M A I N E R E P O R T
PSR
BY
DEGREES
THE EMERGING
HEALTH CRISIS OF
CLIMATE CHANGE
IN MAINE
PHYSICIANS FOR
SOCIAL RESPONSIBILITY
PSR
BY
DEGREES
THE EMERGING
HEALTH CRISIS OF
CLIMATE CHANGE
IN MAINE
PHYSICIANS FOR
SOCIAL RESPONSIBILITY
Physicians for Social Responsibility
Robert K. Musil, PhD, Executive Director
Sharon Newsome, Director, Environment and Health Program
Karen Hopfl-Harris, JD, Associate Director
Joshua Speiser, MS, Grassroots Organizer
Maine Advisory Board
Elizabeth DeSombre, PhD, Colby College Professor of Government and Environmental Studies
Lani Graham, MD, MPH
Bruce Kenney, MD, Family Practitioner
Dan Meyer, PhD, Associate Professor Maine-Dartmouth Family Practice Residency
Syd Sewall, MD, Pediatrician
February 2000
2 DEATH BY DEGR EES
PHYSICIANS FOR SOCIAL RESPONSIBILITY
1101 Fourteenth St., NW, Suite 700
Washington, DC 20005
tel: (202) 898-0150
fax: (202) 898-0172
website: www.psr.org
This report was prepared by Physicians for Social Responsibility
to alert Maine residents to the damaging health effects of climate
change and to encourage them to reverse global warming’s
deadly course by reducing reliance on fossil fuels.
The Emerging Health Crisis of Climate Change in Maine 3
How Global Warming Could Threaten
Health in Maine
Numerous health hazards may increase as a result of global
warming. According to physicians who have studied global
warming and its effects, the most severe health risks in Maine
could include:
• More "extreme weather events," such as ice storms, hurricanes
and flooding, leading to more drownings, electrocutions and
other accidental deaths.
• More respiratory and cardiovascular disease, especially for
those with asthma, due to increased air pollution.
• More waterborne disease, such as intestinal distress from
drinking contaminated water or consuming toxins present in
fish and shellfish.
• More outbreaks of infectious disease spread by insects.
• More deaths and injuries, such as drownings caused by storm
surges, related to sea level rise and coastal erosion.
• More incidents of heat-related disease, such as heat stroke.
• More deaths and injuries due to forest fires intensified by
droughts, hurricanes and other extreme weather conditions
associated with global climate change.
The rapid rate of warming since 1976, 0.35 degrees per decade, is consistent with the
projected rate of warming based on human-induced effects. In fact, scientists now say
that they cannot explain this unusual warmth without including the effects of both
human-generated greenhouse gases and aerosols.
—D. JAMES BAKER, ADMINISTRATOR,
U.S. NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
The world is getting warmer at an unprecedented rate,
never before seen in recorded history. Climate fluctuations have occurred
during previous centuries, but at the dawn of the 20th century, a warming
trend took hold that shows no signs of stopping.1 During the past one
hundred years, average global surface temperatures have increased by
approximately 1 degree Fahrenheit. Eight of the warmest ten years on
record happened in the last decade.
Although uncertainties exist
in measuring this complicated
phenomenon, an overwhelming
consensus has emerged over the
last decade among scientists on
several key points. First, the
increase in temperature is real.
Second, human activities—in
particular our burning of fossil
fuels—are affecting the climate
system.2 Third, warmer conditions
on Earth will directly affect our
lives and well-being.3
This report describes how the
changing global climate will impact
human health. Our focus is on
Maine, a state that is likely to
experience more health problems
and increased mortality due to the
expected changes.
4 DEATH BY DEGR EES
Maine: A State At Risk
The world is definitely warmer than it was 150 years ago, and the warming appears to
have accelerated during recent decades. Many of my students are very concerned. They
are worried about how these changes could affect their lives and, in the future, the lives
of their children. I think their concern is justified. It’s a dangerous game we’re playing
now, altering natural systems.
—DR. OLAF ELLERS, DIRECTOR OF THE COASTAL STUDIES CENTER,
BOWDOIN COLLEGE, BRUNSWICK, MAINE
"As Maine goes, so goes the nation" was a common phrase during the
1800’s.5 Then the saying referred to how the state voted two months before
the rest of the country. Now it may apply to the way in which Maine reacts to
the health threats posed by global climate change.
These threats include heat stroke, respiratory illness, hypothermia, cardiac
arrest and carbon monoxide poisoning, all of which can be triggered by
temperature extremes. Maine already experiences extreme temperatures
during the winter and summer
months.6 However global warming
likely will lead to more such days of
excessive cold and heat.
Maine residents also can expect to
see a greater number of injuries and
deaths resulting from surges, and
other natural forces, that can develop
during storms.7 That is because both
Nor’easters and hurricanes could
become more frequent and severe.
The National Weather Service says
global warming impacts could result
in 10 to 20 foot storm surges along
Maine’s shoreline.8
Floods and droughts could occur
on a more regular basis, increasing
the risk of water contamination and
gastrointestinal illnesses.9 Water
quality problems in rivers such as the
Androscoggin, where pollution
already poses health risks, could be
exacerbated.10
Further water contamination could
occur due to rising sea levels, which could bring saltwater into drinking water
supplies. Increased sea level rise also could lead to more severe flooding of
low-lying property, loss of coastal wetlands, erosion of beaches, and decreased
longevity of low-lying roads, causeways and bridges.11
Maine can expect more severe cases of asthma and other respiratory
problems associated with elevated ozone levels. At present, ozone in Maine
causes breathing difficulty for 395,000 people, approximately one-third of the
population.12
The Complex Origins of Climate Change
Since the end of the last Ice Age 10,000 years ago, temperatures
worldwide have risen about 9 degrees Fahrenheit, mainly due to
natural changes in the geographical distribution of the sun’s
energy and in the amounts of dust, carbon dioxide and other
gases in the atmosphere.
In recent years, the rate of increase in temperatures has been
accelerating. On any given day, the average temperature is about
1 degree F higher than a century ago. Eight of the ten warmest
years in recorded history occurred in just the last decade, with
1998 topping them all.
Human activities are among the most important factors
making Earth warmer. When motor vehicles burn gasoline and
electric utilities burn coal, they release carbon dioxide and other
gases into the atmosphere that trap warm air near Earth’s surface,
in much the same way as glass panels trap warm air inside a
greenhouse—hence the term, "greenhouse effect." Over the past
200 years, the concentration of greenhouse gas in the atmosphere
has increased by 30 percent. The gas will remain there for
centuries, trapping heat and putting human health at risk.4
The Emerging Health Crisis of Climate Change in Maine 5
Economically, Maine also has much at stake, as many residents make a
living from natural resource industries, such as lumber, tourism, agriculture,
and fishing.13 Each of these industries could be adversely impacted by global
climate change, leading to possible job losses. Without sufficient income, some
residents may be unable to afford health insurance.
Making matters worse, numerous Maine citizens already are vulnerable to
the effects of climate change. These include the young, the infirm, and the
elderly. Young individuals are at risk because their immune system, and other
protective systems, have not yet fully developed.14 In the case of heat stress,
for example, sensitivity to heat is greatest in children less than a year old
whose heat regulatory systems have not yet developed to adult potential.15
The infirm are at risk because they are sensitive to heat stress, air pollution,
and other possible effects of global warming. Certain medications, such as
those taken for treatment of AIDS or kidney transplants, also increase sensitivity.
16 The elderly are at risk due to a host of factors, including a possible
drop in the efficiency of their heat-regulating systems, an increase in the
temperature at which sweating begins, a decrease in the ability to perceive
changes in temperature, and pre-existing conditions, such as cardiovascular or
pulmonary diseases.17 Given that the percentage of individuals 65 years old
Energy from the sun drives Earth’s weather and climate, as shown in this illustration. Water vapor, carbon dioxide and other
atmospheric greenhouse gases trap some of the sun’s energy, creating a natural "greenhouse effect." However, problems arise
when the greenhouse effect is enhanced by human-generated emissions of greenhouse gases, such as through the burning of
fossil fuels.
ATMOSPHERE
FIGURE 1
The Greenhouse Effect
Some solar radiation is
reflected by the Earth and
the atmosphere.
Some of the infared radiation
passes through the atmosphere,
and some is re-emitted in all
directions by greenhouse gas
molecules. The effect of this is to
warm the Earth’s surface and
the lower atmosphere.
Most radiation is
absorbed by the Earth's
surface and warms it.
Infrared
radiation is
emitted by the
Earth's
surface.
6 DEATH BY DEGR EES
and over in the state now exceeds the national average,18 many Maine
residents could be hit hard by the effects of global warming.
Maine, like the rest of the country, needs to be deeply concerned about the
impact of climate change on the health of its population.
Are we already experiencing the effects of global warming?
No one knows better than Maine residents that there has always been the
occasional hot summer, or the unusually bad storm. Such events do not
necessarily indicate a long-term pattern. But trends in recent years correspond
closely to computer predictions of climate change, and may well be warning
signs. These include:
• More prevalent extreme weather conditions, exemplified by this year’s winter. Until
January 2000, much of the state experienced over 300 days without snow,
record high temperatures, and 2 1/2 inches below normal rainfall this winter.
19 In less than a week this dramatically changed, as a deep freeze settled
over New England, plummeting the wind-chill by as much as 100 degrees.20
• A spate of heat waves. Nationwide, the number of heat-stressed days has
approximately doubled during the past 50 years. New England is no exception.
Last spring, the driest April on record unfolded into one of the worst
droughts in history. It killed more than 270 people in the Northeast.21
• Rising sea levels along Maine’s coast. For the last 2,000-3,000 years, sea levels
rose about .8mm (.0026 feet) per year. Now that rate has doubled in most
areas, and even tripled around cities such as Eastport.22 This has led to
growing concern among Maine’s coastal communities about property
damage, coastal erosion, and drinking water contamination.23
Such trends are further brought to light in countless scientific reports.
Of note most recently, the National Academy of Sciences presented a 71-page
document that states there is no question Earth’s warming has accelerated
during the past two decades.24 On January 19, 2000, NASA’s Jet Propulsion
Laboratory issued a release stating that the persistence of La Niña and
El Niño events, which cause warmer and cooler than normal sea-surface
temperatures, may be part of a larger, long-lasting climate pattern.25
The following sections describe the specific health effects that are predicted
to result from global warming over the next 50 or 100 years, together with
supporting evidence. In some cases, there is a high level of certainty about the
predictions. In others, the evidence is less definitive. For all cases, there is
reason for concern.
The Emerging Health Crisis of Climate Change in Maine 7
More Extreme Weather Events Leading to More
Heat-Related Illness, Drownings, Electrocutions, and
Other Accidental Deaths
Global warming means not only warmer temperatures, but also more
unpredictability in weather patterns and more extreme weather conditions.26
The concentration of greenhouse gases that cause global warming increases
heat and moisture in the atmosphere. Heat and water vapor create instability,
leading to more frequent, and possibly more severe, weather activity.27 In
addition, the effects of changing weather patterns associated with melting
polar ice are expected to be felt more strongly in northern areas, such as
Maine.28
All of this could mean more ice storms, floods, hurricanes, Nor’easters,
droughts, heat waves and other natural disasters. Although Maine is
accustomed to rapid and extreme swings in weather conditions,29 the events
forecasted to occur with global climate change may be surprising and severe.
Already Maine sustains incredible damage from natural disasters. In 1998,
for example, Maine was the eighth highest-ranked state in the country for
receiving federal disaster funds.30 Insurance losses and federal disaster aid
allocated to Maine that year totaled $144,048,658.31
Extreme weather conditions can have wide-reaching health impacts.
They can cause accidents, illnesses, injuries, and deaths. They can disrupt
electrical power supplies, compromise access to public service broadcasts, and
contaminate drinking water supplies, thereby placing populations in jeopardy.
