Kim Knowlton's Blog: Solving Global Warming

Climate Change-ing your Allergies

2010-04-18T13:34:03Z

It’s an absolutely gorgeous weekend across much of the eastern US. If you’re among the millions of Americans who suffer from seasonal allergies, however, the layer of yellow tree pollen that's settled across car hoods and roofs is your nemesis – it’s most likely what’s making you sneeze and wheeze today. Each morning you wake up hoping today will be better than yesterday, this season will be better than last, and that some day those pesky allergies will just disappear altogether.

With spring in full swing, you may want to check out the National Wildlife Federation (NWF)’s new report, Extreme Allergies and Global Warming. This report contains a wealth of information about how global warming is affecting some health-relevant plants and animals in the US -- trees, grasses, weeds like ragweed and poison ivy, molds, even stinging insects -- that have a great deal to do with your allergies, and the effects are anything but what you’d hoped for.

The NWF report mentions an earlier study by NRDC, Sneezing and Wheezing: How Global Warming Could Increase Ragweed Allergies, Air Pollution, and Asthma. The NRDC report was the first to map areas of the US where people’s health is challenged by the “double whammy” of ozone smog and ragweed allergens. In late summer, rising heat and carbon dioxide concentrations can worsen both air pollutants.

The National Arbor Day Foundation changed the Plant Hardiness Zones in 2006 in response to rising temperatures and changing climate conditions in the US. The NWF study shows how those Zones changed, plus it goes a step further by looking into the future: it projects how the distribution of allergenic pollen-bearing trees could change in the US, in response to a changing climate. This means that many areas now unaccustomed to the annual ritual of runny noses and watery, itchy eyes may lose that advantage in years to come. NWF finds that sixteen states are “hotspots” at risk of increases in tree pollen by the end of the century.

States at risk of high increases in allergenic tree pollen include: Arkansas, Iowa, Maine, Minnesota, New Hampshire, New York, Pennsylvania, Vermont and West Virginia.
States at risk of moderate increases include: Connecticut, Illinois, Kentucky, Massachusetts, Mississippi, Tennessee and Wisconsin.

The report by lead author Amanda Staudt, Ph.D. and others, was prepared with the Asthma and Allergy Foundation of America. Mike Tringale, director of External Affairs at the Asthma and Allergy Foundation of America, reported in a press release that, “Allergies and asthma combined already affect about 50 million Americans and cost nearly $27 billion in medical costs and nearly $6 billion in lost productivity and earnings.” Do the math: as climate change worsens this situation, the costs could be enormous and for allergy and asthma sufferers, worsening symptoms could diminish the quality of life.

Whether your enjoy playing at the ballfield, lying on a grassy lawn, or tending to your garden, there are strategies for staying outdoors during the pollen season. As we suggest in our Sneezing and Wheezing report, you can check the radio, TV, or visit online news outlets for daily pollen reports, in order to plan outdoor activities for lower-pollen days. The National Allergy Bureau has a website with pollen monitoring data from data collection sites around the country.

The call of a sunny spring day is hard to resist, and healthy exercise is something we all need. It’s important to bathe or shower to remove pollen that may have collected on your skin and in your hair after you spend time outdoors on high-pollen days. For the same reasons, it’s a good idea to launder bedding and clothing, and vacuum regularly during pollen seasons.

Cutting global warming pollution can help minimize future allergy risks by reducing the carbon dioxide emissions on which pollen-producing plants and toxic weeds can thrive. It also improves local air quality by reducing emissions of health-harming co-pollutants like particles, smog precursors and toxic chemicals. But whatever you do, realize that the seasons - and quite possibly your own health - are already being affected by climate change.

Keeping tabs on Dengue Fever: Stay tuned

2010-03-02T22:08:56Z

Today, I attended the New York Academy of Sciences’ fascinating symposium on Emerging Infectious Diseases in Response to Climate Change. Experts from around the country are discussing a 21st-century health concern: how climate change can lead to “higher rates of emerging infectious diseases worldwide, reemergence of diseases previously under control, and redistribution of diseases across the planet.”

But one infectious disease in particular is on my mind today: Dengue Fever. I just learned about 22 confirmed cases of Dengue (“breakbone”) Fever that people acquired in Key West, Florida in the summer and fall of 2009. This may not sound like a lot, but these were the first locally-transmitted infections in Florida in more than 40 years. Recurring rains reportedly allowed dengue-carrying mosquitoes to thrive in Key West. Since then, even more dengue cases have been “imported” back into the state by infected travelers returning to Florida.

In another part of the Caribbean just last week, Health Secretary Lorenzo Gonzalez of Puerto Rico declared an epidemic of dengue fever. With more than 200 cases already confirmed and over 600 suspected, this is reportedly triple the usual rate. It’s troubling for cases to run so high at this time of the year, and health authorities are obviously taking notice.

Dengue Fever is one of the most painful viral illnesses known – that’s why it’s called “breakbone fever.” Symptoms include high fever and chills; severe headaches, joint and muscle pain; and rash on arms, legs and torso. It spreads not from person to person, but from the bite of an infected mosquito. However, many people who get the infection can be misdiagnosed with influenza. In a September 2009 door-to-door survey of 240 Old Town Key West residents, 41% tested positive for dengue antibodies, meaning they had a prior infection (and didn’t realize it), or had received a vaccination against a related disease, like yellow fever. Unfortunately, no vaccine against dengue exists as yet.

The 2009 Florida outbreak is also newsworthy because over 229,000 passengers arrived at the Key West Airport in 2009. Vacationers need to know about dengue fever - not to become obsessed by it nor to ruin their travels, but to be prepared and take simple steps to avoid getting bitten by potentially infected mosquitoes. These include using window and door screens, emptying water-filled containers in homes and yards to remove mosquito breeding areas, using insect repellent containing 20-30% DEET, and wearing long pants and sleeves when possible.

