Category: Health

Building Climate Resilience to Extreme Heat During COVID-19

Building Climate Resilience to Extreme Heat During COVID-19

By Anjali Jaiswal, Kim Knowlton, Vijay Limaye

This blog originally appeared on the NRDC website.

As we celebrate the 50th anniversary of Earth Day, the coronavirus pandemic puts a spotlight on climate change and health. Temperatures are already rising to 40°C (104°F) while the countries’ 1.3 billion people remain on lockdown. Government officials and health care professionals in India are actively diligently working to contain the spread of COVID-19 while also initiating efforts to protect communities from imminent heat waves through Heat Action Plans and Cool Roofs. NRDC and partners that are leading this work have recently been selected as finalists for the prestigious 2020 Ashden Awards, which recognize pioneering sustainability solutions.

India’s 2020 Heat Season

Brutally hot weather is a major health threat in India and many other parts of the world. Climate change is fueling more frequent, intense, and longer heat waves. The COVID-19 emergency worsens the response to heat-related illness since hospitals and urban health centers are already stressed. In response to this mounting threat, cities and regions across India are taking concrete actions to build resilience and better prepare and protect communities.

Heat is not merely an inconvenience; it kills. Symptoms of heat-related illness include vomiting, headaches, dehydration, and diarrhea. Staff in hospitals, businesses, and municipal buildings often struggle to keep communities cool and healthy. The number of high-temperature days in India has increased over the past fifty years, and especially since the 1990s, in highly-populated cities, such as Mumbai and New Delhi.

The India Meteorological Department (IMD) and National Disaster Management Authority (NDMA) are already working to prepare and respond to anticipated heatwaves. NDMA is also charged as the central agency responsible for COVID-19 response, making the burden of this season even heavier. For the 2020 heat season, IMD’s seasonal forecast shows the heat wave conditions are likely to be severe. NDMA has already activated the network of state disaster response agencies and city leaders to prepare for the soaring temperatures, including an updated list of Do’s and Don’t’s.

Heat Action Plans and Cool Roof Program

NRDC and a broad set of partners, including the Public Health Foundation of India – Indian Institute of Public Health-Gandhinagar (PHFI-IIPH-G) work with government leaders and key experts across India and internationally to develop, launch, and implement heat action plans. Heat action plans are a comprehensive plans for building climate resilience to extreme heat events through public awareness and community outreach; early warning system and interagency coordination; capacity building among health care professionals; and reducing heat exposure and promoting adaptive measures.

A peer-reviewed and published study found that Ahmedabad, one of India’s largest cities, avoided an estimated 1,190 deaths each year after implementing the country’s first Heat Action Plan. The Ahmedabad Heat Action Plan was originally released in 2013 and developed by NRDC, IIPH-G and partners. Heat Action Plans have since expanded to over 23 states and over 100 cities and districts through the leadership of NDMA.

An important component of heat action plans includes cool roofs. Cool roofs reflect sunlight and absorb less heat. Depending on the setting, cool roofs can help keep indoor temperatures lower by 2 to 5°C (3.6 – 9°F) as compared to traditional roofs. They are cost effective solutions that work to protect vulnerable groups and slum communities.

Cities, states and the national government are taking steps to protect communities and save energy costs, through cool roof programs. For example, Ahmedabad has started a cool roofs program for over 15,000 buildings as part of its heat action plan this year, focusing on slum households and city-owned buildings. Building on its initial pilot program two year ago, Hyderabad now has a draft statewide policy as part of its building efficiency program. The national government is working towards sustainable cooling for all with the India Cooling Action Plan, which includes promotion of passive cooling techniques such as cool roofs and energy efficiency programs for buildings, air conditioners and fans.

Ashden Cool Cities Award Finalist

The Ahmedabad Heat Action Plan, along with its cool roofs program, is among the two finalists up for the award in the Cool Cities category, as highlighted in the Ashden blog earlier this month. We are honored to share the nomination with a women-led architecture firm ECOnsult, keeping farm workers in the Egyptian desert cool.

The Ashden Cool Cities Award, sponsored by K-CEP and Climateworks, emphasized the link between the COVID-19 pandemic and the climate crisis because “those already disadvantaged are most at risk”. That is why the Ashden finalists include organizations helping the most vulnerable. Ashen also highlights another link between the two emergencies and theme for the finalist: “How all of us, whatever our wealth or status, can come together to create change that benefits everyone.”

NRDC is deeply humbled to share the Ashden nomination with the many partners who contribute to effective Heat Action Plans and Cool Roofs Programs. We congratulate all of our partners and their unique roles.

Many cities, states and institutions around India also contributed to the effectiveness of Heat Action Plans, including public and private hospitals, urban health centers, link works, 108 ambulance response services and more. Several international experts also contributed to the Heat Action Plans and Cool Roofs, including deep expertise from the University of WashingtonMount Sinai Icahn School of Public Health, and Georgia Tech Institute of Technology, as well as, NYC Cool RoofsNational Ocean and Atmospheric AgencyGlobal Heat Health Information NetworkIndo-US Science and Technology Forum, the Climate Development and Knowledge Network, among others.

