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Massachusetts Department of Public Health seal Massachusetts Environmental Public Health Tracking

Conceptual Pathways for Climate Change Hazards and Health

Climate Drivers Hazard Exposures Vulnerable Groups Health Risks
Climate Driver: Heat

All Regions
Hazard: Heat Events:
  • More frequent
  • Longer duration
  • More extreme
Exposures: Elevated temperatures Vulnerable Groups:
  • People over age 65
  • People over age 65 and living alone
  • Children under age 5
  • People with preexisting conditions:
    • Diabetes
    • Cardiovascular disease
    • Renal system disease
  • People of color1
  • People working or exercising outdoors
  • People with limited English proficiency
Health Risks:
  • Heat Exhaustion
  • Heat Stroke
  • Illness or death due to cardiovascular disease
  • Illness or death due to renal system failure
Hazard: Poor Outdoor Air Quality:
  • Increases in ozone
  • Increases in particulate matter
  • Increased pollen production
  • Longer pollen season
Exposures: Ozone, Particulate Matter Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • People with pre-existing conditions: asthma, COPD, respiratory allergies, cardiovascular disease
  • People working or exercising outdoors
  • People with limited English proficiency
Health Risks:
  • Respiratory arrest
  • Exacerbation of asthma and other lung disease
  • Exacerbation of allergies and respiratory infections
  • Reduction in childhood lung function development2
Exposures: Pollen Vulnerable Groups:
  • People with allergies
  • People with asthma
Health Risks:
  • Exacerbation of asthma
  • Allergy symptoms
Hazard: Food-borne Illness Exposures: Spoiled food from refrigeration failure in transport/storage Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
Health Risks:
  • Gastrointestinal illness
Exposures: Changes in patterns of salmonella growth Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
Health Risks:
  • Salmonella infection
Hazard: Drought Exposures: Water quality degradation Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
Health Risks:
  • Gastrointestinal Illness
  • Nitrate exposure
  • Naturally occurring arsenic and uranium exposure3
Climate Driver: Heat and Increased Precipitation Combined

All Regions
Hazard: Vectorborne Disease:
  • Longer seasons
  • Expanding ranges
  • Increased habitat
  • Higher breeding rates
Exposures: Ticks Vulnerable Groups:
  • People working or exercising outdoors
  • People with pets that go outdoors
Health Risks:
  • Tick-borne illnesses (e.g. Lyme, Babesiosis, Anaplasmosis)
Exposures: Mosquitoes Vulnerable Groups:
  • People working or exercising outdoors
Health Risks:
  • West Nile Virus
  • Eastern Equine Encephalitis
Hazard: Biological Contamination of Water Exposures: Contact with water contaminated with fecal bacteria (e.g. E. Coli or salmonella) from runoff, flooding, or sewer overflow discharge4 Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
Health Risks:
  • Skin infections
  • Eye infections
  • Wound infections
  • Gastrointestinal Illness
Exposures: Water or shellfish contaminated with Vibrio bacteria (e.g. Vibrio vulnificus, Vibrio parahaemolyticus)5 Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
  • People with liver disease or Thalassemia
  • People who consume raw shellfish
  • People who take medications that decrease stomach acid levels
Health Risks:
  • Gastrointestinal illness
  • Wound infection
  • Septicemia (bloodstream infection)
Exposures: Contact with Algae Blooms (Cyanobacteria)6 Vulnerable Groups:
  • Children under age 5
  • People who boat or swim in fresh water lakes, ponds, and rivers
  • Pets
Health Risks:
  • Gastrointestinal symptoms
  • Skin and eye irritation
  • Neurological damage
  • Liver damage
Hazard: Chemical Contamination of Water Exposures: Contact with chemically contaminated water from flooding and runoff Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
Health Risks:
  • Skin reactions
  • Chronic Illness
Climate Driver: Flooding (inland and coastal)

