unhealthy climate case study

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Life in an unhealthy climate

Abnormal weather has a far greater impact on people's health than previously imagined.

16 Sep 2011 17:03 Mandi Smallhorne

Afirefighter battles a fire fuelled by strong winds and record temperatures in Vyksa, Russia. (MikhailVoskresensky, Reuters)

Krish Perumal does not look forward to Durbans summers. A middle-aged supervisor in a rubber-producing company, he was struck by asthma about 25 years ago when he was in his early 30s. Itsworse when its hot and humid, he says. When you get bad wheezing, then you can get the flu.

Perumal believes his condition is caused by industrial pollutionand he may be right. He lives in southDurban, home to two of South Africas biggest oil refineries and more than 120 industries, and more than280 000 people. The area is a notorious pollution hot spot and a study done a few years ago showed thatchildren here were twice as likely to get asthma as those in the northern parts of the city.

But there is reason to believe that global warming may be playing a part in the rise in respiratory diseasehere and elsewhere (asthma rates have been soaring around the world in the past three decades). Average


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temperatures in Southern Africa have risen by 1.5C over the past century as opposed to 0.8C globally,according to Dr Francois Engelbrecht of the Council for Scientific and Industrial Research (CSIR). Thecombination of higher temperatures and industrial pollutants is bad news for asthma sufferers likePerumaland gives him a special interest in the 17th Conference of the Parties of the United NationsFramework Convention on Climate Change (COP17), which will take place in Durban from November28.

The pollutant by-product of interest here is ozone, which is something most of us connect to the hole in

the ozone layer happening in the Antarctic high up in the sky. But ground-level ozone is common in ourcities. It forms when nitrogen oxides (NOx, a product of combustion in cars, trucks, industrial processesand coal-fired power plants) react with volatile organic compounds in sunlight, explains Dan Ferber, co-author with Dr Paul Epstein of Changing Planet, Changing Health (University of California Press).

Ground-level ozone irritates the respiratory system, damages lung tissue and reduces lung function. Ittriggers coughing, chest discomfort, a scratchy feeling in the throat and other symptoms. It makes peoplemore susceptible to respiratory infections and it exacerbates asthma and emphysema.

Effects on health

When he started working on the book, Ferber says, he had no idea what he would discover. The overall

scope of the potential health problems was surprising to me.

Ferber says that because scientists focus on their own specialities, the public receives information aboutclimate change piecemeala study that looks at how crops are being affected; research on expandingranges for mosquitoes; insight into changing patterns of rainfall. It is only when you step back and try totake in the whole picture that you realise this should be framed as a public health crisis, he says.

Consider how all-encompassing the effects on health are. Most of South Africa has been malaria-freehitherto. But it is common cause that climate change will likely increase the range of the Anophelesmosquito that carries malaria. It will also altersometimes increasing, sometimes reducingthe rangeof other insects that carry disease, such as the ticks that carry Congo fever. South Africa needs to be

prepared for a possible rise in insect-borne diseases.

Then there is water. Water is the primary medium through which people in Africa will experienceclimate change impacts. By 2020, it is estimated that 75-million to 250-million Africans will be exposedto increased water stress, writes Dr Mary Galvin in a forthcoming publication by the EnvironmentalMonitoring Group, Water and Climate Change: An Exploration for the Concerned and Curious.Projections indicate that South Africa will not benefit from the fact that warmer air holds more moisture:specific climatic features mean that, overall, we will be hotter but not get much increase in usefulrainfall.

Some of the rainfall will come in extreme weather events such as the recent floods in the Newcastle andUpington regions, which can damage crops and do not necessarily sink into the underground water table,instead running off and washing away precious topsoil.

What does this mean for our health? Water is, of course, a vital nutrient, but it is also crucial to a securefood supply. A reduced rainfall, combined with changes in times when crops can be planted andharvested because of higher temperatures, will likely add to greater food insecurity. Lester Brown,president of the Earth Policy Institute in Washington, DC, has estimated that for every 1C increase intemperature, yields of staple grains will drop by 10%. This, of course, like all the impacts of climatechange, will hit the poor hardest.


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I can say with confidence that there is a link between rising food prices and climate change, saysFerber. Drought in Australia, wildfires in Russia and other events affect global food supply. In August,for example, China Dailyreported that South Koreas rice harvest was expected to reach a 10-year lownext year because of abnormal weather conditions, which we should perhaps be calling the newnormal.

An absence of fresh, clean water in adequate amounts for drinking and washing, coupled withundernourished people add up to a perfect health storm: water-borne diseases like cholera thrive in such

conditions and malnourished peoples immune systems are unable to mount a sufficient defence.

We should be putting thought into adapting to a water-poor future, says Galvin: Sustainable water usagesolutions that could be implemented not simply by ecologically progressive households or municipalitiesbut on a national scale include rainwater-harvesting landscapes for growing food, from commercialagriculture to small-scale farms to homestead gardens; the use of grey water to irrigate agriculture, parksand public sites; ecological treatment of sewage; dry sanitation systems such as compost toilets and pitlatrines; and reducing water leaks.

Adaptation will also require improving river and local wetland health; adjusting farming practice withresilient crops and shifting seasons; expanding the number of households with food gardens; and

preparing for drought or floods.