Downed electrical power lines and leaks from natural gas, or propane, tanks
can cause fires, electrocutions, or explosions. Intense rainstorms can cause
floods that wash raw sewage into drinking water supplies and spread infectious
diseases such as salmonella, cryptosporidiosis, and giardiasis. Ice storms,
hurricanes, and droughts can intensify forest fires, possibly leading to injuries,
fatalities, and respiratory illnesses. Residents displaced from their homes by
floods and hurricanes also may experience psychological problems, ranging
from depression to post-traumatic stress syndrome.32
Depending on their severity, extreme weather events can tax, or even
cripple, emergency care systems. A survey of hospital emergency departments
in Maine found a 47 percent increase in the number of patients treated
during the ice storm of 1998.33 The loss of power that often occurs during
such storms can result in an inability to run oxygen machines and other
necessary medical equipment. This may endanger the health of many citizens,
particularly those at most risk.34
Direct Effects Of Heat On Health
While average global temperatures have increased by 1 degree Fahrenheit,
temperatures in Maine appear to be rising at a much higher rate. For
example, over the last century, the average temperature in Lewiston has
increased 3.4 degrees Fahrenheit.35 Already, there are 11 more frost-free days
in New England than there were two decades ago.36 This upward trend is
predicted to escalate. By 2100, average temperatures could increase by a full
8 DEATH BY DEGR EES
8 degrees F.37 To put this into perspective, for hundreds of millions of years,
average temperatures across the globe have varied by no more than five to
seven degrees. The average global temperature at the time of the last ice age
was only nine degrees lower than temperatures are today.
Heat waves also have been on the rise in New England for the last 20
years. In Portland, Maine the number of 3-day heat waves went from 4 in
1956–1965 to 21 in 1986–1995.38 In addition, the northeastern United States
is seeing a rise in maximum daytime temperatures, along with higher nighttime
minimum temperatures.39
Heat can directly affect health, as explained below. Often heat leads to
high humidity, which can interfere with the body’s ability to cool itself
through perspiration. In Boston, the nearest city in New England for which
heat wave projections have been made, one study predicts that a warming of
Air Conditioning: The Vicious Cycle
Although residents of warmer states seem to acclimate
to hot temperatures, one of the sad lessons of the heat
waves of the 1990’s is that people who are unused to
hot weather and who do not have air conditioning
suffer the most. In the deadly 1995 Chicago heat wave
that killed over 600 people, the highest casualties were
among elderly residents with no air conditioning.
Unlike previous heat waves, overnight temperatures did
not drop sufficiently to provide much needed relief.
Minimum nighttime temperatures increased abruptly in
the 1970’s and are on the rise, thus the cooling effect
of night air is no longer available during heat waves.40
About one-third of households in the Northeast do
not have any form of air conditioning.41 Maine, with its
occasional heat waves, could also therefore be
susceptible to increases in heat-related deaths.42
Considering that temperatures across many parts of
Maine, such as Lewiston, have already increased over
3 degrees this century,43 the potential for disaster is
certainly present. Already, nearby New Hampshire has
had to receive federal emergency funds, for 1999’s
summer heat wave, to assist its residents who are most
vulnerable to extreme climate changes.
Those who can afford air conditioning are likely to
use it more as the weather gets warmer. Demand for
air conditioning throughout New England and the
Northeast already was at record levels in the exceptional
heat during the summer of 1999.44 This certainly
was true as well for Maine, as evidenced by the
increased energy output during this time by the Wyman
Station power plant on Cousins Island near Yarmouth.
The hotter it gets, the more the demand for air
conditioning increases. The increased energy used to
provide air conditioning can result in more greenhouse
gas emissions in the atmosphere that may cause global
warming, as well as increased emissions of other air
pollutants from power plants. Taxed power plants
powering air conditioners emit fine particulate matter
(PM)45 and are believed to be the biggest (per measurable
point) source of air pollution concentrations along
the East Coast.46 In 1998, the Wyman Station plant ran
about twice as much as normal in July to meet a high
demand for power in New England. PM from the plant
was said to be heavy enough to coat cars, homes,
boats, and lawn furniture with thick layers of soot.47
PM is possibly the greatest consistent threat to
respiratory health. Health effects of inhaling PM include
premature death, increased hospital admissions and
emergency room visits, increased respiratory symptoms
and disease, decreased lung function, alterations in lung
tissue and structure, and changes to respiratory tract
defense mechanisms. Sensitive groups that appear to be
at greater risk from such effects include the elderly,
individuals with respiratory disease, such as asthma,
and children.
As weather heats up, people with respiratory
illnesses who do not have air conditioning are more likely
to keep their windows open to allow for air circulation.
Unfortunately, it is during the summer months that air
pollutant levels are at their highest, thus increasing the
chances of exposure to PM and ozone, another air
pollutant that increases as temperatures rise and can
exacerbate asthma and other respiratory conditions.
To make matters worse, a disproportionate number of
asthma sufferers are poor, and therefore are less likely
to be able to afford adequate air conditioning.48
The Emerging Health Crisis of Climate Change in Maine 9
3 degrees Fahrenheit could increase heat-related deaths during a typical
summer by 50–100 percent.50
Heat can lead to severe health problems such as heat cramps, heat exhaustion,
exertional heat injury, and heat stroke. In addition to heat and humidity,
risk factors for these conditions include advanced age, lack of air conditioning,
and use of certain medications. Vulnerable populations, including the
elderly, children, infants, and the infirm, will suffer the most. Cardiovascular
diseases, such as coronary heart disease, also are a risk factor.51 Maine
currently has the highest death rate from heart disease in New England.52
Heat cramps are muscle spasms that primarily affect people who exert
themselves through strenuous work or exercise. These cramps are believed to
be caused by mineral imbalances. Salt and water replacement usually relieves
them. A more severe condition is exertional heat injury, which commonly
occurs among runners who are not properly conditioned and hydrated. The
body can reach 102 to 104 degrees, with symptoms that include goosebumps,
chills, nausea, vomiting, and unsteady gait. In severe cases, people may have
incoherent speech, or even lose consciousness. Muscles, kidneys, and blood
cells may be damaged.
Heat exhaustion, or heat collapse, is the most common heat-related
condition. It occurs when the cardiovascular system cannot keep up with
heat demands. An affected person feels dizzy, weak, cold and clammy, and
has ashen skin and dilated pupils. The individual may require hospitalization.
53 At greatest risk are infants, small children, the elderly, those working
or exercising outdoors, persons with impaired mobility, and individuals
suffering from cardiovascular disease.54 When moved to a cool place, a victim
of heat exhaustion usually recovers.
FIGURE 2
Occurrence of deadly heat waves on the rise in Maine
Along with the increase in
average global surface
temperatures during the past
several decades, there has
been a dramatic increase in
the occurrence of deadly
heat waves. This graph shows
the rise in number of 3 and 4
day heat waves in Portland,
Maine over 10 year periods
from 1956–1995.49
Source: National Oceanic and
Atmospheric Administration .
No. of 3- and 4-day heat waves
1956–65 1966–75 1976–85 1986–95
21
18
15
12
9
6
3
0
3-day 4-day
4
3
13
7
15
9
21
14
10 DEATH BY DEGR EES
Heat stroke, the most severe of these conditions, can be fatal. If body
temperature reaches 106 degrees or above, damage to the kidneys, muscles,
heart, and blood cells is likely. Sweating stops altogether. Death may come
immediately, or could be delayed until several weeks later.55 The public health
burden of heat waves is compounded, as excessive heat increases the death
rate for other medical conditions.56
Hypothermia, Carbon Monoxide Poisoning, and Other Health
Problems Associated with Ice Storms
The ice storm of 1998 was one of the worst events I’ve ever lived through. I think a lot
of Maine residents would agree with me on that. Many of the health effects were
unexpected, such as people falling off of roofs or succumbing to carbon monoxide
poisoning. I hope that we never experience anything like this again. But the potential is
there, given current global warming patterns.
—ELIZABETH DESOMBRE, PROFESSOR OF ENVIRONMENTAL STUDIES & GOVERNMENT,
COLBY COLLEGE, WATERVILLE, MAINE
While average temperatures are expected to rise in Maine in the winter, the
increased variability of the climate may also mean winters with more days of
extremely low temperatures.57 Over the next several decades, the state can
expect much heavier precipitation in the winter. Some estimates for New
England forecast precipitation increases on the order of 25 to 50 percent.58
And certain models predict precipitation changes for Maine that include
little change in spring, an increase by 10 percent in summer and fall (with a
range of 5–15 percent), and an increase of up to 30 percent in winter
(with a range of 10–50 percent).59
As average temperatures increase, more of Maine’s winter precipitation
may fall in the form of rain, sleet and ice, increasing the likelihood of events
such as the ice storm of 1998, which caused an estimated $320 million in
direct costs for Maine, plus $300 million for repair of long-term forest
damage.60 Although the conditions necessary for the formation of ice storms
are hard to predict, some scientists expect that warmer winter temperatures
will lead to more ice storms in the future.61
Unexpectedly cold weather and large snowfalls can pose a variety of possible
health risks, such as accidents, hypothermia and cardiac-related deaths.
• Hypothermia, an unintentional lowering of the core body temperature to less
than or equal to 95 degrees Fahrenheit, is a deadly medical emergency.62
From 1979 to 1995, 1 out of approximately every 333,000 people in Maine
died from a hypothermia-related illness.63 Already, 1 individual in Maine
has died from hypothermia during the winter of 2000.64 Early signs of
hypothermia often are insidious. They include shivering, numbness, fatigue,
poor coordination, slurred speech, impaired mental state, blueness or
puffiness of the skin, and irrationality.65 Other clinical problems may include
blood, respiratory, renal and glandular abnormalities. Coma, low blood
pressure and cardiac irregularities characterize severe hypothermia.
The Emerging Health Crisis of Climate Change in Maine 11
• Heart failure is a disabling chronic disease that is the leading principal
diagnosis for hospitalization among older adults.66 People with heart problems
are vulnerable to temperature extremes because their cardiovascular
systems must work harder to keep their bodies regulated.67 The predicted
increase in the number and severity of ice storms could, therefore, lead to
more deaths due to cardiovascular disease. Already Maine has a high death
rate for this condition, with 276 individuals dying of heart failure in 1995
alone.68
The Ice Storm of 1998
The extreme weather events projected to occur as a
result of global climate change may be exemplified by
the severe ice storm that hit Maine, as well as much of
the northeastern United States and southeastern
Canada, from January 5 through January 9, 1998. No
one who lived in Maine at that time could forget this
storm, even long-time residents who have seen their
fair share of inclement weather.
The storm began innocently enough on a Monday
morning with freezing drizzle. As the day progressed,
the drizzle turned to freezing rain—a rain that did not
let up until late Friday.69 By Saturday morning, January
10, much of the state was dangerously encased in 1 to
9 inches of ice.70 The town of Gray declared a state of
emergency, and residents were asked to stay indoors
due to the risk of falling ice and other hazards. In
parts of northern Maine, more than two feet of snow
fell during the week and 6 to 10 inches of sleet were
reported in parts of north central Maine.71
Statewide, the storm knocked out power to about
365,000 customers, affecting 840,000 people, or
about 70 percent of the state’s population of 1.2
million. About one third of those that lost power were
without electricity for more than a week. For some, the
electricity was off for up to 3 weeks. During this time,
residents and those involved with the restoration efforts
had to contend with snow, additional freezing rain,
rain, slippery roads, falling ice and other debris, subzero
temperatures, strong winds, and dangerous wind
chills. For many homes, the lack of electrical power
also meant no heat, no running water, and no means
for cooking food.
