A Submission from the Chartered Institute of Environmental Health
February 2009
The Chartered Institute of Environmental Health
Our mission is to maintain, enhance and promote improvements in environmental and public health through knowledge, understanding and campaigning.
As a professional and awarding body, we set standards for the education and professional development of our members and the public, awarding qualifications and accrediting universities and training courses.
As a knowledge centre, we provide information, evidence and policy advice to government departments, students, members of the public and industry. We publish magazines and journals, commission research and develop policy positions.
As a training organisation, we educate employers, practitioners and individuals about environmental health issues. We organise events and courses with recognised qualifications enabling people to make a real difference to health and wellbeing.
As a campaigning body, we are committed to pushing environmental health further up the public policy agenda and are called upon by government and local authorities to share our knowledge, research and evidence.
We are a registered charity with nearly 11,000 members across England, Wales and Northern Ireland.
Any enquiries about this response should be directed in the first instance to:
Gary McFarlane
Director NI
Chartered Institute of Environmental Health
Philip House
123 York Street
Belfast BT15 1AB
Telephone 028 9024 3884
Email g.mcfarlane@cieh.org
1. Summary
1.1 The CIEH commends the Environment Committee on its decision to make climate change the subject of its next inquiry. In our view this is the most urgent and challenging issue faced by not only by the Northern Ireland Assembly, but indeed by governments across the world.
1.2 This written submission seeks to set out some broad proposals. We believe it should be viewed as the start of a process of dialogue on this subject between the organisation and the committee. We would ask for the opportunity to discuss the contents of this paper in more detail with the committee and other stakeholders through whatever process the committee deem most appropriate.
1.3 We will also be happy to provide further supporting documentation and evidence on any of the issues raised in this initial paper if required or requested.
1.4 As a member of both Northern Ireland Environment Link (NIEL) and the Climate Change Coalition Northern Ireland (CCCNI), the CIEH is aware of and would wholly endorse and support the proposals made in those submissions.
1.5 Given the previous point this paper does not seek to reiterate those proposals, but rather to provide further evidence, particularly regarding the health impacts which relates to our field of professional expertise.
1.6 Health impacts clearly carry with them not only a financial cost (primarily through additional burdens on an already overstretched NHS) but also a significant, even profound, social cost which is more difficult to quantify in terms of a financial indicator.
1.7 The future of the economy is entirely dependant on adopting a truly integrated sustainable development approach across all government policy areas. If we fail to urgently incorporate and address environmental factors into all areas of the public, private and community & voluntary sector then our economy, along with the natural systems on which we ultimately depend for life, will collapse. Government in NI must urgently readdress its regrettably poor track record in this. Tackling climate change is the pro-growth strategy for the longer term, and it can be done in a way that does not cap the aspirations for growth of rich or poor countries(1).
2. Background
2.1 At the core of climate change is the increase in average global temperatures. Eleven of the past 12 years (1995-2006) rank among the twelve warmest in the instrumental record of global surface temperature since 1850. (IPCC 4th Assessment report 2007)(2).
2.2 The IPCC report contains conclusions that have profound implications for the future and highlight the absolute critical need for action now. These are summarised below:
21st Century Climate changes are
- Most of the global warming of the past half-century is due to increases in greenhouse gases.
- That the CO2 concentration in the atmosphere is unprecedented in the last 650,000 years
- The changes are cumulative (caused by past activities)
- The effects are irreversible
- There are large time lags – today’s actions are tomorrow’s problems and the world is already committed to more warming over the next few decades (even if we stopped all emissions now)
- They are global – they affect everyone
2.4 This does not in any way in our view contradict or conflict with the evidence that suggests extreme climatic changes are a natural phenomena in the history of the planet. The same evidence also suggests that previous changes to global temperatures took place over substantially longer time periods than what we are now experiencing.
3. Health implications
There is a growing body of information and evidence on the health impacts of climate change. The World Health Organization estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures(3).
As well as having direct effects on health such as those relating to rising temperatures, increased flooding and more infectious disease, climate change also contributes towards widening the gap in health inequalities. Brief outlines of some of the potential health impacts/costs are summarised below. These have been abbreviated from a more substantive document published in November 2008. The data and evidence is drawn from a wide variety of sources and is fully referenced within the document which is available at http://www.cieh.org/library/Policy/Publications_and_information_services/Policy_publications/Climate_Change_Public_Health_Health_Inequalities.pdf
The reason why we believe that the health implications are so important in the Committees deliberations is largely to do with its expressed desire to consider the costs of failing to meet proportionate climate change obligations and commitments for NI (we note and are greatly concerned that as yet no such commitments have been made – we fully support and endorse the proposals set out in the CCCNI submission attached at appendix 1).