Heat effects on productivityWe all know about the 2003 heat wave, the hottest on record in more than 450 years, which killed about40 000 people in Europe. Perhaps we dismiss the significance of this in our minds because the newsfocus was on the elderly people who died in great numbers. What went largely unnoticed at the time wasa significant increase in deaths among those under 65demonstrating that heat has a substantial effecton younger people too. Interestingly, although far more elderly women than men died, men were abouttwice as likely to die as women in the younger age group.

Heat waves will be more common in future, but the increase in average temperatures alone is likely to

have an impact on human health in ways that will reduce productivity, shorten life spans and decreasewellbeing significantly, as Professor Tord Kjellstrom and his South African colleagues pointed out at aseminar at the University of Johannesburg in August. Kjellstrom is an internationally recognised experton the health impacts of climate changehe is part-time professor and visiting fellow at the NationalCentre for Epidemiology and Population Health at the Australian National University in Canberra and isdeveloping a global programme of studies on high occupational temperature health and productivitysuppression (Hothaps) that is aimed at quantifying the impacts of heat exposure at work.

In a warming world we will experience the highest temperatures during the day, while we are at work.The majority of workers will not be able to escape the heat in air-conditioned offices. They will be out inthe fields harvesting crops, labouring on construction sites or in factories that are inadequately cooleddoing the work that feeds us and gives us the pleasant and useful things in life.

Professor Angela Mathee, head of the Medical Research Councils Environment and Health ResearchUnit, and colleagues Joy Oba and Andre Rose have done a pilot study as part of Hothaps. Theydemonstrated that many outdoor workers were already exposed to alarmingly severe health andproductivity impacts from heat exposure.

Focus groups in Johannesburg and Upington spoke of increased thirst, excessive sweating, exhaustion,dry noses, blisters, burning eyes, headaches, nose bleeds and dizziness, among a host of other effectsincluding chronic tiredness: When it is very hot, sometimes when you wake up in the morning you feel


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exhausted, said one Upington participant. As temperatures rise further in the near future, symptoms likethese will have to be urgently addressed by employers and the government.

Sweating it outExcessive perspiration is a serious heat-related health concern that can become a killer. Kjellstrom spokeabout South American sugar-cane cutters who sweated several litres of fluid in a day, but only broughttwo litres of water to work with them because they had to walk and could not carry more. Because theemployers did not provide water in the field, each day they would have to wait until knock-off time to

replace the deficit, which had led to a spate of life-threatening kidney conditions in relatively youngworkers.

The imbalance of salts that results from heavy sweating is one reason why heat exposure reducesproductivity: it leads to a lessened ability to work intensively and a loss of perceptual and motorperformanceeven mild dehydration has been shown to decrease mental performance. The brain alsosends a signal to decrease muscle tone, which leaves people feeling tired and listless.

People will be working at a slower paceif you are working in a consistent temperature above 28C youshould work only half your normal hours, says the professorand their risk of accidents on the job alsowill increase. There are psychosocial effects as well: aggression rises, for example, increasing the risk of

conflict and interpersonal friction in the workplace.

In addition, Kjellstrom points out, heat in many workplaces will interact with chemicals such as solventsand pesticides used on the job; these will evaporate faster, boosting the danger of exposure for workers.And workers who wear protective clothing will be hotter while at the same time being less able toperspire as effectively. In Southeast Asia, innovators are coming up with concepts to tackle this problem.One inventor has developed a vest containing tubes of material that stay frozen solid until about 25Cwhen the temperature hits 30C you stick it in the freezer again.

South African research

Weve known about the effects of heat in the workplace for a long time, says Kjellstrom. But it is only

recently that people have begun to link this knowledge with the oncoming juggernaut of climate change.

Interestingly, the original research on heat and labour was done right here in South Africa about 60 yearsago. Dr CH Wyndham tested the work capacity of fit young men who came to work in the hotunderground of Johannesburgs mines. He found that although about 64% of men could cope withmoderate physical labour in hot conditions, only a few were able to cope with heavy labour. He decidedto acclimatise them by having them exercise in a warm gym daily for a few weeks, after which thenumber who could do hard labour jumped to 29%still less than a third. Wyndhams concept is still inuse to acclimatise and harden new recruits and men who return to the mines after holidays.

Will our future climate be hot enough to trigger these on-the-job health problems? The answer is yes. Atthe CSIR recently, atmospheric modeller Dr Francois Engelbrecht presented the results of six simulationsor models of our future, the largest exercise of its kind ever done here. The news is not good: SouthernAfrica has an observed temperature increase over the past century of double the global average, and thistrend will continue over the decades between now and centurys end. So ifand its an unlikely prospectwe manage to keep the global increase down to two degrees, Southern Africa will experience four.This means that whereas a pleasant Gauteng January day between 1960 and 2000 was usually about25C, it would in future be about 29C. If, as many scientists now believe is likely, the increase is threeor four degrees globally, we are going to have some stinking hot summers.

The middle class and the wealthy will be able to buy their way out of many of these impacts for the next


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decade or soair conditioners and filters will protect us from the heat and pollutants and insectrepellents from mozzies and ticks. And we will probably moan at the price of water and food. Butclimate change will affect the poor the most, worsening the divide between rich and poor and placingserious demands on the public purse.

Few hold out much hope for a meaningful and binding treaty at COP17. But the dark picture expertspaint of our future health prospects if we do not act, and act now, provides South Africans with urgentreasons to hopeand lobbyfor an outcome that holds some promise.

All material Mail & Guardian Online. Material may not be published or reproduced in any formwithout prior written permission.

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