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First Annual National Health And Climate Change Science And Policy Research Consensus Conference - How Will Climate Change Affect Priorities For Your Health Science And Policy Research?

Table of Contents

Health Issue Topic: Water and food-borne contamination

Summary of discussions

What are the potential impacts of global warming and climate change on the contamination of water and food with substances or organisms harmful to human health? Water and food-borne contaminants include pathogenic agents (viral, bacterial, protozoan, other parasitic, and prion) and chemicals. Chemical contaminants of food and water may arise from anthropogenic sources (toxic waste, old dumps, spills, precipitated air pollutants, industrial emissions, agricultural chemicals) or natural sources (naturally occurring heavy metals and other chemicals released from rock or soils). Climatic factors that may impact on human health risks from these pathogenic agents and chemicals include changes in temperature (mainly increase, possibly decrease in some areas), precipitation, and extreme weather events. Sea level rise, Great Lakes levels, and water table levels will be directly affected by climate change, and could have implications for food and water safety. Food and water security (the availability of food and water) and the nutritional value of foods are two other broad areas possibly affected by climate change. One of the challenges in studying climate impacts on food and waterborne illness lies in the difficulty of simulating conditions of climate change at a scale fine enough to detect impacts on livestock and wildlife reservoirs of pathogenic agents, or on human health directly.

The key strategic question identified by this group focused on the impact of climate change on food- and water-related health outcomes. There is a need for increased knowledge and understanding of which contaminants or pathogenic agents in food and water make people sick, how, and where they enter food or water. As well, knowledge gaps need to be filled with respect to the impact of climate change on food and water production, and the introduction of contaminants and pathogenic agents. The process from production to consumption must be mapped. Research questions should focus on the process from one point to the next, taking into consideration the points at which contaminants may enter, and how climate change might enhance or deter this contamination. Subsistence foods may form a special case, since these are generally harvested or collected by the people who will consume them, sometimes raw. All food may be stored or processed prior to consumption, which may affect contaminants in the food and food quality. Climate change may also affect preparation and storage of food in the home, changing the level of contaminants and pathogenic agents in food.

There are certain points in the process from production to consumption at which measures of prevention and mitigation could be considered - but only if researchers can determine how people are getting sick and how the contaminants are moving. The dynamic complexity of food and water systems is such that feedback loops within these systems may result in unexpected effects of contaminants, or unexpected outcomes of mitigation strategies. This breakout group developed two causal loop diagrams, one for the food system, and the other for water. These diagrams illustrate potential entry points for contaminants, potential areas of climate impact, elements of the process under regulation, and feedback loops. The assessment and linkage of available data, and the identification of critical gaps is a high priority. This is an important role for the C-CIARN Health Node.

The research must also explore regions and sub-populations, identifying those that are potentially more susceptible to food and water related illness because of climate change (for example, urban, coastal and northern areas, as well as First Nations. Like other environmental stressors, Climate Change will probably most affect those population groups that are least able to resist due to internal or external causes. Their health may be compromised e.g. due to incomplete development (babies) or physiologic deterioration due to ageing (elderly), or they may be stressed due to illness, or from inadequate nutrition (the poor, and marginal subsistence groups). Behaviour (hygiene) may also be important. In particular, urban populations may be under increased stress because of high temperature and poor air quality. The safety of the water supply to Canadians in coastal areas may be threatened by flooding from sea level rise or extreme weather. Northern and First Nations peoples may encounter changes in their traditional food supply due to wildlife migrations and changes in sea ice. Increased temperatures in the North may increase spoilage of traditional foods. By expanding the research areas in a trans-disciplinary manner, it will be possible to gain knowledge that will help in identifying the sources of problems.

The group also identified a communications issue, saying that scientists and decision-makers in the areas of public health, food and water technology, and the public must be made aware of the impacts of climate change on food and water. In particular, communication between governmental agencies and other researchers is essential to avoid duplication of effort.