As climate change continues to fuel brutal heat waves worldwide, effective public health response strategies are more important than ever before. Drawing on the strengths of government leadership, efficient interagency coordination, scientific expertise, robust communication programs, effective community engagement, strong action on heat preparedness can deliver lifesaving benefits. In discussing the commonality between the coronavirus emergency and climate crisis, Shloka Nath with TataTrusts recently reminded us, “The only boat that is going to save us, is the boat we build together.”

Cover photo from Climate Visuals.
Heatwaves too hot and wet for human life are here

Heatwaves too hot and wet for human life are here

By Tim Radford

Scientists who have repeatedly warned of future lethal conditions of temperature and humidity caused by heatwaves in a world of climate change have grim news: that future has already arrived.

They have combed through local records to identify thousands of episodes in which the dangerous combination of high temperatures and high humidity has risen to levels at which humans could not in theory survive for long. These have happened in Asia, Africa, South and North America and Australia.

More than a dozen such episodes have already been recorded around the Persian Gulf, a region that – researchers warned years ago – could one day become deadly for outdoor workers.

These outbreaks of both sweltering heat and stifling humidity have, researchers report in the journal Science Advances, so far been confined to localised areas and have lasted only hours, but they are now increasing in frequency and intensity.

There are many ways in which extreme heat can lead to death – one group has identified as many as 27 – but at its simplest, a species adapted to maintain a stable temperature by shivering when cold and perspiring when too hot can be overwhelmed by very high temperatures, or in conditions in which the body can no longer lose heat because the air is too moist for perspiration to evaporate.

Scientists measure such hazards by what they call a “wet bulb” temperature, and even the strongest and best adapted humans cannot work safely outdoors when this hits 32°C.

Potentially fatal readings identified in hourly reports from 7,877 weather stations between 1979 and 2017 confirm that such temperatures have already reached dangerous levels – and even as high as 35°C – in Saudi Arabia, Doha in Qatar, in the United Arab Emirates, in Texas, Louisiana, Mississippi, Alabama and Florida in the US, India and Bangladesh, south China, northwest Australia and Iran.

Researchers began warning years ago of the notional threat of extreme heat and extreme humidity in a world in which humans continue to burn fossil fuels and increase greenhouse gases’ concentrations in the atmosphere, and repeated studies have confirmed the reality of the hazard.

Humans cannot survive outdoor “wet bulb” conditions of 35°C for long. The number of readings beyond 30°C has doubled since 1979. There have been 1,000 readings of 31°C and 80 of 33°C.

“Previous studies projected that this would happen several decades from now, but this shows it’s happening right now,” said Colin Raymond, who completed the research at the Lamont-Doherty Earth Observatory at Columbia University, but who is now at Nasa’s Jet Propulsion Laboratory.

“The times these events last will increase, and the areas they affect will grow, in direct correlation with global warming.”

This article was originally posted on the Climate News Network.
Cover photo by Kevin Krajick/Earth Institute.
Extreme summer heat puts millions at risk

Extreme summer heat puts millions at risk

By Tim Radford

Summer on much of the planet could get too hot for comfort by the end of the century, with more than a billion people seriously affected by extreme heat.

As many as 1.2 billion people could be at risk of serious medical stress by the year 2100 simply on the basis of the extreme summer temperatures forecast if greenhouse gas emissions continue to rise, according to new research.

The finding is, in essence, a confirmation of earlier studies: researchers looked closely at the threat to health and, indeed, to life in a globally-heating world have already made a calculation that “more than a billion” could be at risk not just from soaring summer temperatures over longer periods, but also from heightened humidity.

Urgent question

One study found that heat extremes can kill in up to 27 different ways. And lethal heat waves in Europe in 2003, Russia in 2010 and Australia in 2012/2013 have confirmed this in the most unwelcome way possible.

But a study published in Environmental Research Letters journal takes a simple statistical approach to this increasingly urgent question and settles on a notional temperature that factors in not just how high the mercury rises but also how much water vapour might be in the air.

This is known to meteorologists as a “wet bulb” temperature. And the consensus is that, for fit, healthy, acclimatised people, a wet bulb temperature of 33°C is about the limit of tolerance – putting the very young, the very old, and the already ill at risk.

“Every bit of global warming makes hot, humid days more frequent and intense”

Humans can survive much higher thermometer readings in dry climates, but are designed to shed surplus body heat through perspiration – something that becomes increasingly difficult as atmospheric humidity begins to rise. Then the risks of heat rash, heat cramps, heat exhaustion and heat stroke begin to multiply.

So researchers in the US looked at how heat and humidity will increase in a warming planet, for the existing population, and played with 40 climate simulations to build up a picture of probabilities as humans burned more fossil fuels, stoked levels of greenhouse gases in the atmosphere, and turned up the planetary thermostat.

