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Final Report: Integrated Assessment of the Public Health Effects of Climate Change for the United States
EPA Grant Number: R824995Title: Integrated Assessment of the Public Health Effects of Climate Change for the United States
Investigators: Patz, J. F.
Institution: Johns Hopkins University
EPA Project Officer: Winner, Darrell
Project Period: October 1, 1996 through September 30, 1999
Project Amount: $2,700,728
RFA: Global Climate (1996)
Research Category: Global Climate Change , Ecological Indicators/Assessment/Restoration
Description:
Objective:The objectives of the research project were to: (1) assess the potential impact of climate change on important regional public health endpoints, including water-borne diseases (Cryptosporidiosis and Cholera) and vector-borne diseases (Hantavirus, Dengue and Lyme disease); and (2) appropriately characterize and communicate this information to support policy development and analysis.
Summary/Accomplishments (Outputs/Outcomes):The amount of research conducted and published in peer review journals across many fields of health and environmental sciences is evident (see Publications/Presentations below). In each of the projects, key new findings have been made in better understanding the link between climate and human health. These are specific to each disease listed below. Our findings will serve as an excellent foundation for further integration across these public health threats and across climate change assessments from other sectors.
Cryptosporidiosis. We completed the first historical analysis of reported waterborne disease outbreaks (all agents, not just cryptosporidium) across the entire United States since 1948, as potentially related to preceding rainfall. Using Monte Carlo analysis, a statistically significant association was found, suggesting rainfall intensity in a watershed as a contributing factor in disease outbreaks (Curriero, et al., 2001; Rose, et al., 2000). More policy relevant analysis included other important risk factors; in our Lancaster study area, 64 percent of livestock operations located within the 100-year flood plain tested positive for Cryptosporidium parvum oocysts in manure samples (Graczyk, et al., 2000). Work is still ongoing to establish a statistical relationship between C. parvum oocyst density and weather and watershed characteristics in the Susquehanna River basin.
Intermediate steps in this integrated assessment have led to major advances in hydrological runoff modeling achieved by this research. Papers by Brutsaert and Parlange, Cahill, et al., Gibson and Najjar, Najjar, and Szilagyi, et al. (listed and annotated in the Publications section below) add much to improving hydrologic modeling relevant to microbial contamination of drinking water sources. Also, economic analysis for baseline costs of cryptosporidiosis cases was completed (Kocagil, et al., 1998) and strategies provided for improving risk communication to stakeholders (Fisher, 1998).
Cholera. In the Chesapeake Bay, the presence of V. cholerae bacteria was significantly correlated with temperature and total bacterial counts, with the maximum detected in samples collected from the Baltimore Harbor. These results suggest that temperature is a leading factor in determining the population of V. cholerae in the Chesapeake Bay (Jiang, et al., 2000a). Fresh water sites had fewer isolates compared to the brackish water sites, suggesting that salinity also alters the dynamics of the V. cholerae population. Because no virulence factors were found in the isolated bacteria, this population presents low public health risk under current conditions in the bay. In our Mexico study site, sea surface temperature and precipitation data obtained from satellite sensors were used along with epidemiological data from the Ministry of Health. Temperature was always an important parameter associated with increased cholera cases.
Several key findings emerged from our Peruvian study site. Warm temperatures from El Ni?o during 1997/98 led to a doubling of childhood hospital admissions for diarrheal disease (Checkley, et al., 2000). Also, from sewage sampling, a threshold ambient temperature of 19.3?C was predictive of occurrence of V cholera O1 in sewage and subsequent cases of cholera in Lima (Speelmon, et al., 2000). Our epidemiological study of the 1991 massive cholera epidemic (Seas, et al., 2000) revealed 11 initial cases of cholera occurring at nearly the same time, but spread geographically (>1,000 Km) in location. With no cases identified in the previous year, these results suggest regional environmental or climatic conditions as among key determining factors in the 1991 epidemic.
Environmental analysis comprised of seawater and plankton samples from 500 meters offshore at four different marine stations along the coast of Trujillo, Lima and Arequipa, Peru. During August 1997 to September 1999, V. cholerae O1 was cultured from 5 percent of the samples and detected in a "viable but non-culturable" (VBNC) state in 16 percent. V. cholerae O139 was detected in a VBNC state in 27 percent of the samples, but on further analysis, these strains were found to belong to the O22 serogroup. However, the presumptive presence of the V. cholerae O22, ancestor of the dangerous O139 serogroup, suggests the possibility that a new pathogenic serogroup may be emerging.