Technology and mitigation measures can help research, and can help to keep the public informed. Networks are needed that will foster the sharing of information across disciplines, and enhance the reporting of new findings to decision makers and the public.

Regarding the question posed to the groups about the location of C-CIARN's central office, the group stated that the greatest benefit would be achieved if it were situated outside of government, as a watchdog. However, there are also benefits that come from being located in Health Canada.

The following table has been divided into three sections: the first includes sub-topics applicable to both food and waterborne contamination. The second addresses food only, and the third addresses sub-topics specific to waterborne illness. Priorities were not assigned for all items as it was felt that different stakeholders would have different priorities for many of these questions.

Water- and food-borne contamination

Knowledge
Strengths:

The speed at which information is acquired and disseminated is both a benefit and a constraint.
This is a "hot topic" politically. There is pressure on governments to enact legislation to protect people.

Limitations:

There is a lack of information on water- and food-borne contamination as it is affected by climate in general, let alone by climate change.
A problem arises when the population does not listen to or act on the knowledge presented to them by governments or experts.
There is a lack of coordinated management - too many government agencies are involved, and there is in-fighting and a lack of information sharing.
It is important to educate people.
There is information overload, and information is not organized or assessed in terms of quality. The Internet presents real challenges in this area.
Confidence in the information available is eroding, and cynicism abounds.

Data Sources
Limitations

The effect on wildlife is often neglected with respect to water contamination.
There is mo re data on "food" issues than on "water" issues.
With respect to climate data, models are not available on a fine enough scale.
Not enough is known about the effects of climate on water- and food-borne diseases, let alone the effects of climate change.
Jurisdictional barriers are a problem with regard to access to data, not only between levels of government or different departments, but also within departments.
Data on disease is not available free of charge.
The system now in use was devised to deal with isolated incidents. The same methods are now being used to deal with national and global issues.
Health research is not done with climate change in mind; nor has climate change research considered health as an issue.

Methods
Strengths

There is a wide array of methods with which to work.
Many researchers are identifying new methods, but they never talk to each other. This points to the importance of C-CIARN.

Limitations

There is a need for better, more specific tests. There is a lack of specificity in routine tests.
The method of dissemination is an issue: is accurate, accessible information being conveyed?
The method of data collection is multi-jurisdictional and is not integrated.
Environmental and health programs overlap, wasting resources.

Capacity
Strengths

Canada has greater capacity than some countries.

Limitations

There is no database of soil and land use (in a digital format).
There needs to be integration and coordination with the specialists, researchers and stakeholders involved in the climate change issue.
The policy base is too focused on Ottawa and Ontario.
Many of those in government who are working in the field are in an older age bracket. Because of the previous freezes on hiring, capacity must now be rebuilt and training is needed.
There is no deputy minister or assistant deputy minister responsible for the health effects of climate change in Canada, or in any of the provinces.

Water and food-borne contamination

It is important to open the channels of communication among the different departments and improve accountability. Health Canada, which is organizing this conference, has responsibility for linking with Agriculture and Agri-Food Canada and Environment Canada. Some contacts have already been made among the different departments.
A communications network and adequate resources are prerequisites for research.

Strategic Questions

The research agenda should address the following strategic questions:

