should be understood.The need for medical facilities to cope with the increased demands produced by more patients suffering from familiar disorders such as heat stroke or skin cancer and perhaps from comparatively unfamiliar disorders such as malaria and Lyme disease, should be addressed. It is clearly important that the impacts on health should be addressed both qualitatively and quantitatively. It is appreciated that considerable effort has been put into the former and that the list of potential problems has been well defined. The quantitative approach has, however, lagged behind. At the request of Ministers at the Department of Health the Expert Group on Climate Change and Health in the UK was formed in early 1999.The group included experts from the meteorological and climate change fields and also from physiology,public heath, epidemiology and microbiology.A series of meetings were held to identify key areas of concern and, in particular, those areas likely to be susceptible to quantitative study and analysis. It was not the purpose of the group to predict the likely extent of climate change in the UK. It was recognised that a set of widely accepted climate change scenarios for the UK had already been developed under the UK Climate Impacts Programme (UKCIP).The existence of the UKCIP has been an important factor in enabling the work of this group to proceed smoothly. The group adopted the UKCIP climate scenarios for the 2020s, 2050s and 2080s and considered the likely impact of variables such as increased temperatures, increased storminess and raised sea levels on health. Both primary effects, for example, the direct effects of warmer summers, and secondary effects, for example increased prevalence of ticks and insect vectors of disease, were considered. It was accepted from the outset that this report would represent only a first look at a difficult problem. It was agreed that a preliminary analysis, carried out over a short period leading to a series of tentative conclusions and firm recommendations should further work be considered necessary, would be the aim of the group. It is recognised that new studies in a number of relevant areas, underway during the preparation of this report, are nearing completion and will need to be taken into account. That the work was completed in such a short time reflects the commitment and expertise of the group: the Department of Health is grateful for the time and effort that members of the group devoted to this work. The Department is also grateful to the staff of the MRC Institute for Environment and Health who carried the administrative burden of producing the report and aided members throughout: Emma Green and Emma Livesley made particularly important contributions. Julia Cumberlidge, Emma Jenkins and Claire Townsend have also made important contributions. The report was completed in 2000 and published for comment, in early 2001.A small number of individuals and organisations commented upon the report. The tone of the comments was favourable though some omissions and a few errors were detected.The time allowed for comment was extended at the request of several organisations. Details of individual comments are available on request from the Department of Health. [Miss Emma Jenkins, Department of Health, Skipton House (693D), 80 London Road, London SE1 6LH] A small editorial group was set up in late 2001 to consider the comments that had been received and to amend and correct the text. Once this work had been completed the Report was published in its final form. The findings of the Report are summarised in the Executive Summary. The overall picture is worrying. Research to refine the preliminary estimates of effects provided here and to probe effects of climate change that we have not been able to consider is clearly needed: recommendations have been responded to by Government Departments.The case for studies of methods of mitigation of the predicted effects is strong.That efforts should be made to reduce the likely extent of climate change goes without saying - that such climate change will pose a challenge to health in the UK during the coming century is equally clear. Dr R L Maynard Department of Health Contents Page No. EXECUTIVE SUMMARY 7 1 INTRODUCTION 11 1.1 The relationship of the health effects report M McKenzie-Hedger and M Gawith with the UK climate impacts programme 14 M Hulme, G Jenkins, N Brooks, 1.2 What is happening to global climate and D Cresswell, R Doherty, C Durman, why?J Gregory, J Lowe, and T Osborn 18 2 PUBLIC PERCEPTION OF THE HEALTH IMPACTS J Murlis and G Davies OF CLIMATE CHANGE 50 2.1 Introduction 50 2.2 Public understanding of climate change 51 2.3 Public perspectives on environment and health 52 2.4 Health and the global environment 53 2.5 Conclusions 53 3 METHODS TO ASSESS THE EFFECTS OF AJ McMichael,A Haines CLIMATE CHANGE ON HEALTH and RS Kovats 55 3.1 Introduction 55 3.2 Methods available for estimating the effects of climate change on health 57 3.3 Use of scenarios 63 3.4 Uncertainty analysis 63 3.5 Adaptation 64 3.6 Monitoring and surveillance 65 3.7 Discussion and conclusions 66 3.8 Research needs 67 4 OVERVIEW OF CLIMATE CHANGE IMPACTS ON HUMAN HEALTH IN THE UK 70 4.1 Heat-and-cold-related mortality and morbidity and G Donaldson, RS Kovats WR Keatinge and climate changeAJ McMichael 70 4.2 Food poisoning and climate changeG Bentham 81 Page No. DJ Rogers, S Randolph, 4.3 Vector-borne diseases and climate changeS Lindsay and C Thomas 85 4.4 Water-borne diseases and climate changeR Stanwell-Smith 120 PJ Baxter, BE Lee, 4.5 Windstorms and climate changeTA Wyatt and RJ Spence 134 PJ Baxter, I Moller, 4.6 Flooding and climate changeT Spencer, RJ Spence and S Tapsell 152 HR Anderson, 4.7 Air pollution and climate changeRG Derwent and J Stedman 193 4.8 UV radiationG Bentham 218 5 SECONDARY IMPACTS OF MITIGATION J Murlis and M McCarthy 229 5.1 Introduction 229 5.2 UK policy on reducing greenhouse gases 229 5.3 Energy supply industry 230 5.4 Business (including manufacturing and commercial sectors) 231 5.5 Transport 231 5.6 Domestic sector 231 5.7 Agriculture, forestry and land use 232 5.8 Public sector 232 5.9 Conclusion 233 6 RECOMMENDATIONS FOR FURTHER WORK 235 ANNEX: Members of the Expert Group on Climate Change and Health in the UK 237 Executive Summary 1. The Department of Health asked the Expert Group on Climate Change and Health in the UK to advise on the likely effects of climate change on health in the United Kingdom (UK). This report presents the Group’s findings.The available evidence has been examined and it has been concluded that climate change will have a significant effect on health in the UK. The various features of the changing climatic pattern of the UK will affect health in different ways and not all the effects are likely to be negative. The probable warming of our winters, for example, is likely to be associated with a decline in winter mortality.On the other hand, a rise in sea level and an increase in the frequency of severe winter storms will make flooding of low- lying coastal areas more likely. Our examination of the evidence has led to a number of conclusions and recommendations; these are summarised below. One significant conclusion is presented here. It is recognised that far too little is known of the likely effects of climate change on health in the UK and we recommend that an expanded research programme should be put in hand as a matter of urgency. 2. The current review of evidence has been based on data provided by the UK Climate Impacts Programme (UKCIP).These data have been invaluable and the staff of the UKCIP have played an important part in the work of the Group.We do not seek here to summarise the work of the UKCIP - this has been presented elsewhere.The climate scenarios produced by UKCIP for the UK in the 2020s, 2050s and 2080s have been used and the implications of the changes in the UK climate indicated in these scenarios have been considered. It is clear that climate in the UK is changing and will continue to change: UK winters will become less cold but wetter, summers will become warmer and probably drier in some places.Whilst the overall frequency of gales may not change greatly, the frequency of severe winter gales is likely to increase and this, in combination with an increase in sea level may cause severe flooding in low lying coastal areas.We note, with concern, the difficulties inherent in predicting changes in the UK climate and recognise the possibility of non-linearities in the pattern of climate change. For example, melting of the Antarctic ice cap or a significant change in the thermohaline circulation of the oceans could produce profound effects.We accept however, that such events though possible, are unlikely,and have excluded them from our analysis.
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