Children's Environmental Health Symposium 2015 - Impacts of Climate Change on Children's Health

The California Environmental Protection Agency (CalEPA), Office of Environmental Health Assessment, along with the UCSF Pediatric Environmental Health Specialty Unit*, and the UC Berkeley Center for Integrative Research on Childhood Leukemia and the Environment, sponsored a symposium on “Impacts of Climate Change on Children’s Health.” This is part of our continuing series of children’s health symposia conducted as part of the Children’s Environmental Health Program. The conference took place March 4 and 5, 2015 at the CalEPA headquarters, 1001 I Street, Sacramento, in the Sierra Hearing Room. 

The goals of this symposium revolved around setting the stage for dissemination of public health messaging and action.  The goals included:

  • to inform state agency scientists working in environmental and public health of the impacts of climate change on children’s health  
  • to facilitate specific actions by the State of California to improve and protect the  health of the state's children in a setting of future climate change
  • to create a knowledge base for later work developing actions that individuals, families, and communities can take to mitigate the acute health impacts of heat on pregnant mothers, infants, and children
  • to inform regulatory scientists and engineers, legislative staff, and the public about future long-term impacts on children related to air quality, including infectious diseases, and water quality and availability 
  • to understand the co-benefits for children in particular of reducing greenhouse gases, including reduction in associated air toxics, decreased reliance on fossil fuel and smart growth for more liveable cities


  • DAY 1 - WEDNESDAY, MARCH 4, 2015
    • Welcome and Overview of Symposium
      George Alexeeff, PhD, Director, OEHHA;
      Melanie Marty, PhD, Assistant Deputy Director, OEHHA Division of Scientific Affairs
  • SESSION 1. Climate Change and Children’s Health I

KEYNOTE: Overview of vulnerabilities of children to the health impacts of climate change, actions by NIEHS, and California as a microcosm
Presenter: John Balbus, MD, MPH., Senior Advisor for Public Health, NIEHS

John BalbusDr. Balbus introduces us to changes already observed and those expected in California and nationally associated with climate change including drought and extreme precipitation events, heat waves, wildfires and decreased air quality, and others. Children are at special risk of suffering the impacts of climate change as a result of their exposures, sensitivity, and limited adaptive capacity. Dr. Balbus discusses federal strategies and activities including the President’s Climate Action Plan and the President’s Task Force on Environmental Health Risks and Safety Risks to Children.

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Adaptation strategies for protecting children’s health from climate change. 
Presenter: Perry Sheffield, MD, Assistant Professor in Preventive Medicine and Pediatrics, Mt. Sinai School of Medicine, New York City

Perry Sheffield, MDDr. Sheffield summarizes how children’s unique vulnerabilities and social circumstances interact with expected environmental impacts associated with climate change.  She explores adaptation strategies that address the needs of children and build partnerships between public health systems and others. “As we do child-focused adaptation we are battening the hatches against coming storms for future generations”

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Epidemiologic studies of heat-associated preterm delivery
Presenter: Rupa Basu, PhD, MPH, Chief, Air Pollution Epidemiology Section, OEHHA

Rupa Basu, PhD, MPHDr. Basu presents results from  the first large-scale epidemiologic study to examine the relationship between atmospheric temperature and preterm delivery. She also describes an on-going OEHHA study with the Kaiser Division of Research that considers maternal factors, behaviors, and medical conditions that may increase the risk of preterm delivery with rising temperatures.

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Changing climatic conditions and increases in infectious diseases risk for infants and children.
Presenter: Arthur Reingold, MD, Professor and Head of Epidemiology, School of Public Health, U.C. Berkeley

For the past 60 years California has been in the lead studying the relationship between vector-born disease and climate, including ambient temperature and humidity. West Nile, Western Equine, St. Louis encephalitis, malaria and other infectious diseases may increase in California and elsewhere. Human behavior and activity such as migration and travel, urbanization, water control projects, and time indoors may alter climatic impacts.

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  • SESSION 2. Climate Change and Children’s Health II

Impacts of the human transformation of Earth's natural systems: putting climate change in context.
Presenter: Samuel Myers, MD, Senior Research Scientist, Harvard University Center for the Environment Health

Samuel Myers, MDDr. Myers explores the cumulative impacts of global environmental change on human health, including human alterations of our planet for agriculture, resource use, population growth, and climate change. Losses in food production, decreased food quality, and food security will provide challenges to children’s health. 

“We are in the midst of an extraordinary moment in time when human activity is transforming all of our landscapes, geochemical cycles, [its] climate, and the functioning of our ecosystems in ways that are profound, pervasive, and accelerating.”

