COPING WITH CLIMATE CHANGE MANIFESTATIONS ON WATER AND

HEALTH

Konstantinos C. Makris and Syam S. Andra

CYPRUS UNIVERSITY OF TECHNOLOGYCyprus International Institutefor Environmental and Public Health

in association with theHarvard School of Public Health

Disruption

• Little work has been conducted on Sb endocrine disrupting effects.

• However, recent evidence suggests that Sb may be at least partially responsible for estrogenic effects. Choe et al. (2003) reported that antimony chloride has “high estrogenicity” in two bioassays. In an estrogen-receptor dependent transcriptional expression assay using human breast cancer cells, 1 µM antimony chloride had estrogenic activity that was 61% equivalent to 1 nM 17β-estradiol.

What is the cost of avoiding climate change? If we do everything we can now to reduce global greenhouse gas emissions and ensure we adapt to the future effects of climate change, the average estimated cost is 2% of the world annual gross domestic product (GDP).

However, if we do nothing, effects of climate change could cost 5–20% of the annual world GDP.

Stern N. The economics of climate change. Cambridge: Cambridge University Press, 2007.

• In the EU, just over half (51%) of respondents consider climate change one of the world's most serious problems (and 20% feel it is the single most serious problem).

• It is seen as the second most serious issue facing the world, after poverty, hunger and lack of drinking water, and a more serious problem than the economic situation.

(Special Eurobarometer report, October 2011)

Perception of Cypriot Society on Climate Change

Chemical Leaching• Plasticizer molecules like Plasticizer molecules like

antimony, BPA and antimony, BPA and phthalates from plastic wall phthalates from plastic wall skeleton, could move skeleton, could move through the solid polymer through the solid polymer matrix via the following matrix via the following mechanisms:mechanisms:

i. Diffusioni. Diffusion

ii. Photodegradationii. Photodegradation

iii. Relaxationiii. Relaxation

iv. hydrolysisiv. hydrolysis

Climate Change and HealthReduced Health Risk compared with Tap Water?

A Human Health Perspective on Climate Change: A Report Outlining the Research Needs on the Human Health Effects of Climate Change April 22, 2010, NIEHS, USA.

How we STORE, TREAT and USE WATER will be key in adapting to climate change challenges

Coastal Water

Surface Water

(Bottled) Spring Water

Desalinated Water

Ground Water

Hydrogeologic Cycle

Recycled Water

Assess

Plan

Implement

Monitor

Evaluate

Adjust

The Adaptive Climate Cycle

Hess et al., 2011,EHP

How WE STORE, TREAT AND USE WATER will be key in adapting to climate change challenges

•Supply Reduction•Algal Blooms-Toxins-Treatment costs•Pathogen maturation rates (Cholera)•Runoff discharge•Temperature-driven volatility, solubility, biodegradation effects on POP bioavailability•Food supply contamination from irrigation

Coastal Water

Surface Water

Ground Water

Bottled Spring Water

Desalinated Water

Hydrogeologic Cycle

RecycledWater

How WE STORE, TREAT AND USE WATER will be key in adapting to climate change challenges

•Fish productivity-Species extinction/migration•Algal blooms-Cladophora spp.•Dissolved O2 reduction-Hypoxia-Fish kills•Coral reef bleaching-zooplankton reduction•Shell calcification reduction-Ocean acidification• Coastal flooding by sea level rise(?)

Desalinated Water

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Hydrogeologic Cycle

RecycledWater

Seawater pollution with algae and petroleum products might endanger the quality of desalinated water, while treatment cost may be exacerbated.Infrastructure risk due to sea level for on-shore plants.

Desalinated Water

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Hydrogeologic Cycle

RecycledWater

Potable Water in Urban Pipe Networks

Finished water under quality deterioration (DBP formation, biofilm/scales release, Legionella spp. outbreaks).

Stagnation and intermittent flow in drinking water distribution systems enhance biofilm growth.

Changes in hydrostatic pressure within drinking water pipes may facilitate pipe leakage and soil/contaminants intrusion.

