USA. SEHIC established a workgroup to determine indicators of climate change recognizing Pollen as one Environmental Health Indicator for Climate Change (by Diego Fdez-Sevilla)
The State Environmental Public Health Indicators Collaborative (SEHIC) is a Council of State and Territorial Epidemiologists (CSTE) initiative that focuses on the development of indicators and tools to enhance environmental health surveillance capacity within USA state public health agencies. SEHIC works to enhance environmental health surveillance by identifying priority environmental health concerns and the appropriate data resources and methods for indicator development.
Since 2000, the National Environmental Public Health Tracking Program has begun to enhance environmental health surveillance capacity nationally and among state health departments by encouraging the linkage of environmental and public health monitoring data using standardized, systematic methods.
SEHIC has established a process, produced a framework, and created a vision for developing environmental public health indicators for use at the state level, which includes standard language, definitions, and consistent description templates for defining the elements and attributes of indicators. The description templates are accompanied by how-to guides to show exactly how to calculate the measures being generated to describe the indicators.
(Click the links below to view the environmental health indicators)
Background: Exposure to ambient air pollution causes significant public health impacts in the U.S. Exposure to criteria air pollutants (i.e., ozone, particulate matter (PM), sulfur oxides, nitrogen oxides, carbon monoxide, and lead) and toxic or hazardous air contaminants (e.g., benzene, perchlorethlyene, and methylene chloride) have been related to acute and chronic health conditions as diverse as respiratory illness, reduced lung function, cancer, heart disease, and adverse reproductive outcomes. A 2002 analysis found that a 10% reduction of PM and ozone in Santiago, Mexico City, Sao Paulo, and New York over next 20 years would avoid 64,000 premature deaths, 65,000 chronic bronchitis cases, and 37 million person days of work loss (Cifuentes et al, 2002). Recently, the EPA has been mandated to regulate emissions of carbon dioxide (CO2), a major greenhouse gas that causes global warming. Increases in heat due to CO2 emissions and global warming also create conditions which favor raised ozone levels in urban areas, furthering public health impacts.
Completed Indicators: These indicators, which are standardized and can be compared across states, can be used to detect trends over time, to identify geographic areas in need of improvement, and as a basis for influencing environmental public health policy.
Completed indicators include asthma inpatient hospitalization, asthma emergency department visits, and chronic lower respiratory disease indicators. Each indicator includes a template and how-to guide. The template describes the rationale for the indicator, and the how-to guide includes step-by-step instructions on how to calculate the indicator. An Excel spreadsheet can be used to compute age-adjusted prevalence rates for the two indicators. A lessons learned summary document describes the process that was followed by the Asthma Workgroup in developing the indicators.
A new initiative of the CSTE/SEHIC Asthma work group is surveillance of pollen and its relationship to respiratory conditions, such as asthma, in the United States. Increased pollen levels contribute to missed work and school days, more asthma emergency department visits, and the use of over-the-counter medication to treat allergic rhinitis. Climate change effects of higher temperatures and more carbon dioxide will result in increased pollen production, especially for more allergenic types of pollen such as ragweed, and longer pollen seasons. Current pollen activities include:
- A 2012 CSTE Conference poster demonstrating differences in the date when the pollen season started, date it ended and the duration of the pollen season for pollen readings made in Atlanta, GA, Baltimore, MD and Madison, WI.
- Pollen data manuscript now in preparation. It will include pollen data for Atlanta, Baltimore, Madison, Michigan and Maine.
Background: Current literature documents the potential adverse human health impacts presented by climate change. For this reason, the State Environmental Health Indicator Collaborative (SEHIC) established a workgroup to determine indicators of climate and health for state health departments. SEHIC began with a comprehensive review of the scientific literature to identify outcomes and actions related to climate variability that could inform recommendations about the development of a suite of climate and health indicators. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level. The work group recognized that indicators are needed to measure current vulnerability to climate variability and change. Indicators are also needed to track possible changes in health outcomes to determine if climate change is actually affecting their state, local, or regional population.
