Redacted by the Cheney/Bush regime in 2007: from TESTIMONY BEFORE THE COMMITTEE ON ENVIRONMENT AND PUBLIC WORKS UNITED STATES SENATE Climate Change and Public Health Statement of Julie L. Gerberding, M.D., M.P.H. Director, Centers for Disease Control and Prevention Administrator, Agency for Toxic Substances and Disease Registry U.S. Department of Health and Human Services

Blast from the past:



Scientific evidence supports the view that the earth’s climate is changing. A broad array of organizations (federal, state, local, multilateral, faith-based, private and nongovernmental) is working to address climate change. Despite this extensive activity, the public health effects of climate change remain largely unaddressed. CDC considers climate change a serious public health concern.


Climate Change is a Public Health Concern
In the United States, climate change is likely to have a significant impact on health, through links with the following outcomes:


• Direct effects of heat,
• Health effects related to extreme weather events,
• Air pollution-related health effects,
• Allergic diseases,
• Water- and food-borne infectious diseases,
• Vector-borne and zoonotic diseases,
• Food and water scarcity, at least for some populations,
• Mental health problems, and
• Long-term impacts of chronic diseases and other health effects


The United States is a developed country with a variety of climates. Because of its well developed health infrastructure, and the greater involvement of government and nongovernmental agencies in disaster planning and response, the health effects from climate change are expected to be less significant than in the developing world. Nevertheless, many Americans will likely experience difficult challenges.


Catastrophic weather events such as heat waves and hurricanes are expected to become more frequent, severe, and costly; the U.S. population is anticipated to continue to age and move to vulnerable locations such as coastal areas, increasing exposures to specific risks; and concurrent challenges such as water scarcity in certain regions could limit our resilience. In addition, climate change is likely to alter the current geographic distribution of some vector-borne and zoonotic diseases; some may become more frequent, widespread, and outbreaks could last longer, while others could be reduced in incidence.


Heat Stress and Direct Thermal Injury
One of the most likely climate change projections is an increase in frequency of hot days, hot nights, and heat waves. The United States is expected to see an increase in the severity, duration, and frequency of extreme heat waves. This, coupled with an aging population, increases the likelihood of higher mortality as the elderly are more vulnerable to dying from exposure to excessive heat. Midwestern and northeastern cities are at greatest risk, as heat-related illness and death appear to be related to exposure to temperatures much hotter than those to which the population is accustomed.


Extreme Weather Events
Climate change is anticipated to alter the frequency, timing, intensity, and duration of extreme weather events, such as hurricanes and floods. The health effects of these extreme weather events range from loss of life and acute trauma, to indirect effects such as loss of home, large-scale population displacement, damage to sanitation infrastructure (drinking water and sewage systems), interruption of food production, damage to the health-care infrastructure, and psychological problems such as post traumatic stress disorder. 


Displacement of individuals often results in disruption of health care, of particular concern for those with underlying chronic diseases. Future climate projections also show likely increases in the frequency of heavy rainfall events, posing an increased risk of flooding events and overwhelming of sanitation infrastructure.


Air Pollution-Related Health Effects
Climate change can affect air quality by modifying local weather patterns and pollutant concentrations, affecting natural sources of air pollution, and promoting the formation of secondary pollutants. Of particular concern is the impact of increased temperature and UV radiation on ozone formation. Some studies have shown that higher surface temperatures, especially in urban areas, encourage the formation of ground-level ozone.


As a primary ingredient of smog, ground-level ozone is a public health concern. Ozone can irritate the respiratory system, reduce lung function, aggravate asthma, and inflame and damage cells that line the lungs. In addition, it may cause permanent lung damage and aggravate chronic lung diseases.


Allergic Diseases
Studies have shown that some plants, such as ragweed and poison ivy, grow faster and produce more allergens under conditions of high carbon dioxide and warm weather. As a result, allergic diseases and symptoms could worsen with climate change.


Water- and Food-borne Infectious Diseases
Altered weather patterns resulting from climate change are likely to affect the distribution and incidence of food- and water-borne diseases. Changes in precipitation, temperature, humidity, and water salinity have been shown to affect the quality of water used for drinking, recreation, and commercial use. For example, outbreaks of Vibrio bacteria infections following the consumption of seafood and shellfish have been associated with increases in temperatures. Heavy rainfall has also been implicated as a contributing factor in the overloading and contamination of drinking water treatment systems, leading to illness from organisms such as Cryptosporidium and Giardia.