Since January 15, 2010, dengue fever is “officially” a nationally notifiable disease in the US. This is great news, but it seems to be … very quiet news. It’s taken months for the information to become official, so I expected at least a little fanfare and a Press Release. Being nationally notifiable will eventually help spread the word about how to diagnose, track, and protect against dengue. We talked about the need for improved case reporting and coordinated monitoring in NRDC’s July 2009 report Fever Pitch, about dengue fever in the Western Hemisphere. But more people know about dengue fever today: few among the experts at the conference knew about its new officially “notifiable” status in the US, nor about the recent outbreaks.

It took me a while to confirm the reported Key West outbreak. I called and e-mailed helpful Florida State Department of Health and Mosquito Control officials, as well as academic researchers. The Centers for Disease Control and Prevention (CDC) last put together an annual report on surveillance of dengue fever in the US in 2006. CDC has a lot on their plate – especially now, with the dengue fever epidemic in Puerto Rico, which is home to CDC’s Dengue Branch. Sharing information on where and when cases are happening can help people step up their precautions and prevent more illness.

This highlights that we still have a ways to go in coordinating national infectious disease surveillance. Information on confirmed dengue cases, whether imported by travelers or locally-transmitted, should be readily accessible to the public, along with prevention tips. That’s a fantastic goal for the CDC, state and local health agencies to aim toward.

Stay informed and stay tuned – because communication is the key.

Thanks to Andy Revkin, NY Times’ departing climate change reporter

2009-12-17T21:00:59Z

The international climate conference now moving into its final days in Copenhagen is receiving more attention than in previous years. As NRDC's President Frances Beinecke reports, Secretary Clinton's announcement Thursday that the US will participate in funding to help developing communities cope with climate change energized the talks like a "diplomatic defibrillator."

It's taken a while for global warming to capture the kind of public and press notice it's getting right now, but because of the gravity of the topic and the diligent efforts of scientists, policymakers, concerned citizens, and reporters who’ve been working tirelessly for years, the sense of urgency has never been higher – even if there's still a long way to go.

One of the very best of those reporters, Andrew C. Revkin of the New York Times, announced he’ll be leaving his post at the end of the conference, which he’s covering. For more than a decade he’s been perhaps the leading American journalistic voice on climate science, climate-health impacts, climate policy, and new research regarding how societies can adapt and prepare to meet the climate challenge.

I'm grateful to Andy for his science acumen, his wit, and his dedication to reporting on this issue. He’s also been an inspiration to many students at universities and schools, both in-person as a lecturer, and through his writing and his DotEarth blog.

Andy Revkin’s print byline in the Times will be missed.

Depend on Women to Keep the Momentum Rolling on Global Warming

2009-12-17T18:23:29Z

As world leaders continue to arrive in Copenhagen for the final days of critical climate negotiations, the stakes for all of us couldn’t be higher. Women have been engaged throughout the negotiations—from high-level office holders to grassroots leaders who claim their place on the world stage by speaking out for their vulnerable constituencies.

For years women have organized behind the scenes to prepare for the 15th United Nations Climate Change Conference of the Parties (COP-15), and official sessions today focus on “Climate and Gender,” with side events also scheduled to highlight “Women as Agents of Change.”

Earlier in the week—at a “Women’s Leadership on Climate Justice” program moderated by former Irish President Mary Robinson and keynoted by Canadian Inuit organizer Shelia Watt-Cloutier—activists described how women have intimate knowledge of the human cost of global warming. Women and their children, members of impoverished populations living in challenged environments, are most at risk. They are critically aware of the need to enact lasting change to protect themselves and the communities they care for from the climate crisis.

Most of us imagine global warming as polar bears stranded on melting ice floes, threatened low-lying coasts, and disappearing tropical forests. While these are environmental effects of deep concern, the story of global warming is a human health story—and that gets less attention.

Earlier this year, I wrote a commentary for this site on how international physicians’ organizations joined together to sound the alarm about global warming as "the biggest global health threat of the 21st century." Science—including data from the U.S. Global Change Research Program, sponsored by both Democratic and Republican administrations over the last 20 years—has shown that global warming is unequivocal and directly affects human health, both internationally and right here at home.

Worsening heat waves; declining air quality; increasing levels of allergens; changing patterns of mosquito, tick, and flea-borne disease; degradation of food and water supplies; catastrophic weather events, flooding, waterborne disease outbreaks; and large numbers of displaced persons are just some of the health challenges that are already occurring worldwide and likely to worsen within our lifetimes. A 2009 Oxfam International study found that by 2015, the number of people affected by climate-related disasters could climb 54 percent to 375 million people each year, threatening to overwhelm humanitarian relief capacity.

The World Health Organization estimates that currently more than 150,000 people perish each year from the effects of a changing climate. Children are vulnerable because they are more susceptible to excessive heat, air pollution, infectious disease, and they depend on others for care, mobility, and shelter in emergencies. Women land squarely in the most-vulnerable category because they comprise an estimated 70 percent of those living below the poverty line globally. Women are also the caregivers for kids, the elderly and the sick, thus bearing the heaviest burdens in times of emergencies, even at our own peril. Yet up to this point, women have often been left out of conversations about climate solutions.

To prepare for Copenhagen and working on the ground at the conference, the Women’s Environment and Development Organization (WEDO) has operated as part of an alliance of 13 UN and 25 civil society organizations—the Global Gender and Climate Alliance. Their efforts will ensure that gender-specific language remains in documents negotiated in Copenhagen. That work is essential so that signatories commit themselves to protecting women’s rights and to including women in strategies and negotiations going forward.