The impacts of climate change (including temperature, precipitation, sea level rise and extreme weather) on water supply, safety and security, and nutrition;
The point in the food chain at which those impacts are occurring;
The connection between changes in water supply and the availability of safe food;
The impacts of climate change on socioeconomic factors that would affect food and water safety and supply;
The health benefits of climate change (impacts on food and water safety and security, and on nutrition);
The preparations being made to deal with the predicted impacts of climate change on food and water, including awareness of problems that could be created by technological fixes;
Ways of informing the public about the impacts of climate change on food and water safety;
The impacts of climate change on water treatment, sewage treatment and the potential release of microbes;
The impacts of climate change on farming, including longer growing seasons, winter wheat crops, possible new crops, biotechnology developments, changes in pesticide use, and the effects of increased humidity on crop disease;
The impacts of human migration on food and water demands;
The consequences of rising water tables;
The impacts of climate change on our use of water;
The impacts of climate change on the safety and supply of imported food;
The effect of climate change on susceptibility to disease, especially in high-risk groups, and in northern, urban and coastal communities;
The risk that climate change will lead to the emergence of new diseases and increase the incidents of existing diseases;
The impacts of climate change on the use of antimicrobials in animals and humans, and the implications for the development of drug resistance;
The possibility of increased incidence of zoonotic disease, including animal diseases that can be transferred from animal to animal or from animal to human;
The potential for technology to advance health and offset the impacts of climate change;
The research and surveillance infrastructure available to deal with increases in disease and contaminants;
The effects of increased use of refrigeration and air conditioning as climates warm, including increased costs and technological opportunities;
The scale of measurements and models needed to answer key research questions;
The jurisdictional and structural changes that must be made to deal with the health effects of climate change.

How does climate impact on food and water - what are the mechanisms of impact?
What are the impacts of precipitation, sea level rise, extreme weather and temperature on nutrition and on food and water safety, nutrition, security and supply?
Where are those impacts occurring in the food production chain?
What are the connections between changes in water supply and availability of safe food?
What are the impacts of climate change on socioeconomic factors that would affect food and water safety and supply?
How does climate affect susceptibility to these diseases - particularly risk groups and northern, urban and coastal groups?
What is going to happen when the water tables do go up?
Where is the baseline data to address these questions?
How will changes affect our uses of and demand for water?
How does climate change impact the safety and supply of imported food?
What are the climate-related risks of the emergence of new diseases? And increases in incidence of diseases we already have?
What are the impacts of climate change on the use of antimicrobials in animals and humans and implications for development of resistance?
Is there an increase in incidence of zoonotic diseases and animal-to-animal, animal-to-human transmission?
What health benefits does climate change bring?
What are we doing to prepare for predicted impacts of climate change on food and water?
How do we inform the public of the importance of climate impact on food and water safety?
What is the potential for technology to advance health and offset climate impacts?
What impact would human migration have on food and water demands (including special demands and general supply)?
Do we have the research infrastructure and surveillance to deal with increased diseases and contaminants?
What are the impacts on health of climate change on water treatment, sewage treatment and the potential release of microbes?
On what scale do you have to measure and model to answer the questions?
What jurisdictional changes need to be made to deal with the health challenges of climate change?

Health Issue Topic: Water and food-borne contaminants
Research Sub-Topic	Methods		Data Development
Strategic Question	How can researchers obtain needed data, and avoid duplication of work?	What are the best scales for measuring and addressing impacts of climate change on health?	How will climate change affect the prevalence and spread of new and known pathogens from livestock, wildlife and other sources?
Tasks	Identify all interested researchers, establish network between them and data managers.	Ask expert groups to produce recommendations.	Enhanced surveillance studies, development and use of models for trend analyses.
Products	A communications network.	Guidelines for measuring and modelling health impacts of climate change. Policy options for risk management.	Baseline database, models, maps, trend analyses, policy options.
Uses / Linkages	More efficient research process, faster answers for decision-makers.	National and international health impacts assessments; improved adaptation strategies.	Better recognition and control of zoonotic diseases and epidemics.
Order On Critical Path	High


