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We were glad to see temperatures drop over the European part of Russia in the first days of February this year. We?re pretty much fed up with those slushy winters of the last few years, we do miss the Uncle Frost scattering fresh snow over the withering trees. But we seem to hope in vain. No pleasurable spells of the Russian winter are lying in store for us, according to specialists in meteorology. The anticipated effects of warmer temperatures on humans is the saddest thing.

What is the link between the climate changes and the spread of diseases? Can humans protect themselves against the effects of hostile weather? Dr. Boris Revich, senior research fellow with the Center for Demographic and Environmental Studies of the National Institute of Economic Planning under the Russian Academy of Sciences, answers questions put by Tayana Bateneva, an Izvestia columnist:

Q: The opinions expressed by specialists on the global warming vary. Some believe that the planet Earth is going to be irrevocably damaged, others maintain that the process? nature is wavelike and the ecosystems have gone through similar things before and somehow managed to recover. Are you claiming that our health takes the heaviest toll due the global warming impact?

A: I?m not just claiming that. Some negative signs of the process can be seen already.

It really doesn?t matter to people who live in today?s world that the global warming is a global phenomenon comprising the warming and cooling cycles of the weather lasting for centuries etc. We need to realize the importance of it to the world, the way we take into account the factors of environment and food pollution and so forth. Those who?re responsible for our health should take steps.

Q: What are the real consequences of the global warming in case of a 1-2 degrees rise of annual average temperatures?

A: An individual will hardly notice such an insufficient increase yet the communities as a whole will be seriously affected. First and foremost, it will enhance the risk of growth of many infectious and parasitic diseases.

Q: Because the bacteria and viruses prefer a warmer environment?

A: Correct. Lots of things like living under warm conditions, and pathogenic organisms are moving to the north. For example, the warmer a climate turns, the higher level of precipitation becomes. The area of water reservoirs and swaps gets larger thus creating excellent conditions for mosquitoes which carry malaria and a number of dangerous fevers. The same applies to animals, the intermediate hosts of fleas, ticks and other insects. They?re also bound farther up the north, and they bring the disease. You can see the proof in the growing numbers of patients diagnosed with malaria, encephalitis and borreliosis over the last few years in Russia and the rest of the world. We can also mention plague and some fevers, such as the Crimean-Congo fever and the Western Nile fever, there?s also the Omsk hemorrhagic fever and other dozens sources of natural infections this country is arguably holding the leading place in the world. Though the same processes are taking place in the USA, Canada and other countries with northern territories. But Russia will be impacted in the hardest way due to the global warming.

Q: The health authorities have been able to tackle the problem so far. The epidemic outbreaks were put under control, the death toll was relatively low.

A: Yes, they?ve been putting it out by far. There?s yet another risk, though. The sewer and water-supply pipelines of the northern cities are mostly in disrepair. The area of the permafrost is going to shrink due to warming, its limits are going to shift up north for 200 km, maybe even father. The dislocation of soil due to thawing, an upsurge of subsoil waters and swamping of the territory may trigger a breakdown of the sewerage system. The pathogens will get in the fresh water causing outbreaks of cholera, typhoid fever, dysentery and other ?water? diseases. The rising temperatures also create favorable conditions for the spread of parasitic diseases such as helminthiasis and a few others.

Q: Summer heat is a health risk factor, isn?t it?

A: It definitely is, especially for the city residents who can?t seek shelter out in the country. The issue is quite sensitive both in terms of health care and social security.

The elderly with health problems, the poor and children are the prime targets of the heat wave.

Q: We can remember the media reports on thousands of deaths caused by extremely high temperatures last summer in Western Europe. We have no statistics of that sort for Russia. Any reasons?

A: Nobody commissioned any research program into the problem. The French National Institute of Demography started conducting analysis of daily death rates shortly after the heat wave hit Paris. The authorities were regularly publishing preliminary results of a study on the heat impact. Just a handful of people do research on similar subjects here.

Q: A number of Russians were killed by that summer heat too, didn?t they?

A: About 300 people died due to large amounts of carbon monoxide in the Moscow air during the hot summer of 2002 when the peat bogs and forest were ablaze, according to data gathered by specialists of the Moscow Institute of Human Ecology and Hygiene.

Researchers all over the world are engaged in the study of the so-called fine dyspersated particles that get in the air due to fuel combustion, large-scale forest fires etc. Those fine particles have been found to be carcinogenic substances, they can also make the asthma attacks more severe.

Q: Could anything have been done to save the victims last year?

A: If the health authorities had taken steps similar to those taken abroad, the victims could have survived. The air pollution problem is a big problem in Japan too. Over there you can buy a respirator practically in any store or kiosk just like you can buy a pack of chewing gum here. The Japanese can choose from a variety of respirators for different occasions: one type is to be worn to protect against the pollen, others must be used in case of fire, and different types must be used for protection during an epidemic. Some respirators have a multilayer filtering that isn?t recommended to senior citizens or patients with respiratory disorders. Others are light weight, ergonomic etc. I?ve brought a bunch of them and wore the simplest one during that smoky summer. People looked at me as if I was some kind of a freak, to say the least. Then I began spotting other people wearing respirators. But did you hear or see any warnings to use respirators broadcast by the media? Did you newspaper printed any simple recommendations to the readers back then?

Q: We definitely printed nothing about the respirators.

Too bad, it could have saved a few people. When the dog days hit New York, special warnings for the elderly and the sick are broadcast every 15 minutes on TV. The people are recommended to refrain from gardening, lawn mowing, they?re advised to stay home after 11 AM and before 17 PM , drink more water etc. Did you happen to hear any recommendations like that here?

Q: How can one recommend things like that? Different people take high temperatures in different ways...

The Americans carried out a research on the subject. The findings show the positive temperatures? limit for a city the size of Chicago is 29 C. The heart attacks and suicide death rates rise dramatically should the temperatures keep climbing.

Q: How on earth are the suicidal tendencies linked to the summer heat?

The research data shows that people tend to attempt suicide more often in hot weather.

Q: Does these findings also apply to our situation?

We did a special study in Tver, a typical Russian town. Our research project was financed by RFFI. In the course of our study, we compared data daily death rates in town with the number of emergency medical services provided to the residents. And we also analyzed the air temperatures. We found a clear link between the death rate due to certain cardiovascular diseases, suicide, death by drowning and the air temperatures. The exact figures aren?t so impressive, though. But once we apply the data to a city of a few million residents, the figures will be much larger.

Q: To what extent is our health care system capable of minimizing the effect of the global warming?

The authorities should keep the population posted with respect to the health risks. It doesn?t imply the distribution of vaccine against all possible threats and a nation-wide immunization program. We should be put in the picture and have a better understanding of what may happen to Nature and man. The doctors should be adequately trained therefore changes should be introduced to the curricula of medical schools and upgrade programs. We can?t just brush this problem aside.

Q: The steps that you?ve mentioned require a heavy funding and a government policy.

Many countries have already developed state programs aimed at minimizing the effects of the global warming. The task is extremely complex. It would be just fine if our Health Ministry could come up with a plan to get things going, spread the word to the State Duma, the government and local health authorities. The Russian Academy of Medical Sciences took the fist step in that direction by organizing a seminar ?The climate change and health issues in Russia in 21st century.?


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