Professor J E Banatvala CBE
MA MD FRCP FRCPath FMedSci
Church End, Henham,
Bishop's Stortford, Herts CM22 6AN
Tel. 01279 850386
Ms Charlotte Littleboy
House of Commons
Dear Ms Littleboy,
Health Effects of Climate Change: Role of Aviation
The accumulated data from a number of scientific studies demonstrates unequivocally that the world's climate system is warming. There are reports, almost on a weekly basis, in the scientific literature as well as via the media, of the effects of climate change, much of which in recent times is man-made. Less is known, however, about the health effects on populations resulting from such changes which may affect humans directly, but also less directly but equally important, as a result of disease in livestock and agriculture.
It must be remembered, however, that single events may occasionally be falsely attributed to climate change. Increased frequency and severity are likely to be significant. To ensure that adverse health is indeed related to climate change, it is important to assess surveys attributing variations to longer term effects of climate change rather than just annual variability. Furthermore, climate change must be disentangled from other drivers which may result in ill health, e.g. migration, deforestation, conflict. There may also be a reporting bias. Thus there is a risk that scientific communications with climate change in the title is likely to get published; it's a new growth industry.
Other industrialised countries: In parts
of Europe there has been an increase in tick borne encephalitis (Baltic States
and South Scandinavia) and there was recently an outbreak of a mosquito borne
infection Chikungunya in
It is in developing countries, particularly in the Tropics as well
as in the Arctic regions that the effects of climate change are already having
a major impact on health. In Sub-Saharan
Africa, for example, vector transmitted infections are affected by temperature,
humidity and precipitation and include malaria, Dengue and
Aviation and Climate Change
Much is being done to reduce the emission of climate change gases industrially and domestically, less so for aviation. Indeed, civil aviation is one of the world's faster growing means of transport and unless steps are taken now to curtail demand, aviation will soon become the major factor driving climate change.
Although airport development, which in the UK now includes proposals to expand Heathrow and Stansted, may not have a major affect on the health of the population in the UK, such proposals, if fulfilled, will have an a cumulative effect globally. Certainly the population in their homes or those responsible in the work place are being advised to reduce CO2 emissions, but is this sufficient? Providing an example which can readily be assimilated by the general public, it has been estimated that to offset emissions of CO2 from the proposed extended use of the existing runway at Stansted Airport, it will be necessary to replace 350 million conventional light bulbs with low energy bulbs, or shut 1.4 million homes (more than exist in Hertfordshire, Essex and Suffolk) or take 2.3 million cars off the road. For the proposed second runway at Stansted, or the third at Heathrow, the comparison would be even more drastic.
The Royal Commission on Environmental Pollution, in its report on the Environmental Effects of Civil Aircraft in Flight (2002) recommended restricting airport development, emphasising that short-haul passenger flights made a disproportionate contribution to the global environmental impacts of air transport. Furthermore, it stressed that air travel will become one of the major sources of anthropogenic climate change by 2050. This report expressed the fear that the Government showed little sign of recognising this regarding further growth of aviation as inevitable.
EU Members adopted the 1999 WHO Charter recommendations, stating that the welfare of communities must be put first when creating transport policy, adverse effects falling disproportionately on vulnerable groups, e.g. children, the elderly, those with disabilities and those socially excluded. The WHO stressed the importance of conducting Environmental (EIA) and Health Impact Assessments (HIA) assuring that air quality and noise pressure levels were acceptable for environments including schools, hospitals and dwellings.
HIAs should be conducted for major industrial developments
including, of course, airports and with EIAs consider local and global issues
and mitigating ill effects. For
The HIAs for the increased use of the existing runway and for the
proposed development of the second runway at Stansted excluded climate change
from their Terms of Reference. When
questioned, the relevant Strategic Health Authority which has a duty of care
not only for those residing in the vicinity of
Stansted Airport, but also
globally, expressed the view that climate change was a national not a local
issue, a view which contrasted with that expressed by the then Secretary of
State for DEFRA. The Chairman of the
Royal Commission on Environmental Pollution expressed the view to me, when
questioned about the HIA for the first runway, that he thought it was "bonkers"
to exclude climate change (his word not mine).
The Director of the London School of Hygiene and Tropical Medicine, Sir
Andy Haines, whose department has done extensive peer reviewed and internationally
recognised work on the health effects of climate change, stated that mitigating
the effects of climate change should be both a local and national priority. In the recent HIA for the proposed second
runway at Stansted, the exclusion of climate change was justified on the
grounds that the health effects of climate change had already been reported
extensively by the DH in 2007. This
report relates only to the
The Royal Commission on Environmental Pollution's Report on the Urban Environment (2007) has recommended "that the UK Government and devolved administrations develop a statutory framework for including Health Impact Assessments in the planning process, accompanied by appropriate guidance". However, the Government, particularly the Department of Health, has a duty of care to the population; DIFID has a more global responsibility. The Department of Health should ensure that HIAs are conducted independently, perhaps using the expertise of University departments. This may go some way to ensuring that commercial interests do not override environmental and health considerations.
What steps should the
Apart from taking up the recommendations of the Royal Commission on Environmental Pollution, ensuring the HIAs are conducted independently, the following areas are of importance:
1. Industrialised countries like the
2. 75% of emerging and re-emerging human pathogens are also present in animals. Many human infections are zoonoses, i.e. transmissions infected from animals to humans. Encouragement must be given to the development of vaccines to protect animals and thereby humans.
3. Responsibility for human, animal and plant health has been segregated and encouragement should be given to co-ordination with appropriate funding and political direction.
4. The development of co-ordinated surveillance, including the use and development of rapid diagnostic techniques which can be used in the field. Molecular diagnostics now make this possible.
5. Expertise in infections occurring in developing, particularly tropical countries, present at
the end of the war or for a while during
"Empire" days, has been lost but should be regained. Unfortunately there is relatively little
training today in microbiology in the medical undergraduate curriculum. This should be rectified. Opportunities to train abroad should be
encouraged, whether by university departments, or by the HPA. Current resources constrain developments
Professor J.E. Banatvala
Adviser to Stop Stansted Expansion on Health related matters
1. Royal Commission on Environmental Pollution. The environmental effects of civil aircraft in flight. November 2002. http://www.rcep.org.uk
2. World Health Organisation, June 1999,
charter on transport, environment and Health.
3. Royal Commission on Environmental Pollution; The Urban Environment. March 2007
4. Banatvala J. Unhealthy airports. The Lancet 2004;364:646-648