It is impossible and perhaps even unethical to attempt to place a financial figure on these - particularly in the case of predicted or modelled mortality increases as a result of extreme weather events such as: heatwaves and/or floods; increases in infectious diseases; possible civil unrest; or simply hunger. But it is very clear that Northern Ireland will face global impacts.
In November 2008 CIEH organised and facilitated a conference which incorporated many of the issues summarised below. The panel of speakers included leading international thinkers and academics as well as input from major UK advocates, policy makers, and business leaders. Webcasts of those presentations are available for viewing at http://www.cieh.org/event/climatechange_webcasts.html and may be useful for the committee to consider as part of their deliberations.
3.1 Food poverty, food security and demographics
3.1.1 The potential impact of climate change on world agriculture is enormous for us in the UK. The UK is self sufficient in food. We import around 40 percent of our food needs.
Some argue that we are heading towards a significant crisis in world food supplies as world crops are already being hit by extreme weather. For example, recent drought in Australia caused wheat prices to rise resulting in increased bread, cereal and animal feed prices across the world. Additionally countries are increasingly converting agricultural land to the production of bio-fuels – putting further pressure on basic food items like rice, wheat and corn.
3.1.2 Food animals, particularly, cattle produce significant amounts of methane. Methane, like carbon dioxide, is also a greenhouse gas – and in actual fact a much more potent one. Methane has been estimated to have around five times the warming potential of CO2. Meat consumption in the developing world, particularly China and India, is increasing significantly as overall affluence increases and those populations aspire to lifestyles that the privileged world has enjoyed for decades. A world of global carnivores with meat consumption levels akin to that of the US and UK is not sustainable. Interestingly, this is but one example of where there is a strong complimentarity between what might arguably be a sound environmental policy direction for the future, i.e. reducing consumption of red meat and increasing intake of fresh fruit and vegetables, and clear public health benefits in that this would entirely compliment current health policy.
3.1.3 Another very significant factor is population growth and demographics. The global population is currently increasing by around 7 million per month, and people are living longer lives. This has implications for consumption of both natural and man made resources and subsequently greenhouse gas emissions. Virtually everything we consume carries a carbon cost since energy, water and ultimately fossil fuels are inextricably linked to the production of all goods and services including food.
3.1.4 Equally significant may well be substantial increases in migration. Even in the best case scenario several scientific models already predict severe climate impacts in low lying deltas such as North East Africa, Bangladesh and Southern Asia. This has profound implications for global migration patterns and could significantly increase migration to these islands. Predictions indicate that by 2050 up to 1 million people could be displaced from each of these regions as a result of rising sea levels alone – the loss of these areas are also extremely significant in terms of world food production.
3.1.5 As a result of the above coupled with the inextricable link between food production and two key natural resources – oil and water – food prices are accelerating exponentially. Food prices have risen 45 percent since the end of 2006. There is, and is likely to be in the future, less land available in the world to grow crops, less oil and water for its production (while increased rainfall maybe a phenomenon of climate change we see in these latitudes, drought will be equally significant in other major food production areas of the world) and more people to feed. Food security is a very real and poignant threat. The 2006 interdependence report, published by the New Economics Foundation, indicated that the UK was, at that stage, reliant on the rest of the world by 16 April each year. That reliance includes food.
3.1.6 Even without global food shortages it is virtually certain that increasing food prices, coupled with other increasing vital daily living costs such as energy and water, will see increasing numbers of vulnerable people facing life threatening poverty, whether that be food, fuel or both. This will add to the burden of food poverty already existent in NI as outlined in a report published by the Public Health Alliance for the island of Ireland (PHAII) in November 2007(4).
3.2 Heatwaves
3.2.1 Heatwaves are potentially lethal for vulnerable people, particularly those living in cities. Associated air pollution can further add to the dangers. For northern European countries, the heatwave threat is perhaps one of the most dramatic manifestations of climate change. For Europe, one of the most significant examples of the danger of climate change was the 2003 heatwave in France. In an advanced nation with excellent healthcare 35,000 people died. In the UK that summer it is estimated that there were 2,000 to 3,000 excess deaths [i.e. more than usual] in England.