Research Sub-Topic
Strategic Question	What and where are the most important sources of chemical contaminants?	Where and how do contaminants enter food and water systems?	How do changes in water supply affect availability of safe food?
Tasks	Analyze and summarize data in the National Pollutant Release Inventory (NPRI) and other databases, including the long-range transport of toxic air pollutants (LRTP). Produce and use models for assessing exposure of population in relation to climate change.	Map food and water sources and processing in relation to contaminants and climate. Develop research framework. Assess and fill data gaps.	Design and carry out studies, develop and use models for risk assessments.
Products	Databases, maps for identifying contaminant "hot spots" and groups at risk of adverse effects.	Databases and maps; trend analyses. Research framework.	Databases, maps, trend analyses, models, risk assessments.
Uses / Linkages	Policy development to better protect groups at risk by detecting changes due to climate.	Better health risk assessment and management by detecting changes due to climate.	Better health risk assessment and management by detecting changes due to climate.
Order On Critical Path		High


Research Sub-Topic	Health Effects		Exposure
Strategic Question	How are the health effects of contaminants in food and water influenced by climate change?	What is the baseline prevalence of nonreportable food- and water-borne illnesses.	How does climate affect contaminant entry and fate in food and water?	How will climate change affect the emergency of new food- and water-borne illnesses?
Tasks	Review literature. Identify and use databases. Develop and use models for assessing influence of climate change on contaminant exposure - effect relationships.	Enhanced surveillance studies.	Review literature. Identify and use suitable fugacity and mass-balance models, climate models, and geographic information systems (GIS), satellite data.	Review literature. Identify and use criteria for assessing climate sensitivity of diseases; develop or adapt and use bioclimate models. Identify risk factors for disease emergence.
Products	New knowledge on how climate change alters exposure to contaminants and their health effects.	Baseline database.	Databases, maps, trend analyses for assessments of exposure and of health risks.
Uses / Linkages	Better health risk assessment and management by taking into account effects of climate.	Better health risk assessment and management.	Better tools for assessing risks of emerging infectious diseases, from better understanding of climate-pathogen relationships.
Order On Critical Path		High	High	Moderate


Research Sub-Topic		Vulnerability
Strategic Question	How will climate change and variability affect the transmission of food- and waterborne pathogens from livestock, wildlife, shellfish or seafood to humans?	How will climate change affect socioeconomic factors that influence availability of, and access to, safe food and water supplies for vulnerable population groups (including large migrations into or within Canada)?	How will climate change affect the health risks from foodand water-borne contamination to vulnerable population groups (children, elderly, ill, low income, homeless, First Nations)?
Tasks	Find and use criteria for assessing risks of transmission in relation to climate variables. Develop and use bioclimate models, and pathogen monitoring programs, including use of molecular probes.	Interdisciplinary studies to assess a broad range of socioeconomic factors affecting ability of vulnerable population groups to obtain adequate supplies.	Use existing data to establish present exposure levels and health status, monitor and/or model changes related to climate change. Include studies of "new" or emerging diseases.
Products	Databases, models, improved methods for pathogen surveillance and food and water safety assessment (see, e.g., US FoodNet program with Hazard Analysis Critical Control Points).	Improved knowledge of factors affecting vulnerable groups.	Databases, models, maps, better methods / knowledge of exposures to, and health effects of, biological and chemical contaminants. Better knowledge of stressors acting on vulnerable groups.
Uses / Linkages	Better health risk assessment and management; better ability to adapt to changes.	Better health risk assessment and management; better ability to adapt to changes.	Better health risk assessment and management; better ability to adapt to changes. More efficient use of resources.


Research Sub-Topic		Preparedness & Adaptation
Strategic Question	What regions (e.g., North, coastal, urban) might be most vulnerable to increased contamination of food and water sources due to climate change?	What integrated systems, regulations, technologies are needed to recognize and monitor climate impacts on food- and water-borne contamination?	What systems are needed to prepare for and cope with major occurrences of foodand water-borne contaminants?	What juris- dictional changes are needed to manage health challenges related to climate change?
Tasks	Assess regional vulnerabilities through climate and environmental effects databases, modelling and surveillance. Coordinate studies with relevant ministries and NGOs.	Integrate and increase federal/ provincial/ territorial/ municipal capacities to recognize health risks from climaterelated food- and water-borne contaminant problems.	Carry-out coordinated simulations of emergencies.	Legal and policy analyses and recommen- dations for improvement.
Products	Databases, models, maps and other graphic means of showing areas and types of food at risk of contamination.	Diagnostic and monitoring methods, tools and networks; guidelines, databases, risk assessment methods and tools, models; training; and action plans.	Improved emergency preparedness plans and resources.	Improved sharing of legal responsibilities.
Uses / Linkages	Better health risk assessment and management. Better emergency prepared- ness planning.	Better health risk assessment. Better information for decision- making.	Better health risk assessment and management.	Better health risk management.
Order On Critical Path


