2_Prof Hari Kusnanto - Climate Change and Impacts on Health in Indonesia

8/13/2019 2_Prof Hari Kusnanto - Climate Change and Impacts on Health in Indonesia

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Health Impact of Climate Change:

What are the Research Gaps?Hari Kusnanto

Center for Environmental Studies

and Faculty of MedicineGadjah Mada Universty



CLIMATE CHANGE:

changes in mean climatic

conditions and variability:

temperature, precipitation,humidity, wind pattern

Anthropogenic

Green House Gas

Emission

MITIGATION

Natural Climate

Forces

Extreme

Weather Events

Disrupted

Ecosystems

Sea Level Rise,

Salination of

Fresh Water,

Storm Surges

Environmental

Degradation

ENVIRONMENT

EFFECTS

HEALTH

EFFECTS

Thermal stress,

Injuries from

storms, flood

Less food yields

Microbial

proliferation, food

poisoning, unsafewater

Changes in vector

pathogen

Impaired crops,livestock, and

fisheries yields

Displacement,

poverty, mental

healthADAPTATION

McMichaeli et al., 2006

(The Lancet 367:859-869)



Human Health Impact:

Increased risk of heatwave-related health impacts Continued cold-related health effects, in particular

where access to energy is scarce

Increased flood related impacts, including landslide

Increased malnutrition in areas already affected(drought)

Changes in food-borne disease patterns

Changes in distribution of infectious diseases,

including vector-borne diseases Increased in waterborne diseases, in particular where

water, sanitation and hygiene standards are low

Increased frequency of respiratory disease from

atmospheric pollution and allergenic pollen



Increased Risk of Heatwave-related Health

Impacts and Cold-related Health Effects

Wang, J., Williams, G., Guo, Y., Pan, X., Tong, S. 2013Maternal exposure to heatwave and preterm birth in Brisbane,

Australia, Br i t ish Jo urnal of Obstetrics and Gynaecology

120(13):1631-1641.

Astrom, D.O., Forsberg, B., Edvinsson, S., Rocklov,

J. 2013. Acute fatal effects of short-lasting extremetemperatures in Stockholm, Sweden: evidence

across a century of change, Epidemiology 24(6):820-

829.

Heatwave was significantly associated with preterm birth: the

associations were robust to the definitions of heatwave. Thethreshold temperatures, instead of duration, could be

more likely to influence the evaluation of birth-related heatwaves.

Unlike for heat extremes, there was no decline in the

mortality with cold extremes over time



Flood Related Impact and Drought Related Effects

Nguyen, K.V., James, H. 2013. Measuring household resilience

to floods: a case study in the Vietnmanese Mekong River Delta,

Ecology and Society 18(3): art. no. 3.

(1) households'confidence in securing food, income, health, and

evacuation during floods and recovery after floods; (2) households'

confidence in securing their homes not being affected by a large flood

event such as the 2000 flood; (3) households' interests in learning and

practicing new flood-based farming practices that are fully

adapted to floods for improving household income during the flood

season

Rodysill, J.R., Russel, J.M., Crausbay, S.D., Bijaksana, S., Vuille,

M., Edwards, R.L., Cheng, H. 2013. A severe drought during the

last millenium in East Java, Indonesia, Quaternary Science

Review 80:102-111.

severe multidecadal drought in East Java throughout the turn of the

19th century was driven by locally reduced convection resulting from a

combination of heightened El Niño activity and volcanic

eruptions.



Changes in food-borne disease patterns

Little change has been observed in the incidence of

foodborne climate-related diseases in Bahrain with

highest rates in the summer season

Hamadeh, R.R., Al Roomi, K., Al Sayyad, A.S. 2013. Foodborne

climate-related diseases in Bahrain, Journal of the Bahrain

Medical Society 24(3):105-107.

Griibovski, A.M., Bushueva, V., Boltenkov, V.P., Buzinov, R.V.,

Degteva, G.N., Yurasova, E.D., Nurse, J. 2013. Climate variations

and salmonellosis in northwestern Russia: a time series

analysis, Epidemiology and Infection 141(2):269-276.

Higher temperatures were associated with higher

monthly counts of salmonellosis while the association

with precipitation was less certain



Forecasting dengue incidence (data from Yogyakarta Province) -

a time series Poisson multivariate regression model using

monthly mean temperature and cumulative rainfall as

predictors



Survival rates of Ae. aegypti following exposure to

an infectious blood meal as a function of diurnal

temperature range

Lambrechts L et al. PNAS 2011;108:7460-7465

large temperaturefluctuations will reduce

the probability of vector

survival through longer

extrinsic incubation

period and expectation

of infectious life

at mean temperatures <18 °C,DENV transmission increases as

DTR increases, whereas at mean

temperatures >18 °C, larger DTR

reduces DENV transmission.



Morin et al., 2013



Water-borne and respiratory diseases

Cann, K.F., Thomas, D.R., Salmon, R.L., Wyn-Jones, A.P., Kay, D.

2013. Extreme water-related weather events and waterbornedisease, Epidem io logy and Infect ion 141(4):671-686.

The most common pathogens reported in these outbreaks were

Vibrio spp. (21.6%) and Leptospira spp. (12.7%).

Outbreaks following extreme water-related weather events

were often the result of contamination of the drinking-watersupply (53.7%)

Li, P., Xin, J., Wang, Y., Shang, K., liu, Z., Li, G., Wang, M. 2013.

Time series analysis of mortality effects from airborne

particulate matter size fractions in Beijing, Atmospher icEnvi ronment 81:253-262.

Our analyses conclude that temperature and particulates,exposures to both of which are expected to increase with

climate change, might act together to worsen human health in

Beijing, especially in the cool seasons



Crabtree, A. 2012. Cimate change and mental health following

flood disasters in developing countries, a review of theepidemiological literature: what do we know, what is being

recommended, Au strasial Journal of Disaster and Trauma

Studies 1:21-30.

All studies show that there are serious mental healthproblems following flooding events and this gives us good

grounds to mainstream mental health issues in disaster

response



RESEARCH GAPS?Huynen, M.M.T.E., Martens, P., Akin, S.M. 2013.

CLIMATE CHANGE: AN AMPLIFIER OF

EXISTING HEALTH RISKS IN DEVELOPING

COUNTRIES

Environment Development and Sustainability

15(6):1425-1442

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2_Prof Hari Kusnanto - Climate Change and Impacts on Health in Indonesia