Women officials are well represented COP-15: Danish Environmental Minister Connie Hedegaard presided over the talks until she passed that role to Denmark’s prime minister (observers say in order to “ramp up” the urgency of the final high-level meetings); U.S. Secretary of State Hillary Clinton arrives in Copenhagen today; House Speaker Nancy Pelosi, along with the presidents of Finland and the Philippines, is scheduled to attend an event highlighting women’s leadership; and EPA Administrator Lisa Jackson has appeared frequently in the media as a spokeswoman—as she did before leaving for Copenhagen when, announcing a finding that greenhouse gases endanger human health and public welfare, she opened the door to sweeping new domestic regulations of many industries. (Aiding in the effort toward a cleaner U.S. future, Senator Barbara Boxer [D-CA] has joined with Senator John Kerry [D-MA] to cosponsor the Clean Energy Jobs and American Power Act.)

Women, who know how their villages work and how to make sustainable, long-term local change happen, can drive meaningful progress from the bottom up. Among those joining Watt-Cloutier at the women’s leadership panel earlier this week to speak out on women’s needs were Constance Okollet, an organizer and farmer in eastern Uganda; Ulamila Kurai Wragg, a journalist who reports on the impact of climate change in the Cook Islands and Fiji; and Rehana Bibi Khilji, founder of a human rights group in rural Pakistan. These activist leaders have their counterparts in the United States, such as Majora Carter, who founded Sustainable South Bronx; Peggy M. Shepard, of West Harlem Environmental Action (WEACT); and Sharon Hanshaw, who works to rebuild her community in post-Katrina Biloxi, Mississippi, through Coastal Women for Change.

According to Frances Beinecke, president of the Natural Resources Defense Council, a strong financial commitment by the United States to help developing nations adapt to the effects of global warming is key to holding together the current negotiations. “Our financing pledge could be the game-changer in the most important—and dangerously fragile—negotiations of our generation,” she wrote from Copenhagen.

Leadership from the top is essential, but there are also thousands of local opportunities to take swift action, so that we can thrive and remain secure in a globally warming future. So let’s move together. Our lives really do depend on united action.

This post originally appeared at the Women's Media Center website.

The Rising Tide of Illness: Global Warming and the Threat of Waterborne Diseases

2009-10-15T20:57:32Z

Water is something we often take for granted as we watch it come out of the tap and into our glass, or enjoy a dip in a cool lake in summer. Water is a health-sustaining necessity, and abundant clean water has long been considered one of America's greatest resources. But what most people don't know is that right here in the U.S., including estimates of cases that go unreported, contaminated water could be causing as many as 33 million gastrointestinal illnesses each year. In 2005-2006, the Centers for Disease Control and Prevention (CDC) reported 28 outbreaks related to drinking water and 78 outbreaks from recreational water use, resulting in over 5,000 reported illnesses and 7 deaths.

A new NRDC factsheet describes how global warming can increase the risk of more frequent and more widespread waterborne illnesses, as temperatures continue to rise, droughts occur with more frequency, and more frequent severe rainfall events occur that can wash disease-causing pathogens into surface and drinking water supplies. These disease-causing pathogens include parasites like cryptosporidium and giardia; bacteria like salmonella and E.coli; and viral hepatitis A. A 1993 outbreak of crypytosporidiosis in Milwaukee sickened over 400,000 people and resulted in 69 deaths when an filter system failed in one of two municipal water treatment plants after the heaviest rainfall in 50 years in nearby watersheds.

And what could climate change do to waterborne disease risks? One study in the Great Lakes projects a possible 50% to 120% rise in the frequency of disease-causing flood events by the end of this century, as temperatures rise and heavy rainfalls increase.

Today is Blog Action Day, the largest single social action event on the web; more than 6,900 bloggers have signed up to write about global warming. NRDC is a partner of today's online event. We're involved in ongoing research, outreach, and advocacy on global warming and health.

Just last month in Georgia, massive flooding after extreme rainfall events sent raw sewage pouring into the Chattahoochee River near Atlanta, which "provides drinking water for more than 3.5 million people, including 70% of the people in metro Atlanta" according to an NPR story. The river was "chock-full of E.coli" at levels 42 times above the safe level, according to the Atlanta Journal-Constitution, and flooding was estimated to cost more than $250 million in property damage - not including the health costs of illnesses and at least nine deaths.

Early October saw devastating flooding in India that killed at least 350 people, left 1.5 million homeless, and 5 million without food. Some at the Red Cross Red Crescent Climate Centre noted that sudden swings from drought periods to flooding in the region is consistent with projections of the kinds of extreme weather events that climate change can bring.

There are some positive steps we can take to both reduce global warming pollution and adapt to climate change. NRDC signed a letter October 14th, 2009 along with 23 other environmental, science and public health groups, "in support of legislative action to address the critical climate challenge we face" -- and specifically the public health adaptation language and some new funding provisions in the Clean Energy Jobs and American Power Act (S.1733). The letter was sent to Senators on Capitol Hill who are discussing the Clean Energy Jobs and American Power Act.

We are at a critical point in history. We have the tools to help ourselves prepare for climate change -- what international physicians are calling "the biggest global health threat of the 21st century." To help prevent increasing occurrences of water-related illnesses:

CDC should improve environmental monitoring and surveillance of waterborne disease outbreaks
Environmental Protection Agency (EPA) should improve water quality regulations
Congress should act to limit emissions of global warming pollutants.

We need to urge our leaders to take the kind of decisive action that will reduce global warming pollution, protect human and ecosystem health, and preserve the safety of our drinking water supply for our kids' future, too.

Breakbone Fever: Not What the Doctor Ordered

2009-10-15T16:13:33Z

Over the next few decades, if we don't take steps to protect ourselves, we could see more cases of dengue fever - a mosquito-borne viral disease -- appearing more frequently, in more places around the world. As we've learned from recent experiences with West Nile virus and other vector-borne infectious diseases, many factors play into the spread of these illnesses. Disease-carrying mosquitoes are one such factor, and global warming can impact mosquitoes in many ways.