Damage to property and public lands was
extensive, and still persists to this day. By late April
1999, the storm had damaged an estimated $300
million worth of timber and most of the maple trees
used for syrup were hurt severely, affecting the
economic well-being of many residents.72 Numerous
trees turned into "widow makers," whose dangling,
heavy limbs could fall and crush anyone who works,
walks or drives through wooded areas. At least 4
communication towers fell during the storm. In the Bar
Harbor area, a 1/2-inch guy wire was reported to be
encased in ice 9-inches in diameter.73 At least 5 deaths
were attributed to the storm. Two men died in separate
incidents from carbon monoxide poisoning from
inadequately ventilated generators. Carbon monoxide
poisoning actually reached epidemic proportions in
Maine at this time, with over 400 people treated at local
hospitals. One man died when a tree fell on him as he
was cleaning up debris. Tragically, an elderly man died
of hypothermia after he fell down a flight of stairs in his
dark, unheated home. Yet another man was crushed by
the roof over a gas station island which was weighed
down with ice and snow from the storm.74
The ice storm led to further accidents, as well as
illnesses. A survey of three hospitals after the storm
showed a marked rise in bone fractures, neck injuries,
eye injuries, non-fracture muscle and bone injuries,
cases of cold exposure, burns, lower respiratory tract
illness, cardiac disease, acute gastrointestinal distress
and even increases in alcohol, substance abuse and
mental health problems.75 A survey among residents
further revealed incidents of vomiting, cough with fever
and severe headaches with dizziness. The direct cause
of these conditions was not specified. Many of these
people dangerously were left without power or
telephone service for almost the entire month.76
The storm left a heavy price tag in its wake, not
only in terms of the damage to human health and
property, but also economically. Numerous disaster
shelters were set up throughout affected areas.
President Clinton declared a federal disaster and more
than $13.7 million was provided in federal assistance
to Maine.77 Overall, the storm cost the United States
$1.4 billion and $3 billion in Canada.78
12 DEATH BY DEGR EES
Most of us are aware of the risks posed by heart failure and hypothermia,
but the ice storm of 1998 showed that a number of less familiar problems
result from such weather events. After the ’98 storm, both the Maine Bureau
of Health and the Centers for Disease Control and Prevention developed a
community needs survey to assess the potential health hazards to residents of
the state who remained without power.79 The assessment revealed that individuals
experienced a variety of health problems following the storm, including
vomiting, diarrhea, cough with fever, severe headaches with dizziness,
burns, lower respiratory tract disease and severe cuts.80 Other than the ice
storm itself, the report does not list the specific causes of these conditions.
The devastating ’98 storm further showed the health risk posed by carbon
monoxide, as carbon monoxide poisonings reached epidemic proportions
statewide. Between 300 and 400 people were treated at area hospitals, possibly
the largest outbreak of carbon monoxide poisoning ever in the nation.81
Carbon monoxide poisonings can occur during blizzards when people sit in
idling automobiles with exhaust pipes blocked by snow.82 Poisonings may also
occur during power outages, when people often use unvented residential
appliances such as stoves and heaters.83 Inadequately ventilated generators
pose another risk, and led to the deaths of two Maine men in 1998. Kerosene
and propane-fueled space heaters, gas-fueled log sets, and cooking devices
used improperly for heating can expose people to potentially hazardous levels
of carbon monoxide, as well as other toxic gases.84
Carbon monoxide is an odorless, colorless gas that can attach itself to
hemoglobin, impairing the oxygen-carrying capacity of the blood and starving
a body’s tissues and organs of oxygen.85 The poor and the elderly especially
are vulnerable to carbon monoxide poisoning. As of 1996, 11.2 percent of
Maine’s population lived below the poverty level,86 many of whom were
youths under the age of 18.87 The poor are less able to afford proper heating
systems, and often live in crowded housing with inadequate ventilation,88
factors that heighten the risk for carbon monoxide poisoning. The elderly are
vulnerable due to decreased lung capacity,89 pre-existing health conditions,
and other factors. 13.9 percent of Maine’s population is 65 years old and
over,90 a figure that increases every year.
Health Threats From Snowfall Extremes: The Winter of 1999–2000
Carbon monoxide poisoning, hypothermia, heart failure and weatherrelated
accidents also may occur as a result of extreme snowfall. Climate
change models predict more variability in snowfall conditions, which can lead
to such extremes. These conditions are evidenced by the winter of 1999–
2000. Already, this year’s winter promises to break many records. For
example, only trace amounts of snow fell in the city of Portland during
December, 1999. Normal snowfall for that time of year is 17 inches.91 This is
the smallest quantity of snow in 119 years of December snowfall records.92
Snow finally came on January 16, 2000, but, at 8 inches, was heavy, and
accompanied by bitter cold and strong winds. Temperatures in the single digits
and wind gusts of 30 to 50 miles per hour made the temperature feel as cold
as 50 degrees F below zero.93 3,500 Maine residents lost power in the cities of
Belgrade, Mount Vernon, Manchester, Oakland and Rome. Another 500
The Emerging Health Crisis of Climate Change in Maine 13
customers lost power in Denmark and Sebago.94 Hazardous road conditions
affected drivers. At least one death was attributed to the harsh snowfall and
storm.95 Snow and ice conditions increased the number of distress calls for
inadequate heat.96
More Illnesses, Injuries And Fatalities Related to Precipitation,
Floods, Thunderstorms and Hurricanes
Over the next several decades,
precipitation in Maine is projected to
show little change in spring, increase
by 5–15 percent in summer and fall,
and increase by 10 to up to 50 percent
in winter.97 The amount of rain
on extremely wet days also is predicted
to increase. Such heavy rainfalls
can cause flooding, especially
when combined with sea level rise,
which is already a problem
throughout much of Maine.
Floods cause an average of 146
deaths per year nationwide, most of
which are due to drownings associated
with motor vehicles in flash
flood conditions.98 Monetary damages associated with floods usually are steep.
Just one flash flood in 1997 at North Monmouth caused $250,000 damage to
roads and $100,000 damage to homes.99 Floods also may result in cases of
infectious disease, through contamination of drinking water supplies by
bacteria and parasites. The most common of these illnesses, diarrhea, usually
lasts only a few days. For individuals with weakened immune systems, however,
this condition can be long-lasting and even fatal.
Floodwaters can contain fecal material from industrial and agricultural
byproducts, and overflowing sewage systems. Maine’s farming communities,
in particular, face risks when pastures and crop fields are flooded. Although
skin contact with floodwater does not, by itself, pose a serious health risk,
there is a threat of disease from eating or drinking anything contaminated
with floodwater. Floods may cause not only physical, but also mental, illnesses.
Residents displaced from their homes may experience psychological
problems, ranging from depression to post-traumatic stress syndrome.100 These
problems could hit hard in Maine, since numerous residents, especially the
elderly, have lived in the same region and home for much of their lives.
In addition to an increased risk for floods, climate change may also
heighten chances for more turbulent thunderstorms, due to predicted increases
in atmospheric instability. As it stands, severe thunderstorms already
are cause for concern in Maine. For example, a thunderstorm in the town of
Westbrook during August, 1998, created extensive damage.101 Many homes
and vehicles were struck by falling trees. Wind gusts of up to 70 miles per
hour left more than 30,000 homes without electricity. The cost for repairs
totaled well over 2 million dollars.
14 DEATH BY DEGR EES
Lightning from such events causes deaths and injuries in Maine each year.
On just one day—February 22, 1997—a lightning storm sent nearly a dozen
people to hospitals in the towns of Oxford and Greenville.102 Even more
injuries and fatalities due to lightning are expected to occur as a result of
global warming.
More Droughts Predicted
We have begun to experience drought conditions in the summer, which not only affect
our ability to grow crops, but also potentially impact our access to clean drinking water
from our wells. With drought, sometimes water in the wells gets so low that "septic tank
water" or saltwater—if the homes are on the coast—can intrude.
—PAM PERSON, PROGRAM DIRECTOR, COALITION FOR SENSIBLE ENERGY,
AND CO-CHAIR, MAINE GLOBAL CLIMATE CHANGE INC.
It may seem odd to think about droughts alongside floods and increased
rainfall, but a variable and unstable climate that can shift from one extreme
to another is precisely what global warming is likely to bring. The climate
shifts predicted by some global climate change models may increase the
frequency and severity of New England droughts.104
On average, New England experiences moderate drought conditions about
once every ten years.105 The worst episode this century was in the mid-1960’s.
More recently, a prolonged drought occurred in the summer of 1997. In
No. of days after Dec. 31
FIGURE 3
Ice Out on Moosehead Lake, Greenville, Maine
The date of "ice out" (the
date at which ice melts) on
Moosehead Lake has been
reported since 1848. The
data shown assigns a
numbered day of the year to
each reported date, based
upon the number of days
after December 31st. For
example, January 1 = 1 and
February 1 = 32. The trend
line indicates a tendency to
earlier dates, suggesting less
severe winters and earlier
spring conditions, both of
which are predicted to occur
as a result of global
warming.103
Source: Publius Research
1848 1868 1888 1908 1928 1948 1968 1988
100
110
120
130
140
150
160
The Emerging Health Crisis of Climate Change in Maine 15
addition to economic losses, drought can result in water shortages, which can
impair local sewer systems or force individuals to curtail their use of water for
hygiene, washing food, and managing crops. Most of Maine experienced a
severe drought in the summer of 1999, accompanied by reports of wells
running dry and water shortages. More than 60 percent of Maine households
draw their drinking water from groundwater supplied from private or public
wells or springs.106 These individuals
may be particularly vulnerable to the
effects of drought.
Droughts also concentrate
microorganisms in water supplies
and encourage pests such as aphids,
locusts and whiteflies that can
damage crops.107 A pattern of drought
interrupted by sudden rains can lead
to large increases in rodent populations
that can carry diseases such as
hantavirus.108 Lastly, drought conditions
can dry out forests, increasing
the risk for forest fires.
Climate Change, Water
Quality and Disease
Research shows that climate
change will have major effects on
precipitation, stream flows, storm
surges, runoff, water temperatures,
and evaporation, thereby affecting
Maine’s water supply. Both the
quantity and quality of available
water could be at risk. Increasing
saltwater intrusion from rising sea
levels, for example, may impact
rivers and aquifers.109
There remains considerable uncertainty
as to specifically how regional
precipitation and waterways could be
affected by global climate change.
Certain facts, however, are clear. Low
stream flows can cause substances in
water to concentrate, which may
lead to more polluted waters. On the
other end of the spectrum, excess
water runoff can bring more pesticides,
along with agricultural and
human wastes, into the water supply.
Threats to Groundwater
Groundwater, or water that is located beneath the surface of the
ground in fractures in bedrock and between grains of sand and
gravel deposits, is a valuable resource in Maine. Over sixty
percent of all households in the state get their drinking water from
these underground sources, primarily through wells. Agriculture
relies upon groundwater for crop irrigation and livestock watering.
Industries use groundwater in food processing, mining, metal
finishing and other processes. Individuals and municipalities use
groundwater for drinking water and waste disposal, garden and
lawn watering and watering of golf courses.110
Given its importance in Maine, there is particular concern
about what effect global warming will have on the quality and
quantity of this water. Changing climate is expected to increase
evaporation and precipitation.111 Both of these conditions could
damage Maine’s groundwater. The first could dry up wells, a
serious problem in a state that is predicted to experience longer
and hotter summers accompanied by drought. The second could
cause flooding, which perhaps is even more dangerous.
Flooding can contaminate groundwater with illness-causing
bacteria and parasites. Fecal material from overflowing sewage
systems, industrial and agricultural byproducts and saltwater also
can contaminate groundwater. Pollutants may come from landfills,
road salt storage, animal wastes, septic systems, underground
petroleum storage tanks and the misuse and disposal of chemicals.
112 Even without floods and other events predicted to occur
more often as a result of global climate change, these pollutants
are causing problems for Maine’s groundwater. A survey of wells
by the Department of Environmental Protection in Maine revealed
that 270 of the state’s wells are contaminated and 342 are
threatened with the risk of contamination.113
Contaminated groundwater can have serious health and
economic impacts on individuals and municipalities. Drinking
contaminated groundwater may cause significant health problems,
including nervous system disorders, kidney and liver disorders and
cancer.114 The costs of cleaning contaminated groundwater can be
staggering. In many cases, the water will not be usable again as a
drinking water supply. In addition, property values in the affected
areas may fall sharply.115 At present, such problems are under
control in Maine. But if climate change projections hold true, tragic
consequences are in store for residents who rely upon groundwater.
