Executive summary

Human effects on the environment now include unprecedented changes at the global level in the atmosphere and the stratosphere. Climatologists project that the accumulation of greenhouse gases in the lower atmosphere will change the world's climate, and this has apparently already begun. Stratospheric ozone has been depleted in recent decades. The relationship between the two phenomena is complex, and new knowledge is emerging. Authoritative international reviews have concluded that these global environmental changes will affect human health, mostly adversely. At the global level, some of the ongoing changes in patterns of human disease are compatible with the advent of climate change. However, further research is needed to clarify these and future relationships.

Climate change and stratospheric ozone depletion are anticipated to have a range of health effects. Some will be direct effects, such as deaths related to heat waves and skin cancer induced by ultraviolet radiation. Others will result from disturbances to complex physical and ecological processes, such as changes in patterns of infectious disease, drinking-water supplies and agricultural yields. Some health effects may become evident by 2010; others would take longer. Further, failure to reduce fossil fuel combustion, as the principal means of reducing greenhouse gas emissions, will result directly in a continuing (and increasing) avoidable burden of mortality and disease from exposure to local air pollution.

There is a need to consider how these global change processes will affect the health of European populations, how to minimize adverse health effects, how to improve monitoring and research and how to facilitate all such actions through Europe-wide coordination, sharing of information and cooperation in wider international efforts.

The 1992 United Nations Conference on Environment and Development recognized, in Agenda 21, that the unavoidable uncertainties associated with forecasting the potentially serious effects of global environmental change do not justify a wait-and-see approach. Rather, in such circumstances there is a strong case for prudent and precautionary action. This precautionary principle is manifestly relevant to global climate change and stratospheric ozone depletion because irreversible changes in the world's environment and climate systems may occur and because the associated health outcomes are potentially serious.

This report reviews the scientific evidence and policy implications for the potential effects of climate change on human health. The introduction describes the initiatives carried out on climate change and human health at both the global and European levels. The first chapter gives an overview of climate change and scenarios for the 21st century for Europe. The second chapter addresses the health effects of climate change, with particular attention to potential effects on thermal stress and vector-borne diseases. The third chapter reviews the health effects of stratospheric ozone depletion, particularly the effects of ultraviolet radiation on the immune system. Climate change may already be affecting human health, and a chapter on the early health effects of climate change is therefore included (early effects in this context are defined as effects anticipated within the next 10-30 years). The final chapters describe the actions necessary to reduce the health effects of climate change. Action includes the benefits for population health of policies to reduce climate change (mitigation) and of preventive action to reduce potential health effects of climate change (adaptation).

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