Water and food-borne diseases

Assessment versions

Published (reviewed and quality assured)

• Water and food-borne diseases (CLIM 038) - Assessment published Sep 2008

Justification for indicator selection

Four main issues should be considered when evaluating the relationship between health outcomes and exposure to changes in rainfall and water availability and quality: (1) links between water availability, household access to improved water and the health burden due to diarrhoeal diseases; (2) the role of extreme rainfall (intense rainfall or drought) in facilitating water-borne outbreaks; (3) effects of temperature and runoff on microbiological and chemical contamination of coastal, recreational and surface waters; (4) direct effects of temperature on the incidence of diarrhoeal and other diseases. Climate variability and change also change the risks of fires and pest and pathogen outbreaks, with negative consequences for food, fibre and forestry (Menne et al., 2008).
Access to safe water remains an extremely important global health issue. The risk of outbreaks of water-borne diseases increases where standards of water, sanitation and personal hygiene are low.
Extreme precipitation events leading to floods or droughts can have direct and indirect health effects. Flooding can cause drowning, injuries (cuts, sprains, laceration, punctures, electric injuries, etc.), diarrhoeal diseases, vector-borne diseases (including those borne by rodents), respiratory infections, skin and eye infections, and mental health problems. Floods also have other effects with health consequences: damage to infrastructure for health care and water and sanitation, crops (and/or disruption of food supply) and property (lack of shelter), and disruption of livelihood and displacement of populations. Droughts or extended dry spells can impair provision of safe water leading to water-related health problems, for example through reducing the volumes of river flow, which may increase the concentration of effluent pathogens, posing a problem for the clearance capacity of treatment plants.
Climate change is also likely to affect the quality of coastal waters, by changing natural ecosystems or the quality of the waters draining into the coastal zone. This poses specific risks for the recreational use of bathing waters, particularly for transient tourist populations that may not have built-in resistance to endemic water-related diseases or may be faced with water quality that does not meet the stringent conditions imposed in the home country. The quality and safety of seafood is directly linked to the quality of the water in the coastal zone.
Intestinal infectious diseases that are transmitted through food or water are sensitive to climate and weather factors. Such diseases are the main causes of infectious diarrhoea and cause significant amounts of illness each year in Europe. Approximately 20 % of the population in western Europe is affected by episodes of diarrhoea each year (van Pelt et al., 2003). Such infections have a significant economic impact in terms of treatment costs and loss of working time (Roberts et al., 2003).
Various adaptation options are available, which include ensuring access to safe drinking water, providing sanitation services, and establishing common standards for surveillance systems and contingency plans for detecting and preventing water-borne disease outbreaks. Water-safety plans may need to be revised for changing climate conditions. Such plans will need to include ways of ensuring safe drinking water from source to tap through better risk assessment and management. Improved management of water demand in the context of fully-integrated planning for river-basin management will become imperative as a first coping mechanism, but is unlikely to satisfy all the needs created by demographic growth, rising living standards and economic development. Alternative strategies will need to be explored, including reusing treated wastewater, using grey water, harvesting rainwater and, where economically viable, desalination. Contamination of food products usually arises from improper practices at some point during the journey from farm to fork. Providing education and timely information on the best ways to handle food and avoid food-borne diseases to producers, food handlers and consumers is essential. Food-borne disease outbreaks can be prevented by using safe water and raw materials, keeping food clean and at safe temperatures, cooking food thoroughly, and keeping raw and cooked food separate.

Scientific references:

