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Mediterranean Climate Change Impacts Elena Xoplaki Justus-Liebig University of Giessen, Germany
Mediterranean
Climate Change Impacts
Elena Xoplaki
Justus-Liebig University of Giessen, Germany
elena.xoplaki@geogr.uni-giessen.de
Outline • The Mediterranean basin • Climate change – Mean and extremes • Health issues
Outline
• The Mediterranean basin
• Climate change
– Mean and extremes
• Health issues in the Mediterranean basin
• Adaptation strategies
• Conclusions
The Greater Mediterranean Region It is influenced by subtropical processes, mid-latitude dynamics … Source: ESA,
The Greater Mediterranean Region
It is influenced by
subtropical processes,
mid-latitude dynamics
Source: ESA, 2010
High population density (~60 persons/km 2 ), vulnerability,
exposure to climate change….a “hot spot”
Xoplaki, 2002
Giorgi, 2006
What we know about the Mediterranean Liguria Santorini Es Trenc Carthage Formentor Cyprus
What we know about the Mediterranean
Liguria
Santorini
Es Trenc
Carthage
Formentor
Cyprus
Do we know? Mykonos Pindos Rome Formentor Venice
Do we know?
Mykonos
Pindos
Rome
Formentor
Venice
Do we know?
Do we know?
Vulnerability in the Mediterranean Hydrologic cycle – Rainy season Water resources & water quality Agriculture
Vulnerability in the Mediterranean
Hydrologic cycle – Rainy season
Water resources & water quality
Agriculture & environment
Economics & social development & behaviour
Temperature extremes – Heat waves
Air pollution, health
Tourism
Vulnerability in the Mediterranean Deforestation, afforestation, desertification Land degradation Food production, food
Vulnerability in the Mediterranean
Deforestation, afforestation, desertification
Land degradation
Food production, food security
Livelihood
Civil security, migration
Political conflicts
Energy demand, energy generation, solar, wind
Public health
The Mediterranean Climate Summer temperature CRUCRU StationStation datadata °°CC ToretiToreti 20102010
The Mediterranean Climate
Summer temperature
CRUCRU
StationStation datadata
°°CC
ToretiToreti 20102010
Mediterranean Climate Change Summer temperature 1951-2006 CRUCRU StationStation datadata °°C/decadeC/decade
Mediterranean Climate Change
Summer temperature 1951-2006
CRUCRU
StationStation datadata
°°C/decadeC/decade
ToretiToreti 20102010
Mediterranean summer Tmax & Tmin -0.12°C/decade +0.67°C/decade -0.19°C/decade +0.61°C/decade -0.27°C/decade
Mediterranean summer Tmax & Tmin
-0.12°C/decade
+0.67°C/decade
-0.19°C/decade
+0.61°C/decade
-0.27°C/decade
+0.48°C/decade
-0.30°C/decade
+0.43°C/decade
Kuglitsch 2010
The Mediterranean Climate Winter precipitation StationStation datadata CRUCRU mmmm ToretiToreti 20102010
The Mediterranean Climate
Winter precipitation
StationStation datadata
CRUCRU
mmmm
ToretiToreti 20102010
Mediterranean Climate Change Winter precipitation, 1951-2005 CRUCRU StationStation datadata ToretiToreti 20102010
Mediterranean Climate Change
Winter precipitation, 1951-2005
CRUCRU
StationStation datadata
ToretiToreti 20102010
Extreme events in the Mediterranean
Extreme events in the Mediterranean
Extreme precipitation Probability of occurrence of extreme events. Estimated tendency sign increase sign decrease
Extreme precipitation
Probability of
occurrence of
extreme events.
Estimated
tendency
sign increase
sign decrease
no significance
Toreti 2010
Dry days (< 1 mm), October – March Differences of dry days occurrences sign increase
Dry days (< 1 mm), October – March
Differences of dry
days occurrences
sign increase
sign decrease
no significance
Heat waves trends HWI95: +1.33 ± 0.06°C/decade 56% stations significant HWL95: +0.85 ± 0.02 days/decade
Heat waves
trends
HWI95: +1.33 ± 0.06°C/decade
56% stations significant
HWL95: +0.85 ± 0.02 days/decade
37% stations significant
HWN95: +0.17 ± 0.01/decade
47% stations significant
Kuglitsch et al. 2010
Heat waves trends Heat waves “hot spots”? Western Balkans Western Turkey Black Sea Coast Kuglitsch
Heat waves
trends
Heat waves “hot spots”?