Hantavirus. We have found that high risk areas for Hantavirus Pulmonary Syndrome can be predicted based on satellite generated risk maps of climate-dependent land cover over 6 months in advance (Glass, et al., 2000). Predicted risk paralleled vegetative growth, supporting the hypothesis that heavy rainfall from El Ni?o in 1992 was associated with higher rodent populations that triggered the Hantavirus outbreak in 1993. Landsat satellite remote sensing images from 1995, a non El Ni?o "control" year, showed low risk in the region, whereas the images from the 1998 strong El Ni?o again showed high risk areas. Trapping mice in the field (collectors blinded to risk category), validated these satellite generated risk maps with mouse populations directly related to risk level, with a correlation factor over 0.90 (Glass, et al., unpublished data). Risk classification also was consistent with the numbers of HPS cases in 1994, 1996, 1998, and 1999. Our methods, developed in partnership with CDC and the Indian Health Service are already being implemented for disease prevention in the southwest by the U.S. Department of Health and Human Services (DHHS).
Dengue Fever. The dengue fever transmission model (DENSiM) was improved to better account for water container temperature and water height, important to larval mosquito development rates (Chen, et al., 1998). Dengue simulation model runs have been completed for Brownsville, Texas using the Hadley Center HADCM2 and VEMAP interpolated climate projections for the years 2030, 2060 and 2100. Dengue transmission simulation shows very high sensitivity to relative humidity and temperature (e.g., excessive dryness limits mosquito survival). Also, while warm temperatures generally increase transmission dynamics, the extreme high temperatures predicted by HADCM2 for Texas diminish the risk of dengue in this location. Dengue is currently more relevant to our other study site, the U.S. territory of Puerto Rico, where we have completed all field data collection, and are currently completing model simulation runs. It is expected that these results will differ from those of Texas due to humidity differences. These findings that better characterize the relationship between climate and risk of dengue transmission have international public health application, and can be used to optimize environmental intervention strategies to bring disease risk below threshold levels that are determined by climatic conditions.
Lyme Disease. In the mid-Atlantic region, tick survey data was
analyzed for 15 locales. Multi-Resolution Land Characteristics (MRLC) data
provided landcover characteristics based on satellite imagery and, along with
10-year retrospective climate values (1984-93) were entered into the USDA Lyme
simulation model (LYMSiM) to determine baseline Lyme disease risk via the
vertebrate hosts involved in maintaining its life cycle: white-tailed deer and
white-footed mice. With the exception of a few sparsely forested sites, deer
carriage of the Ixodes tick approached 100 percent and mouse infection by the
Lyme spirochete varied between 60-80 percent for the baseline model runs. Under
climate change scenarios from GCMs generated from GFDL and Max Plank transient 2
(2020) and transient 3 (2050), the risk of infection increases for mice in most
locales, and tick carriage remains high for deer. Transient 2 models yielded
slightly higher infection rates than transient 3 models. Plans are already
underway to apply this simulation modeling to another EPA project in the upper
Midwest, where Lyme disease also is endemic.
Journal Articles on this Report: 19 Displayed | Download in RIS Format
| Other project views: | All 117 publications | 28 publications in selected types | All 26 journal articles |
| Type | Citation | ||
|---|---|---|---|
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Brutsaert W, Parlange MB. Hydrologic cycle explains the evaporation paradox. Nature 1998;396(6706):30. |
R824995 (Final) |
not available |
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Cahill AT, Parlange MB, Jackson TJ, O'Neill P, Schmugge TJ. Evaporation from nonvegetated surfaces: Surface aridity methods and passive microwave remote sensing. Journal of Applied Meteorology 1999;38(9):1346-1351. |
R824995 (Final) |
not available |
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Checkley W, Epstein LD, Gilman RH, Figueroa D, Cama RI, Patz JA, Black RE. Effects of El Nino and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children. Lancet 2000;355(9202):442-450 |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Cheng SQ, Kalkstein LS, Focks DA, Nnaji A New procedures to estimate water temperatures and water depths for application in climate-dengue modeling. Journal of Medical Entomology 1998;35(5):646-652. |
R824995 (Final) |
not available |
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Curriero FC, Lele S. A composite likelihood approach to semivariogram estimation. Journal of Agricultural, Biological, and Environmental Statistics 1999;4(1):9-28. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Easterling DR. Development of regional climate scenarios using a downscaling approach. Climatic Change 1999;41(3-4):615-634. |
