2. Human environmental impacts now include unprecedented changes at global level in the atmosphere and the stratosphere. Cli-matologists project that greenhouse gas accumulation in the lower atmosphere will change the world's climate and has apparently already begun to do so. Depletion of stratospheric ozone has occurred 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 in adverse ways. At 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.
3. It is anticipated that climate change and stratospheric ozone depletion will have a range of health impacts. Some will result from direct effects (e.g. heatwave-related deaths and skin cancer induced by ultraviolet radiation); others will result from disturbances to complex physical and ecological processes (e.g. changes in patterns of infectious disease, drinking-water supplies and agricultural yields). Some health effects may become evident within the coming decade; others would take longer. Furthermore, 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.
4. There is a need to consider how these global change processes will affect the health of European populations, how to minimize adverse health impacts, 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.
5. The 1992 United Nations Conference on Environment and Development (UNCED) recognized, in Agenda 21, that the unavoidable uncertainties attached to forecasting the potentially serious impacts 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 of the possible occurrence of irreversible changes in the world's environment and climate systems and because of the potentially serious nature of the associated health outcomes.
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