Holding Human Health Over the Coals

By LIZ DURKEE

Despite the gadgets and technological wizardry that define our era, human beings don't require much to survive. Yet we've manipulated the natural world to the point where our basic needs are at risk. The World Health Organization says it best: "Climate change affects the fundamental requirements for health – clean air, safe drinking water, sufficient food and secure shelter."

Climate change is bad for human health. Extreme weather is no friend to our minds and bodies, especially our respiratory systems. The culprits are higher temperatures, ground-level ozone pollution, sea level rise, storms, heavy rains and flooding, fire and drought (not to mention earthquakes and tornadoes, unexpected but real events in Massachusetts this year).

The good news is that there will be fewer cold weather-related injuries and deaths and no likely rise in that most insidious local disease - Lyme.

But the risks are clear. Rising temperatures and more severe heat waves cause increased loss of life and heat stress-induced illness, spikes in the severity of chronic respiratory and cardiovascular diseases and risk for diabetics. Hotter weather expands pollen seasons, worsening asthma and allergy symptoms. It increases the risk of water pollution and algae blooms. More carbon dioxide causes poison ivy to grow faster and become more potent.

According to a study published by the Union of Concerned Scientists: "Hotter, drier summers punctuated by heavy rainstorms may create favorable conditions for more frequent outbreaks of mosquito-borne diseases such as West Nile virus." The Vineyard Gazette reported this summer that a mosquito in Tisbury tested positive for West Nile.

In their book, Changing Planet, Changing Health, Dr. Paul R. Epstein and Dan Ferber write: "Heat already kills about 1,500 people per year in the United States, making it more lethal than hurricanes, tornadoes, floods, and earthquakes combined. But unlike those natural disasters, heat waves kill silently, leaving no destruction or physically altered landscapes. What's more, their victims are disproportionately elderly, infirm, poor, minority, or living alone."

Increased ground-level ozone reduces air quality. The Intergovernmental Panel on Climate Change reports: "Even modest exposure to ozone may encourage the development of asthma in children." The Climate Institute adds: "During the past two decades, the prevalence of asthma in the U.S. has quadrupled, in part because of climate-related factors."

The Union of Concerned Scientists notes that ground-level ozone, "is associated with increased hospital admissions for pneumonia, asthma, allergic rhinitis, and other respiratory diseases, as well as premature death."

Urban areas will fare worse than the Island, but more people everywhere will buy air conditioners to relieve the impacts, thus increasing the amount of greenhouse gases that are pumping up the heat and ozone levels.

Public health officials know that higher heat and ozone pollution make it more challenging to meet air quality standards, yet President Obama recently shelved a proposal to tighten ozone standards.

Meanwhile, longer summer droughts increase the likelihood of fires, which can degrade air quality, cause lung and respiratory problems and endanger firefighters. Droughts - as well as storms, heavy rains and floods - can stress local food production and increase reliance on imported and chemically-treated food.

Living on an Island adds salt to our climate-induced health wounds. Sea level rise and more intense storms, rainfall, and flooding cause physical injury and death from storm debris and drowning and put rescue personnel in harm's way. Major storms can cause the loss of water and sanitation services, drinking water contamination, lost access to medical facilities, stress-related heart attacks and strokes, and water-borne and bacterial infections, all of which could crack, if not crumble, the local economy.

Flooding causes mold growth that aggravates respiratory problems – allergic rhinitis, asthma, chronic obstructive pulmonary disease, and allergies. Winddriven storms can spread fungal spores. Flooding creates breeding grounds for mosquitoes.

Dr. Fred Lowe, an asthma and allergy specialist at the Martha's Vineyard Hospital and in Falmouth, says "There is a clear increase in the percentage of people with asthma and allergies ... there are a lot of theories out there but climate change is not one of the most prevalent right now." The link to climate change is an interesting idea, he says, but "the most recent theories are that people are exposed to too little allergens, that children's environments are too clean," unlike, for example, living on a farm. He agrees that mold is an issue in areas of flooding and dampness.