They calculated that, by 2100, the numbers at risk of sweltering, gasping and sickening heat extremes will have multiplied.

The planet is already around 1.2°C warmer than it was at the start of the Industrial Revolution. If the temperature notches up to 1.5°C above the long-term average for most of human history, then every year an estimated 500 million could be exposed to unsafe extremes.

If the temperature rises by 2°C – the upper limit the world set itself in an historic Paris climate meeting in 2015 – the numbers at risk would reach 800 million.

And if the planetary average annual temperature rise was by 3°C – and right now the planet is on course to exceed even that figure – then an estimated 1.2 billion would at least once a year be at risk of extended spells of dangerous heat and humidity.

Research leader Dawei Li, once of Rutgers University and now postdoctoral associate in the Department of Geosciences at the University of Massachusetts, says: “Every bit of global warming makes hot, humid days more frequent and intense.

“In New York City, for example, the hottest, most humid day in a typical year already occurs about 11 times more frequently than it would have done in the 19th century.”

This article was originally published on The Climate News network.
Cover photo by Chris JL on Flickr.
COVID-19: A dress rehearsal for the climate crisis?

COVID-19: A dress rehearsal for the climate crisis?

By Erin Owain

Today, over a quarter of the world’s population is living under lockdown, with country borders closed, and travel suspended. As social interaction is severely limited and economies are brought to their knees, it is unsurprising that climate change is no longer at the forefront of the global conversation. Officially declared a pandemic by the World Health Organization (WHO) on 11th March 2020, the COVID-19 outbreak has unveiled the complexity of the fundamental systems upon which society relies. In so doing, the virus has exposed the reality that transformational changes are essential for the continuation of human prosperity.

COVID-19 is putting the resilience of our global community and fundamental systems to the test. The  global response is beginning to reveal how the global community could react and respond to the climate crisis, providing an insight into the disruption we are likely to see in the coming decades.

Sally Uren, CEO of Forum for the Future, explores this in a recently published blog – shedding some light on the transformative system change which is essential for tackling the climate crisis.  In the blog, Urenhighlights some of the issues that have been visible during pandemic so far, and which are informative with regards to how society may respond to the climate crisis, and the changes needed to increase the resilience of our global community.

Uren touches on many issues , including the potential for the COVID-19 crisis to be a catalyst for global financial reform as the crisis has shed light on the rigidity of the current financial system and stressed the need for a more agile, responsive system. Furthermore, Uren highlights how we are witnessing significant shifts in society behavior, a growing awareness in personal responsibility and care for the wider global community – shifts which are essential if we are to reach net-zero by 2050 and take control of our global emissions. Moreover, the crisis is shedding light on the need for governments, organisations and businesses to radically transform their integral systems and operating models to build flexible, resilient systems.

Sustainability is essential if we are to build a resilient global community and avoid future catastrophes which will inevitably occur if we choose to continue along the current emissions pathway. Transformational systems change is necessary if we are to tackle the climate crisis.

During such times of crisis, the strength and resilience of the human race is  extraordinary. COVID-19 is an unprecedented test of our resilience as a global community; climate change will  provide a far sterner test for societies and economies, undermining the natural systems on which social and economic stability is built. As Uren suggests, COVID-19 may be a dress rehearsal for the climate emergency.We must learn all the lessons we can, and seize the opportunity to build resilience into the fabric of our societies.

Cover photo by 🇨🇭 Claudio Schwarz | @purzlbaum on Unsplash.
Health-related costs of climate change will add billions to damage assessments

Health-related costs of climate change will add billions to damage assessments

By Dr. Marc Kodack

The recent physical damage and destruction of facilities and infrastructure in the United States, both on and off military installations, e.g., Tyndall Air Force Base, Florida from Hurricane Michael in 2018; Offutt Air Force Base, Nebraska and flooding from the Missouri River in 2019, will cost billions of dollars to repair or replace. Both Hurricane Michael and the Missouri River flooding were likely influenced by climate change. Besides the physical effects of these and other events, there are also health-related costs from climate change that will also affect the populations that live and work on installations, their surrounding communities, and the larger surrounding region. These health care costs will be in the billions of dollars.

To estimate what these climate-related health costs may be, Limaye et al (2019) used data from 10 cases across 11 states that occurred in 2012. The research improves on 2011 research by Knowlton et al. Understanding these costs are important because health costs are regularly absent from the damage assessments prepared for facilities and infrastructure, whether this infrastructure is military or civilian; identifying these costs raises their importance for estimating future health costs and their implications to the holistic damage estimates that climate change is forecasted to cause; and better estimating these costs prepares communities to assess whether the kinds of adaptation efforts they undertake, including those related to health, will return the benefits they anticipate.