Today is Blog Action Day, the largest single social action event on the web; more than 6,900 bloggers have signed up to write about global warming. NRDC is a partner of today's online event.

Say you work in a health clinic. You're starting to hear more about dengue fever (also known as "breakbone fever" because of its extremely painful symptoms), and you just read about it in On Earth magazine's Fall 2009 cover story, or in NRDC's recent report Fever Pitch about the disease and its spread. But what are the symptoms of dengue fever that you should look for when patients come back ill from travel abroad? What do you do to help them, and where do you go if you have questions?

If you see a patient who has a fever, and they've traveled to a tropical area within two weeks of the beginning of their symptoms, you should consider dengue fever in your differential diagnosis. The symptoms in the classic "dengue triad" include high fever and chills; severe headaches, eye pain, bone, joint, and muscle pain (hence the nickname "breakbone fever"); and a rash on the arms, legs, and torso, with swelling and redness of the hands and feet. The rash sometimes doesn't appear until several days after the fever starts, so the absence of a rash shouldn't exclude dengue.

Commercial lab tests are more available here in the US for a serological diagnosis, but the results need to be interpreted carefully since anti-dengue antibodies are non-specific among the flaviviruses, including West Nile and St. Louis encephalitis. According to the Centers for Disease Control and Prevention (CDC), when dengue fever is suspected, healthcare providers should send a blood specimen, associated clinical information (case form), and a brief travel history to the state public health laboratory with a request that the specimen be tested for dengue there or at the CDC's Dengue Branch in San Juan, Puerto Rico. If that's not possible, contact the (CDC). We've heard dengue may now be in the process of becoming a nationally notifiable disease, which is great news.

You can get more information designed especially for clinicians from the CDC website. An unequivocal diagnosis of infection requires lab confirmation, either by isolating the virus or detecting specific antibodies. Laboratories that can perform these tests may not be nearby, and specimens require special handling.

Treatment for suspected infections should include bedrest and plenty of fluids. To manage the pain and fever, acetaminophen can be given - but avoid aspirin and other non-steroidal anti-inflammatory medications. In rare cases, people -- usually children -- will need to be treated in the hospital for dengue fever. If that happens, doctors should draw blood samples while the patient is sick and again after recovery to confirm the dengue fever diagnosis.

In general, the prognosis of dengue fever is excellent, however people who have previously had the disease and are re-infected with a different strain can experience a complication: dengue hemorrhagic fever (DHF). Symptoms of DHF include peteciae and purpura, along with bleeding. Patients with these symptoms will require hospitalization and supportive care to prevent shock and death.

I recently spent some time traveling in India, where dengue fever outbreaks have become a tremendous public health issue. Millions of impoverished people there live in close contact with mosquito breeding areas. The nation is aiming to ramp up its lab capacity, case reporting and centralized monitoring systems, which will improve infectious disease preparedness. I took personal precautions to keep mosquitoes away while there and had no problems at all - but watched for symptoms after I returned home, since it's possible to be bitten and not realize it. (No symptoms appeared, and I enjoyed an amazing trip!)

This Saturday October 17th at 7:00 pm on many Planet Green network stations, Focus Earth with Bob Woodruff will air a segment titled "Outbreak." In it, you'll be able to see first-hand what dengue fever means for people living in the Texas-Mexico border area, and what's being done to address this health concern in the border community. I was interviewed for the show, along with dengue experts and people who live and work in Brownsville, Texas, and Matamoros, Mexico.

If you're a health care professional, encourage your patients not to mess around with a fever of unknown origin after they return home from travels abroad. It's good advice to, "Tell friends about travels, but tell doctors about symptoms."

Doctors Demand Climate Change Action to Avert "Global Health Catastrophe"

2009-09-22T20:47:12Z

As Congress continues to grapple with health care reform this week, heads of state meet at a UN summit to face the challenge of climate change in preparation for a December conference in Copenhagen. Given the dire health consequences of global warming noted by the author, success at the UN could rein in health care costs in the long run, while taking a giant step toward a healthier world.

September 21, 2009

Physicians are sounding the alarm about the dangers that global warming poses to health. Last week, the prestigious journals The Lancet and British Medical Journalpublished an open letter in which doctors representing 18 international medical associations urged immediate action by policymakers to avoid a global public health catastrophe. Doctors are speaking out as they realize that their most vulnerable patients-the poor, the elderly, the very young, the already-infirm, and the women who traditionally are caregivers to all-will bear the biggest burden of climate change's negative impacts.

Science has shown that global warming will cause temperatures to climb even higher, rainfall and droughts to become more extreme, and sea levels to rise. With increasing frequency and intensity, we can expect consequences that directly affect human health: heat waves that kill; worsening air pollution and allergen levels; changing patterns of infectious disease; degradation of food and water supplies; and catastrophic weather events. Growing populations of refugees-pushed from their homes by environmental catastrophe and wars over resources-will face dire threats to their health and well-being.

Global warming has been called a "threat multiplier" because it will exacerbate energy, security, and health problems that already plague society. Never before have we had the means to look 100 years into the future. But now, thanks to climate modelers, we have that chance. Even with a level of uncertainty about precisely what the future will hold, the consensus of the modelers is unmistakable: a hotter world with an altered water cycle, changed ecosystems, diminished food security and water supplies, and the health of people on every continent threatened.

A special report published in May by The Lancet called climate change "the biggest global health threat of the 21st century." Global warming's impacts are felt today in places like India, Africa, the Arctic and small island nations. On Tuesday, September 22, the heads of state preparing for the UN climate change negotiations in Copenhagen later this year have an enormous responsibility. According to the doctors signing the Lancet/BMJ letter, "A successful outcome at Copenhagen is vital for our future as a species and for our civilization."

