A new integrative perspective on early warning systems for health in the context of climate change
Introduction
Both the drivers of climate change, as well as its impacts, severely affect health at a global level. Fossil fuel burning (a major driver of climate change) crucially contributes to the 7 million annual deaths from outdoor and indoor air pollution, whereas climate-related risks and exposures are bound to threat many aspects of the societies we live in, severely affecting health (WHO, 2018).
The causality between some climate-influenced direct exposures and health outcomes is well-established and understood, such as the impact of heat waves on mortality (Carmona et al., 2016; Martinez et al., 2019; Linares et al., 2020) and -with more heterogeneity-also on population morbidity (Cheng et al., 2019; Díaz et al., 2017). Others, such as the impact of heat waves on car accidents, work-related accidents, and mental health or violence are still to be fully explained. Mental health disorders, for example, seem to be influenced by climate change mainly in relation to the loss of homes or uninsured economic losses due to extreme weather events, droughts or the rise in sea level but in the practice this issue is largely unexplored (Watts et al., 2018).
Changes in vector borne diseases and their geographic redistribution (Ebi et al., 2018; Linares et al., 2020) are another of the risks of climate change on human health whose influence will be exacerbated in Europe (Cramer et al., 2018), as will food-borne and water-borne, expected to increase in coming years as a consequence of the increase in global temperature (Kovats et al., 2004; Ciscar et al., 2014).
Indirectly, climate change also affects the concentrations of air pollution present in large cities, reducing ventilation and pollutant dispersion or through the elimination of processes of troposphere-stratosphere exchange of ozone (Linares et al., 2020). It influences the increase in forest fires with a clear impact on the health of citizens (Linares et al., 2018), and increases concentrations of tropospheric ozone as a consequence of the temperature increase. Mineral dust advection can also be affected by atmospheric dynamics, especially in Europe, where in recent years an increase has been detected in PM10 concentrations in the Eastern Mediterranean as a consequence of dust storms (Krasnov et al., 2016). These desert dust intrusions have a clear effect on, not only through the increase in PM10 concentrations, but also through the increase in other pollutants (Moreira et al., 2020; Pandolfi et al., 2014).
Section snippets
The need for Integrated Prevention and action plans for climate change and health
All of these risks require implementation of health policies aimed at reducing population vulnerability and the design of early warning systems that serve to take action and put in place prevention plans.
For example, in the case of heat waves, prevention plans together with different heat adaptation processes) have proven to have excellent results in terms of reducing the impact of morbidity and mortality related to temperature extremes (Linares et al., 2020).
In the case of air pollution,
Integrated Prevention and Action Plan on Climate Change and Health
A proposal for an Integrated Prevention and Action Plan on Climate Change and Health would aim at jointly activating individual plans that have already been developed but are not connected. Such integrated plans would include different phases or stages of action (Fig. 1).
Phase 1: Activation of the Plan. Based on available forecasts of different selected indicators and exceeding the thresholds defined by the indicators that are a part of the health surveillance system, the Integrated Plan would
Conclusions
Climate change has multiple impacts on human health, both direct and indirect. In the case of heat waves in particular, the connection with factors such as air pollution and multiple implications for health make development of public health surveillance systems that bring together the diverse indicators described in this chapter necessary. There is a need to design and implement action plans that account for the greatest number of environmental factors that are impacted by heat waves and that
Disclaimer
The authors declare they have no actual or potential competing financial interests. This article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health, the World Health Organization, or the UNEP DTU Partnership.
CRediT authorship contribution statement
C. Linares: Conceptualization, Writing - original draft. G.S. Martinez: Methodology, Writing - review & editing. V. Kendrovski: Resources. J. Diaz: Supervision.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
The authors gratefully acknowledge Project ENPY 376/18 and Project ENPY 107/18 grants from the Carlos III Institute of Health.
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2023, Science of the Total EnvironmentCitation Excerpt :Conventionally, heat wave prevention plans focus exclusively on temperature-related effects. Our results strongly suggest that these plans must be more comprehensive (Linares et al., 2020), i.e., they should integrate all factors with potential health impacts that may be exacerbated by a heat wave. These include the aforementioned increase in air pollution, forest fires (Linares et al., 2018b), the increase in foodborne diseases (Duchenne-Moutien and Neetoo, 2021), and the exacerbation of droughts (Salvador et al., 2020).
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2022, Environmental ResearchCitation Excerpt :However, this lack of interdependence fails to address the factual co-occurrence and causal links of these exposures. Conversely, an integrative approach for the multiple effects that climate change has on population health may help further reduce impacts via improved timeliness and potential economies of scale (Linares et al., 2020). Our survey was conducted largely before the Covid-19 pandemic.