3.2.2 There is a one in 40 chance that by 2012, southern England will have a severe heatwave which could again cause up to 10,000 heat related deaths. A wide variety of people are at risk, but particularly the most vulnerable in society including the elderly and those already ill. The risk of this type of occurrence within NI is, as yet, unquantified. However what is clear is that national UK targets for reductions in greenhouse gas emissions and international targets such as Kyoto have been calculated in an attempt to contain global temperature rise to no more than 2c above pre industrial levels by 2050. In other words by 2050 it is likely that summer temperature peaks will be significantly higher in the UK, and potentially including NI.
3.2.3 As with all health impacts, efforts to mitigate the effects of climate change must be considerably stepped up. However it is equally vital that appropriate and commensurate adaptive efforts are made in NI. At present NI, unlike England and Wales, does not have any plans in place to deal with a heatwave emergency. This needs to be addressed as a matter of urgency.
3.3 Cold-related illness
3.3.1 Despite predicted temperature rises cold related illness needs to remain a public health priority. In the last five years, more than 130,000 people over 65 have died from cold related illness during the winter months in Britain. There has been considerable political debate, campaigning, and ultimately intervention by the NI Assembly within the last six months concerning the issue of fuel poverty.
3.3.2 To what extent cold related deaths will be affected through climatic changes in the future is unclear. Some predictions suggest that they may well decrease due to milder winters, whilst other modelling has suggested the contrary, particularly with more extreme rises in global temperatures because of the way in which weather systems are affected (the changes are not necessarily either linear or corresponding – i.e. increased global temperatures can actually cause colder weather). What is more certain is that there is a high likelihood of increasing fuel poverty in the future due to increasing fuel and energy costs as well as increasing food costs. It is clear that efforts to reduce the number of people living in fuel poverty need to be substantially increased.
3.3.3Strategies or interventions developed to tackle fuel poverty must include facilitating a greater move towards more sustainable heating alternatives. For example, the previous grants scheme administered by DETI, which encouraged and facilitated the installation of renewable technologies for households and encouraged a move away from fossil fuel dependence not only helped households in cutting fuel bills but also reduced carbon emissions.
3.4 Increased rainfall and rising sea levels
3.4.1 Floods are the most common natural disaster in Europe. They can cause death and serious injury as well as psychological distress through the devastating effects that such events can lead to, such as the loss of one’s home or material possessions. Apart from the obvious direct health impacts of flooding there are also additional potential risks created as a result of secondary consequences that may arise, for example pollution incidents (chemical or biological and including the contamination of drinking water supplies); an increase in breeding grounds for disease carrying organisms due to high volumes of standing water; soil disturbances as a result of flood water which may increase exposure of agents such as anthrax and toxic contaminants such as heavy metals and disease and hazards associated with evacuation.
3.4.2 The potential for the frequency of flooding incidents is increasing not only because of increasing rainfall in the UK, but also due to rising sea levels. Sea level rise also affects the drainage capabilities of substantial river basins and estuaries. NI has not escaped from serious flooding incidents in recent times. In December 2005 properties around the Ormeau road in Belfast were flooded for the 3 rd time in 5 years(5) . Serious flooding incidents occurred in June 2007 and August 2008 affecting large parts of NI.
3.4.3 Quite apart from the obvious social costs associated with these incidents in terms of the damage to and displacement of people from their homes, and the payouts in insurance claims which has been estimated to run into several million, the combined cost to the public purse from these incidents can conservatively be estimated at 6.2 million(6).
3.5 Waterborne disease and water pollution
3.5.1 Waterborne disease outbreaks, like cholera, are currently regarded as low risk in developed countries. However after Hurricane Katrina in the USA in August 2005 a cluster of Vibrio organisms were attributed to flood water and other environmental exposure. Severe flooding has the potential to significantly affect drinking water supplies through contamination of the mains supply. Most at risk are people with poorly treated private water supplies, unfiltered surface water and groundwater. More surface water turbidity caused by heavy rain escalates indicator bacteria and pathogens - a challenge for water treatment works, particularly those abstracting direct from rivers. Cryptosporidium parvum, Giaria Iamblia and microsporidia are found in higher numbers after heavy rainfall. They can cause diarrhoea, stomach cramps and vomiting. Acute gastroenteritis proved to be another consequence of Hurricane Katrina. A Norovirus outbreak was reported in Texas among evacuees in overcrowded temporary shelters.