Storm water runoff from heavy precipitation events can also ncrease fecal bacterial counts in coastal waters as well as nutrient load, which, coupled with increased sea-surface temperature, can lead to increases in the frequency and range of harmful algal blooms (red tides) and potent marine biotoxins such as ciguatera fish poisoning.


Vector-borne and Zoonotic Diseases
Vector-borne and zoonotic diseases, such as plague, Lyme disease, West Nile virus, malaria, hantavirus pulmonary syndrome, and dengue fever have been shown to have a distinct seasonal pattern, suggesting that they are weather sensitive. Climate change-driven ecological changes, such as variations in rainfall and temperature, could significantly alter the range, seasonality, and human incidence of many zoonotic and vector-borne diseases. More study is required to fully understand all the implications of ecological variables necessary to predict climate change effects on vector-borne and zoonotic diseases.


Moderating factors such as housing quality, land-use patterns, and vector control programs make it unlikely that these climate changes will have a major impact on tropical diseases such as malaria and dengue fever spreading into the United States. However, climate change could aid in the establishment of exotic vector-borne diseases imported into the United States.


Food Scarcity
Climate change is predicted to alter agricultural production, both directly and indirectly. This may lead to scarcity of some foods, increase food prices, and threaten access to food for Americans who experience food insecurity.


Mental Health Problems
Some Americans may suffer anxiety, depression, and similar symptoms in anticipating climate change and/or in coping with its effects. Moreover, the aftermath of severe events may include post-traumatic stress and related problems, as was seen after Hurricane Katrina. These conditions are difficult to quantify but may have significant effects of health and well-being.


Climate Change Vulnerability
The effects of climate change will likely vary regionally and by population. The northern latitudes of the United States are expected to experience the largest increases in average temperatures; these areas also will likely bear the brunt of increases in ground-level ozone and associated airborne pollutants. Populations in mid-western and northeastern cities are expected to experience more heat-related illnesses as heat waves increase in frequency, severity, and duration.


Coastal regions will likely experience essentially uniform risk of sea level rise, but different rates of coastal erosion, wetlands destruction, and topography are expected to result in dramatically different regional effects of sea level rise. Distribution of animal hosts and vectors may change; in many cases, ranges could extend northward and increase in elevation.


For some pathogens associated with wild animals, such as rodents and hantavirus, ranges will change based on precipitation changes. The west coast of the United States is expected to experience significant strains on water supplies as regional precipitation declines and mountain snowpacks are depleted. Forest fires are expected to increase in frequency, severity, distribution, and duration. The health effects of climate change on a given community will depend not only on the particular exposures it faces, but also on the underlying health status, age distribution, health care access, and socioeconomic status of its residents.


Local response capacity will also be important. As with other environmental hazards, members of certain ethnic and racial minority groups will likely be disproportionately affected. For example, in low-lying coastal communities facing increasingly frequent and severe extreme precipitation events, there could be increased injuries, outbreaks of diarrheal disease, and harmful algal blooms; saltwater may intrude into freshwater tables and infrastructure is likely to be damaged by severe storms, hampering economic recovery.


In certain Southern coastal communities with little economic reserve, declining industry, difficulty accessing health care, and a greater underlying burden of disease, these stressors could be overwhelming. Similarly, in an urban area with increasingly frequent and severe heat waves, certain groups are expected to be more affected: the home-bound, elderly, poor, athletes, and minority and migrant populations, and populations that live in areas with less green space and with fewer centrally air-conditioned buildings are all more vulnerable to heat stress. Some populations of Americans are more vulnerable to the health effects of climate change than others.


Children are at greater risk of worsening asthma, allergies, and certain infectious diseases, and the elderly are at higher risk for health effects due to heat waves, extreme weather events, and exacerbations of chronic disease.


In addition, people of lower socioeconomic status are particularly vulnerable to extreme weather events. Members of racial and ethnic minority groups suffer particularly from air pollution as well as inadequate health care access, while athletes and those who work outdoors are more at risk from air pollution, heat, and certain infectious diseases.


Given the differential burden of climate change’s health effects on certain populations, public health preparedness for climate change must include vulnerability assessments that identify the most vulnerable populations with the most significant health disparities and anticipate their risks for particular exposures. At the same time, health communication targeting these vulnerable populations must be devised and tested, and early warning systems focused on vulnerable communities should be developed. With adequate notice and a vigorous response, the ill health effects of many exposures from climate change can be dampened.


http://www.desmogblog.com/full-version-of-white-house-edited-cdc-climate-report-with-highlights