Limaye et al focus on considering “morbidity and mortality costs across a range of health impacts in a consistent way, in order to “demonstrate a conceptual framework [and method] for the estimation of other health-related costs linked to climate-sensitive events.” Earlier studies used different methods to estimate health costs making combining the results difficult.

The year 2012 was selected because multiple events of different duration and intensity occurred in different places across the U.S. In addition, morbidity and mortality data were available for each event. While not all of these events have been directly attributed to climate change, these events are consistent with the likely range of direct and indirect climate change effects. The events selected include “wildfires in Colorado and Washington, ozone air pollution in Nevada, heat stress in Wisconsin, infectious disease outbreaks of tick-borne Lyme disease in Michigan and mosquito-borne West Nile virus in Texas, extreme weather in Ohio, Hurricane Sandy (impacts in New Jersey and New York), allergenic oak pollen in North Carolina [increased asthma] and harmful algal blooms on the Florida coast.”

The estimated total health-related costs in 2018 dollars for all the events was almost $10 billion, with a sensitivity range of $2.7-to-$24.6 billion. The two highest estimated cost events were for Hurricane Sandy at $3.2 billion and the wildfires in Washington at $2.3 billion. The $10 billion is likely a conservative estimate. For example, mental health data were only available for Hurricane Sandy and none of the other events. Cases of extreme heat and Lyme disease are usually underreported leading to lower estimates of these costs.

If climate change effects worsen over the next several decades because of inaction to reduce greenhouse gases, the consequences will cost billions of dollars. For example, the National Oceanic and Atmospheric Administration published their annual summary of billion-dollar weather and climate disaster damage events. For 2019, there were 14 separate events with a total cost of $45 billion. For 2015-2019 the total costs exceeded $525 billion. However, these costs do not include the health-related costs associated with these events which would cause these costs to rise by billions of dollars more. Thus, when estimating climate change adaptation costs and benefits, including health-related costs in these estimates would more accurately reflect the potential consequences of climate change to populations across the U.S.

This article was posted on PreventionWeb.
Cover photo by Friends of Earth Scotland, Climate Visuals
Taking action on air pollution at city level to build urban resilience

Taking action on air pollution at city level to build urban resilience

By Emma Marsden and Bulganmurun Tsevegjav 

The Asian Development Bank (ADB) on 8–9 October hosted a regional inception workshop to kick start the implementation of the regional technical assistance titled “Strengthening Knowledge and Actions to Improve Air Quality” (TA 9608) at the ADB headquarters in Manila. The TA addresses urban air pollution, which has become a serious environmental and social problem in many of Asia’s cities, posing a major health risk, among other negative impacts, to their residents, particularly vulnerable groups.

About 98 percent of cities in Asia experience levels of fine particulate matter (PM2.5) beyond the internationally recognized World Health Organization (WHO) air quality guideline.1 Given this high level of exposure, several questions arise: What are the main causes and consequences of urban air pollution in Asian cities? Are national and city governments taking adequate measures to address the problem? How can city governments, including the energy and transport sectors, best tackle urban air pollution at the city level? How can lessons learned and best practices adopted in other countries and cities, such as the People’s Republic of China (PRC), be shared?

These questions sit behind the TA outputs and were at the heart of the dialogues during the regional inception workshop.

Major Sources of Air Pollution Presented in the Workshop. Source: Clean Air Asia. 2014. Mainstreaming Air Quality in Urban Development through South–South Twinning.

Highlights of the workshop

Around 80 participants (40% female) from government, non-governmental organizations, and civil society attended the workshop. Participants included national and city government officials from the five developing member countries (specifically, seven cities) targeted by the TA: Bangladesh (Faridpur), Mongolia (Erdenet), Pakistan (Peshawar and Sialkot), the Philippines (La Trinidad), and Viet Nam (Ho Chi Minh and Vinh Yen). Representatives from WHO and the International Labor Organization, academia, ADB Youth, and international health, energy, transport, and finance experts were also in attendance.

The two-day event was designed so that city-level participants without any technical knowledge of air quality management could benefit from the workshop sessions as much as the experts. The first sessions introduced the basic concepts of urban air pollution, major sources, and how it affects public health.

Conversations around air pollution are often focused on the perception that it is the outside air that is the most polluted. However, participants heard that in some countries indoor air pollution levels can be even higher that outside, and therefore cities also need to address it alongside outdoor air pollution. Policy and legislative, institutional, technological, and financial solutions, including low carbon technologies and the use of market-based instruments for air pollution control, were presented.

Following this, city representatives were given the opportunity to present the urban air pollution challenges they face in their cities and how the TA through its support for developing a Clean Air Action Plan can aid their current efforts.

Overall, the objectives of the remaining sessions were to: 

  • Provide information on the TA including project background, the overall approach, method, scope and deliverables.
  • Introduce the process of Clean Air Action Plan development, including case study examples from Mongolia, the Philippines, and Viet Nam.
  • Provide an opportunity for the country and city representatives to discuss their air quality issues and to prepare a draft of the workplan for development of the City-Level Clean Air Action Plans.