In addition to mainstream medicine, alternative care such as acupuncture is used to treat some respiratory diseases.

Extreme weather also affects our mental health - from the loss of loved ones, homes, and jobs to stress, anxiety, and an overall lost sense of security. The Climate Institute reports: "Following a severe weather event, a significant part of the community ... will suffer the debilitating effects of extreme stress, emotional injury and despair. Unabated, a more hostile climate will spell a substantial rise in the incidence of post-traumatic stress, anxiety and depression - all at great personal suffering and, consequently, social and economic cost."

Dr. Charles Silberstein, a psychiatrist at the Martha's Vineyard Hospital, says: "People who are likely to be troubled by any kind of traumatic change can have a recurrence or exacerbation of symptoms . . . that include not sleeping well, being consumed by worry, more hyper-vigilance, and being startled more easily."

Is climate change affecting the residents of the Vineyard? "I don't know if it's true or not," Dr. Silberstein says. "People talk about the world being a less consistent place, that the future is frightening. It's harder to be a child or adolescent today. If the world as we know it is disrupted ... it's hard on kids."

Dr. Silberstein is a co-author, with Dr. Diane M. Becker, of a unique and valuable 2006 health report entitled, Martha's Vineyard: The Health Conditions and Health Status Report. The report does not address climate change, yet several health conditions already prevalent on the Island are now associated with it including depression, inhaled allergies such as hay fever and rhinitis, and non-melanoma skin cancer.

The report states: "The prevalence of a lifetime history of all skin cancers is significantly higher in both part-time and full-time residents of Martha's Vineyard compared to the U.S. population."

The Centers for Disease Control and Prevention warn that "another direct affect of climate change, depletion of stratospheric ozone, will result in increased ultraviolet (UV) radiation exposure. UV radiation exposure increases the risk of skin cancer and cataracts."

In the first piece in this series, Lyme disease was linked to climate change. That connection is "hogwash," according to Dr. Samuel R. Telford 3rd, professor in the Tufts University Department of Biomedical and Infectious Diseases.

Dr. Telford has done a great deal of Lyme disease research on the Vineyard and by his observation: "If anything, the Islands will benefit from climate change, we will become like southern Virginia on down where there are few bona fide cases of Lyme, and our Canadian neighbors will get the epidemic situation."

Oddly enough, an invasive species may aid victims of Lyme disease. At the Native Earth Teaching Farm Rebecca Gilbert, a farmer and herbalist, says she attends international herbal conferences every two years and "one of the herbs showing the most promise for Lyme disease is Japanese knotweed." She adds that if you overlay maps of the emergence here of Lyme and Japanese knotweed, it is "spooky; plants grow where they are needed in some way."

Ms. Gilbert, who has suffered from Lyme disease, recommends "taking all the antibiotics prescribed for Lyme disease, and not herbs with active Lyme. But when doctors don't have any more answers, we have herbs that can help."

Even if greenhouse gas emissions end tomorrow (and they will not end anytime soon) the impacts to human health will continue. Island health care providers - from the hospital to the complementary care community - have an opportunity to develop a strong, interdisciplinary plan to address climate-related health care.

The U.S. Global Change Research Program reports that "The probability of exacerbated health risks due to climate change points to a need to maintain a strong public health infrastructure to help limit future impacts."

As humans and patients we need to understand the connection between human health and the environment. Mold, for example, is linked to allergies which are linked to depression (which is linked to Lyme disease); all spring from the natural world - moisture, plants, air quality, extreme weather. Seeing the causes can help bridge the gap between symptoms and successful treatment. And we all need healthy bodies and minds to face a challenging future.

This series of essays about climate change was published in the Vineyard Gazette over a period of seven months in 2011. It appears here with permission. Copyright Vineyard Gazette. All rights reserved.

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