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Climate change and pharmacy in Australia: 1. Increased deaths and hospitalisations

Con Berbatis
A Pharmacy Researcher Perspective

Issue 74: August 2008
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Editor: The Garnaut draft report on climate change released in July 2008 has every likelihood of impacting on our lives like few other events.
The health consequences of climate change and their mitigation have been under-reported.  The Garnaut report estimates heat-related changes to health indicators under ‘unmitigated’ (no action) and ‘mitigation’ scenarios.
Con Berbatis reviews predicted heat-related deaths and hospitalisations up to 2100.
Part 2. reviews heat-related   working days lost and increased rates of food- and mosquito-borne infections .
He points to likely impacts on future pharmacy practice in Australia
.

1.0 Background and aims

The Australian National University’s Professor Ross Garnaut introduced the 537-page Draft Report of the Garnaut Climate Change Review to the National Press Club in Canberra on 4 July 2008.1

 This was  followed on 16 July by the Minister for Climate Change and Water, Senator Penny Wong, with the  Government’s Green Paper on the Carbon Pollution Reduction Scheme.2

The Green Paper canvassed the government’s version of the emissions trading scheme raised in the Draft Report. Professor’s Garnaut’s report emphasised the technical elements of the range of physical, human and economic effects of climate change.

In the launch, Professor Garnaut outlined each of the impacts reviewed in the Draft Report. On the effects of climate change on health he said: “...There are likely to be substantial health costs associated with the warming that will be associated with unmitigated climate change through the 21st Century. We can model the monetary health costs.... if you have much higher levels of mortality and in Queensland because of the much higher proportion of hot days a lot of people will attach value to that independently from the costs of medical services...” 3

   

The study of impact of climate change on health in Australia has been led since 2000 by Professor Tony McMichael’s group at the ANU’s National Centre for Epidemiology and Population Health.4

 Professor  Garnaut said that a Technical Report would ensue in August and a Final Report in September.

The aims of this preliminary study are:

  • Review  the reported temperature-related impacts on health including deaths, hospitalisation, work days lost , Salmonella (food- borne) and Dengue fever (mosquito-borne) infections as these have been well documented; and
  • Identify issues that may affect pharmacy practice in community and institutional settings in Australia


2.0 Measurement of the main health impacts due to climate change

A search of the Pub Med and Medline electronic databases for the key terms “pharmacy and climate change” found  no published papers in Australia or internationally hence this may be the first occasion this matter has been reviewed technically for pharmacists. 

The data for each of the reported impacts of climate change were derived mainly from papers commissioned to specialist groups.5

The Draft Report and four commissioned submissions on health impact on health were examined for this study. 1, 6-9

 

The adverse effects on human health occur as a result of climate changes. These may  operate directly such as heatwaves or indirectly by disturbing ecological systems such as mosquito population activity and  their mobility. 1

The main risks to health in Australia are likely to be associated with temperature extremes such as heatwaves; severe weather events (bushfires, floods, etc); increases in the production of aeroallergens (spores, pollens) which would exacerbate asthma and other allergic respiratory diseases ; food-borne diseases ( including Salmonellae and Campylobacter) ; vector-borne diseases ( for example dengue virus and Ross River Virus) and mental health consequences due to disruption of social, economic and traditional ways of living in remote communities. 1

The methodology for measuring health impacts according to the various climate scenarios are reported in the main submission (Box 1).6 Three no-mitigation scenarios (U1, U2 and U3) and four mitigation scenarios (M1, M2, M3 and M4) were considered.

 

Box 1. The seven climate scenarios used in the health impact analyses for the Garnaut Review. 6

 
Click on box to view an expanded view of scenarios

3.0 Results of the main health impacts due to climate change

The following results were adapted from the Draft Report and four submissions. 1, 6-9 

3.1 Temperature-related deaths

Small declines in temperature related-deaths are expected to occur by mid-century due to decreased cold-related sickness and death (Figure 1).  From mid-century the change in the number of heat-related deaths in Australia varies under the different climate change scenarios. The increases up to approximately 9,000 deaths annually in 2100 are avoidable under the global mitigation scenarios M1, M2 and M4 (Figure 1).