16 DEATH BY DEGR EES
Extreme weather events that cause flooding or disruptions in water
supplies may bring on gastrointestinal disease. Two of the greatest threats are
from giardia and cryptosporidium.
• Giardiasis: Giardiasis is an illness caused by an one-celled microscopic
parasite that lives in the intestines of people and animals. It survives well
in water. During the past 15 years, Giardia lamblia has become recognized
as one of the most common causes of waterborne human disease in the
United States.116 In 1994 there were 335 cases of giardiasis in Maine,117 but
the true number of cases in the state was probably several times higher. In
1999, 240 cases were reported.118 Diarrhea, abdominal cramps and nausea
are the most common symptoms of giardiasis.
• Cryptosporidiosis: Another major threat to the United States water supply is
from an organism called Cryptosporidium, which is small, difficult to filter,
resistant to chlorine and ubiquitous in many animals.119 Symptoms of the
illness include diarrhea, stomach cramps, upset stomach, or slight fever.
Cryptosporidiosis can be serious, long lasting and sometimes fatal for
people with AIDS, and others whose immune systems are weakened.120 In
1999, there were almost 3,500 cases of cryptosporidiosis in the United
States. Incidents of the disease have been rising in Maine. In 1994 there
were 22 reported cases, while 1999 had 30.121
Food Contamination
Warmer, moister weather encourages the spread of diseases caused by food
contaminated with toxic E. coli, salmonella, cyclospora and hepatitis-A.122
Hepatitis A is a liver disease with symptoms that include jaundice,
fatigue, abdominal pain, loss of appetite, intermittent nausea, and diarrhea.
An estimated 125,000–200,000 total infections of Hepatitis-A occur each year
in the United States, of which about two-thirds can cause clinical disease and
approximately 100 are fatal.123 Hepatitis-A usually is transmitted by fecal-oral
routes of exposure from food and waterborne sources. An outbreak of this
disease occurred in Maine in 1997, and sent 66 people to local hospitals.124
E. coli and salmonella also have jeopardized health in Maine. In 1998,
for example, 37 cases of E. coli were reported in the state.125 1995 saw 66
cases of E. coli. Salmonella has been an even greater problem in the state.
In 1998 there were 165 reported salmonella cases. Maine had 192 cases in
1994.126 The predicted warmer, moister weather could bring these numbers up
even higher in the coming years.
Red Tides And Seafood Poisonings
Certain seafood-related health problems arise when poisonous algae,
known as dinoflagellates, bloom along New England shores in the spring or
fall. Global warming is predicted to increase the occurrence and severity of
such blooms. The harmful algae often stain water red—hence the expression
"red tides." In 1999 red tides resulted in two precautionary closures for
shellfishing. The first was for mussels in the southern part of the state.
The Emerging Health Crisis of Climate Change in Maine 17
The second occurred in northern Maine, near Canada, and applied to soft
shell clams.127
Nationally, such harmful algal blooms (HAB’s) appear to be on the rise and
seem to be expanding throughout the United States.128 Before 1972, there
were only isolated HAB outbreaks around the southern coast of Maine.129
Since that time, HAB events have occurred along the entire New England
coastline. Red tides, and other HAB’s,
impact human health when individuals
consume shellfish that previously
fed in infected waters. Raw or cooked
shellfish can then pass the toxins to
humans, causing shellfish poisoning.
During the 1980’s, Maine had over
8,000 reported cases of shellfish
poisonings.130 Luckily, none proved to
be fatal. The number of cases has
dramatically reduced since that time,
due to effective monitoring and
public education. The threat of
illness, however, remains. As described
below, there are five principle
types of seafood/shellfish poisoning.
• Amnesic Shellfish Poisoning (ASP):
ASP can be life threatening. It may
become evident up to 24 hours
after an individual consumes toxic
shellfish. Symptoms include
nausea, vomiting, abdominal
cramps and diarrhea. In severe
cases, neurological symptoms also
appear, such as dizziness, headache,
seizures, disorientation,
short-term memory loss, respiratory
difficulty and coma.131 In
1987, four victims died after
consuming toxic mussels from
Prince Edward Island, Canada.132
Fish and crab also may cause ASP.
From 1985 to 1995, 6 to 10 ASP
events occurred along the coast of
Maine,133 causing shellfishing
closures.134
• Ciguatera Fish Poisoning (CFP): CFP
produces all of the above symptoms,
as well as reversal of temperature
sensation, muscular
aches, anxiety, sweating, and a
Endangered Salmon
Maine’s fisheries are among the most valuable in the United
States. In New England they are second only to those of Massachusetts.
Lobsters, ocean perch, pollack, cod, clams and shrimp
are among the catch. Salmon used to make up a big portion of
this catch, but no more. On November 18, 1999, the federal
government proposed an endangered species listing for Atlantic
salmon in Maine.135
What happened to the salmon? While factors such as dams
and over-fishing can reduce fish populations, a report issued by
the Maine Atlantic Salmon Commission suggests that one of the
principle reasons for the salmon’s decline is sea surface temperature
changes. Atlantic salmon thrive in 4 to 10 degree Celsius
waters, but beyond this range, their survival rate appears to be
compromised.136 Right now, small numbers of adult salmon are
returning to Maine to spawn, and young smolts in Gulf of Maine
rivers are surviving at a lower rate than expected.137
Global warming likely is the culprit. The EPA projects that
global warming may change, and perhaps already has, the
temperature and chemical composition of the waters that fish
inhabit.138 The amount of oxygen in the water may decline, while
pollution and salinity levels increase139 and can literally poison the
fish to death.
Consumers of contaminated salmon and seafood face health
risks. High water pollution and toxic algal blooms heightened by
global climate change increase the possibility for developing
ciguatera, a frightening illness that may cause paralysis and even
death. In addition to the number of direct physical problems
caused by global warming’s effect on seafood, there is great
stress on Maine’s fisherman, who rely upon good catches to make
a living. And it is not just the fishermen themselves. There are
countless others who work in processing plants throughout the
state.
A drop in the number of salmon, shrimp and other catches
can lead to a drop in the income of these individuals, many of
whom are already living from paycheck to paycheck. Lack of
income further leads to an increased risk of health problems, not
only because of increased mental stress, but also because people
are not able to afford health insurance. As it stands, 12.7 percent
of Maine’s population is without health coverage.140 Many of these
individuals are children141 and the elderly, people who are
vulnerable to health problems associated with climate change.
18 DEATH BY DEGR EES
numbness and tingling of the mouth and digits. Paralysis and death have
been documented.143 There is no antidote, but survivors have recovered
after taking the drug manitol and undergoing supportive therapy.144
• Diarrhetic Shellfish Poisoning (DSP): DSP produces gastrointestinal symptoms,
usually beginning within 30 minutes to a few hours after consumption
of toxic shellfish.145 Although the illness is not fatal, it can lead to
incapacitating diarrhea, nausea, vomiting, abdominal cramps and chills.
• Neurotoxic Shellfish Poisoning (NSP): This condition is nearly identical to
ciguatera, but also causes respiratory problems, such as asthma-like
episodes. It is less severe than ciguatera, and no deaths have yet been
reported.146 It is, however, a debilitating and frightening illness.
• Paralytic Shellfish Poisoning (PSP): PSP is extremely deadly, as symptoms
appear rapidly and severely. They include tingling, numbness, burning,
drowsiness, fever, rash and staggering. Respiratory arrest occurs within
24 hours of consuming toxic shellfish in the most severe cases. There is no
known antidote.147 6–10 PSP events occurred along Maine’s coast from
1985–1995.148 Shellfishing closures and public education efforts prevented
any serious outbreaks of PSP poisonings.149
FIGURE 4
Expansion of HAB (Harmful Algal Blooms) in the Northeastern US
These maps depict the HAB
(Harmful Algal Bloom)
outbreaks known before 1972
(top) and after (bottom) 1972
to 1995. As global climate
change models have predicted,
HAB events appear to be
spreading and increasing in
number. The maps shown do
not provide a compilation of all
events, but rather give an
indication of major or recurrent
HAB episodes. In addition to
the toxic impacts shown, harmful
micro and macroalgal species
have caused whale and other
marine mammal mortalities,
habitat destruction and a
general decline in coastal
aesthetics in many U.S. coastal
areas, including those found in
Maine, during the last 20
years.142
paralytic
shellfish
poisoning
paralytic
shellfish
poisoning
fish kills
brown tide
amnesic
shellfish
poisoning
Pre-1972 Post-1972
The Emerging Health Crisis of Climate Change in Maine 19
Air Pollution, Respiratory and
Cardiovascular Disease
Projected climate changes could lead to exacerbation of respiratory disorders associated
with reduced air quality in urban and rural areas and effects on the seasonality of
certain allergic respiratory disorders.
—INTERNATIONAL PANEL ON CLIMATE CHANGE,
REGIONAL IMPACTS: NORTH AMERICA, 1998.
Two air pollutants are affected by heat: ozone and volatile organic
compounds (VOC’s). Each has adverse health impacts. In addition, climate
changes can affect pollen levels, which exacerbate allergies.
Smog
Ground-level ozone is the major component in what we commonly call
smog, the most pervasive outdoor air pollutant in the United States. Smog is
at its worst on hot, sunny days, which likely will become more numerous
with global warming.
Ozone, or smog, is a toxic and irritating gas that, even in small amounts,
can affect lungs and health. It is formed when nitrogen oxides and volatile
organic compounds (VOCs), emitted from motor vehicles, power plants,
refineries, factories, and other combustion and industrial sources, are heated
by sunlight.150 Given that cars are a source of VOCs and that the number of
vehicle miles traveled in Maine continues to rise above the national average,
151 high ozone days, and the health problems they create, are also likely to
increase. Warmer temperatures increase the concentration of these pollutants
in the atmosphere.152
Exposure to elevated ozone can cause serious coughing, shortness of
breath, pain when breathing, lung and eye irritation, and greater susceptibility
to respiratory infections such as bronchitis and pneumonia.153 Numerous
studies have shown that higher ozone levels cause more asthma attacks,
increase the need for medication and medical treatment, and result in more
hospital admissions and visits to emergency rooms.154 Even moderately exercising
healthy adults can experience a 15 to 20 percent—or higher—reduction
in lung function from exposure to low levels of ozone over several hours.155
In addition to the effects on those suffering from respiratory illnesses, some
healthy people simply are more sensitive to ozone than others, and experience
more health effects from ozone exposure than the average person.156
Maine violated the proposed EPA eight-hour standard for ozone 29 times
during 1999.157 This means that the state’s air quality had ozone levels
exceeding 85 parts per billion (ppb) on those occasions.158 During this same
year, Maine had three 1-hour exceedances, where ozone levels were higher
than 125 ppb.159
Ozone causes breathing difficulty for 395,000 people in Maine—
approximately one third of the state’s entire population.160 These individuals
are most commonly the elderly, children, and those who have respiratory
ailments.161 From April to October of 1997, ozone-related illnesses, such as
20 DEATH BY DEGR EES
respiratory and cardiovascular problems, sent thousands of people to hospitals
in Maine.162 Since 1980, yearly state ozone health warning level exceedance
days, for 8 hour violations above 85 ppb, always numbered at least 20, and
were usually way above that figure.
Numerous studies link ozone with aggravation of asthma, impaired
immune function, greater susceptibility to respiratory infections (such as
bronchitis and pneumonia) and lung tissue damage. The symptoms include
coughing, shortness of breath, and eye and throat irritation.163 Of these
conditions, asthma is a special concern.
Asthma is reaching epidemic proportions in the United States, particularly
among children. A leading cause of absences from school, asthma can reduce
lung capacity and, if left untreated, can be fatal.164 Children’s airways are
smaller than those of adults, which makes them more vulnerable to asthma.