Following the regional inception workshop, city-level inception workshops are being held, from which the City-Level Clean Air Action Plans will be developed. To inform the action plans, the TA will refer to existing baseline data, and the TA team will also collect new data on the air quality situation and undertake analytical studies at the city level to fill in knowledge gaps.

Furthermore, policy and legislative, institutional, technological, and financial solutions will be evaluated, taking on board lessons learned and best practices from other countries and cities, including a technology transfer event planned for the PRC in late 2020.


Image: Indoor Air Quality Can Have a Large Impact on Health Outcomes in Cities. Source: B Tsevegjav, Presentation on Indoor Air Quality: Case from Mongolia. TA 9608 Regional Inception Workshop.

Background of the project

The TA project aims to increase the commitment of the selected countries to improve air quality management, helping the target cities to build a business case for investment through the preparation of City-Level Clean Air Action Plans, and investment plans that will see to its implementation.

The TA has three main outputs (also detailed in the diagram below):

  •  Output 1 focuses on “assessment” of air quality status and capacity for air quality management at city level, including monitoring of air quality levels in secondary cities using low cost monitors, which will help to raise political and public awareness and provide the scientific basis for taking action.  
  • Output 2 is oriented towards “solutions” and is intended to help cities identify applicable and deliverable policy and legislative, technological, and financial solutions to tackle their air pollution sources as identified by Output 1.   
  • Output 3 intends to build on these two outputs to “mainstream air quality management” through the development of City-Level Clean Air Action Plans that are backed by investment roadmaps and have stakeholder buy in.
Image: Key outputs of the ‘Strengthening Knowledge and Actions for Air Quality Improvement’ project

This article was originally posted on the Asian Development Bank’s Livable Cities Blog.
Cover Photo by Holger Link on Unsplash
New-borns face multiple climate health risks

New-borns face multiple climate health risks

By Tim Radford

Today’s world is not a welcoming place for babies, who – across the globe – face multiple climate health risks.

On present trends, any new-born today is likely to live in a world 4°C hotter than it has been all through human history.

On present trends, climate change will affect infant health by reducing the yield and nutritional value of maize, wheat, soybean and rice, to stunt growth and weaken immune systems.

Older children will be at increasing risk from climate-related diseases such as cholera and dengue fever, and adolescents will be at increasing risk from toxic air, driven by fossil fuel combustion and ever-higher temperatures.

And then throughout their lives, today’s newly-borns will be at hazard from increasingly severe floods, prolonged droughts and wildfires.

“This year, the accelerating impacts of climate change have become clearer than ever,” said Hugh Montgomery, who directs the Institute for Human Health and Performance at University College London.

“The world has yet to see a response from governments that matches the unprecedented scale of the challenge facing the next generation”

“The highest recorded temperatures in Western Europe and wildfires in Siberia, Queensland and California triggered asthma, respiratory infections and heat stroke. Sea levels are now rising at an ever-concerning rate. Our children recognise this climate emergency and demand action to protect them. We must listen, and respond.”

Professor Montgomery is a co-chair of the Lancet Countdown, which has assessed research from 120 experts in 35 global institutions on health damage from climate change and the lifelong health consequences of rising temperatures.

The Lancet is one of the world’s oldest and most distinguished medical journals and has already published three important studies of the  challenge of climate change in terms of nutritiondiet and the effect of extreme temperatures on human health.

The latest study compares a world in which governments everywhere fulfil a promise made in Paris in 2015 and contain global heating by the century’s end to a rise of “well below” 2°C, or follow the notorious “business as usual” scenario in which developing economies burn ever more fossil fuels and ratchet up global temperatures to potentially catastrophic levels.

The new study looks at the available indicators and warns that climate change driven by global heating is already damaging the health of the world’s children and will shape the wellbeing of an entire generation unless the Paris targets are met.

Targets receding

Right now, average planetary temperatures have already risen by 1°C in the last century and the latest analysis of national plans to reduce fossil fuel use suggest that the Paris targets will not be met.

And climate change has begun to take its toll. In the last 30 years the average global yield potential of maize has shrunk by 4%, of winter wheat by 6%, of soybean by 3% and rice by 4%: this alone makes more infants vulnerable to malnutrition and rising food prices.

Eight of the ten hottest years ever recorded have happened in the last decade, and this heating has been driven by fossil fuel use: every second the world burns 171,000 kg of coal, 186,000 litres of oil and 11,600,000 litres of gas.

Nine of the 10 most suitable years for the transmission of dengue fever – carried by the mosquito – have happened since the turn of the century. Last year was the second most suitable year on record for the spread of the bacteria that cause diarrhoeal disease and wound infection.

In 2016, deaths from outdoor air pollution were set at around 2.9 million; of these, 440,000 were from coal alone. The share of global energy from coal actually rose by 1.7% between 2016 and 2018.

