Climate Change and Human Health Den e e er Cases Philippines 1992 2005 40 35 35 30 29 9 25 25 22 8 20 15 1 14 10 5 52 199 92 8 5 1995 4 1994 5 14 12 8 2005 2004 2003 2002 2001 2000 1999 1998 199 1993 1992 0 No of Cases ( ho san s) Figure 4. Relation of Dengue Cases and Temperature Change in the Philippines. Adapted from Perez, 2009. 26 alaria Cases in the Philippines 1995 2005 3 000 2 500 2 000 24 1 883 1 500 1 483 greatest contribution to global warming.28 Carbon dioxide comes from combustion of fossil fuel and solid waste, cement manufacturing and steel and iron production. Methane comes from landfills, enteric fermentation, and coal mining. Nitrous oxide comes primarily from agricultural soil and mobile combustion. Examples of agricultural activities are applications of nitrogenous fertilizers, enteric fermentation, manure management, agricultural soil management, and field burning.28 Link between Climate Change, Environmental Pollutants, and Incidence of Diseases Climate change also has a significant impact on air pollutants. Air-borne pollutants such as carbon dioxide, carbon monoxide, methane, nitrogen oxide, and sulfur dioxide contribute to the warming of global temperature. 29 Warmer temperatures increase the presence of secondary air pollutants such as ozone and particulates in the atmosphere. According to Martens et al.,19 air pollutants can aggravate allergic and cardio-respiratory illnesses.2 Table 8 presents a study of the Department of Health (DOH) on the impact of air pollution to the public health of Metro Manila. The data show the effect of air pollutants to human health such as respiratory and cardiovascular diseases. 22 3 1 1 24 13 8 2 1 501 1 89 1 589 Table 8. Air Pollution Impacts on Public Health of Metro Manila30 Morbidity 10,000 excess cases of acute bronchitis 1 000 500 300 excess cases of asthma 1 5 Mortality 40-200 persons due to cardiovascular causes 300-330 persons due to respiratory causes 9 excess cases of chronic bronchitis No of Cases Figure 5. Relation of Malaria Cases and Temperature Change in the Philippines. Adapted from Perez, 2009.26 Discussion At the advent of industrial revolution, increasing fossil fuel use, deforestation, irrigated agriculture, animal husbandry, among others have been associated with the increase in the concentration of atmospheric greenhouse gases (Haines, et al, 2000), resulting in an unprecedented variability of climate.27 Indeed, the global climate temperature is linked to human activities.8 The largest contributor to build up of greenhouse gases comes from human-generated activities such as land use planning, transportation systems and infrastructure, building construction and operation. The greenhouse gases that are produced from various agricultural and industrial activities include carbon dioxide, methane, and nitrous oxide. Of the three main gases, carbon dioxide has the 96 ACTA MEDICA PHILIPPINA Climate change can affect health in several pathways. These pathways can be through 1) increased frequency and intensity of heat waves; 2) increased floods and droughts; 3) changes in the distribution of vector-borne diseases; and 4) risks of disasters and malnutrition.17 There are several diseases that can be impacted by climate change. These are insect and rodent borne diseases (e.g., dengue, leptospirosis, and malaria), water-borne diseases (e.g., schistosomiasis, cholera), food-borne diseases (e.g., diarrhoeal diseases and typhoid), respiratory diseases (e.g., asthma, bronchitis, and respiratory allergies and infections), and heat-related illnesses (e.g., sunstroke, sunburn, heat stress or exhaustion, dehydration).13 The study of Ebi in 2008 showed the correlation of various diseases with indicators of climate change. His study was conducted in five provinces and one city in the Philippines.31 The study showed that diarrhea and malaria are most affected by climate change while diseases such as tuberculosis, meningococcemia, tetanus, chicken pox, influenza, bronchitis, pneumonia, nutritional deficiencies, malignant neoplasms (cancer) and mumps had the higher percent correlation with the climate change. In another study, VOL. 50 NO. 2 2016

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