Adding to their vulnerability is the fact that children breathe more rapidly
than adults. When someone suffers repeated asthma attacks, the pathways of
the lungs become so narrow that simple breathing is as difficult as "sucking a
thick milk shake through a straw."165 The prevalence of asthma in children
under age 18 rose 72 percent in the 12 years from 1982 to 1994, while the
death rate from asthma for children 19 years and younger in the United
States increased by 78 percent from 1980 to 1993.166 Asthma accounts for one
in six pediatric emergency room visits in the U.S. One out of every twelve
children in Maine has asthma.167 Children are not the only members of the
population who are vulnerable to asthma. 40,000 Maine adults have
asthma.168 In addition, adults who smoke increase their risk for developing
respiratory disorders, such as asthma.169 21.9 percent of people over the age of
55 in Maine smoke.170
Physicians do not fully understand what causes asthma, but warmer
weather likely will make it worse. One study found that warmer average
temperatures are associated with increased asthma prevalence, possibly
because higher temperatures are associated with higher levels of allergen
exposure.171 More generally, however, asthma is associated with air pollutants
such as ozone and particulate matter.
Volatile Organic Compounds (VOC’s)
Another set of air pollutants consists of VOC’s that are emitted by large
power plants and municipal waste combusters, as well as by small sources,
such as dry cleaners, printers, cars and trucks. VOC’s include a variety of
hazardous air toxins, including benzene, toluene, xylenes and heavy metals
such as cadmium, mercury, chromium and lead. These hazardous air pollutants
are associated with cancer as well as adverse neurological, reproductive,
and developmental effects. Higher temperatures cause VOC’s to evaporate and
disperse more rapidly into the atmosphere.172
Pollen
When the thermometer starts rising on warm days, pollen counts tend to
rise as well. In 1999, Maine had 16 severe pollen count days, and numerous
The Emerging Health Crisis of Climate Change in Maine 21
other days with high pollen and mold
spore counts.173 Many scientists
believe that rising temperatures will
create favorable conditions for an
even wider variety of pollenproducing
plants, leading to an
increase in levels of airborne pollen
and spores that aggravate respiratory
disease, asthma, and allergic disorders.
174 Hay fever sufferers in Maine
are likely to experience more attacks,
during more months of the year.
Sea Level Rise and
Related Health Risks
The warming is moving down the
Antarctic Peninsula and is probably
responsible for some of these ice shelves on
both sides of the Peninsula breaking up in
recent years . . . And if we already see the
effects of warming on the Peninsula of the
West Antarctic Ice Sheet with the breaking
up of these ice shelves, then those ice
shelves at the northern margins of the
East Antarctic Ice Sheet, extending for
8,000 km over an enormous front, are a
much greater concern.175
—TERENCE J. HUGHES,
INSTITUTE FOR QUATERNARY STUDIES,
UNIVERSITY OF MAINE
The sea level along much of the
United States coastline has been
rising at a rate equal to 10–12 inches
per century.176 Most of the rise has
occurred as warmer temperatures
cause the ocean to expand. Melting
glaciers and Antarctic ice shelves also
contribute to the rise. In 1996, a
Rhode Island-sized ice shelf broke off,
melted and turned to sea water.177
Global warming could increase the
rate of sea level rise due to further
expansion of the sea’s surface layer and glacial melting.178 The Environmental
Protection Agency (EPA) and other organizations expect the sea level along
The State of the Science
Although the average temperature worldwide is increasing, hence
the term "global warming," the story becomes more complicated
at the local level. One reason is that the warmer atmosphere
holds greater amounts of water, resulting in more precipitation.
Another is that warmer air means changes in wind patterns. The
resulting weather changes will vary from place to place. In
general, we can expect more extremes—more heat waves, more
storms, wetter climates in some places, drier climates in others,
and even cooler temperatures in certain areas. Many scientists,
therefore, prefer the term "global climate change" to "global
warming." In this report, we use the two terms more or less
interchangeably.
Our current understanding of the potential impacts of climate
change is limited by a number of factors. Climate models that
project climatic changes and their impacts are still being developed
and perfected. Natural climate variability and other factors
such as air quality, land use, population, water quality, health
care infrastructure and the economy can also impact projections.
A few scientists even argue that countervailing climatic forces,
such as sulfur dioxide, actually are cooling the atmosphere.
However, the majority of climate scientists agree that greenhouse
gases produced by humans are changing Earth’s atmosphere and
that now is the time to take action on a global level.
Forecasting models are gaining credibility every day as
weather and other environmental occurrences confirm projected
scenarios. In addition, scientists continue to uncover data that
supports the occurrence of climate change. For example, a study
published in the summer of 1999 in the scientific journal Nature
examined the Antarctic ice cores. Scientists found that atmospheric
temperatures historically correlate with atmospheric
concentrations of the greenhouse gases carbon dioxide and
methane. Today, concentrations of these gases appear higher
than they have been in the past 450,000 years.179
Even if certain individuals are able to adapt to changes
caused by global warming, some populations will remain susceptible.
These individuals include infants, children, the elderly and
the infirm. Maine’s elderly population continues to grow in
numbers higher than the national average,180 so the state will be
among those most vulnerable to climate change.
Clearly the availability and continued development of better
information on the potential impacts of climate change, and the
interaction of these impacts with other important factors, is critical
if society is to understand the science of climate change and to
prepare for the changes global warming will bring.
22 DEATH BY DEGR EES
the Gulf and Atlantic coasts to rise an
additional foot by 2050, possibly as
early as 2025. It is likely that sea
level actually will rise by two to four
feet over the next century.187
Until recently, sea level in Maine
rose about .0026 feet per year. This
rate lasted for thousands of years, but
has begun to dramatically change in
the last several decades. Now, that
rate has almost tripled, according to
measurements taken in Portland and
Eastport,188 and is even higher in
areas such as Rockland.189 Sea level
rise can result in flooding of lowlying
property, loss of coastal wetlands,
erosion of beaches, saltwater
contamination of drinking water, and
decreased longevity of low-lying
roads, causeways and bridges. It also
increases the vulnerability of coastal
areas to storms and associated
flooding.190 Each of these possibilities
brings with it a number of health
risks, including gastrointestinal
distress from drinking contaminated
water, car accidents due to damaged
roadways, drownings associated with
storm surges and psychological
distress from loss of income and
property.
Possible responses to sea level rise
include allowing the sea to advance
and adapting to it, and raising the
land (e.g., by replenishing beach
sand, elevating houses and infrastructure).
Both of these responses
will be costly, either in out of pocket
costs or in lost land and structures.191
For example, the EPA reports that the
cumulative cost of sand replenishment
to protect Maine’s coastline
from sea level rise by 2100 is estimated
at $200–$900 million.192 Hard
barriers also are fallible, as evidenced
by the destruction of a 230 foot sea
wall in a storm at Kennebunk on
October 10, 1998.193
Maine’s Battered Southern Coast
For hundreds of years, Maine’s 3,500 mile coast has drawn
explorers, settlers and visitors to the state. Few can resist the
coast’s rugged, natural beauty, which perhaps explains the
number of homes located in towns and cities along the shoreline,
not to mention the prevalence of hotels and recreation centers that
cater to tourists who bring valuable income to the state. The
Atlantic Ocean continuously beats against the coast, but the rocky
shoreline appears strong and invincible, ready to withstand any
torment.
Unfortunately, even Maine’s coast is little match for the sea
level rise and coastal erosion predicted to occur as a result of
global climate change. Increased precipitation and melting
glaciers and ice shelves already appear to be causing the Atlantic
to swallow up portions of the coast. Nearby Massachusetts loses
65.4 acres per year of its shoreline due to coastal erosion, and
Maine’s rate of loss could be just as great.181 At Rockland, for
example, sea level already is rising 3.9 inches per century, and is
likely to rise another 14 inches by 2100.182 Steps can be taken to
reduce damages, but these are often expensive and ineffective.
The estimated cost for such measures is between $200 to 900
million.183
The risks associated with these measures are evidenced by
what happened in Maine on October 10, 1998. That day, heavy
rain accompanied by strong winds spread over the southern part
of the state. By afternoon, rivers, streams and low areas began to
flood. Large and powerful waves caused astronomically high tides
that eroded sections of the coast. The Kennebunk sea wall,
erected to protect residents from such events, proved to be of little
help and, in fact, became a hazard itself. 230 feet of the concrete
and steel wall collapsed, causing it to slide forward and drop
onto the beach.184 Storm surges increased the risk for drownings
and other related injuries, but miraculously, residents escaped
harm. The President declared both Cumberland and York Counties
federal disaster areas.
The effects of sea level rise and coastal erosion are not
always so dramatic. Often they occur at a relatively slow pace,
gradually eating away sections of Maine’s treasured coast and, in
the process, causing stress and concern for residents. This is
evident in areas such as Camp Ellis in Saco, where a committee
has formed to address the ever-increasing problems.185 The town
manager of Wells, situated along Maine’s southern "Gold Coast,"
has issued a statement voicing concerns about problems affecting
the town due to climate change and sea level rise. The situation is
so bad along the coast that people are allowed to build homes
there only if they take out "rolling easements," in which prospective
homeowners are given permission to build, but on the
condition that they will remove the structure if and when it is
threatened by an advancing shoreline.186
The Emerging Health Crisis of Climate Change in Maine 23
A Plague of Ticks and Mosquitoes
Because of the heating of the atmosphere, disease-bearing insects are breeding faster and
living longer at higher altitudes and latitudes. Witness the rapid increases in malaria,
yellow fever, hantavirus and lyme disease in the northern latitudes. Most remarkably,
there is no debate over climate change in any country except the United States.194
—ROSS GELBSPAN, JOURNALIST, IN AN ARTICLE FOR THE BOSTON GLOBE
In the warmer and wetter days to come, insects and rodents likely will
multiply in number, increasing the human health risks for diseases they can
spread. In terms of vector-borne illness—meaning diseases carried by a host,
such as a mosquito or tick—the rate of insect biting and the rate of maturation
for the disease-carrying microorganisms depend on temperature. Both
rates will increase with warmer weather.195 In fact, field and laboratory studies
have shown that temperature is the most important determining factor with
respect to transmission of a viral agent by a vector.196 Within a certain range,
warmer temperatures also enable such disease vectors to spread to higher
elevations and more temperate latitudes.
Lyme disease, carried by ticks, is endemic to several regions of the
United States, and accounts for more than 95 percent of all reported cases of
vector-borne illness in the country.197 Lyme disease is dramatically on the rise
in Maine. In 1994, lyme disease cases totaled 33. In 1998 this figure more
than doubled to 76 cases.198 A warming trend could increase Maine’s tick
populations, while warmer winters will permit people to enter tick-infested
habitats earlier in the season, thereby increasing the risk for transmission of
the disease.199 Ticks in New England also carry babesiosis (animal malaria),
ehrlichiosis (a treatable bacterial disease), and a virus that can cause
encephalitis.200
Other more exotic and frightening diseases also could become more prevalent
as the weather gets hotter and wetter. Many of the organisms and processes
linked to the spread of infectious diseases are especially influenced by
climate variations such as temperature, precipitation, and humidity. Therefore,
climate change can be expected to cause shifts in the patterns of infectious
diseases and where they are seen worldwide. 201 For example, public health
officials throughout the world are seeing an alarming resurgence of parasitic
diseases, such as malaria, and arboviruses (viruses borne by arthropods), such
as dengue fever.
Disease outbreaks are occurring more frequently in the United States due
to factors such as increased immigration and travel abroad by Americans who
bring diseases home. Once a parasite that causes a disease is brought into a
state by travelers, a warmer climate fosters faster growth of the parasite, as
well as the host organism, thus increasing the risk of local transmission. Some
diseases that may pose new threats in Maine are West Nile virus, hantavirus,
and malaria.
One of the most recent and disturbing new disease outbreaks was the West
Nile virus in the New York City area in 1999. Until the summer of 1999, the
virus had never been reported in the Western Hemisphere.202 Fifty-six cases
were identified as of October 19, 1999, resulting in seven deaths, and the
24 DEATH BY DEGR EES
Centers for Disease Control feared the virus could travel beyond New York to
other states.204 The virus is carried mainly by mosquitoes, but also by ticks, and
is passed along to birds and humans.