Better future possible

And the journal also records a rise in extreme weather events: out of 196 countries, 152 experienced an increase in citizens exposed to wildfires since the first four years of the century; and a record 220 million more citizens over the age of 65 were exposed to heatwaves in 2018, compared with 2000. This is an increase of 63m just on 2017.

In 2018, compared with 2000, heat extremes cost the world’s economies a potential 45 billion hours of additional work: in the hottest month, outdoor agricultural workers and construction teams lost as much as 20% of potential daylight working hours.

But, the Lancet Countdown experts say, if the world did fulfil its Paris Agreement promise, then any child born today would grow up on a planet that had reached net zero carbon emissions by their 31st birthday: there would be a healthier future for coming generations.

“The climate crisis is one of the greatest threats to the health of humanity today, but the world has yet to see a response from governments that matches the unprecedented scale of the challenge facing the next generation,” said Richard Horton, editor-in-chief of the Lancet.

“With the full force of the Paris Agreement due to be implemented, we can’t afford this level of disengagement. The clinical, global health and research community needs to come together now and challenge our leaders.”

This article was originally published on the Climate News Network.
Cover photo by Khoa Pham on Unsplash
Climate threat from inhalers can prove costly

Climate threat from inhalers can prove costly

By Kieran Cooke

Many people affected by breathing conditions like asthma may be unwittingly adding to global heating, because of the climate threat from inhalers often used to relieve their suffering.

Many of the appliances used at present – termed metered-dose inhalers – contain propellants that are potent greenhouse gases (GHGs) which contribute to the problems of climate change.

A new study by researchers at the University of Cambridge in the UK says that if health services switched to prescribing “green” inhalers instead, big cuts would be possible in the output of the climate-damaging gases.

The study, published in the BMJ Open journal, says that by switching from expensive brand-named drugs and inhalers to alternative products, there’d also be considerable cost savings.

It’s estimated that more than 330 million people worldwide suffer from asthma, with a substantial proportion of that number having to use inhalers.

Ozone damage

Commonly-used metered-dose inhalers contain liquefied compressed gases that act as a propellant, atomising the drug in the inhaler and pumping it out to the user.

At one stage chlorofluorocarbons (CFCs – potent greenhouse gases which also damage the Earth’s ozone layer) were used in inhalers. Their use is now banned, and another gas called hydrofluoroalkane, or HFA, acts as the propellant instead.

The Cambridge study says that though HFAs do not damage the ozone layer, they are nonetheless potent greenhouse gases and contribute to overall global warming.

It recommends a switch from metered-dose inhalers containing HFAs to what it describes as effective alternatives such as dry powder inhalers or aqueous mist inhalers.

“Climate change is a huge and present threat to health that will disproportionately impact the poorest and most vulnerable on the planet”

The researchers were mainly examining the use of inhalers in the UK and the costs to the country’s National Health Service (NHS). Some countries have already switched to non-HFA inhalers.

“In 2017, around 50 million inhalers were prescribed in England, of which seven out of ten were metered-dose inhalers, compared to only one in ten in Sweden”, says the study.

The researchers say they found that the output of greenhouse gases from metered-dose inhalers was between 10 and 37 times that of dry powder inhalers.

“At 2017 prescription levels, replacing one in ten metered-dose inhalers in England with the cheapest equivalent dry powder inhalers could lead to a reduction in drug costs of £8.2 million (US$10.6m) annually and would reduce carbon dioxide-equivalent emissions by 58 kilotonnes.”

“At the individual level each metered-dose inhaler replaced by a dry powder inhaler could save the equivalent of between 150 and 400kg of CO2 annually, which is similar to many actions that environmentally-concerned individuals are taking at home already, such as installing wall insulation, recycling or cutting out meat.”

Zero carbon aim

The researchers stress that patients shouldn’t stop using inhalers, but should discuss their treatment with their doctor. Patients should ensure inhalers are used correctly and properly disposed of.

“Climate change is a huge and present threat to health that will disproportionately impact the poorest and most vulnerable on the planet, including people with pre-existing lung disease”, says Dr James Smith, consultant in public health at the University of Cambridge.

“Our study shows that switching to inhalers which are better for the environment could help individuals and the NHS as a whole, and reduce their impact on the climate significantly.

“This is an important step towards creating a zero carbon healthcare system fit for the 21st century.”

This article was originally posted on the Climate News Network.
Cover Image by Darko Stojanovic from Pixabay
Rising heat drives hungry people to hospital

Rising heat drives hungry people to hospital

By Tim Radford

Australian and Chinese scientists have identified a new hazard in the summer heat waves – more undernourished and hungry people are driven into hospitals.

They combed the records of Brazil’s hospitals, matched them against temperature readings and found that for every 1°C increase in temperature, there was a 2.5% increase in hospital admissions for undernutrition.