Indicator Pilot: The Council of State and Territorial Epidemiologists climate change subcommittee developed 24 climate and health indicators including instructions on how to calculate each indicator and a template to facilitate organizing and recording the data. Each indicator’s description and accompanying instructions were pilot tested in 2011 and 2012 to improve and finalize the implementing instructions and to generate multistate data for each indicator. With the results from these pilots, CSTE finalized the climate and health indicator documents.
Completed Indicators: Some indicators are measures of environmental variables that either directly or indirectly can affect human health, such as maximum and minimum temperature extremes. Other indicators can be used to project future health impacts based on changes in exposure, assuming exposure-response relationships remain constant over temporal and spatial scales.
What makes pollen a relevant bio-indicator?
Pollen can adversely influence health outcomes such as allergies and asthma however, I miss to see more inside research applied in using the atmospheric load of biological particular matter not only as the hazardous matter we are exposed to but also as the symptom indicating the health state of our environment. After all, we can look into how we are going to react towards changes in our environment, but I wonder if we are missing valuable information about how our biological environment is reacting already by simply overlooking the symptoms. Climate change has been linked to longer pollen seasons, increased pollen production, changes in the types of pollen observed in a particular location, and increased pollen allergenicity.
I think it would be of great help to reach the point where we could be able of identifying the health state of a ecosystem by looking into the nature, quantity and quality of the atmospheric load generated by/within it. It has been already identified that environmental pressure from anthropogenic activities induce higher pollen allergenicity due to stress triggering alterations in protein composition, as well as the interaction of elevated pollen levels with other respiratory triggers (SOx, NOx, and DEPs) from air pollution.
One of the focus points I try to highlight is the need for more inside research applied in using the atmospheric load of biological particular matter not only to characterize the level of concentration for the hazardous matter we are exposed to but also to identify the health state of an environment. In EEUU it seems that pollen has been recognized as an element from which to obtain information for environmental research meanwhile in Europe the directive for Air quality avoids considering pollen as an air pollutant relevant to be monitored since it is not “man made”.
I can tell though that pollen, being a male gametophyte, reflects the state of health in the metabolism of plants as you could identify also in any biological organism with sexual reproduction (i.e. humans). Situations of stress, over stimulation, malnutrition and exposure to pollutants affect the quantity, quality and viability of pollen grains (like humans). Same as finding mold in your house is indicative of an unhealthy environment for humans, the aerobiological load found in a location could tell the state of your environment throughout knowing the kind and conditions in which organisms and plants are living in your neighbourhood.
If you want to find out more about this project follow the link : Environmental Health: Indicators
Update July 2014:
In September 2013 Adele Houghton, the Council of State and Territorial Epidemiologists and State Environmental Health Indicators Collaborative Climate Change Subcommittee published the document: “Developing climate change environmental public health indicators : guidance for local health departments”.
Climate change EPHI frameworks have been developed at the state level by the Council of State and Territorial Epidemiologists’ (CSTE) State Environmental Health Indicators Collaborative (SEHIC) (available at: http://www.cste.org/?page=EHIndicatorsClimate) and at the federal level by the U.S. Centers for Disease Control and Prevention’s (CDC) National Environmental Health Tracking Network (NEHTN) (available at: http://ephtracking.cdc.gov). The purpose of this guidance document is to help LHDs leverage existing resources such as the SEHIC and NEHTN climate change indicators for use at the local level.
This guidance document outlines a three-tiered approach to establishing a local climate change environmental public health tracking (EPHT) program — placing emphasis on opportunities to partner with external resources at the local, state, and federal levels. It also explains how climate and health tracking programs can support LHDs’ efforts to provide the 10 Essential Services of Public Health and to achieve accreditation.
This document is not designed to establish the links between climate change and human health or to provide guidance about how to launch a climate and health program. Furthermore, it does not offer specific technical information about how to conduct geospatial analysis or downscaled climate modeling. Instead, it is designed to assist LHDs in making use of existing climate change EPHI frameworks using current capacity. For readers who are interested in delving into greater detail, links to more specific information are included throughout the document.