Malaria in Maine? It sounds unlikely, but consider this: Maine had 3 cases
of malaria in 1999 and 5 cases in 1998, from residents who had contracted
the illness while traveling.205 A relationship has been observed between some
exceptionally hot and humid weather and isolated spreading of malaria.206
And, some scientists estimate that an increase in average global temperatures
of several degrees by the year 2100 will increase the capacity of mosquitoes to
transmit the disease 100-fold in temperate countries.207
Even hantavirus, a deadly disease carried by deer mice, is not inconceivable
in Maine. Nearly half of all hantavirus cases result in death. The geographical
range of the deer mouse extends into New England and currently, cases have
been reported as far north as Rhode Island.208
FIGURE 5
Warmer weather promotes breeding by disease-carrying mosquitoes
This graph shows the
correlation between
temperature and the
rate at which
mosquito larvae
mature.203
Source: Focks et al 1993.
Rate (hr)
0.00
0.015
0.010
0.005
Temperature (°F)
59 68 77 86 95 104 113 122
The Emerging Health Crisis of Climate Change in Maine 25
Economic and Physical Stresses Could Result from
Impacts on Forestry, Agriculture, and the Syrup
Industry
Maine’s nickname, The Pine Tree State, reveals just how important stands
of timber are to residents. Forests, valuable both for ecological and economic
reasons, cover nearly 89 percent of the state. White pine hardwood, spruce fir
and northern hardwood types dominate, and are the basis of two major
industries: paper and allied products and lumber and wood products.209 In fact,
forestry is tied to the three most valuable industries in the state: paper and
allied products, tourism, and lumber and wood products. Climate change is
predicted to affect the range of forested land and the type of trees able to
grow, thereby putting all of these industries at risk. Because of this potential
impact to Maine’s major industries, a large portion of Maine’s population
could be subjected to economic and psychological stress.
Economics ties the health of the forests to human health, given the rising
costs of health insurance and medical care. And impacts on the economy
could increase Maine’s already high percentage of citizens without health
insurance coverage. Therefore, those employed in these industries could be hit
hard.
The same economic and physical stresses could affect Maine citizens
engaged in the maple syrup industry, particularly those residing in the White
Mountains. Climate change could threaten the now-thriving industry by
raising overall temperatures and increasing night warming. If this forecast
holds true, the flow of sap in the White Mountains could severely drop,
forcing numerous maple syrup producers out of business.210
The population of Maine that fills over 60,000 full and part-time jobs in the
agriculture and agrifood industry211 could also suffer. Climate change is the
primary determinant of agricultural productivity.212 Thus, the variable weather
conditions predicted to occur due to global warming could have a significant
impact on Maine farmers and the state’s economy. Maine’s two major crops,
potatoes and hay, are especially vulnerable.213 Growers of such crops could be
forced to alter their farming practices, or face economic losses. Like those
involved in forestry or the syrup industry, these individuals could suffer
economic and psychological stress that could compromise their ability to
afford proper housing, food and medical coverage for themselves and their
families.
More Injuries and Fatalities Predicted to Occur
Because of Forest Fires
Temperature increases and related weather extremes predicted to occur as a
result of global warming, such as drought, could wreak havoc on Maine’s
timber stands. Droughts dry forests, paving the way for forest fires, that, at
present, already are a big problem in the state. In 1999 during just one week
in April—which is a relatively low fire season month—over 85 wildfires were
reported in Maine.214
26 DEATH BY DEGR EES
Forest fires pose numerous public
concerns. They can have a devastating
effect on timber production and
wildlife. They may destroy homes
and other high value property.
Wildfires can kill young trees that
represent the timber for tomorrow.215
From a health standpoint, they may
cause injury and fatalities to
firefighters and nearby residents.
Smoke, which can cover a wide area,
may increase respiratory illness, such
as asthma and chronic obstructive
pulmonary disease, for many people,
particularly those with pre-existing
respiratory conditions.216
Where Physicians for Social Responsibility (PSR) Stands
Physicians for Social Responsibility (PSR), the active conscience of American medicine,
uses its members’ expertise and professional leadership, influence within the medical
and other communities, and strong links to policy makers to address this century’s
greatest threats to human welfare and survival.
While we recognize that uncertainties exist in the measurement of global warming
—just as all scientific measurement is uncertain—we are moved to action for several
compelling reasons. First, the overwhelming consensus among scientists is that Earth’s
temperature is increasing and weather patterns are changing in ways potentially
harmful to human health. This fact is overlooked in statements funded by the energy
industry that attempt to minimize the severity of global warming. Second, just like
businesses, governments, and responsible individuals, PSR feels the need to act
decisively in the face of uncertainty to protect those whose welfare has been entrusted
to us.
We cannot say exactly when to expect a noticeable increase in floods, or in
deaths from asthma among people living in smog-congested cities. No one can. But as
Surgeon General Luther Terry stated in his 1962 report on motor vehicles and air
pollution, the need for further research should not stop us from taking "all practicable
steps to minimize" the hazard. We are certain that fossil fuels play a role in global
warming, one step that we can control. For the sake of our own well-being, and that of
future generations, we need to act now.
PSR is working to create a world free of nuclear weapons, global environmental
pollution, and gun violence. In 1985, PSR shared the Nobel Peace Prize with
International Physicians for the Prevention of Nuclear War.
The Emerging Health Crisis of Climate Change in Maine 27
What You Can Do
As a person becoming ill develops a fever as a sign, this planet has begun to show signs
of illness, and human illness or death is certain to follow. History is full to overflowing
with examples. The best action that can be taken to avoid tragedy, whether managing
the illness of one or many, the earth or humanity, is early intervention.
—LANI GRAHAM, MD, MPH; FORMER DIRECTOR, MAINE BUREAU OF HEALTH
Our new data and understanding now point to the critical situation we face: To slow
future change, we must start taking action soon.
—D. JAMES BAKER, ADMINISTRATOR,
U.S. NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
Can residents of Maine do anything to reverse the trends before global
warming creates a perpetual state of emergency? Yes, they can. The
number one priority is to lower the use of fossil fuels. Opportunities for
doing so are everywhere.
To be sure, questions remain about the exact causes of global warming
and how seriously it threatens human health, but enough is known about
global warming to require action now. Its potential to cause harm is
indicated by the insurance industry’s decision to create a $200 billion
reserve to pay for damages expected to be caused by the increase in
hurricanes and other extreme weather events.217 Moreover, the energy
conservation techniques recommended here to protect against global
warming are basically the same as those desperately needed to cut air
pollution. The quality of our children’s lives will depend upon the actions
we take today.
There is a lot you can do, starting now, to bring down consumption of
fossil fuels.
1Demand that electric utilities use low-carbon technologies and renewable
energy. Maine still has some dirty power plants that need to clean
up their act. Support efforts that require all power plants to meet
federal air pollution standards.
2 Get your own house in order. Use energy-efficient light bulbs. Install a
solar thermal system to help provide your hot water (carbon dioxide
reduction: 720 pounds per year). Recycle all of your home’s waste
newsprint, cardboard, glass and metal (carbon dioxide reduction: 2,480 lbs./
yr.). Leave your car at home for one or two days a week and you will save
tons of carbon dioxide emissions. Lower your thermostat in winter and raise
28 DEATH BY DEGR EES
it in summer, thereby reducing the demand for electricity and the burning of
fossil fuels.
3If you are buying a new car, go for a more energy-efficient one.
Encourage auto makers to develop and sell cars, trucks and sport
utility vehicles (SUV’s) with better mileage and higher fuel efficiency
(CAFE) standards. At a web site newly launched by the EPA and the U.S.
Department of Energy (http://www.fueleconomy.gov), you can do a sideby-
side comparison and select the most energy-efficient vehicle that meets
your needs.
4Urge the businesses you patronize to become energy-efficient. U.S.
businesses spend about $100 billion on energy each year to operate
commercial and industrial buildings. By using energy efficient products
and procedures, organizations could reduce their energy use by 35 percent,
or $35 billion nationally. There are now numerous programs in place to help
businesses change their energy usage and save money at the same time. Put
your favorite businesses in touch with EPA’s Energy Star Buildings program
(1-888-STAR-YES, http://www.epa.gov/greenlights), and Climate Wise
program (1-800-459-WISE, http://www.epa.gov/climatewise).
5Carpool, and drive less. Nationally, cars contribute 30 percent of
greenhouse gases in the air. In Maine, emissions from cars contributed
a hefty 47 percent in 1990, a figure that is actually on the rise, due to
increased use in light trucks and sport utility vehicles. Do your part, by
carpooling and using public transportation whenever possible.
6 In this election year, work for candidates who are serious about
reducing emissions of carbon dioxide and other greenhouse gases.
Support senators who have taken a stand in favor of ratifying the
Kyoto Protocol to the Framework Convention on Climate Change. Tell the
members of Congress that we are not afraid of higher fuel efficiency (CAFE)
standards—for cars, SUV’s and light trucks—and they should not be either!
7 Work with local groups and chapters of national organizations to
promote awareness of global warming and related issues in Maine.
These include: the Maine Chapter of Physicians for Social Responsibility
(207-772-0680), Maine Global Climate Change, Inc. (207-469-6770),
American Lung Association of Maine (800-499-5864), American Heart
Association (800-242-8721), Independent Energy Producers of Maine
(207-626-0730), Coalition for Sensible Energy (207-469-6770), Sierra Club
Foundation, Maine Chapter (207-761-5616), National Resources Council of
Maine (207-622-3101), Friends of Casco Bay (207-799-8574), Maine
Audubon Society (207-781-2330), Maine Cardiovascular Health Council
(207-622-7566), Maine Organic Farmers and Gardeners Association
(207-568-3141), Consumers for Affordable Health Care Foundation
(207-622-7083), Maine Peace Fund (207-772-0680), Bicycle Coalition of
Maine (207-288-3028), Conservation Law Foundation, Inc. (207-594-8107),
The Emerging Health Crisis of Climate Change in Maine 29
China Region Lakes Alliance (207-445-5021), A.E. Howell Wildlife Conservation
Center (207-532-6880), Forest Society of Maine (207-945-9200), Friends
of Acadia (207-288-3340), The Island Institute (207-594-9209), Maine Coast
Heritage Trust (207-729-7366), Natural Resources Council of Maine
(207-622-3101), The Nature Conservancy, Maine Chapter (207-729-5181)
and many others.
8Encourage local, state and national decision makers and politicians to
support the Earth Day Clean Energy Agenda. On April 22, 2000, the
thirtieth annual Earth Day will be celebrated all around the country.
This year the Earth Day message includes the Clean Energy Agenda that calls
for clean power, clean air, clean cars and clean investments. A transition to
energy efficiency and renewable energy will go a long way in combating
global warming. Physicians for Social Responsibility is a member of the Earth
Day Network (EDN), a global alliance of environmental organizations working
together to battle climate change. Our Death by Degrees report can be used as
a tool to educate everyone about the potential health effects of global warming
as part of a message for the need for cleaner energy. Contact the Earth
Day Network (206-264-0144) or see the web site (http://www.earthday.net)
for more information about Earth Day 2000 and to find out what events are
planned in your area.
30 DEATH BY DEGR EES
NOTES:
1. Manning A, 90’s Were Warmest Years In
Centuries, USA Today, January 11, 1999.
http://www.usatoday.com/weather/clisci/
wc042398.htm.
2. Intergovernmental Panel on Climate Change
(IPCC), The Regional Impacts of Climate Change;
An Assessment of Vulnerability (1998). http://
www.epa.gov/globalwarming/reports/pubs/
ipcc/chp8/america15.html.
3. IPCC, Climate Change 1995, Second Assessment
Report, Working Group I Summary for Policy
Makers (1996).
4. IPCC, Climate Change 1995, Impacts,
Adaptations and Mitigation of Climate
Change: Scientific Technical Analyses,
Working Group II to the Second Assessment
Report at 561–584 (Cambridge University
Press 1995).
