While negotiators from more than 160 countries tried to agree on legally binding reductions in greenhouse-gas emissions (Kyoto, Japan; Dec 1-11), physicians and scientists warned of the adverse consequences of global warming for human health.
Particulate matter released by burning fossil fuels poses a short-term danger (Lancet 1997; 350: 1341-49), but physicians also warned of long-term health threats. In an open letter distributed in Kyoto, doctors warned that a 1-3·5°C rise in global temperature over the next century, as predicted by Intergovernmental Panel on Climate Change data, could unleash a public-health disaster.
Referring to a 1996 WHO report, Paul Epstein (Boston, MA, USA) said there was evidence of malaria and dengue fever in regions where populations have no acquired immunity. Epstein agreed that inadequate health-service provision, poverty, and other factors were partly responsible for the outbreaks, but was adamant that global warming was having an impact. Climate variability associated with the warming had already produced an increased number of disease-carrying rodents, he said, an event thought to have been involved in the 1993 US hantavirus infection outbreak.
Andrew Haines (London, UK) shared Epstein's concerns. "There are some early signs of malaria and other vectorborne diseases being experienced at higher altitudes than was previously the case."
Scientists also predict that global warming will increase the incidence of floods and droughts, and that sea levels will rise. All of these changes may affect health, say physicians. Drought may cause food and water shortages in arid parts of the world while increased precipitation elsewhere will provide new breeding sites for waterborne diseases, they warn. Small island states and low-lying areas will be most affected by increased precipitation and rising sea levels, noted Haines.
Delegates praised the Kyoto Protocol as an important first step in the battle against climate change, but the medical community was less convinced. "Even the best possible agreement is, according to scientists, not good enough to avoid climate change. As far as the health sector is concerned, that really worries us", said Rudi Slooff (WHO). Cooperation between physicians and meteorologists is needed to combat the projected health risks, said Slooff.
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