But people are also vulnerable right here in the United States, according to experts at the U.S. Centers for Disease Control and Prevention. In an article that I wrote with colleagues at Columbia University and elsewhere, we projected that heat-related deaths in New York could nearly double by 2050. We are not immune to the health risks of climate change. Our already-stressed health care system, especially emergency rooms according to a recently published study, will be challenged to cope with the additional demands that global warming will place on patients and practitioners. As the doctors writing last week in The Lancet said, "while the poorest in the world will be the first affected, none will be spared."

The U.S. Senate has in its hands right now climate legislation passed by the House of Representatives in June. This legislation, the American Clean Energy and Security Act (or "ACES") would establish reductions on U.S. greenhouse gas emissions and ensure that they decline even further in years to come. The United States is still among the leading per-capita emitters of global warming pollution, but passage of this bill will help reverse that and establish America as an international leader on climate change in Copenhagen.

Doctors abide by the principle: "First, do no harm." They are schooled to advocate above all for the health of the patients in their care. At this point in time, doing nothing on climate change may be tantamount to doing harm.

And maybe this is why now doctors are leading the charge.

We can join these doctors and demand that our policymakers create binding, mandatory emissions reductions that will decline over the years to come, aiming us toward a cleaner, greener energy future. The great news is that there are enormous opportunities in doing this: we can reduce air and water pollution as we burn less fossil fuels, build stronger communities that rely more on public transportation, offer more opportunities for healthy exercise with less reliance on cars, more access to healthy local food, and improve human health right now.

We can join with these wise physicians and become advocates for the health of those most vulnerable in society-and for our own health-by reducing global warming pollution. If we do, we can move toward a more secure future for the global community that will be our children's inheritance.

Our leaders cannot afford to be indecisive now, and we need to tell them so.

by Kim Knowlton for The Women's Media Center (www.womensmediacenter.com).

Is Global Warming A “Slow-Motion Disaster?” Not for India

2009-09-11T23:00:12Z

On the eighth anniversary of the tragic events of September 11th 2001, there are still many challenges to create a more secure world. Global warming has been highlighted recently as a threat to national security- but climate adaptation can help build more resilient, healthy communities.

I've been traveling in India for the last ten days with NRDC colleagues Anjali Jaiswal and Seth Silverman, as part of a new India initiative. We attended the Joint Indo-U.S. Workshop on Climate Change and Health in Goa, India where we heard climate-health researchers from both countries talk about the enormous challenges India faces from a changing climate. Andy Revkin has called global warming a "slow-motion disaster." In India, we can see what full-speed looks like.

Heat and drought throughout much of India are devastating communities and food supplies this year. When rains break the drought, flooding frequently contaminates water supplies. In 1999, 700,000 in India died from diarrheal illness, most of them children. Insect-borne diseases still plague India: millions of malaria cases are reported in India each year.

For nearly 300 million people in India who live on less than one dollar a day, extreme weather events are a matter of life and death.

And heat waves, drought, floods, and disease outbreaks are projected to become more intense, last longer, and happen more often or over larger areas as global warming continues.

This is a public health emergency. Climate-health adaptation needs to receive more support so implementation can begin, for projects that include early warning systems for heat waves and floods, dikes to hold back contaminated floodwaters, low-tech water supply and storage for rural villages, among a host of other ideas.

Speaking with Indian government and business leaders, we found enthusiastic support for climate-health adaptation. It's time for the U.S. to get energized about climate-health preparedness, too.

Reducing adverse health impacts is a key reason to reduce global warming emissions.
Climate change is a global problem that is harming health in every nation.
Emissions reductions must be accompanied by climate adaptations to help communities cope with health effects already being felt.

The American Clean Energy and Security Act (or ACES) passed by the House of Representatives in June is now before the US Senate. ACES has provisions that would support funds for international climate adaptations. It would also establish a Climate Change Health Protection and Promotion Fund to enhance state and local preparedness here at home.

Let's move ahead and reduce global warming pollution, support international efforts to adapt to climate-health disasters, and secure our own domestic preparedness fund by passing ACES in the Senate. Then we can really begin the business of learning how to thrive together in a changing world.

The Looming Threat of Dengue Fever in the U.S.

2009-07-09T23:01:39Z

It's summertime, and one of the rites of the season is the onset of mosquito activity in many parts of the country. For most Americans, these pests are simply an annoyance, but in many parts of the world they can be deadly, and they could become more dangerous here too.

A new report from the Natural Resources Defense Council, Fever Pitch, describes some of the factors that have contributed to the 30-fold increase in a mosquito-carried viral disease, dengue fever, over the last fifty years.

Two mosquito species that the new NRDC report maps in the US, Aedes aegypti and Aedes albopictus (also known as the Asian Tiger), have been known to carry the dengue fever infection. That doesn't mean they are all teeming with the virus naturally, but rather that they are able to contract the virus by biting someone sick with dengue and then transmit the virus to others. Just because the mosquitoes are in your state or county doesn't always mean that dengue fever disease outbreaks will occur, or that you'll get the disease - it simply means that your state or county may be vulnerable to an outbreak in the future. NRDC's report finds that more than 173 million Americans in at least 28 states live in counties where one or both of these mosquitoes have been found.

We would like to see more testing of mosquitoes in the US so we can know if, when, and where mosquitoes are carrying the dengue virus. When travelers infected with dengue fever "import" the virus back into the US, especially during the summer months when mosquitoes are active, it could increase the possibility of local transmission to other people.