Figure 1. Temperature-related deaths for Australia from 1990 to 2100 modelled for five temperature scenarios. ‘No climate change’ considers population changes only. 6



Click on graph to get an expanded view of the data


For unmitigated scenario U1, a large increase in the number of national temperature-related deaths is estimated   (Figure 1). Much of the increase is attributed to expected excess deaths in Queensland and the Northern Territory. For example Queensland is predicted to have over 4000 additional health-related deaths yearly in the unmitigated case  U1  and 9,500 additional deaths in the ‘bad case’ unmitigated scenario U2 (Table 1).1 In comparison the excess health-related deaths are minimised in the mitigated cases in Queensland (Table 1). 1 

Table 1. Differences in heat-related deaths in Queensland between probable unmitigated and mitigated futures at 2100. 1


Click on table to get an expanded view of the data


3.2 Temperature-related hospitalisations

Excessive temperature-related hospitalisations nationally under climate change are estimated to be delayed into the second half of the century and become pronounced just in the last quarter century (Figure 2). 6 Tasmania may even experience a small decrease. The differences in temperature-related hospitalisations between the mitigated and unmitigated climate scenarios are between an estimated 500 and 1000 cases annually (Figure 6). 6 The estimates were based on hospital data from Sydney, Melbourne and Brisbane.

Figure 2. Temperature-related hospitalisations in Australia from 1990 to 2100 modelled for six temperature scenarios. ‘No climate change’ considers population changes only.( Inset is detailed for 2075 to 2100.)6

4.0 Conclusions

The following conclusions were drawn from the Garnaut Draft Report and submissions commissioned from expert health groups:

  • In the unmitigated climate scenarios heat-related deaths are estimated to increase markedly after 2050 and may reach an estimated 9,000 deaths annually in Australia. Queensland and the Northern Territory would experience a disproportionate excess in heat-related deaths;
  • In the unmitigated climate scenarios excessive temperature-related hospitalisations are estimated to be delayed until after 2075. An annual difference of between 500 and 1000 temperature-related hospitalisations is estimated at 2010.


The above estimates of increased temperature-related deaths and hospitalisations from 2050 to 2100 are amongst the first reported climate change-related health impacts in Australia.
These estimates provide a basis which will be expanded with other indicators in the next report together with likely implications for community and hospital pharmacy practice.

Con Berbatis
School of Pharmacy
Curtin University of Technology (Western Australia)
31 July 2008.
Email: berbatis@git.com.au  


References

1.           Garnaut Climate Change review. Draft Report. June 2008. At: http://www.garnautreview.org.au 
2.           Commonwealth of Australia. Department of Climate Change. Carbon Pollution Reduction Scheme. Green Paper. July 2008.
At: http://www.greenhouse.gov.au/greenpaper/index.html
3.           Garnaut R. National Press Club address: draft report launch. 4 July 2008.
At this location
4.           Woodruff R, Hales S, Butler C, McMichael T. Climate change health impacts in Australia: effects of dramatic CO2 emission reductions. Australian Medical Association and Australian Conservation Foundation, 2005.
At this location.
5.           Garnaut Climate Change Review. Papers commissioned by the Garnaut Review. 2008.
At this location
6.           Bambrick H, Dear K, Woodruff R, Hanigan I, McMichael A. The impacts of climate change on three health outcomes: temperature-related mortality and hospitalisations, Salmonellosis and other bacterial gastroenteritis, and population at risk from dengue. Garnaut climate change review.   2008.  
At this location.
7.           Bambrick H, Woodruff R. Climate change impacts on the burden of Ross River virus disease. Garnaut climate change review. June 2008.
At this location.
8.           Green D. Climate impacts on the health of remote northern Australian indigenous communities. Garnaut climate change review. February 2008.
At this location.
9.           Berry H, Kelly BJ, Hanigan IC, Coates JH, McMichael AJ, Walsh JA, Kjellstrom T. Rural mental health impacts of climate change.
Garnaut climate change review. June 2008.  
At this location.

 

 


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