Western Balkans
Western Turkey
Black Sea Coast
Kuglitsch et al. 2010
Eastern Mediterranean heatwaves from The International Disaster Database; Kuglitsch, 2010
Eastern Mediterranean heatwaves
from The International Disaster Database; Kuglitsch, 2010
Apparent temperature > 105°F/40.7°C Changes are strongest over humid and warm regions (coasts and river
Apparent temperature > 105°F/40.7°C
Changes are strongest over humid and warm regions (coasts and river basins)
Fischer and Schär 2010
Health risk and population density 2071-2100 Source IIASA Fischer and Schär (2010)
Health risk and population density
2071-2100
Source IIASA
Fischer and Schär (2010)
Climate change will affect, in profoundly adverse ways, some of the most fundamental determinants of
Climate change will affect, in profoundly adverse
ways, some of the most fundamental determinants of
health*: food, air, water.
Margaret Chan, Director General, WHO
** HealthHealth isis aa statestate ofof completecomplete physical,physical, mentalmental andand socialsocial wellwell--beingbeing
andand notnot merelymerely thethe absenceabsence ofof diseasedisease oror infirmity.infirmity.
((PPreamblereamble toto thethe ConstitutionConstitution ofof thethe WorldWorld HealthHealth OrganizationOrganization,, 1946)1946)
Climate change can affect human health Heat/cold waves Heat stress Cardiovascular failure Respiratory diseases Air
Climate change can affect
human health
Heat/cold waves
Heat stress
Cardiovascular failure
Respiratory diseases
Air pollution
Respiratory and cardiovascular
diseases
Adapted from Confalonieri et al. 2007
Sustainable development and mitigation
Vector- and rodent borne disease
Malaria
Encephalitis
Hantavirus
West-Nile Fever
Lyme disease
Environmental
Socio-economic
conditions
conditions
Climate change
Long term
Direct exposures (extreme events)
changes in
climate
Indirect exposures
(through changes in vector
ecology, food yields, ect.)
Water- and food borne diseases
Cryptosporidiosis
Campylobacter
Leptospiriosis
Toxic infections (mycotoxins)
Seasonality in gastro-intestinal
diseases
Inter-annual
climate variability
Short-term climate
variability
Social & economic
disruption
Water stress
Skin and eye diseases
Infectious diseases
Food supply
Extreme events
Malnutrition
Health
systems
Prevention and
adaptation
Refugees/Migration
Exposure-response Max apparent TT – daily mortality April – September Valencia Athens Rome Bari Lisbon
Exposure-response
Max apparent TT –
daily mortality
April – September
Valencia
Athens
Rome
Bari
Lisbon
Tunis
Barcelona
Istanbul
Palermo
Tel Aviv
Analitis et al. 2012
Valencia Athens J-shaped relationship highest increase in temperate cities Rome Bari Lisbon Tunis Barcelona
Valencia
Athens
J-shaped relationship
highest increase in
temperate cities
Rome
Bari
Lisbon
Tunis
Barcelona
Istanbul
Palermo
Tel Aviv
Analitis et al. 2012
Increase in total natural deaths by age group in heat waves days 80 60 Total
Increase in total natural deaths by
age group in heat waves days
80
60
Total causes: 14%
Cardiovascular: 22%
Respiratory: 32%
40
20
0
-20
0-64yrs
65+yrs
all ages
-40
Analitis et al. 2012
% increase
Athens
Barcelona
Bari
Istanbul
Lisbon
Palermo
Rome
TelAviv
Tunis
Valencia
Heat waves effect on total mortality Heatwave effect on TM, all ages 50 40 30
Heat waves effect on total mortality
Heatwave effect on TM, all ages
50
40
30
20
10
0
-10
No poll.