Undernutrition is defined as “inadequate intake of energy and nutrients to meet an individual’s needs to maintain good health.” That is: with extremes of heat come the ravages of hunger. The researchers also found that the very young and the very old were the most vulnerable.

Undernutrition is a global public health concern, especially in the low- and middle-income nations. In 2016, around 420 million adults of 20 years and more, and 192 million children and adolescents between 5 and 19, were underweight.

Of children under 5 years of age, 150 million were stunted, and 52 million were wasted. Around 45% of deaths of children under 5 were associated with undernutrition.

“The malnourished are more often from the poorest communities: they cannot stay indoors with the air-conditioning switched on”

And now the climate emergency, which brings with it ever greater extremes of heat, could make a global problem even worse.

Quite how dangerous heat and dangerous hunger are linked is uncertain, but the researchers report in the Public Library of Science journal PLOS Medicine that they have confirmed that the link is a real one.

Yuming Guo of Monash University in Australia and colleagues gathered data from the 5,570 cities in Brazil’s unified health system from January 2000 to December 2015. However, they included data only from the 1,814 cities – with more than 78% of Brazil’s population, in five regions – that could produce 16 complete years of records.

They had already established that hospital admissions rose with the thermometer. This time they established that one in six of the hospitalisations for undernutrition – that is, 37,129 cases – could be attributed to heat exposure. This proportion had risen from 14% in 2000 to 17.5% in 2015, during which time average temperatures rose by 1.1°C.

Spreading heat extremes

The links between heat and health have been repeatedly confirmed. Heat extremes, driven by global average temperature rises, in turn powered by profligate fossil fuel use, are on the increase: by the end of the century, they will be more intense, more frequent and more prolonged. And by the end of the century, three-fourths of the world could be at potentially lethal risk from the baking days and sweltering nights.

Researchers have repeatedly established that extremes of heat can affect harvest yields, and that high growing season temperatures, driven by ever higher levels of atmospheric carbon dioxide, can reduce protein and vital nutrient levels in crops, to amplify global hunger and malnourishment. One research group even catalogued 27 ways in which heat extremes could kill.

These are long-term consequences. What the latest study does is put a measure to the short-term effect of heat upon illness linked to undernourishment. How the connection works is – the scientists concede – “not well understood.”

They suggest that high temperatures could reduce appetites, provoke more alcohol consumption, or reduce motivation to shop and cook, which would make any existing under-nutrition even worse. They also think that the sweltering heat could worsen already-impaired digestion and increase the frequencies of gastroenteritis.

Less healthy targeted

And, of course, those already undernourished are less healthy and less able to naturally regulate their own body temperatures. Finally, the malnourished are more often from the poorest communities: they cannot stay indoors with the air-conditioning switched on.

There could be many factors. But one thing is clear: heatwaves most harm those already less healthy because of undernutrition. By 2050, climate change could reduce global food supplies by more than 3% and cause around 30,000 underweight-related deaths.

But, the researchers warn, this now looks like an under-estimate, because it does not take into account the short-term and direct effects of temperature rise on future undernutrition-related morbidity and mortality.

“This direct, short-term effect will be increasingly important with global warning,” the scientists warn. 

This article was originally published on the Climate News Network.
Cover photo by Russel Watkins on Wikimedia Commons.
How heatwave images in the media can better represent climate risks

How heatwave images in the media can better represent climate risks

By Dr Saffron O’Neill

Dr Saffron O’Neill is an associate professor in geography at the University of Exeter. Between 2012 and 2017 she held an Economic and Social Research Council Future Research Leader Fellowship on “Visualising climate change”. This article first appeared on the Carbon Brief website.

As the northern hemisphere summer comes to an end, it seems a fitting time to reflect on how the news media has reported on this year’s summer heat and heatwaves.

This has been an exceptionally hot summer: across Europe, there have been two distinct periods of very hot weather. Temperature records were broken in June across many countries, during what became the hottest June ever recorded in Europe.

Another period of intense heat occurred in July, matching – and maybe even exceeding – the record set the previous month. Analysis suggests this event was made up to 100 times more likely because of human-caused climate change.

And just this past weekend has seen more records broken in the UK, with the hottest August bank holiday Monday on record and the hottest August bank holiday weekend as a whole.

This record-breaking heat made headlines across the UK’s media, with many stories illustrated with images focusing on the fun of the summer sun. Yet heatwaves have serious impacts, which are projected to become more potent with rising global temperatures. This prompts the question of what impact using these images has on the wider public? And what images would be more appropriate to illustrate these news stories?

Fountain frolics or train cancellations?

In the early summer heatwaves in the UK, many news outlets chose to represent stories about extreme heat as something to be enjoyed: images of sunbathing on the beach amongst colourful parasols, or splashing around in city fountains.

Many of these articles were juxtaposed with headlines that belied the seriousness of the coming weather. Just two examples of many: “Hell is coming” Mail Online, in a story accompanied by a picture of a woman splashing in a fountain by the Eiffel Tower. A live-text discussion on the Guardian website entitled “Heatwave: Paris suffers 42.6C hottest day ever” was illustrated by people enjoying the hot weather on Brighton Beach.