Unless there's a large outbreak of the disease, you may not be able to find out how many cases of dengue fever are being reported in your state for months or years. Because the reporting system is so slow, and filled with holes, we'd like to see the system changed and updated. NRDC is advocating for dengue to become a nationally notifiable disease, with more rapid central reporting of suspected dengue fever cases, so individuals and scientists can get up-to-date information about the number of dengue cases in their state in a matter of weeks.

To help prevent an outbreak in your community, be sure to remove mosquito habitats around your home: empty any standing water from flower pots, buckets, or empty cans, and get rid of old tires or empty containers. Clean your pet water bowls daily, and watch out for clogged rain gutters: the mosquito vectors breed in standing water. Cover outdoor cisterns if you have them, and ask your neighbors to do the same.

And since global warming may be affecting dengue, an effective way to reduce the likelihood of spread is to address climate change at its source by reducing global warming emissions. Call your Senator or Representative to ask them what they're doing to protect their constituents from dengue fever and other climate-change related health risks (which include increases in deadly heat waves, air pollution-related illnesses, and the frequency of extreme storms with flooding.)

Is NRDC saying that global warming is the main cause of the increase in dengue fever infections in recent years? Nobody knows precisely why dengue fever infections have been increasing, and there are likely multiple reasons. But global warming and its associated increasing temperatures, lengthening summers, and changing patterns of rainfall and droughts, are among the factors that can make it easier for dengue to spread. Other factors include uncontrolled, unplanned urbanization and population growth; rapid international travel and trade; and widespread poverty. All these factors can help dengue-carrying mosquitoes exist in closer proximity to people. Global warming may work in conjunction with these factors by helping the mosquito "vectors" live longer, in more, and in different, places. NRDC is advocating for more funding for local environmental monitoring and disease surveillance that will, in the future, make it easier to understand the relative importance of all the different factors that may be giving dengue fever such a strong foothold in the Americas.

Once Bitten: Top Traveler Questions About Dengue Fever

2009-07-08T20:49:11Z

International travel is surely one of the great pleasures in life, something we look forward to and prepare for with great delight. Besides anticipating the gorgeous landscapes, or learning a bit about local history and culture, it's wise to learn about any local health concerns too. In many parts of the Western Hemisphere and Asia, dengue fever, a mosquito-borne viral disease, can be a serious health risk.

A new report from the Natural Resources Defense Council, Fever Pitch, describes some of the factors that have contributed to the 30-fold increase in dengue fever over the last fifty years. Urbanization and population growth, rapid international travel and trade, and widespread poverty - along with the effects of a changing climate - have created ideal conditions for the "world's most important insect-borne viral disease" to flourish in many parts of the Western Hemisphere. But if you're about to travel to South America or another tropical destination, there's no need to be worried about dengue fever. Just go armed with information. Then you'll be prepared to protect yourself, and there will be little reason to worry.

Before you travel, visit the US Centers for Disease Control and Prevention website, find out what parts of the world are currently experiencing dengue outbreaks, and learn more about how to protect yourself against dengue fever while you're traveling.
Protect yourself during your trip, and upon your return.The safest way to travel in dengue-endemic areas is to stay in air-conditioned or well-screened hotels with well-kept grounds, wear long-sleeved, loose clothing, and use insect repellent with 20-30% DEET on exposed skin. After a bite from an infected mosquito, it takes an average of 4 to 7 days for a person to begin to develop symptoms like a fever, aches, or rash. Many travelers don't even start to feel sick until they are back in the US.
If you're a traveler, it's very important to get information about dengue fever or other disease outbreaks in your destination country before you travel, know the precautions to take and the symptoms to watch for - and be sure to talk to your doctor back home about where you have traveled if you're not feeling well after you return.
Dengue fever can spread into the US from infected travelers. While many take comfort in being with their doctors back home when ill, if someone becomes infected with dengue fever while abroad, they can unknowingly "import" the virus to the US. Our Fever Pitch Map shows where dengue cases have been diagnosed in the U.S. When someone has the fever, which lasts 2 to 10 days, if they are bitten by another mosquito, it could spread the disease to other people.
One friend who was unfortunate enough to have gotten dengue on a tropical trip said, "I felt like my bones were made out of glass- I ached all over, and I just couldn't move. I've never been so miserable in my life." Yet, in general, the prognosis of dengue fever is excellent. Treatment for suspected infections usually includes bedrest and plenty of fluids. To manage the pain and fever, you can take acetaminophen - but be sure to avoid aspirin and other non-steroidal anti-inflammatory medications. In rare cases, some people-usually children-will need to be treated in the hospital for dengue fever. If that happens, doctors may need to draw blood samples while the patient is sick and again after recovery to confirm the dengue fever diagnosis.
So while you're packing sunscreen and shopping for other supplies, pick up the latest tips on how to enjoy a safe tropical trip at the CDC Travelers' Health Website.

And NRDC will do our part: (1) We will urge the CDC to require reporting of dengue fever so the spread of the disease within the US can be accurately tracked; and (2) We will continue to push for strong climate legislation in order to slow global warming.

New Lancet study calls climate change ‘the biggest global health threat of the 21st century’

2009-05-15T06:11:40Z

The Lancet - one of the world's most prestigious medical journals - has just published a 41-page study with the University College London Institute, summarizing a commissioned report on climate change and health. It's stunning that The Lancet is devoting so much coverage to this subject now, although the journal does have a track record of having published other excellent individual climate-health papers over the years. The new urgency conveyed by the piece highlights how much is happening right now on this issue, as it:

Calls climate change "the biggest global health threat of the 21st century"
Highlights disproportionate health vulnerabilities that exacerbate inequities between rich & poor people, communities, and nations
Emphasizes the need for public health professional to engage in advocacy to reduce climate change, and to secure funding to address preparedness needs
Urges that climate change be considered in all levels of governance actions, and its health impacts placed high on agendas for planning, academic curriculum, conferences, journals, meetings, etc.