O3
PM10
Analitis et al. 2012
% increase
Athens
Barcelona
Istanbul
Lisbon
Palermo
Rome
TelAviv
Tunis
Valencia
Temperature & air pollution effects • Synergistic effect of higher PM 10 concentrations and higher
Temperature & air pollution effects
• Synergistic effect of higher PM 10 concentrations and higher
temperatures
• More pronounced for the elderly and cardiovascular
causes; not entirely consistent in all cities
• Synergistic effect of O 3 with temperature only for total
mortality, elderly
• No synergistic effect between NO 2 and temperature
• Heat waves effects larger during days with higher PM 10
concentrations; however NOT statistically significant
• Overestimation of apparent temperature and heat waves
without adjustment for PM 10
Wolf et al. 2012
Climate sensitive infectious diseases The burden of disease
Climate sensitive infectious diseases
The burden of disease
Population density Cultural and economic separation between high income countries (northern shore) and mid-income
Population density
Cultural and economic
separation between
high income countries
(northern shore) and
mid-income countries
(N. Africa, Middle East)
Burden of infectious diseases Total population (x1000) All causes death rate (per 100000) WHO 2004
Burden of infectious diseases
Total population
(x1000)
All causes death rate
(per 100000)
WHO 2004 - GBD
Burden of infectious diseases Infectious and parasitic diseases death rate (per 100000) Infectious and parasitic
Burden of infectious diseases
Infectious and parasitic
diseases death rate
(per 100000)
Infectious and parasitic
diseases (without climate
related) (per 100000)
WHO 2004 - GBD
Burden of infectious diseases Infectious vs. all causes death rate (%) Infectious (climate) vs. all
Burden of infectious diseases
Infectious vs. all causes
death rate (%)
Infectious (climate)
vs. all causes
death rate (%)
WHO 2004 - GBD
Causes for observed emergent infectious diseases a) the infection was present but unrecognized or unrecorded
Causes for observed emergent
infectious diseases
a) the infection was present but unrecognized or
unrecorded
b) the pathogens existed in the past but in a less
virulent form
c) environment and behavioral changes provide
new conditions in which the disease may flourish
d) a new epidemic arise from the introduction of a
virulent organism into a non-immune population
HaggetHagget (1994)(1994)
Epidemiological factors: economical security • Capability of individuals & government to overcome difficulties
Epidemiological factors:
economical security
• Capability of individuals &
government to overcome
difficulties connected with
infectious diseases
• Security correlated with
economic welfare and
investment on health
• Clear differences between
EU-countries and the
others
Epidemiological factors: land and water use Changes in the Mediterranean – anthropogenic biomes • colonization
Epidemiological factors:
land and water use
Changes in the Mediterranean – anthropogenic biomes
• colonization of new environments in order to expand
food production
• abandonment of farmland reverting to woodland
• alteration of the local water regimes due to water control
and irrigation
• disease implications of the growing urban population and
the abandonment of rural areas
alterations in the survival of pathogens and in the
interaction between hosts and vectors
Agricultural and forest land cover and land cover change Croplands % Variation of cultivated area
Agricultural and forest land cover
and land cover change
Croplands %
Variation of cultivated area 1962-2003
Pastures and
rangelands %
Forest area change 1990-2005
Forests
Remaining forest
Original extent
FAO 2007
Water resources, water use FAO 2007
Water resources, water use
FAO 2007
Water use – water availability EEA 2012
Water use – water availability
EEA 2012
Water resource exploitation 2025 PlanBleu
Water resource exploitation 2025
PlanBleu
Epidemiological factors: mobility of hosts and vectors • enhancement of spatial mobility for human hosts,
Epidemiological factors:
mobility of hosts and vectors
• enhancement of spatial mobility for human hosts,
vectors and micro-organisms
• bird migratory routes
• displacement of human populations as a result of
war, natural disasters
• merchant shipping
• travel
• human migration
Main bird migration routes
Main bird migration routes
Migration routes
Migration routes
Maritime trade Europe – Asia routes of one company
Maritime trade Europe – Asia
routes of one company
Mobility, air travel Grublerand Nakicenovic 1991
Mobility, air travel
Grublerand Nakicenovic 1991
Relevant climate- sensitive infectious diseases for the Mediterranean Basin
Relevant climate-
sensitive
infectious
diseases for the
Mediterranean
Basin
Assessing health effects Adaptation strategies • Assessments of climate change and health impact vulnerability and
Assessing health effects
Adaptation strategies
• Assessments of climate change and health impact
vulnerability and adaptation provide essential
information about the risks to health, their
differential distribution between groups and
places, future projected risks and help to set
priorities for adaptation and financing.