Wet/dry alterations cause soil movement (swelling) impacting pipe physical condition failures/leakages.

Backflow and wastewater intrusion into pipes of drinking water systems poses serious health risk.

How WE STORE, TREAT AND USE WATER will be key in adapting to climate change challenges

Desalinated Water

•Low aquifer and river flow (anoxic zones) deteriorate water quality and increase treatment costs.•Seawater intrusion-Brackish waters•Salting-out effect for increased bioavailability of POPs•Deeper water table pumping—higher costs

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Hydrogeologic Cycle

RecycledWater

How WE STORE, TREAT AND USE WATER will be key in adapting to climate change challenges

•Increased demand•Treated water quality reduction (xenobiotics)•Urban storms may increase the contaminant load in treatment plants.

Desalinated Water

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Hydrogeologic Cycle

RecycledWater

How WE STORE, TREAT AND USE WATER will be key in adapting to climate change challenges

•Increased withdrawal-Spring capacity issues-Shift to bottled water•Water quality reduction-Brackish waters•Plasticizer leaching

Desalinated Water

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Hydrogeologic Cycle

RecycledWater

Neglected Water Compartment—URBAN STORMWATER

Desalinated Water

Coastal Water

Surface Water

Ground Water

(Bottled) Spring Water

Recycled Water

Hydrologic Cycle

STORM Water

Extreme Rainfall-Induced Health Hazards

EXTREME WEATHER EVENTS URBAN STORMAWATER MANAGEMENT

Venice, IT, summer 2006

Kris Snibbe/Harvard Staff Photographer, Harvard Gazette, October 27, 2011

More than 50% of waterborne disease outbreaks were preceded by intense rainfall events in the USA above the 90th percentile (Curriero et al., 2001, AJPH). In need of stormwater urban collection ponds and deployable portable filters for contaminants

1. Erosion-Sedimentation2. Increase downstream pollution fromBrownfields’ contaminant release3. Unwanted mixing of freshwater with sewage during floods and downstream runoff4. Pump station failure, power outage, possible loss of water supply

Αccess to improved water source, GDP and infant mortality

Hunter et al., 2010. Water Supply and Health. PLoS Med 7(11): e1000361

Sea Rise and SaltWater Intrusion• Average estimated sodium intakes from drinking water ranged from 5 to

16 g day-1 in the dry season, compared with 0.6–1.2 g day-1 in the rainy season. The annual hospital prevalence of hypertension in pregnancy was higher in the dry season (OR = 12.2%; 95% CI, 9.5–14.8) than in the rainy season (OR = 5.1%; 95% CI, 2.91–7.26) (Khan et al., 2011, EHP).

• Increases in water salinity may increase POP/pesticide bioavailability due to salting out effect.

Water and Health -- Adaptation Measures

1. Climate change effects on water sectors before hitting hard our economy need to be classified and hierarchically addressed by pertinent agencies

2. Interdisciplinary efforts need to be initiated by engaging plethora of expertises, ranging from engineers, economists, health scientists, biologists, environmental scientists, and others as needed

3. Coastal infrastructure sustainability and maintenance, Sea level rise?

4. Disaster management and preparedness plans

5. Climate change and public health education and learning

Acknowledgement

• We would like to thank the Harvard-Cyprus program of the Harvard School of Public Health for partially funding and supporting of this study.

1. Heat Stress may be overwhelming for patients suffering with cardiovascular or respiratory disease, diabetes, and other chronic diseases.

2. Need to estimate heat related mortality and compare it with the increased air pollution mortality due to the use of air conditioning inPeak demand seasons (summer).

Extended Heat Periods and Heat Waves

Example of the impact of the average air temperature on daily mortality in humans. These data represent the mortality (324.7 deaths per day) in The Netherlands from 1979 to 1987. The size of each block is proportional to the sample size. Data and graph modified from Kunst et al. (1993).

Shortened Gestational Age with Heat Stress Periods

Dadvand et al., 2011. Climate Extremes and the Length of Gestation. Environmental Health Perspectives.