There's a new wealth of emerging evidence that's cited in The Lancet article - including a recent paper in the journal Environmental Health Perspectives on the 2006 California Heat Wave that NRDC scientists Gina Solomon, Miriam Rotkin-Ellman, and Kim Knowlton co-authored with colleagues from the California Dept of Public Health. In that paper we found over 16,000 excess emergency department visits and nearly 1,200 excess hospitalizations occurred across California in just a little over two weeks, at a cost of $133 million.

And what's NRDC doing today on climate-health preparedness? Our Global Warming & Health Project is researching the links between global warming & health, trying to educate the public & policymakers about those links, advocating for a better-prepared public health system that can adapt to climate's health challenges, and promote solutions that reduce greenhouse gases and harmful chemicals at the same time. We're also trying to get health to become an increasingly focal concern in local and state adaptation plans.

NRDC reports have projected future changes in unhealthy ground-level ozone smog under a changing climate, evaluated heat wave morbidity, mapped climate-ozone-pollen interactions -- and we're currently looking at factors that contribute to vector-borne disease vulnerability. Check out the Global Warming and Health Project's website, and please stay tuned for breaking stories on emerging climate science and health preparedness strategies. We're all in this together - so stop, look, and please listen to this Lancet article.

Global Warming Poses a Double Threat to Health for Asthma and Allergy Sufferers

2009-05-12T15:04:22Z

USAToday ran a story today that in Alaska, global warming is lengthening pollen seasons and increasing ground-level ozone smog concentrations - but air quality and health is being affected in the lower 48 states, too.

NRDC's report Sneezing and Wheezing: How Global Warming Could Increase Ragweed Allergies, Air Pollution, and Asthma details how rising carbon dioxide and heat can affect allergies and asthma. It also has an interactive map that you can zoom in on to see whether your county and state has a problem already with ragweed pollen and smog.

Unfortunately for human health, ragweed pollen production tends to increase with higher carbon dioxide concentrations; summertime ozone levels in many areas also tend to be higher then in part due to warmer temperatures. Hot, clear summer days with calm winds tend to increase both ozone and pollen concentrations. Global warming and increasing carbon dioxide levels are projected to worsen air quality and could threaten human health in many areas.

For example, San Antonio, Texas is among the top 15 "Asthma Capitals of 2007" identified by the Asthma and Allergy Foundation of America as one of the most challenging places in the nation to live with asthma (based on asthma death rates, pollen levels, air pollution levels, poverty and uninsured rates, etc). And as Texas heats up more with global warming, San Antonio's ozone problem will get worse, and if you're one of the unlucky asthma sufferers there.

Among the 15 top U.S. Asthma Capitals for 2007 were:

Atlanta (GA)
Philadelphia; Harrisburg; and Scranton (PA)
Raleigh; Charlotte; and Greensboro (NC)
Knoxville (TN)
Little Rock (AR)
San Antonio (TX)
Milwaukee (WI)
Grand Rapids (MI)
Chicago (IL)
Los Angeles; and Fresno (CA)

NRDC's research found that 13 of the top 15 capitals were in counties where both ragweed and smog problems occur - and that's a double-whammy to health if you're someone with asthma and allergies. Our mapping showed that millions of Americans live in areas with both these problems. NRDC's Dr. Gina Solomon describes some of the implicaions from a physician's point of view - so please read on and consider how global warming could already be affecting the health of you and your family.

Kids' Health Suffers As Climate Change Worsens Smog

2009-05-04T16:14:24Z

If you have had the mistaken impression that climate change is something that's not going to affect anyone you know, or any place nearby until a long time from now -- please think again. A new study led by Dr. Perry Sheffield from the Mount Sinai School of Medicine in New York City - along with her colleagues Dr. Philip Landrigan at Mt. Sinai, Dr. Patrick L. Kinney at Columbia's Mailman School of Public Health, and me at NRDC - found that more children will end up hospitalized over the next decade because of respiratory problems resulting from projected climate change. The abstract was presented on Sunday, May 3, 2009 at the Pediatric Academic Societies Annual Meeting in Baltimore, Maryland. Dr. Sheffield's work on this eye-opening research finds a direct connection between air pollution and the health of children.

Air pollution has many known harmful effects on kids' respiratory health, and one of the best-documented impacts of climate change is an increase in ground-level ozone smog concentrations, in response to rising temperatures. The hotter the temperature and the more incident sunlight, the more ozone tends to form. Rising temperatures are projected for urban areas like the New York City metropolitan area as global warming continues. But it's not just city kids that will experience health risks from climate change: suburban areas downwind can experience even higher ozone levels.

For this study, Dr. Sheffield evaluated computer model simulations of New York City air quality and its health effects. She found that by 2020, respiratory hospitalizations are projected to rise 4-7% percent for children under two years old because of projected climate change-related ozone smog increases. "These significant changes in children's hospitalizations from respiratory illnesses would be a direct result of projected climate-change effects on ground-level ozone concentrations," said Dr. Sheffield. "This research is important because it shows that we as a country need to implement policies that both improve air quality and also prevent climate change because this could improve health in the present and prevent worsening respiratory illness in the future."

A little over two weeks ago on April 17, 2009, EPA Administrator Lisa Jackson announced that the Agency has already officially recognized that greenhouse gas pollution endangers human health and the environment. Here in New York City, kids in many communities already experience high asthma prevalence rates, and Dr. Sheffield's new study may cause local parents deep concern. Our kids rely on us, the older (and supposedly wiser) generation, to be their protectors. Now it's time for the regulators -- and legislators -- to keep following through and do their part to protect children's health from the dangers of global warming.