5. Johnson J, Maine, in Compton’s Encyclopedia
Online v3.0. Available to AOL ISP subscribers
at: http://comptonsv3.web.aol.com/search/
fastweb?getdoc+viewcomptons+A+4834++Maine.
6. National Climatic Data Center (NCDC), Mean
Number of Days With Maximum Temperature 90
Degrees or Higher, data through 1998. http://
www.ncdc.noaa.gov/ol/climate/online/ccd/
max90temp.html.
7. NCDC, query results on extreme weather
events in Maine between 1/1/97 and 9/30/99.
http://www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~storms.
8. U.S. Environmental Protection Agency (EPA),
EPA Launches Global Warming Meetings, June
26, 1997. (Notes provided by the Maine EPA).
9. Epstein PR, The impact of climate change on
human health in "New England Regional
Climate Change Impacts Workshop: Workshop
Summary Report," Sept. 3, 1997.
10.EPA, Climate Change and Maine. September
1998. http://www.epa.gov/globalwarming/
impacts.
11.Ibid.
12.Testimony of Senator Sharon Treat, State of
Maine, Before the Senate Subcommittee on
Clean Air, Wetlands, Private Property, and
Nuclear Safety, June 24, 1999. http://
www.senate.gov/~epw/tre_6-24.htm.
13.Conversation with Elizabeth DeSombre,
Professor of Environmental Studies and
Government at Colby College. January, 2000.
14.Longstreth J, Public Health Consequences of
Global Climate Change in the United States—
Some Regions May Suffer Disproportionately,
Environmental Health Perspectives, Volume
107, Supplement 1, February 1999.
15.Ibid.
16.Ibid.
17.Ibid.
18.U.S. Census Bureau, Maine data for the years
1990–1997. http://www.census.gov/statab/
www/states/me.txt.
19.Conversation with Tom Berman, Forecast
Officer, National Weather Service Forecast
Office, Gray, Maine. January, 2000.
20.Gelbspan R, Chilling evidence of climatic
meltdown, The Boston Globe, January 21, 1999.
21.Ibid.
22.Maine Department of Environmental
Protection (Maine DEP), Global Climate Change
("Global Warming"). http://janus.state.me.us/
dep/air/global.htm.
23.Carter J, (Panel Member of Maine’s Citizens
and Communities and Town Manager,
Wells, Maine); Speaker’s Outline; Global
Climate Change in Maine—The Risks and
Opportunities, a conference held April 7&8,
1999 in Lewiston, Maine.
24.Hebert J, Scientists Report Warmer Earth. Written
for The Associated Press, released on January
13, 2000.
25.Media Relations Office, Jet Propulsion
Laboratory, La Niña’s Persistence May Be Part of
Larger Climate Pattern. Released on January 19,
2000.
26.IPCC, The Regional Impacts of Climate Change:
An Assessment of Vulnerability (1998), supra n 2.
27.Longstreth J, supra n 14.
28.Hadley Center for Climate Prediction and
Research, Climate change and its impacts:
a global perspective (1997). http://www.metoffice.
gov.uk/sec5/CR_div/Brochure97/
future.html.
29.Climate Change Research Center, New
England’s Changing Climate, Weather, and Air
Quality, http://www.neci.sr.unh.edu/
neccwaq.html.
30.U.S. Public Interest Research Group (USPIRG),
Flirting With Disaster: Global Warming And The
Rising Costs of Extreme Weather, October 27,
1999.
31.Ibid.
32.Gerrity ET and Flynn BW, Mental health
consequences of disasters, in Noji E, ed. The Public
Health Consequences of Disasters, New York:
Oxford University Press, 101–21 (1997).
33.Centers for Disease Control and Prevention
(CDC), Community needs assessment and
morbidity surveillance following an ice
storm—Maine, January 1998. MMWR, 47(17):
351–354 (May 8, 1998).
34.Conversation with Pam Person, Program
Director, Coalition for Sensible Energy and
Co-chair, Maine Global Climate Change, Inc.
January 2000.
35.EPA, Climate Change and Maine, supra n 10.
36.Epstein, supra n 9.
37.Ibid.
The Emerging Health Crisis of Climate Change in Maine 31
38.NOAA Air Resources Laboratory, Trends in
U.S. Extreme Heat Indices, updated June 27,
1999. http://gus.arlhq.noaa.gov/milestn/
mile3.html.
39.Easterling DR, in EPA Launches Global Warming
Meetings, June 26, 1997.
40.Epstein, supra n 9.
41.U.S. Census Bureau, Table No. 1223,
Appliances and Office Equipment Used by
Households, by Region and Family Income: 1997,
in Statistical Abstract of the United States:
1998.
42.EPA, Climate Change and Maine, supra n 10.
43.Ibid.
44.As the heat goes on, so do power switches;
CMP sets a record for power use amid the hot
weather’s assault, The Portland Press Herald,
1A, July 23, 1998.
45.Environmental Health Perspectives 103:12,
December 1995. http://
ehpnet1.niehs.nih.gov/docs/1995/103-12/
forum.html#climate.
46.Ibid.
47.Pochna P, Neighbors Claim Rise in Plant’s
Pollution, Casco Bay Online News, August 24,
1998. http://www.cascobay.com/news/
news82498.html.
48.Asthma hospitalization rates and socioeconomic
status in New York State (1987–1993)
in J Asthma 36:239–51 (1999).
49.NOAA. http://gus.arlhq.noaa.gov/. The data
in this figure was developed by NOAA
scientists for the purpose of determining
trends in extreme heat events. Extremes are
defined using threshold values of temperature
and apparent temperature. Extremes vary
from one city to another because people
acclimate to local conditions. Therefore,
extremes must be defined locally. (Dian
Gaffen, Trends in U.S. Extreme Heat Indices—
updated
6/27/99). http://gus.arlhq/noaa.gov/milestn/
mile3.htm.
Threshold values are defined as apparent
temperature values that are exceeded on only
15 percent of days in July and August (Ibid).
Apparent temperature, or heat index, is a
combination of air temperature and humidity
(NOAA Climate Variability and Trends Group,
Climate Extremes and Health (updated
8/17/99). http://www.arlhq.noaa.gov/ss/
climate/research/extremes.htm. Therefore,
when apparent temperature exceeds the 85th
percentile threshold value, an extreme heat
stress day has occurred. For the purposes of
Figure 2, a heat wave occurs when three or
four consecutive days reach extreme
temperatures.
50.EPA, Climate Change and Maine, supra n 10.
51.Hahn RA et al, Cardiovascular disease risk
factors and preventative practices among
adults—United States, 1994: A behavioral risk
factor atlas, MMWR, 47(SS-5):35–69
(Dec 11, 1998).
52.Carter J, Maine Greens Address the Health Issues:
Health Care, November 1994.
53.CDC, Heat related deaths—United States 1993,
MMWR, 42(28):558-560 (Jul 23, 1993).
54.World Health Organization, Climate Change and
Human Health (McMichael AF et al, eds.)
1996.
55.CDC, Heat related deaths- United States 1993,
MMWR, 42(28):558-560 (Jul 23, 1993).
56.Ibid.
57.World Health Organization, "Potential health
effects of climate change." (1990). http://
www.ciesin.org/docs/001-007/001-007.html.
58.EPA, Climate Change and New Hampshire
(1997). http://www.epa.gov/globalwarming/
impacts/stateimp/newhampshire/index.html.
59.EPA, Climate Change and Maine, supra n 10.
60.Global climate change data provided by Deb
Garrett of the State of Maine Department of
Environmental Protection.
61.Preliminary summary of 1999 workshops.
New England Regional Assessment, courtesy
of Barrett Rock, University of New Hampshire.
62.CDC, Hypothermia-Related Deaths—Georgia,
January 1996—December 1997, and United
States, 1979–1995, MMWR, 47(48):1037–1040
(Dec 11, 1998). http://www.cdc.gov/epo/
mmwr/preview/mmwrhtml/00055930.htm.
63.Ibid.
64.Conversation with Catherine St. Pierre,
Planning Research Associate, Maine Office of
Data Research and Vital Statistics (February
2000).
65.CDC, Hypothermia-Related Deaths—
Georgia, January 1996–December 1997, and
United States, 1979–1995, supra n 62.
66.CDC, Changes in Mortality from Heart
Failure—United States, 1980–1995, MMWR,
47(30):633–7 (Aug 7, 1998). http://
www.cdc.gov/epo/mmwr/preview/
mmwrhtml/00054249.htm.
67.EPA, Global Warming Impacts—Health. http://
www.epa.gov/globalwarming/impacts/health/
index.html.
68. CDC, Changes in Mortality from Heart
Failure, supra n 66.
69.NCDC, Climate Data: Ice Storm, January 5–10,
1998. http://www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~123665.
70.Ibid.
71.Ibid.
72.Ibid.
73.Ibid.
74.Ibid.
75.CDC, Community Needs Assessment and
Morbidity Surveillance Following an Ice
Storm—Maine, January 1998, supra n 33.
32 DEATH BY DEGR EES
76.Ibid.
77.Federal Emergency Management Agency,
News Report—Weekly Federal/Maine Ice Storm
Recovery Wrap-Up (As of Monday, March 2,
1998). http://www.fema.gov/dix98/
meis083.htm.
78.NCDC, Narrative—April 12, 1999 Update.
http://www.ncdc.noaa.gov/ol/reports/
janstorm.html.
79. CDC, Community Needs Assessment and
Morbidity Surveillance Following an Ice
Storm—Maine, January 1998, supra n 33.
80. Ibid.
81. NCDC, Event Details: January 1998 Ice Storm.
http://www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~123665.
82. CDC, Carbon monoxide poisonings associated
with snow-obstructed vehicle exhaust
systems—Philadelphia and New York City,
January 1996, MMWR, 45(01):1–3
(Jan 12, 1996).
83. CDC, Community needs assessment and
morbidity surveillance following an ice storm,
supra n 33.
84. CDC, Use of unvented residential heating
appliances—United States, 1988 –1994,
MMWR, 46(51);1221–1224 (Dec 26, 1997).
85. Mayo Clinic, Carbon monoxide: How to protect
your family. http://www.mayohealth.org/
mayo/9812/htm/co.htm.
86. U.S. Census, Maine Population Statistics. http://
www.census.gov/statab/www/states/me.txt.
87. U.S. Census, Model-Based Income and Poverty
Estimates for Maine in 1995 (statistics listed for
population as of July 1996). http://
www.census.gov/hhes/www/saipe/estimate/
cty/cty23000.htm.
88. Longstreth J, Public Health Consequences of
Global Climate Change in the United States—
Some Regions May Suffer Disproportionately, supra
n 14.
89. Ibid.
90. U.S. Census, Maine Population Statistics, supra n
86.
91. National Weather Service, Portland, Maine,
Climate Data For The Month Of December 1999.
http://www.state.me.us/mema/weather/
pwmclmpwm.
92. Ibid.
93. The Associated Press, Skiers stay off trails in
bitter cold, in The Bangor Daily News, January
18, 1999. http://www.bangornews.com/News/
20000118000000Skiersstay.html.
94. Ibid.
95. Alpert L (for the Associated Press), Bitter Cold
Hammers Northeast, January 18, 2000.
96. Ibid.
97. EPA, Climate Change and Maine, supra n 10.
98. CDC, Flood-related mortality—Georgia,
July 4-14, 1994. MMWR, 43:526–30
(Jul 29, 1994).
99. NCDC, Climate Data for Flash Flood, April 16–17,
1999, North Monmouth. http://
www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~90997.
100.Gerrity ET & Flynn BW, Mental health
consequences of disasters, supra n 32.
101.NCDC, Climate Data for Thunderstorm Wind in
Westbrook on August 24, 1998. http://
www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~123747.
102.NCDC, Storm Events in Maine from January 1,
1997 to September 30, 1999. http://
www4ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~storms.
103.Publius Research. http://www.maine.com/
users/publius/iceout.htm.
104.Preliminary Summary of 1999 Workshops,
supra n 61.