•Gestational age at delivery determines fetal maturity at birth.

•Shorter gestational age at delivery was documented to be the primary cause of perinatal mortality, both in Europe and US.

•Risk increases with decrease in gestational age.

•A 5-day reduction in gestational age was observed when subjects were exposed to 32 °C (Heat Index) on the day before delivery (p = 0.03)

Stress-Pollution Interactions

• Temperature effects may be acting as an effect modifier towards the toxicity of a pesticide during an animal study (Gordon C.J., 2003, Environ. Res.). For example, toxicological experiments with rodents for a pesticide showed no-effect level at 5 mg/kg at relatively warm ambient temperatures when literature showed 75 mg/kg as a no-effect level.

(Gordon C.J., 2003, Environ. Res.)

Heat-Related Interventions-Dilemmas• Identification of elderly and children

while provisioning them with access to air conditioning. Could increased use of air conditioning serve as a cost-effective intervention measure when their use leads to air pollution and risk for power outage in the summer?

• Both health (exposure and toxicologic) and economic-based risk assessment plans.

• Socioeconomic status and the built environment may be extremely important factors of susceptibility to heat waves and heat stress on morbidity/mortality in Cyprus.

Microplastics in the marine environment and Climate Change

• Physiological effects on marine biota induced by bioavailable compounds desorbed from ingested plastics are being investigated, since mass of ingested plastic in Great Shearwaters (Γλάροι) was positively correlated with PCBs in their fat and eggs.

• There is also potential danger to marine ecosystems from the accumulation of plastic debris on the sea floor. The accumulation of such debris can inhibit gas exchange between the overlying waters and the pore waters of the sediments, and disrupt inhabitants of the benthos

(Moore, C.J., 2008, Environ. Res.).Laysan albatross chick, Kure Atoll, 2002, photo: Cynthia Vanderlip, AMRF.

High Air and Water Temperatures

• Solvent Switching is defined as contaminant partitioning into different phases towards thermodynamic equilibrium. Temperature-driven effects on Henry constant for various organics. Concentrations of contaminants may not exceed thermodynamic constraints.

• Solvent Depletion is an energy-intensive process that increases fugacity since solvent concentrations decrease. Food web alterations, organic carbon changes, biomagnification). Concentrations of contaminants may exceed thermodynamic constraints.

(McDonald et al., 2002, ES&T)

Greenhouse gases + sunlight O3

T Secondary PM and photodegradation

Harmful and Nuisance Algal Blooms

Cyanobacteria (blue-green algae) produce toxins (microcystins, nodularins, saxitoxins, anatoxin-a, anatoxin-a(s) , cylindrospermopsin) whose health effects range from liver damage, including liver cancer, to neurotoxicity.

Nuisance algal blooms like those of Cladophora spp. are expected to grow in frequence in Cyprus coasts.

CLIMATE CHANGE IN A NUTSHELL

Greenhouse Effect

CO2

CH4

N2O

Processes

Temperature Rise

Sea Level Rise

Manifestations

Rainfall Variations

Melting Ice Cap

•Ocean Circulation

•Water Temperature

•Salinity

Consequences

Disasters

•Floods

•Cyclones

•Heat Waves

•Droughts

Outcome

•Casualties

•Famines

•Diseases Spread

•Biodiversity Losses

•Economic Losses

•Transportation

•Industry

•Agriculture

•Heating

•Urbanization

•Deforestation

Fossil Fuel Burning

Land Use Changes

Factors

Reference: Modified from UNFCCC 2007.