Research Sub-Topic	Communication	Health Issue Topic: Food-borne contaminants
Research Sub-Topic	Communication	Exposure
Strategic Question	How can we best inform the public of the importance of the effects of climate on food and water safety?	What changes in food production, processing, transport, storage, preparation and use will be needed to adapt to climate change?	How will climate change and variability affect the availability and safety of imported foods?
Tasks	Develop or adapt and test various communications strategies and methods for key public sectors.	Critical path analyses and monitoring of foods which are susceptible to chemical or microbial contamination. Controlled studies under simulated extreme climate conditions.	Assess vulnerability of sources of imported foods to extreme environmental factors. Assess availability, quality and safety of alternative food supplies under extreme conditions.
Products	Appropriate messages and information channels for key target audiences. Greater transparency and accountability.	Guidelines for safe practices, improved contaminant monitoring methods and tools.	Safe imported foods.
Uses / Linkages	Better informed public, and better decisionmaking.	Better health risk assessment and management.	Better health risk assessment and management.
Order On Critical Path


Research Sub-Topic	Preparedness	Health Benefits	Health Issue Topic: Water-borne contaminants
Research Sub-Topic	Preparedness	Health Benefits	Exposure
Strategic Question	What measures will be needed to make sure that imported foods are safe.	How will climate change and variability affect the nutritional value and availability of food?	How will climate change affect the quantity and quality of freshwater supplies (surface, aquifers, well and recreational waters) due to contamination?
Tasks	Assess adequacy of measures to ensure safe production, processing, storage and transportation.	Chemical and dietary analysis of food grown under expected climatic conditions. Assess suitability of alternative sources of foods grown in vulnerable regions.	Use climate models and existing databases on water quality, geologic, geographic, land use factors to assess climate impacts, especially of extreme changes.
Products	Safe imported foods.	Adequate supplies of nutritious foods.	Databases, maps, other information to show vulnerable areas and kinds of expected risks.
Uses / Linkages	Better health risk assessment and management.	Better health risk assessment and management.	Planning of adaptive measures.
Order On Critical Path			High


Research Sub-Topic
Strategic Question	How will saltwater flooding of coastal areas, and floods from extreme events affect human health due to altered freshwater supplies, and from impaired wastewater treatment and containment?	How will changes in hydrology due to climate change affect risks to human health from the leaching and transport of toxic chemicals (e.g., Cd, Hg, Pb, U) from stocks, soils and sediments?	How will climate change and variability affect our demands and uses of freshwater?
Tasks	Use existing maps and data on areas at risk of coastal and other flooding, to carry-out regional and local risk assessments.	Use existing databases and other information and assess leaching and transport potentials and risks to human health.	Establish inventories of sources and flows of water, assess effects of varying and extreme climate and of existing/future demands on quality and quantity of freshwater (e.g., the IJC study of the Great Lakes-St. Lawrence system).
Products	Databases, maps, other information to show vulnerable areas and kinds of expected risks.	Assessment of exposure to, and health risk from water-borne toxic chemicals.	Assessments of availability of, and user needs for, Canadian freshwater supplies.
Uses / Linkages	Planning of adaptive measures.	Planning of adaptive and protective measures.	Planning of adaptive measures.
Order On Critical Path	High	Medium.	High

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