3.5.2 Floods can also increase the risk of rodent-borne disease. Flood related outbreaks of leptospirosis have been reported in several developing countries. Given that there are significant concerns over the increasing prevalence of pests in the UK, this is a risk which needs to be considered more seriously. Breeding of other potential insect vectors following floods could become a matter of concern in the UK, particularly when coupled with warmer weather. Standing water as a result of flooding creates an ideal breeding ground for mosquitoes.
3.6 Waterborne diseases due to increases in temperatures
3.6.1 Pipes and reservoirs are more vulnerable to micro-organisms during frequent droughts, particularly in coastal areas and at the end of water distribution systems. Algal blooms are likely to increase and associated health problems, from skin irritation to severe systemic disease.
3.6.2 Drinking water quality is more vulnerable in warmer climates. The risks from increased consumption of bottled water in warm weather are contamination, multiplication during storage and re-use of containers. Importing and transporting bottled water also increases our carbon footprint.
3.6.3 Water shortages and standpipes during drought periods could indirectly increase infections because of difficulties maintaining hygiene. Upland sources in peat-covered catchments would contain higher levels of dissolved organic carbon, risking trihalomide formation or disinfection with chlorine. This would be more likely after dry periods.
3.6.4 Water associated diseases like legionellosis could increase with the increased use of air conditioning and humidifiers that may be needed as part of adaptation interventions necessary to prepare for heatwaves etc.
3.6.5 As pathogens survive longer in warmer water, there are implications for wider leisure use of untreated fresh and marine waters contaminated by sewerage and animals.
3.7 Food poisoning
There is a strong correlation between notified food poisoning, Salmonella infections and temperature in the UK. Climate change could cause about 10,000 extra cases of food poisoning a year in the UK(7).
3.7.2 Higher temperatures also increase the risk of infection in animals, multiply bacteria in animal feed and add risk to the food chain.
3.8 Sunburn and skin cancer
3.8.1 Rates of melanoma, the most dangerous form of skin cancer, have risen by over 40 percent in the past decade, making it the fastest rising cancer in the UK. Melanoma skin cancer rates could treble over the next 30 years. There are more than 76,000 new cases of skin cancer in the UK each year.
3.9 Other health effects
3.9.1 As mentioned above, pests could become even more important disease vectors in the UK as a result of climate change. The spread of West Nile fever in the US and Lyme disease in Europe are warning signals of the impact of pests on public health. The World Health Organization report Public Health Significance of urban Pests has recently highlighted this issue. Paradoxically, the control of significant pests in the UK has been declining over the past decade. Given the evidence that indicates future temperature increases and the clear consequences of this in terms of the increased risk from pests this decline needs to be reconsidered.
3.9.2 As temperatures and rainfall increase, mosquitoes carrying the malaria parasite will extend their range. The Australian Centre for Epidemiology and Public Health estimates that up to 80 million people will be living in malarial regions by 2080. Indigenous malaria may be re-established in the UK by 2050.
3.9.3 The risk of disease from tick bites, such as tick borne encephalithis (TBE) and Lyme disease is harder to estimate, but the trend is upwards.
3.9.4 Other insect vectors that could be re-introduced in a warmer climate include fleas responsible for plague, associated with an increase in rodent populations or movement of rats during flooding.
3.9.5 Stinging and biting insects (bees, wasps, horseflies, hornets) could increase along with the danger of severe allergic reactions.
4. Discussion
4.1 This paper has sought to compliment and indeed support the recommendations made in the CCCNI submission as well as develop in more detail some of the critical public health implications of climate change. There is currently very little research that attempts to quantify the actual costs associated with some of these projections and predictions. In part that is because it is very difficult to do so, coupled with the fact that there are some extremely sensitive issues around doing so – how for example does one “cost” the loss of a human life through a heatwave for example?
4.2 It is however clear that there will be significant financial costs associated with dealing with highly probable consequences of unmitigated or unadapted climate change in terms of emergency responses; associated health care and treatment costs; and escalating insurance costs. It is also clear that “doing nothing” will have severe and seriously detrimental consequences for the NI economy.