105.Ibid.
106.Maine Department of Human Services,
Groundwater Assessment.
107.Epstein PR, The impact of climate change on
human health in New England, supra n 9.
108.Ibid.
109.Frederick KD et al, Water and global climate
change (Pew Center 1999).
110.University of Maine Cooperative Extension,
Safe Home Program Report, Bulletin #7119-I
DEPLW-100-A99-I.
111.EPA Global Warming Impacts- Water
Resources. http://www.epa.gov/
globalwarming/impacts/water/index.html.
112.University of Maine Cooperative Extension,
supra n 110.
113.Hunter B, Maine DEP Groundwater
Assessment—"Leaking underground and
above ground storage tanks."
114.University of Maine Cooperative Extension,
supra n 110.
115.Ibid.
116.CDC, Giardiasis Fact Sheet. http://
www.cdc.gov/ncidod/dpd/giardias.htm.
117.DHS EPI, Summary of Trends in Select Reportable
Diseases Annual Frequency and Five Year Mean/
Median, Maine 1994-1998, based on MMWR year.
118.Ibid.
119.Guerrant RL, Cryptosporidiosis: an emerging,
highly infectious threat. CDC Synopses. http://
www.cdc.gov/ncidod/EID/vol3no1/
guerrant.htm.
120.CDC, Cryptosporidiosis Fact Sheet. http://
www.cdc.gov/ncidod/dpd/crypto.htm.
The Emerging Health Crisis of Climate Change in Maine 33
121.CDC, Notifiable Diseases/Deaths in Selected
Cities Weekly Information, December 24,
MMWR, 48(50);1155-1162 (Dec 24, 1999).
http://www.cdc.gov/epo/mmwr/preview/
mmwrhtml/mm4850md.htm.
122. Epstein, supra n 9.
123. CDC, Viral Hepatitis-A Fact Sheet. http://
www.cdc.gov/ncidod/diseases/hepatitis/a/
fact.htm.
124. DHS EPI, supra n 117.
125. Department of Maine Health Services,
Summary of Trends in Select Reportable Diseases
Annual Frequency and Five Year Mean/Median,
Maine 1994–1998.
126. Ibid.
127. Conversation with John Hurst, Director of
Biotoxin Monitoring, Maine Department of
Marine Resources; February 2000.
128. Woods Hole Oceanographic Institution,
Harmful Algal Blooms in your region. http://
www.redtide.whoi.edu/hab/
HABdistribution/habexpand.html.
129. Justice G, Shellfishing bans lifting as season
of red tide ebbs, The Boston Globe, p. 76, July
9, 1993. Morris J, Midnight poachers
ignoring red tide; officials fear market
consequences, The Union Leader, p. A1,
June 13, 1993.
130. Conversation with John Hurst, supra n 127.
131. Natural Office for Marine Biotoxins and
Harmful Algal Blooms, The Harmful Algae
Page: Human Illnesses Associated with Harmful
Algae. http://www.redtide.whoi.edu/hab/
illness/illness.html.
132. Ibid.
133. Woods Hole Oceanographic Institution,
chart: ASP events in the United States of
America. http://www.redtide.whoi.edu/hab/
HABdistribution/ICESmap/USASP.gif.
134. Conversation with John Hurst, supra n 127.
135. US Fish & Wildlife Service News Release,
Federal Government Proposes Endangered Species
Listing for Atlantic Salmon in Maine, November
18, 1999. http://northeast.fws.gov/newsrel/
mesalmon.html.
136. Maine Atlantic Salmon Commission, Atlantic
Salmon Stocks Report. http://news.fws.gov/
salmon/asalmon75.html.
137. US Fish & Wildlife Service, supra n 135.
138. EPA Global Warming Impacts—Fisheries.
http://www.epa.gov/globalwarming/
impacts/fisheries/index.html.
139. Ibid.
140. U.S. Census Bureau, Health Insurance
Coverage: 1998—State Uninsured Rates. http://
www.census.gov/hhes/hlthins/hlthin98/
3yr98.html.
141. U.S. Census Bureau, Low Income Uninsured
Children By State: 1996, 1997 and 1998. http://
www.census.gov/hhes/htthins/huc98.html.
142. http://www.redtide.whoi.edu/hab/
HABdistribution/habexpand.html.
143. Conversation with John Hurst, supra n 127.
144. Ibid.
145. Ibid.
146. Ibid.
147. Ibid.
148. Woods Hole Oceanographic Institution,
chart: PSP events in the United States of
America. http://www.redtide.whoi.edu/hab/
HABdistribution/ICESmap/USPSP.gif.
149. Conversation with John Hurst, supra n 127.
150. Spellman FR and Whiting NE, Environmental
Science and Technology, 185 (Governments
Institute 1999).
151. Maine Environmental Priorities Council,
Maine’s Environmental Issues—Air Quality,
Issues, cited in 1996 risk ranking.
152. EPA, Global warming: impacts- health. U.S.
http://www.epa.gov/globalwarming/health/
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153. EPA, Health and environmental effects of
ground-level ozone. Fact Sheet, July 17,
1997. htpp://ttnwww.rtpnc.epa.gov/
naaqsfin/o3health.htm.
154. Weisel CP, et al, Relationship between
summertime ambient ozone levels and
emergency department visits for asthma in
central New Jersey in Environ Health
Perspectives 103 Suppl 2:97–102 (1995).
155. EPA, Health and environmental effects of
ground-level ozone, supra n 153.
156. EPA, Office of Air Quality Planning and
Standards, Smog—Who Does It Hurt? What You
Need To Know About Ozone and Your Health.
http://www.epa.gov/airnow/health/
smog1.html#5.
157. USPIRG, Danger in the Air: Unhealthy Smog
Days in 1999, Table 1. Summary of 1999
Exceedances and Smog Days by State.
158. Ibid.
159. Ibid.
160. Testimony of Senator Sharon Treat, supra
n 12.
161. Ibid.
162. Clean Air Task Force, Adverse Health Effects
Associated with Ozone In the Eastern United
States, Exhibit 4-7 Ozone-related Adverse
Health Effects by State (mean cases
April–October 1997), October 1999.
163. EPA, Health and environmental effects of
ground-level ozone, supra n 153; Dickey JH,
No room to breathe. http://www.psrus.org/
breathe.htm
164. CDC, Asthma—a speaker’s kit for public
health professionals. http://www.cdc.gov/
nceh/programs/asthma/speakit/cover.htm.
34 DEATH BY DEGR EES
165. EPA, Office of Air Quality Planning and
Standards. Smog—Who Does It Hurt?, supra
n 156.
166. CDC, Facts about asthma. August 8, 1997.
http://www.cdc.gov/od/oc/media/fact/
asthma.htm.
167. Treat, S, supra n 12.
168. American Lung Association of Maine,
Helping you to manage and control asthma (fact
sheet). http://www.mainelung.org/
learn_with_us/asthma/asthma.htm.
169. CDC, Surveillance for Five Health Risks
Among Older Adults- United States,
1993–1997, MMWR, 48(SS08):89–130
(Dec 17, 1999). http://www.cdc.gov/epo/
mmwr/preview/mmwrhtml/ss4808a5.htm.
170. Ibid.
171. Hales S, et al., Prevalence of adult asthma
symptoms in relation to climate in New Zealand,
in Environ Health Perspectives, 106:607–10
(1998).
172. New Hampshire Department of Environmental
Services, Reducing toxic air pollutants in
New Hampshire. http://www.des.state.nh.us/
ard/toxpage.htm.
173. Southern Maine Medical Center, Pollen
Count Data, 1999.
174. Office of Science and Technology Policy,
Climate Change: State of Knowledge, Executive
Office of the President, October 1997, p. 12.
175. From an interview reprinted in Climate Alert,
v8, #3, May–June 1995, ph 202-547-0104.
176. U.S. EPA, Global warming trends: sea level.
http://www.epa.gov/globalwarming/climate/
trends/sealevel.html.
177. Maine DEP, Global Climate Change, supra
n 22.
178. Titus JG, Greenhouse effect, sea-level rise
and barrier islands, in Coastal Management
20, (1990).
179. Petit JR et al, Climate and atmospheric history of
the past 420,000 years from the Vostok ice core,
Antarctica, published in Nature, 399:429–435
(June 3, 1999).
180. U.S. Census data for the state of Maine,
supra n 18.
181. Giese G, A Coast At Risk in "Maine
Launches Global Warming Meetings,"
June 26, 1997, Maine EPA.
182. U.S. EPA, Climate Change and Maine, supra
n 10.
183. Ibid.
184. NCDC, Climate Data: Coastal Erosion,
October 10, 1998, Kennebunk. http://
www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~123769.
185. City of Saco, Maine, Camp Ellis Beach
Erosion Study news summary. http://
www.sacomaine.org/document_archives/
other/camp_ellis_erosion.html.
186. EPA, Global Warming Impacts- Coastal
Zones. http://www.epa.gov/globalwarming/
impacts/coastal/index.html.
187. EPA, Global warming site-impacts: coastal
zones. http://www.epa.gov/globalwarming/
impacts/coastal/index.html.
188. Maine DEP, Global Climate Change, supra
n 22.
189. EPA, Climate Change and Maine, supra
n 10.
190. Ibid.
191. Ibid.
192. Ibid.
193. NCDC, Climate Data—Coastal Erosion on
October 10, 1998 at Kennebunk. http://
www4.ncdc.noaa.gov/cgi-win/
wwcgi.dll?wwevent~ShowEvent~123769.
194. From "Chilling evidence of climactic
meltdown," The Boston Globe, January 21,
1999.
195. Epstein PR, Climate ecology and human
health, Consequences, Volume 3, No. 2, 1997.
196. WHO, supra n 54 at 91.
197. CDC, Recommendations for the use of Lyme
disease vaccine recommendations of the
Advisory Committee on Immunization
Practices (ACIP). MMWR, 48(RR07):1–17
(Jun 4, 1999).
198. DHS EPI, supra n 117.
199. EPA, Climate Change and New Hampshire,
supra n 58: WHO, supra n 54 at 92.
200. Epstein, The impact of climate change on
human health in New England, supra n 9.
201. WHO, supra n 54 at 71.
202. Preston R, West Nile mystery, in The New
Yorker, p. 90, October 18 & 25, 1999.
203. Kovats S, et al, Global climate change and
environmental health: Proceedings of the
1997 annual conference of the Society for
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citing Focks, et al, J Med Entomol 30:1003–17
(1993).
204. CDC, West Nile Virus Encephalitis—New
York, 1999, MMWR, 48(41):944-946, 955
(Oct 22, 1999).
205. CDC, Notifiable Diseases/Deaths in Selected
Cities Weekly Information, MMWR,
48(51);1183-1190 (Jan 7, 2000). http://
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mmwrhtml/mm4852md.htm.
206. Cited in IPCC, supra n 2.
207. Ibid.
208. CDC, Hantavirus pulmonary syndrome—
slide show. (1999).
209. Johnson J, supra n 5.
The Emerging Health Crisis of Climate Change in Maine 35
210. Hamburg S, Beech Trees Move Slowly in EPA
Launches Global Warming Meetings,
Doc. WGB97-0166.
211. Maine Department of Agriculture report.
http://www.state.me.us/agriculture/
homepage.htm.
212. Alexandrov VA & Hoogenboom G, Climate
variation and crop production in Georgia, USA
during the 20th Century.
213. Ibid.
214. Miller, A, Maine Forest Service Douses Burn
Permits, Wiscasset Newspaper, April 29,
1999. http://wiscassetnewspaper.maine.com/
1999-04-29/burning_permits.html.
215. Maine Forest Service, Forest Fires Control
Division report. http://www.state.me.us/
doc/mfs/ffchome.htm.
216. Duclos P, et al, The 1987 forest fire disaster
in California: assessment of emergency
room visits, in Arch Environ Health 45:53–8
(1990).
217. Cited in David Ignatius, Naysay now, pay
later, in The Washington Post, A19, August 18,
1999.
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