All Regions
Hazard: All Flooding Exposures: Contaminated flood water (direct contact or flood-contaminated drinking water) Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
  • People with limited English proficiency
Health Risks:
  • Skin infections
  • Eye infections
  • Wound infections
  • Trench foot
  • Gastrointestinal illness
Exposures: Debris/Physical hazards Vulnerable Groups:
  • Adolescents and Young Adults7
  • Utility workers
  • Rescue workers
Health Risks:
  • Injury or death from debris, downed wires, drowning, falls, and motor vehicle crashes
Exposures: Loss of Electricity, heat Vulnerable Groups:
  • People over age 65
  • People living alone
  • Children under age 5
  • People using medical equipment that requires electrical power or medications that require refrigeration
Health Risks:
  • Carbon Monoxide (CO) Poisoning
  • Falls and injuries in the home
  • Medical emergencies due to loss of medical equipment function
  • Medical emergencies due to spoiled medications
Exposures: Relocation/Displacement Vulnerable Groups:
  • People over age 65
  • People with limited mobility
  • People under age 18
  • People with low socioeconomic status
  • People who rent their homes
  • People with limited English proficiency
  • People of color
Health Risks:
  • Psychological stress
  • Financial loss stress
  • Loss of employment
  • Substance abuse

Exposures: Mold

Vulnerable Groups:
  • Children under age 5
  • People with compromised immune systems or respiratory disease
  • People with Allergies
  • People with Asthma
Health Risks:
  • Allergic reactions
  • Respiratory illness

Hazard: Tidal Flooding

 

Exposures: Salinization of land leading to loss of shade cover and green space Vulnerable Groups:
  • People susceptible to heat-related illness (see groups vulnerable to heat events)
Health Risks:
  • Heat-related illnesses (see heat related health risks)
Exposures: Salt intrusion into drinking water supplies Vulnerable Groups:
  • People with hypertension or other salt-sensitive illnesses/medications
Health Risks:
  • Hypertension
  • Medication interactions
Climate Driver: Extreme Weather

All Regions
Hazard: Damage to critical infrastructure Exposures: Loss of electricity, heat Vulnerable Groups:
  • People over age 65
  • People living alone
  • Children under age 5
  • People using medical equipment that requires electrical power or medications that require refrigeration
Health Risks:
  • Hypothermia
  • Carbon Monoxide (CO) Poisoning
  • Falls and injuries in the home
  • Medical emergencies due to loss of medical equipment function
  • Medical emergencies due to spoiled medications
Exposures: Loss of water and sewer/septic utilities Vulnerable Groups:
  • People over age 65
  • Children under age 5
  • Pregnant women
  • People with compromised immune systems
  • People with limited English fluency
Health Risks:
  • Gastrointestinal illness
  • Dehydration
Exposures: Damage to roadways Vulnerable Groups:
  • People over age 65
  • People living alone
  • Children under age 5
  • Pregnant women
  • People with limited mobility
  • People with chronic medical conditions requiring frequent care
Health Risks:
  • Death or injury due to delayed emergency response
  • Motor vehicle accidents/injuries
Hazard: Direct storm impacts Exposures: Debris/Physical hazards Vulnerable Groups:
  • Adolescents and Young Adults7
  • Utility workers
  • Rescue workers
Health Risks:
  • Injury or death from debris, downed wires, falling trees, falls, and motor vehicle crashes
  1. Hattis D, Ogneva-Himmelberger Y, Ratick S. The spatial variability of heat-related mortality in Massachusetts. Applied Geography 33 (2012) 45-52.
  2. Gauderman WJ, Avol E, Gilliland F, Vora H, Thomas D, Berhane K, McConnell R, Kuenzli N, Lurmann F, Rappaport E, Margolis H, Bates D, Peters J. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med. 2004 Sep 9;351(11):1057-67.
  3. USGS Uranium and Arsenic Bedrock Well Study for Massachusetts on Mass.gov: https://www.mass.gov/service-details/arsenic-uranium-bedrock-well-study-location-lookup-for-arsenic-and-uranium
  4. Flood Waters or Standing Waters: Health Risks. Available from the US Centers for Disease Control: https://www.cdc.gov/healthywater/emergency/extreme-weather/floods-standingwater.html
  5. Vibrio vulnificus Infections and Disasters: Disaster Recovery Fact Sheet. Available from the US Centers for Disease Control: https://www.cdc.gov/disasters/vibriovulnificus.html
  6. Harmful algal blooms in fresh water bodies (Massachusetts DPH fact sheet). Available at Mass.gov: https://www.mass.gov/files/documents/2016/08/ww/algae-fresh-water-english.pdf
  7. Lowe D, Ebi KL, Forsberg B. Factors Increasing Vulnerability to Health Effects before, during and after Floods. Int. J. Environ. Res. Public Health 2013, 10, 7015-7067.
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