Mediterranean countries with UNCFFF communications Country UNFCCC communication (link) Specific health concerns
Mediterranean countries with
UNCFFF communications
Country
UNFCCC communication (link)
Specific health concerns outlined
Albania
http://unfccc.int/resource/docs/natc/turnc1.pdf
only general health concerns mentioned, not specified
Croatia
http://unfccc.int/resource/docs/natc/hrv_nc5.pdf
heatwaves, foodborne disease, respiratory allergies, malaria, tick borne
meningoencephalitis,
France
http://unfccc.int/resource/docs/natc/fra_nc5rev.pdf
mainly heat, separate assessment published
Greece
http://unfccc.int/resource/docs/natc/grc_nc5.pdf
forest fires and floods, as well as air pollution aggravated in cases of extreme heat
waves
Italy
http://unfccc.int/resource/docs/natc/ita_nc5.pdf
all possible risks are listed
Malta
http://unfccc.int/resource/docs/natc/mlt_nc02.pdf
all possible risks are listed and in part assessed
Montenegro
http://unfccc.int/resource/docs/natc/mnenc1.pdf
all possible risks are listed and partly assessed
Spain
http://unfccc.int/resource/docs/natc/esp_nc5.pdf
only general health concerns mentioned, not specified
Algeria
http://unfccc.int/resource/docs/natc/algnc1.pdf
only general health concerns mentioned, not specified
Schistosomiasis, Malaria, Lymphatic Filariasis, Rift Valley Fever, emerging:
Egypt
http://unfccc.int/resource/docs/natc/egync2.pdf
Tuberculosis, Avian Influenza, water-borne and food-borne diseases
Israel
http://unfccc.int/resource/docs/natc/lbnnc01.pdf
only general health concerns mentioned, not specified
Lebanon
http://unfccc.int/resource/docs/natc/lbnnc01.pdf
only general health concerns mentioned, not specified
Morocco
http://unfccc.int/resource/docs/natc/mornc1e.pdf
only general health concerns mentioned, not specified
Tunisia
http://unfccc.int/resource/docs/natc/tunnc1esum.pdf
health not mentioned
Turkey
http://unfccc.int/resource/docs/natc/turnc1.pdf
only very general health concerns mentioned, not specified
Mapping climate change vulnerabilities to infectious diseases Would specific vector-borne diseases be affected by
Mapping climate change
vulnerabilities to infectious diseases
Would specific vector-borne diseases be affected by climate change?
Semenza et al. 2011
Mapping climate change vulnerabilities to infectious diseases Semenza et al. 2011
Mapping climate change
vulnerabilities to infectious diseases
Semenza et al. 2011
Adaptation strategies • Training for assessing health risks of climate change • Enabling national public
Adaptation strategies
• Training for assessing health risks of climate change
• Enabling national public health experts to coordinate the
development of a climate change and health strategy,
emphasizing the health sector role in adaptation and
mitigation
• Sustainable adaptation:
– Strengthen monitoring and disease surveillance
– Strengthen public health systems in responding to climate change
– Promote the development of a green economy and health co-
benefits of mitigation and adaptation
Conclusions • climate change-related exposures and health impacts are likely to increase in the Mediterranean
Conclusions
• climate change-related exposures and health impacts are
likely to increase in the Mediterranean
– high temperatures, heat waves and air quality
– changes to the distribution and patterns of climate sensitive
infectious diseases
– health risks related to water availability and quality, droughts,
food and nutrition can trigger migration and conflict. The full scale
of the health security risks need to be further understood
– additional efforts need to be put into data collection, surveillance,
homogenized definitions and partnerships across disease networks
Conclusions • Adaptation strategies: –strengthen health, social and environmental systems and services to improve
Conclusions
• Adaptation strategies:
–strengthen health, social and environmental systems and services
to improve their capacity to prevent, prepare for, and cope with
climate change
–ensure that all current and future mitigation and adaptation climate
change measures, policies and strategies integrate health issues at
all levels
–raise awareness to encourage health promoting mitigation and
sustainable adaptation policies in all sectors
–increase the health and environment sectors’ contribution to
reducing greenhouse gas emissions
–share best practices, research, data, information, technology and
tools at all levels on climate change, environment and health and
to identify research gaps (WHO Regional Office for Europe, 2010).
Healthy cities – Key messages • Cities are complex systems, so urban health outcomes are
Healthy cities – Key messages
• Cities are complex systems, so urban health outcomes are dependent
on many interactions
• The so-called urban advantage—whereby urban populations are, on
average, at an advantage compared with rural populations in terms of
health outcomes—has to be actively promoted and maintained
• Inequalities in health outcomes should be recognised at the urban
scale
• A linear or cyclical planning approach is insufficient in conditions of
complexity
• Urban planning for health needs should focus on experimentation
through projects
• Dialogue between stakeholders is needed, enabling them to assess and
critically analyse their working practices and learn how to change their
patterns of decision making
Rybin et al. The Lancet 2012
ThankThank youyou veryvery muchmuch forfor youryour attention!attention!
ThankThank youyou veryvery muchmuch
forfor youryour attention!attention!