CLIMATE CHANGE – BROADER IMPACTS

Reference: 1) USEPA , 2) UNEP/GRID-Arendal, Potential climate change impacts , UNEP/GRID-Arendal Maps and Graphics Library, http://maps.grida.no/go/graphic/potential-climate-change-impacts (Accessed 13 October 2011)

• WATER, AIR, WEATHER, ECOSYSTEMS, OCEANS

Cyprus-Specific Synoptic Plan

• Current and foreseeable climate change (CC) environmental manifestations

• Water-Related, but not visually observed CC Environmental Manifestations

• CC-Impacted Health Categories and Water

• Hydrologic Cycle Alterations due to CC

• Water-Related CC Health Impacts

• Water-Mediated CC Heath Impacts

• Synthesis and Adaptation Plans

• What is Next for Cyprus

Climate Change and Health Effects

Heat Periods and Waves, Storms/Hurricanes, Floods, Drought, Nutrition, Food Safety, Air Pollution, Aerosolized Allergens, Infectious Diseases, Occupational Health, UV Radiation.

2 9 2 | N AT U R E | VO L 4 7 2 | 2 1 A P R I L 2 0 1 1

J. Estrin, NY Times, March, 2010

Susceptibility: Intrinsic biological factors that can increase health risk of individual such as medical history genetic variants and stage in life.

Vulnerability: Human populations at higher risk due to environmental or personal-socioeconomic factors.

Both susceptible and vulnerable populations are called sensitive.

Key Population Health Terms

http://maps.grida.no/go/graphic/trends-in-sea-level-1870-2006

Sea Level Rise Between 1870-2006

Climate Change and Aflatoxins

Reference: 1Patterson and Lima, 2010. How will climate change affect mycotoxins in food? Food Research International 43 (2010) 1902–1914; 2CAST. (2003). Mycotoxins: Risks in plant, animal, and human systems. Ames IA, Council for Agricultural Science and Technology.

Climate change affects fisheries industry

http://maps.grida.no/go/graphic/vulnerability-of-national-economies-to-potential-climate-induced-changes-in-fisheries

Ocean Acidification and Climate Change

http://maps.grida.no/go/graphic/acidification-due-to-climate-change-impacts-for-oceans-and-coral-reefs

High Air and Water Temperatures

• Decrease dissolved oxygen levels• Increase contaminant load to water bodies (both chemical and microbial) • Reduce stream and river flows• Foster algal blooms• Increase the likelihood of saltwater intrusion near coastal regions• Increase disinfection by product formation in potable water supplies• Ozone formation• Enhance ice/snow melt and possible release of POPs, e.g., PAH, PCB,

Dioxins, EDC• Volatility, Solubility, Biodegradation• Increase incidence cases of Legionella spp. outbreaks due to prevailing of

thermophila bacteria in higher ambient temperature environments

Reference by Noyes et al., 2009, Environ. International

Recycled Water Influent Effluent Influent EffluentConcentration Concentration MRL MRL

 

Atenolol 3900 < MRL 200 1.1

Atorvastatin 100 < MRL 100 0.53

Atrazine < MRL < MRL 50 0.26

Benzophenone < MRL 410 10000 53

Caffeine 82000 26 1000 5.3

Carbamazepine 580 390 100 10

DEET 1500 400 200 20

Diazepam < MRL 3.4 50 0.26

Dilantin < MRL 61 200 20

Fluoxetine < MRL < MRL 100 0.53

Iopromide < MRL 120 2000 11

Meprobamate 310 14 50 0.26

Primidone < MRL 20 100 0.53

Sulfamethoxazole 240 7.7 50 0.26

TCEP < MRL 420 2000 11TCPP < MRL 3000 20000 2000

Trimethoprim 110 < MRL 50 0.26

BHA < MRL < MRL 200 1.1

Bisphenol A < MRL < MRL 1000 5.3

Diclofenac 1400 < MRL 100 0.53

Gemfibrozil 3800 88 50 0.26

Ibuprofen 4300 33 200 1.1

Musk Ketone < MRL < MRL 5000 26

Naproxen 1400 < MRL 100 0.53

Octylphenol < MRL < MRL 5000 26

Triclosan 480 5.7 200 1.1

Concentrations of target compounds (ng L-1) and minimum reporting levels (MRL) in wastewater samples from Larnaca, CY (Makris and

Snyder, 2011).

Tremendous pressure on increased recycled water production in light of climate change effects.Xenobiotics in recycled water need to be treated prior land application.