4.3 Whilst the lack of research for NI is on the one hand a difficulty, it is difficult to see how this gap can be bridged either easily or, more importantly, in time. There is clear scientific evidence to suggest that emissions can only continue to rise for at best another eight years – six years would be, arguably, a wiser target – before they need to begin decreasing. That conclusion is based in turn upon the widespread consensus that it is imperative to contain global temperature rises to no more than 2 degrees above pre industrial levels. The key reason why this target is held as so critical is because even the most conservative modelling suggests that further temperature rises will trigger natural “positive feedback” mechanisms within our environment which will in turn then cause even greater release of greenhouse gases and therefore in turn even greater and more catastrophic climate change(8) .
4.4 Whilst we accept the lack of current NI specific evidence in terms of cost analysis, we would urge the assembly to take both a pragmatic and risk averse approach to this, particularly because of what is already known in terms of the science. “Business as usual” is not in our view an option.
4.5 As already outlined, CIEH wholly supports and endorses the proposals made by both CCCNI and NIEL to this inquiry (appendix 1). It is imperative in our view that a robust legal framework is put in place and that the Assembly commits to the appropriate and commensurate targets, including the proposed interim target of a 40% reduction by 2020. It is also vitally important that the correct framework is developed to support both the achievement and the robust monitoring of these targets.
4.6 In addition to government other sectors, including the business, local authority and community and voluntary sectors have vital roles to play in the collective efforts to tackle climate change. Notwithstanding the previous point it is vital that this is not overlooked.
4.6 Action by local authorities will be critical to the achievement of the Assembly’s climate change objectives. Local authorities are uniquely placed to provide vision and leadership to local communities by raising awareness and to influence behaviour change. In addition, through their core business and services, LAs can have significant influence over emissions in their local areas both directly and indirectly. The forthcoming community planning responsibilities could and should add even greater capacity and support for this potential.
4.7 Serious consideration should be given to linking all parts of the public sector into the achievement of binding targets for NI through appropriate statutory means. This could be achieved for local authorities through a strengthening of the mandatory sustainable development powers and duties.
4.8 At present NI lacks any coherent and consistent framework for potentially monitoring current and future carbon emissions at local level. DEFRA have developed a national indicator, NI186, to allow reporting of per capita emissions by local authority area(9). However, to the best of our knowledge at the time of this submission, this framework and data collection does not extend to cover NI. We would strongly advocate that this should be the case and that this needs to be addressed as a matter of urgency.
4.9 At present there the UK heatwave plan does not extend to cover NI, nor is there any equivalent. This issue needs to be addressed in an appropriate way.
4.10 Likewise there is a need to look comprehensively at the wider health aspects and risks associated with flooding incidents and ensure that appropriate and commensurate precautions are in place to prevent against potential public health threats.
4.11 Notwithstanding the previous points regarding the need for a clear government commitment to binding targets and an appropriate framework to develop prioritised future actions, it is clear that there is much that could be and needs to be done in the shorter term. Government must lead this agenda by example. Yet there are still large parts of the public sector which operate (i.e. in terms of the way they do their business) in a largely unsustainable way. Through better use of technology, much greater facilitation of remote and home working, much better staff engagement and ownership of the issue through appropriate capacity building and awareness raising programmes, the public sector could not only achieve significant carbon savings but also significant financial ones. All government departments should seek to put in place an effective environmental management system forthwith and should utilise the considerable expertise and assistance that already exists in NI in doing so.
Appendix 1
Footnotes
(1) The Stern Review; http://www.hm-treasury.gov.uk/stern_review_report.htm
(2) IPCC 4 th Assessment report; http://www.ipcc.ch/ipccreports/index.htm
(3) Impact of regional climate change on human health; Patz, JA et al; 2005
(4) Food Poverty – Fact or Fiction; http://www.phaii.org/index.cfm/section/publications/
(5) http://archive.niassembly.gov.uk/io/research/2008/9708.pdf
(6) http://archive.niassembly.gov.uk/io/research/2008/9708.pdf
(7) Cooking up a storm, Tara Garnett, Centre for Environmental Strategy, University of Surrey, 2008. Prof G. Bentham, Centre for Environmental Risk, University of East Anglia
(8) Six degrees; Lynas M; 2006
(9) http://www.defra.gov.uk/environment/localgovindicators/ni186.htm