R824995 (1999) R824995 (2000) R824995 (Final) R829388 (2006) |
not available |
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Fisher A. The challenges of communicating health and ecological risk. Human and Ecological Risk Assessment 1998;4(3):623-626. |
R824995 (Final) |
not available |
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Glass GE, Cheek JE, Patz JA, Shields TM, Doyle TJ, Thoroughman DA, Hunt DK, Enscore RE, Gage KL, Irland C, Peters CJ, Bryan R. Using remotely sensed data to identify areas at risk for hantavirus pulmonary syndrome. Emerging Infectious Diseases 2000;6(3):238-47. |
R824995 (Final) |
not available |
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Jiang SC, Louis V, Choopun N, Sharma A, Huq A, Colwell RR. Genetic diversity of Vibrio cholerae in Chesapeake Bay determined by amplified fragment length polymorphism fingerprinting. Applied and Environmental Microbiology 2000;66(1):140-147. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Jiang SC, Matte M, Matte G, Huq A, Colwell RR. Genetic diversity of clinical and environmental isolates of Vibrio cholerae determined by amplified fragment length polymorphism fingerprinting. Applied and Environmental Microbiology 2000;66(1):148-153. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Kocagil P, Demarteau N, Fisher A, Shortle JS. The value of preventing Crytosporidium contamination. Risk: Health, Safety & Environment 1998;(9):175-196. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Matyjaszewski K. Environmental aspects of controlled radical polymerization. Macromolecular Symposia, 2000, Volume: 152 (MAR) , Page: 29-42. |
R824995 (Final) R826735 (1999) R826735 (Final) |
not available |
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Najjar RG. The water balance of the Susquehanna River Basin and its response to climate change. Journal of Hydrology 1999;219(1-2):7-19. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Patz JA. Public health risk assessment linked to climatic and ecological change. Human and Ecological Risk Assessment 2001;7(5):1317-1327. |
R824995 (Final) |
not available |
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Rose JB, Daeschner S, Easterling DR, Curriero FC, Lele S, Patz JA. Climate and waterborne disease outbreaks. Journal of the American Water Works Association 2000;92(9):77-87. |
R824995 (2000) R824995 (Final) |
not available |
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Seas C, Miranda J, Gil AI, Leon-Barua R, Patz J, Huq A, Colwell RR, Sack RB. New insights on the emergence of cholera in Latin America during 1991: the Peruvian experience. American Journal of Tropical Medicine and Hygiene 2000;62(4):513-517. |
R824995 (1999) R824995 (2000) R824995 (Final) |
not available |
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Speelmon EC, Checkley W, Gilman RH, Patz JA, Calderon M, Manga S. Cholera incidence and El Nino-related higher ambient temperature. Journal of the American Medical Association 2000;283(23):3072-3074. |
R824995 (2000) R824995 (Final) |
not available |
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Szilagyi J, Parlange MB. Baseflow separation based on analytical solutions of the Boussinesq equation. Journal of Hydrology 1998;204(1-4):251-260. |
R824995 (2000) R824995 (Final) |
not available |
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Szilagyi J, Parlange MB, Patz JA, Graczyk TK. Sensitivity of watershed runoff under humid conditions to potential climate variations. Journal of Environmental Engineering-ASCE 2002;128(7):635-642. |
R824995 (Final) |
not available |
global climate, human health, health effect, regionalization, habitat, integrated assessment, hydrology, public health, climate model, remote sensing, estuary, public policy, decision making, cost benefit, willingness-to-pay. , Water, Air, Scientific Discipline, RFA, Drinking Water, climate change, Health Risk Assessment, Ecological Risk Assessment, Atmospheric Sciences, Hydrology, public health endpoints, Global Climate Change, hydrologic models, public health effects, remote sensing, habitat diversity, climatic models, policy making, environmental monitoring, integrated assessments, climate variability, water-borne disease, Cholera
Relevant Websites:
http://www.jhu.edu/~climate
http://www.jhsph.edu/globalchange
The dedicated project site (http://www.jhu.edu/~climate ) aims to appropriately characterize and communicate
current research in an accessible format. The site has received several design
awards and has been featured by search engines and similar sites. The web site
was submitted to multiple search engines and linked to key programs and
institutions in the sciences and academia.
Design Awards: Solutions for Networking and InterNet Working (SNIN)
Design Award
Market-Tek Design Award
Ravi's Design Elite
HMS Beagle
Web Design Pick
Starting Point Featured Design Site
BioMedLink Featured
Site
AltaVista Site of the Day
The site also was featured on CNN Interactive, November 17, 1998, and written up in Environmental Health Perspectives, May 1999.
Progress and Final Reports:
1999 Progress Report
2000 Progress Report
Original Abstract