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Potential Relationships between exposure situations and disease conditionsHealth condition of
concernExposure situations
PollutedAir
Excreta andhouseholdwastes
Polluted water ordeficiencies in watermanagement
Pollutedfood
Unhealthyhousing
Globalenvironmentalchange
Acute respiratoryinfections
‚ ‚
Diarrhoeal diseases ‚ ‚ ‚
Malaria and othervector-bornediseases
‚ ‚ ‚ ‚
Other infections ‚ ‚ ‚ ‚
Cancer ‚ ‚ ‚
Cardiovasculardiseases
‚ ‚
Mental disorders ‚
Chronic respiratorydiseases
‚ ‚
Injuries andpoisonings
‚ ‚ ‚ ‚ ‚
Source: The World Health Report 1998. Life in the 21st Century – A Vision for All (NB: last column modified )
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‚
‚
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Source Activities
Emissions
Environmental Concentration
Air Water Food Soil
Exposure
External Exposure
Dose
Early/ Subclinical
Moderate/ Clinical
Advanced/ Permanent
Health Effects
Traditional hazards Modern hazardsHuman activitiesNatural phenomena
Developmentactivities
Drivingforce
Pressure
State
Exposure
Effect
ActIons
Health and environment cause-effect framework
Actions
Pressure GHG emissions
State Climate variability and change
ExposureHeatwaveswindstorms,floods, droughts
Food, water-vector-borne infections
Foodshortage
Airpollution
Effect CVDRespiratory
Mal-nutrition
Infectiousdiseases
InjuriesDrownings
Mentalhealth
Global,national,monitoring
National,internationalagencymitigation,adaptationstrategies
Treatment
Internationalagreements; Nationalpolicies
DPSEEA: Climate and Health
Drivingforces
Population growth
Developmentpolicies
Transport, Energypolicies
Health impacts
Human health impacts and vulnerability to climate change
Agriculture impacts
Forests impacts
Water resources impacts
Impacts on coastal areas
Species and natural areasClimateClimatechangechange
Adaptive
capacity
Regional weatherchanges
•Heatwaves•Extreme weather•Temperature•Precipitation
•Contamination pathways•Transmission dynamics•Food availability•Migration
Temperature relatedillness and death
Extreme weather related health effects
Air pollution relatedhealth effects
Water and food bornediseases
Vector and rodent borneDiseases
Psychological effects
MalnutritionResearch
Moderating influences
Adaptationmeasures
Climate Change
Pathways by whichclimate changeaffects health
Adapted from Patz et al, 2000
Health effects
Causal web: Climate variability and diarrheal disease
Drought
Floods
Unsafe and limitedwater
Hygiene difficult
Nutritional deficiencies
Temperatureincrease
Contamination from pitlatrines, septic tanksand sewage systems
Debris and carcasses inrivers
Failure of watertreatment facilities
Food spoilage
Algal blooms
Climatevariability
Diarrhealdisease
Current and future actions:
•Global, regional burden of disease assessment•Assessing early health impacts of climate change
•National health impact assessment guidelines•National adaptation strategies for health
•Pilot warning system projects (e.g. heatwaves)
•Joint WHO/UNEP/WMO activities:Capacity buildingInformation exchangeResearch promotion
Adaptive actions for the health sector:
primary adaptive measures: actions taken to prevent the onset of disease arising from environmental disturbances, in an otherwise unaffected population (e.g. supply of bed nets to all members of a population at risk of exposure to malaria, early warning systems, integrated environmental management)
secondary adaptive measures: preventive actions taken in response to early evidence of health impacts (e.g. strengthening disease surveillance and responding adequately to disease outbreaks)
tertiary adaptive measures: health-care actions taken to lessen the morbidity or mortality caused by the disease (e.g. improved diagnosis and treatment of malaria)
Impact Primary adaptive measures Secondary adaptive measures
Heat -Heatwave warning systems -Health personnel educated tostress -Urban planning detect and treat heat stress
Extreme -Disaster preparedness and mitigation -Disaster responseweather -Early warning systems events -Disaster protection measures
Infectious -Integrated environmental -Disease surveillance anddiseases management monitoring
-Control of vector-, food- and water- borne diseases
Examples of primary and secondary adaptive measures to reduce health impacts
Impact Primary adaptive measures Secondary adaptive measures
Food -International mechanisms of -Monitoring and surveillancesecurity agriculture, trade and finance -Implementation of nutrition
-Seasonal climate forecasting action plans -Famine early warning systems -National and local agriculture measures
Water -Pollution reduction and control policies -Monitoring and surveillance -Demand management and water -Capacity building allocation policies -Waste water treatment -Economic and regulatory measures to increase irrigation efficiency -Capacity building
Examples of primary and secondary adaptive measures to reduce health impacts
climate Change and Adaptation Strategies for Human health (cCASHh)
V ulnerability A ssessment to E xtreme W eather E vents ,of V ector B orn D iseases , of W ater Food born D iseases
E pidemiologal
EvaluationWHO
LSHTM
NIPH
SU
dWd
E conomic
A ssessment
Feem
P olicy
A nalysis
WHO
Current available datasets, Monitoring resultsResearch results
I ntegrated
A ssessment
ICIS
dWd
Outreach
Framework for adaptation Pik