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Indicators of climate change in California: Tracking climate change trends and impacts.
Presenter: Carmen Milanes, MPH, Chief, Integrated Risk Assessment and Research Section, OEHHA

Carmen Milanes, MPHMs. Milanes presents a comprehensive picture of climate change in California based on the 2013 OEHHA “Indicators of Climate Change in California” report.  These changes are based on observations and monitored data. For example, sea level has risen eight inches over the last century in San Francisco. Changes in greenhouse gas emissions, acidification of coastal waters, temperature, precipitation, and other changes impacting agriculture, the ecosystem, and health are examined. Despite economic growth in California, greenhouse gas emissions are not increasing.

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Climate change impacts on air quality and childhood asthma.
Presenter: John Balmes, MD, Professor, UC San Francisco School of Medicine; Director, Center for Occupational and Environmental Health

John Balmes, MDComponents of air pollution such as ozone and nitrogen dioxide have important impacts on children’s lung development and respiratory health and are expected to increase with climate change. By 2050 California is predicted to have an additional 30 days annually with unhealthy ozone levels. High ozone levels can cause asthma in children and increase children’s emergency room visits for asthma. Increases in pollens resulting from climate change will result in greater health effects in combination with air pollutants. Dr. Balmes also discusses wildland fires and California Air Resources Board activities addressing climate.

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California Department of Public Health activities on children’s health and climate change – Integrating children’s health into climate change planning. 
Presenter: Paul English, PhD, MPH, Scientific Adviser, Environmental Health Investigations Branch, California Department of Public Health

Paul English, PhD, MPHDr. English reviews CDPH activities related to Children’s Health and Climate change. California’s children have underlying medical and social conditions, for example, 14 percent have asthma and 8 percent are born early, that increase their vulnerability to our changing climate. CDPH surveillance has documented increasing emergency room child visits for heat and dehydration during heat waves in recent years. This presentation describes California climate-related activities that address children’s health including cap and trade, adaptation strategies, and climate action planning.

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  • DAY 2 - THURSDAY, MARCH 5, 2015
    SESSION 3. Climate Change Mitigation in California and Children’s Health
  • Welcome and Summary of Day 1 Sessions - Melanie Marty, PhD, Assistant Deputy Director, OEHHA Division of Scientific Affairs


A Modest Proposal: Make the Tax on Carbon a Down Payment for Children.
Richard J Jackson MD MPH AIA(Hon) ASLA(Hon), Professor, Environmental Health Sciences, UCLA Fielding School of Public Health

Richard J Jackson MD MPHDr. Jackson tackles the big questions: What is it that we need to do to mitigate and prepare? What keeps us from doing it with our full commitment? He presents innovative planning strategies being developed and implemented that can mitigate climate change impacts and improve health. To do this we need to integrate science, leadership, ethics, and equity.

“We have been thinking small and we need a much larger strategy about how we are going to protect our children and our grandchildren.”

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Climate-smart conservation and human benefits.
Presenter: Ellie Cohen, CEO and President, Point Blue Conservation Science

Ellie Cohen, CEO and President, Point Blue43 percent of the land surface on the Earth has been transformed to agricultural and urban uses. Ms. Cohen introduces principles of climate- smart conservation that can both contribute to children’s health today and in the future. This approach brings together adaptation and mitigation rather than separating them.  She presents a vision of what the future may look like if we make climate-smart conservation decisions now.

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Implications of climate change on water resources in California and mitigation strategies, including reuse
Presenter: Mark Bartson, PE, Supervising Engineer, Technical Operations Section, division of Drinking Water, California State Water Resources Control Board

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AB 32 greenhouse gas reductions, national and international implications.
Presenter: David Mallory, PE, Manager, Climate Change Policy Section, Project Assessment Branch, Industrial Strategies Division, California Air Resources Board

Mr. Mallory provides an overview of AB 32 and related climate programs of the ARB and other state agencies. Complementary strategies that serve as a national and international model for reducing greenhouse gas emissions include incentive programs, regulations, and market-based mechanisms (e.g., cap and trade). Cleaner air, more livable communities, and a clean economy are additional benefits for California’s children.

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Concluding remarks (George Alexeeff)

*The University of California, Western States Pediatric Environmental Health Specialty Unit is supported by the American College of Medical Toxicology (ACMT) and funded (in part) by the cooperative agreement award number 1 U61TS000238-01 from the Agency for Toxic Substances and Disease Registry (ATSDR).