Drink It Up: Water & Health- (Un)Common, Priceless Commodities

2009-03-20T19:38:30Z

When you grow up in northeastern U.S., you get to take water for granted. A person can get so used to rainy, drizzly, dreary days that you start to dream about hot, dry, clear-sky deserts, totally without mud to scrape or snow to shovel. Then you leave your hometown, travel a bit, maybe see a dusty, thirsty community struggling to survive, and realize what an incredible gift it is to have naturally abundant sources of safe, clean water.

Today - this very day - one billion people don't have any clean water to drink; they will go thirsty the whole day. In 2004, an estimated 2.2 million people around the world died from unsafe drinking water, and 90% of them were children under five. In my work at NRDC on global warming and health, I get to explore how global warming threatens to make matters even worse by increasing heat and drought, altering rainfall patterns, and in many places exacerbate this lack of access to abundant, clean water. Now those rainy New York days don't seem so bad after all, since they replenish our magnificent drinking water reservoir system.

As the World Water Forum wraps up a momentous week in Istanbul, some of my colleagues from NRDC are there to talk with others working on these issues. To help people understand the range of human health problems that are affected by global warming, back here at home NRDC's Global Warming & Health Project is working on two upcoming factsheets. These will detail the links between global warming, environmental changes, drinking water quantity and quality, infectious diseases, and health. One factsheet will consider how those factors affect harmful algal blooms; and a second will look at effects on waterborne illnesses, including cryptosporidiosis, giardiasis, and cholera.

In some parts of the U.S., water for drinking (as well as agriculture, tourism, etc.) is already in crisis, including much of the American West - California, for example. And projected global warming is likely to worsen the Western water situation. Yet in other parts of the country (like the lush northeast), it's sometimes a challenge to raise people's awareness that the global and national drinking water crisis is everybody's business.

Tonight, I'm going to go to eat dinner with friends at a restaurant that's part of the Tap Project, a group trying to help connect people to the world's need for safe water by giving patrons the chance to make a $1 donation (in lieu of the table water typically enjoyed for free). That dollar can provide 40 days' worth of clean drinking water for a child. This Sunday, March 22nd, is World Water Day -a good chance to find out more about global warming, health and water issues, or just be grateful when you turn on the tap to pour yourself a glass of cool, clear water.

Mind the Gap: Climate-Health Preparedness in the U.S. Needs More Support

2009-03-19T19:46:04Z

When I moved to New York City, "mind the gap" was one of the first really useful warnings I learned - namely don't get too close to the subway platform edge or the oncoming train could ...well, do some untoward harm to you or someone you cared for. Such harm never happened because I heeded the warning - and I love New York, as they say, so I want to stick around a long time to enjoy its splendors.

But now that I'm doing global warming and health research at NRDC, I'm concerned about getting the word out on another set of hazards, namely the range of health risks associated with climate change - including more frequent heat waves, worsening air pollution, and increasing incidence of diarrheal diseases. And a new paper well worth reading has just been released online in the journal Environmental Health Perspectives (or EHP).

The paper is written by environmental health researchers from American universities, NGOs and consulting firms, including all seven co-authors of the "Human Health" chapter of the U.S. Climate Change Science Program's Analysis of the Effects of Global Change on Human Health and Welfare and Human Systems which came out in July 2008. The government itself called that peer-reviewed report "the most up-to-date synthesis and assessment of scientific literature on the impact of global change on human health" in the US. (Some of my own research on heat-related and ozone-related mortality under a changing climate was referenced in that chapter.)

"The preparedness gap" means the gap between what's needed to prepare to cope with global warming's health risks vs. the capacity that we actually have on hand right now. According to the new EHP paper this includes lack of infrastructure to monitor & report climate-sensitive health outcomes, lack of some fundamental understanding of baseline relationships (in part because of lack of investment in long-term data collection), and lack of tools to help policymakers prioritize research and preparedness programs that deal with climate and health.

The article details the amount of actual, directed federal funding that's been dedicated to research on climate-health impacts. The authors found that less than $3 million per year has been spent in extramural federal funding, while broader definitions that included research somehow related to climate and health had previously suggested far more generous amounts-- $164 million or more-- were spent annually. The authors then go on to explain why $200 million or more is really needed each year:

Restoring the nation's weakened environmental surveillance and health monitoring system would cost $100 million or more annually, a step that's vital to allow for early warnings of environmental health emergencies. (A 2008 NRDC report on US health monitoring programs details some much-needed changes.)
$1-2 million could help develop a software tool to help state and local health departments project risks of climate change - and no such model now exists.
Results of recent surveys reveal that many of the nation's public health officers feel unprepared regarding climate change, saying their departments need additional funding, staff and training to respond in an effective way.

Kind of like standing at the edge of a subway platform and seeing a big train coming, but not being able to move fast enough to get out of its way...

The new Omnibus bill includes $7.5 million for climate & health research at CDC for FY'09, certainly a tremendously positive step in the right direction- especially given the languishing state of climate-health dedicated funding in prior years. However, we are just getting started in terms of what we need to do to strengthen our nation's public health infrastructure. The EHP researchers recommend investment in four research areas:

Characterize observed weather/climate and health associations
Identify effects of climate change on health already happening in the U.S.
Develop & use models to project future climate-health impacts in the U.S.
Prioritize, implement & evaluate adaptation options

NRDC is advocating for additional funding to the US Centers for Disease Control & Prevention (CDC) in FY'10 so that they can apply their climate-health expertise to:

Establish a Research Coordinating Center at CDC
Establish a Interagency Task Force on Climate Change & Health
Support State & Local Preparedness
Create Academic Research Centers of Excellence

Stay tuned for more updates on NRDC's climate-health preparedness work, and please do mind this gap! It affects us all, especially the next generations -- our children and grandchildren -- who'll have to deal with even more health issues exacerbated by a changing climate.