The Daily Telegraph, 27 August 2019

This commitment to headlines of heatwave suffering alongside jolly holiday snaps shows no signs of being a one-off trend. Before, during and after the record-breaking August Bank Holiday, numerous newspapers followed suit.

Mirror headline from Thursday last week spoke of “Met Office health warnings for 33C bank holiday heatwave”, yet it was illustrated by another holidaymakers-on-busy-beach photograph. A Daily Telegraph article on Tuesday carried the headline “Climate warning as more summer records tumble” in the print edition and was illustrated by nuns on a beach and children playing in water. And a Sunday Telegraph piece in its print edition advising that “Heat could tip A&E units into queues chaos, warn doctors” is accompanied by an image of families canoeing.

The Sunday Telegraph, 25 August 2019

Of course, summer holidays are meant to be enjoyed – and as anyone who has ever lived in the UK knows, Brits in particular seem to love a good-news weather story (almost as much as a bad-weather story). But where were the images of people struggling in the heat?

Daily lives

Although there has been a rapid increase in the visual coverage of climate impacts in media stories, often lacking from the visual narrative around heatwaves are the less enjoyable aspects. These might include the significant transportation failures as railway lines buckled, the severe health impacts on older folks and vulnerable people, the effects of extreme heat on animals and food production, and the lack of buildings and infrastructure well-adapted to offer a comfortable environment to their occupants during extreme heat.

For many going about their daily lives during these heatwaves, life was not all fountain frolics and sunbathing.

The most recent assessment report from the Intergovernmental Panel on Climate Change (IPCC) report shows that rising global temperatures is expected to bring more of these sorts of heatwaves in the coming years and decades. In fact, in future years, summers like 2019 may be commonplace rather than seeming exceptionally hot.

The Irish edition of the Daily Mirror, 26 June 2019

An unbearably hot train commute compounded by delays and cancellations, farmersstruggling to keep their animals cool enough for days on end, hospital emergency departments coping with an influx of heat-related illness, struggling to get a baby to sleep in a hot and stuffy bedroom: people struggling to go about their daily lives because of the weather. These could be examples of compelling and relatable visuals with which to illustrate stories of extreme heat.

Therefore, finding – and using – more effective ways to visually communicate about an increasingly hot future is a pressing issue.

Why do visuals matter?

diversity of evidence points towards how media representations play an important role in how we think, feel and act on climate change.

Much research has focused on analysing how the media represent climate change through text, mainly through work examining the text of newspaper articles. Yet this work fails to take account of the role of visual images.

A growing group of experts working on climate change visuals is showing that the images used to communicate about climate change play a key role in shaping readers’ thoughts and feelings about the issue.

Images are key for setting the context and narratives about climate change. Images shape how important people think climate change is – their “sense of saliency” about the issue; and whether they feel able to act on it – their “sense of self-efficacy”.

Yet, the images of climate change that the media tend to favour are restricted to a fairly narrow range of themes. And many of these fail to increase either a sense of saliency or a sense of self-efficacy. For example, a common way of illustrating climate news is using photographs of politicians, yet these images strongly undermine saliency. Conversely, images which increase a sense of self-efficacy, such as images of energy futures, are rare in the media. This is true across a range of countries, from the US, UK and Australia to Austria, Switzerland and Germany.

Opportunities for change

There has been little work examining how media organisations select and use images for weather and climate news.

What little there is suggests that there is a disconnection between journalists writing news stories and picture editors and others selecting images to go alongside them. As a result, visual and text-based narratives often pull in different directions, and can even advance contradictory claims – much as can be seen in the heatwave news reporting.

But this is not to lay blame at the feet of journalists, editors or media organisations. Climate change is a complex and amorphous issue – so how can we improve how it is represented visually?

We know from empirical evidence that it is often not very helpful to try to “scare” people into action with dread-inducing images, in this case, of extreme heat. But images of ice creams and holidays don’t do much to progress the visual lexicon of heatwave risk either.

The Scottish edition of the Times, 26 July 2019

Rather, researchers and academics need to work with media organisations, image libraries and communication practitioners to craft a more diverse and engaging set of visuals from which to illustrate and imagine climate change.

Earlier this summer, I was involved in a Twitter thread commenting on a BBC News article, “Climate change: UK’s 10 warmest years all occurred since 2002”, which was illustrated with an image of people sunbathing under colourful parasols on a UK beach.

To the credit of the BBC, the image was subsequently changed to one of a train shimmering through heat haze. In a more concerted effort, the communications specialists at Climate Outreach have created the Climate Visuals project, a growing library of evidence-based images for effective climate engagement. I hope that this, and other initiatives like this one, will be the start of a conversation to create a more diverse and engaging visual discourse for imagining and adapting to our climate changed future.