| Comparative Risk Assessment of the Burden of Disease from Climate Change Diarmid Campbell-Lendrum1,2 and Rosalie Woodruff3 1Department of Public Health and Environment, World Health Organization, Geneva, Switzerland; 2London School of Hygiene and Tropical Medicine, London, United Kingdom; 3National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia Abstract
The World Health Organization has developed standardized comparative risk assessment methods for estimating aggregate disease burdens attributable to different risk factors. These have been applied to existing and new models for a range of climate-sensitive diseases in order to estimate the effect of global climate change on current disease burdens and likely proportional changes in the future. The comparative risk assessment approach has been used to assess the health consequences of climate change worldwide, to inform decisions on mitigating greenhouse gas emissions, and in a regional assessment of the Oceania region in the Pacific Ocean to provide more location-specific information relevant to local mitigation and adaptation decisions. The approach places climate change within the same criteria for epidemiologic assessment as other health risks and accounts for the size of the burden of climate-sensitive diseases rather than just proportional change, which highlights the importance of small proportional changes in diseases such as diarrhea and malnutrition that cause a large burden. These exercises help clarify important knowledge gaps such as a relatively poor understanding of the role of nonclimatic factors (socioeconomic and other) that may modify future climatic influences and a lack of empiric evidence and methods for quantifying more complex climate–health relationships, which consequently are often excluded from consideration. These exercises highlight the need for risk assessment frameworks that make the best use of traditional epidemiologic methods and that also fully consider the specific characteristics of climate change. These include the long-term and uncertain nature of the exposure and the effects on multiple physical and biotic systems that have the potential for diverse and widespread effects, including high-impact events. Key words: burden of disease, climate change, national, quantitative comparative risk assessment, regional. Environ Health Perspect 114:1935–1941 (2006) . doi:10.1289/ehp.8432 available via http://dx.doi.org/ [Online 11 July 2006]
Address correspondence to D. Campbell-Lendrum, Department of Public Health and Environment, WHO, Geneva CH-1211, Switzerland. Telephone: 41-22-781-4261. Fax: 41-22-791-1383. E-mail: Campbelllendrumd@who.int We are grateful to T. McMichael, S. Kovats, P. Wilkinson, S. Edwards, F. Tanser, D. Le Sueur, M. Schlesinger, N. Andronova, R. Nicholls, T. Wilson, S. Hales, M. Livermore, A. Prüss-Üstun, C. Corvalán, and B. Menne for contributions to the global assessment exercise, and to T. McMichael, N. Nicholls, K. Hennessy, S. Hales, T. Kjellstrom, and A. Woodward for Oceania. The views expressed in this article are those of the authors and do not necessarily reflect the position of the World Health Organization. The authors declare they have no competing financial interests. Received 17 June 2005 ; accepted 10 May 2006.
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