Warning on Warming

Insect-borne diseases, storm damage, and smog alerts are raising health concerns
Illustration by Arthur Giron

Last year, West Nile virus hit Michigan hard — so hard, in fact, that Julie Smith, the public health educator for Oakland County, started placing prevention information in local communities in February, four months before the devastating disease typically shows up.

The Culex mosquito, which transmits West Nile, thrives on warm, dry weather. Kathleen Forzley, manager of the county’s health division, saw the impending signs. “Last year,” she says, “was a perfect storm.”

Going Viral

West Nile first appeared in Michigan in 2002, and planning for it is on the climate change “to do” list for county, state, and federal health officials. They’ve known for some time, along with many scientists and experts on the effects of climate change, that the way we approach our health in the future will need to take into account a potentially much different environment than the one in which we live today.

We may all need to acclimate our hearts and lungs to more intense heat. We may all need to brace ourselves for more aggressive allergy attacks. And we may all need to take better — and smarter — precautions against insects that cause diseases like West Nile. After all, mosquitoes are happy to morph, adapt, and thrive in extreme weather conditions.

Traveling Smart

Precautions taken for domestic travel could start to look more like those of seasoned international travelers who are used to inoculating themselves against diseases rarely seen in North America. Florida snowbirds, for example, might need to start worrying about dengue fever — which is common in Africa — after a 2010 outbreak in Key West.

The idea that climate change will affect our health and how we deal with it in the future isn’t new. A seminal paper on the subject, written by Dr. Howard Frumkin when he was director of the National Center for Environmental Health, spelled it out in 2008, even as many people remain unaware of the phenomenon today. According to Frumkin, Michiganians in the near future will be dealing with more insect-borne diseases, such as West Nile; more frequent, intense, and longer-lasting periods of high temperatures; more frequent and severe storms; and heavier air pollution, including allergens.

Swatting At Mosquito-Borne Illness

The dengue fever outbreak in Key West, which afflicted approximately 30 people, is a stark example of what people like Frumkin preach. The United States eradicated this mosquito-borne illness, along with yellow fever and malaria, decades ago. And while cases still show up in America, it’s usually only in people who recently traveled to places where these diseases still thrive, says Shane Bies, administrator for public health nursing in Oakland County. In the case of Key West, however, a Centers for Disease Control study showed that the dengue fever found there was not an import; it came from a local subtype of the disease’s main strain. As North America’s climate starts to resemble much hotter climes in Asia and Africa where mosquito-borne illnesses are more common, experts say, we’re more likely to find ourselves fighting the same diseases.

Feeling The Heat Index

Of course, the effects of climate change on our health won’t always be this dramatic. But it doesn’t mean the effects are any less dangerous if ignored. That’s why Michigan officials have already made and executed plans for extremely hot and steamy days, which can be just as damaging to our health as a foreign disease. When temperatures soar and air pollution is high, there are now cooling centers for people without air conditioning. These simple precautions are meant to avoid the kind of tragedy that hit Chicago in 1995, when a heat wave killed more than 700 people and sent thousands to the hospital for heat-related illnesses.

“We know that people in Detroit die during heat waves and that more vulnerable populations are affected,” says Dr. Marie O’Neill, of the University of Michigan’s School of Public Health.

Searching For A Breath Of Fresh Air

Hotter temperatures also foster a different danger: pollution from the ozone (the main component of smog, not to be confused with the thinning ozone in the upper atmosphere that makes sunblock more critical), airborne particles, and other pollutants that make the air worse to breathe — especially for those with asthma and allergies. It’s the reason officials declare Ozone Action Days.

Macomb and Oakland counties are among the country’s cleanest for exposure to short-term particle pollution, according to the American Lung Association’s “State of the Air 2013,” which looks at conditions in 2011. Complacency isn’t an option: Macomb, Oakland, and Wayne counties get failing grades for high ozone days: an F for both Macomb and Wayne, a D for Oakland.

The damage wreaked by air pollution can linger long after officials sound the “all clear” for ozone action. That’s because not only does air pollution make it harder to breathe, it also contributes to shorter life expectancy and cardiovascular disease, and may increase premature births and contribute to smaller babies with poorer brain development, says O’Neill. One of her U-M colleagues helped develop an American Heart Association statement in 2010 that says particle pollution can trigger cardiovascular deaths, heart attacks, strokes, heart failure, and irregular heartbeats, especially in susceptible individuals.

Newer research shows that ozone’s damage to the lining of the lungs may have another effect.

“The thinking in the last few years is that air pollution, including ozone, actually can cause the onset of asthma,” says Dr. Ted Schettler, science director of the Science and Environmental Health Network.

Storm Weather Watch

Michigan is also seeing more severe storms. Climate scientists predict we’ll see more flooding like the kind that inundated downtown Grand Rapids in April, complete with injuries, displacement of people from their homes, and water contamination.

Scientists also say that climate change helped trigger a record-setting bloom of toxic algae that covered a remarkable and unprecedented one-fifth of Lake Erie in 2011, an event that may be a warning of more severe blooms in the future, according to a paper published in April in the Proceeding of the National Academy of Sciences.

Those blooms aren’t just icky. The most dominant blue-green algae in the Great Lakes can produce a liver toxin and skin irritant.

Extreme weather events also churn up parasites like cryptosporidium and giardia that make people sick. Twenty years ago in Milwaukee, 400,000 people were sickened by cryptosporidium that got into the city’s water supply. That time, it was due to human operator error. Next time, it could be bad weather that puts the parasite in a place dangerous to our health.

As Washington stonewalls public policy to address causes of climate change, public health and public safety officials are moving to mount the defenses they can against the phenomenon’s very real effects.

That includes Bies.

“We just need to make sure that we don’t get caught off guard,” he says.

Taking It Easy: Tips for work and play during hot spells

If predictions from the Union of Concerned Scientists prove right, high school athletes and outdoor workers may, by the end of this century, have to take special steps while working outdoors in Michigan during the summer.

The more hopeful of two scenarios in the UCS’ Confronting Climate Change in the U.S. Midwest predicts a full month of summer daytime temps exceeding 90 degrees — double that to two months for their less optimistic prediction. By contrast, from 1961 to 1990, Detroit averaged just 10 days with temperatures over 90.

“The biggest issue is humidity and heat,” says Tom Spring, a Royal Oak certified personal trainer who chairs the American College of Sports Med- icine’s committee for people with his certification.

Spring’s recommendations include small periods of exercising or working outdoors in the heat if you’re not used to it, doing outdoor activities before 10 a.m., and drinking water that’s at room temperature.

Head indoors if you’re not able to catch your breath or if you experience signs of heat stress: dizziness, lightheadedness, disorientation, changes in vision, and dry skin.

“If you’re finding that you’re not sweating,” Spring says, “it means you’re severely dehydrated.”

You may find that aerobic conditioning helps with heat tolerance.

“The more cardiovascularly fit you are,” Spring says, “the more you’re able to adjust. A fit cardiovascular system is more adaptable to different conditions.”