• References D'Souza, R.; Becker, N.; Hall, G. et al., 2004. Does ambient temperature affect foodborne disease? Epidemiology 15: 86-92. EC, 2007. Commission Staff working document. Annex accompanying the Green paper from the commission to the council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions. Adapting to climate change in Europe -- options for EU action. http://ec.europa.eu/environment/climat/pdf/ia_sec_8.pdf . Fleury, M.; Charron, D. F.; Holt, J. D. et al., 2006. A time series analysis of the relationship of ambient temperature and common bacterial enteric infections in two Canadian provinces. International Journal of Biometeorology 50 (6): 385-391. Goulson, D.; Derwent, L. C.; Hanley, M. et al., 2005. Predicting calyptrate fly populations from the weather, and the likely consequences of climate change. Journal of Applied Ecology and Society 42: 795-804. Hall, G. V.; D'Souza, R. M.; Kirk, M. D., 2002. Foodborne disease in the new millennium: out of the frying pan and into the fire. Medical Journal of Australia 177 (2/16 Dec): 614-618. Hunter, P.R., 2003. Climate change and waterborne and vectorborne disease. Journal of Applied Microbiology 94: 37-46. Kistemann, T.; Classen, T.; Koch, C. et al., 2002. Microbial Load of Drinking Water Reservoir Tributaries during Extreme Rainfall and Runoff. Applied and Environmental Microbiology 68 (5): 2188-2197. Korenberg, E., 2004. Environmental causes for possible relationship between climate change and changes of natural foci of diseases and their epidemiologic consequences. Climate change and public health in Russia in the XXI Century. Proceeding of the international workshop, Moscow. Kovats, R. S.; Edwards, S.; Hajat, S. et al., 2004. The effect of temperature on food poisoning: time series analysis in 10 European countries. Epidemiology and Infection 132 (3): 443. Kovats, R. S.; Edwards, S. J.; Charron, D. et al., 2005. Climate variability and campylobacter infection: an international study. International Journal of Biometeorology 49 (4): 207-214. Kovats, R. S. and Hajat, S., 2008. Heat stress and public health: a critical review. Annual Review of Public Health 29 (9): 11-55. Kríž, B., Beneš, C., Částková, J. et al., 1998. Monitorování epidemiologické situace v zaplavených oblastech v České Republice v roce 1997. (Monitoring the Epidemiological situation in flooded areas of the Czech Republic in 1997). In: Konference DDD '98; Kongresové Centrum Lázeňská Kolonáda Poděbrady, 11.-13. května 1998 (Proceedings of the Conference DDD'98, 11-12th May, 1998, Proděbrady, Czech Republic). Proděbrady, Czech Republic. Lake, I. R.; Bentham, G.; Kovats, R. S. et al., 2005. Effects of weather and river flow on cryptosporidiosis. Journal of Water and Health 3 (4): 469-474. Lehane, L. and Lewis, R. J., 2000. Ciguatera: recent advances but the risk remains. International Journal of Food Microbiology 61 (2-3): 91-125. Lindgren, E.; Naucke, T., 2006. Leishmaniasis: influences of climate and climate change epidemiology, ecology and adaptation measures. In: Menne, B; Ebi, K. (eds.). Climate change and adaptation strategies for human health. Darmstadt: WHO Regional Office for Europe, Steinkopff; pp. 131-156. Louis, V. R.; Gillespie, I. A.; O'Brien, S. J. et al., 2005. Temperature-driven Campylobacter seasonality in England and Wales. Appl Environ Microbio, 71 (1): 85-92. Menne, B.; Apfel, F.; Kovats, S. et al., 2008. Protecting health in Europe from climate change. WHO Regional Office for Europe. Copenhagen. Reacher, M.; McKenzie, K.; Lane, C. et al., 2004. Health impacts of flooding in Lewes: a comparison of reported gastrointestinal and other illness and mental health in flooded and non-flooded households. Communicable disease and public health 7 (1): 39-46. Roberts, J.; Cumberland, P.; Sockett, P. et al., 2003. The study of infectious intestinal disease in England: Socio-economic impact. Epidemiology and Infection 130: 1-11. Semenza, J. and Nichols, G., 2007. Cryptosporidiosis surveillance and water-borne outbreaks in Europe. Euro surveill 12 (5). http://www.eurosurveillance.org/em/v12n05/1205-1227.asp . Tam, C.; Rodrigues, L.; O'Brien, S. et al., 2006. Temperature dependence of reported Campylobacter infection in England, 1989-1999. Epidemiology and Infection 134 (1): 119-125. van Pelt, W.; de Wit, M. A.; Wannet, W. J. et al., 2003. Laboratory surveillance of bacterial gastroenteric pathogens in the Netherlands, 1991-2001. Epidemiology and Infection 130 (3): 431-441.

Indicator definition

• Percentage change of weekly salmonella cases by 1 ⁰C temperature increase

Units

http://www.eea.europa.eu/publications/eea_report_2008_4/pp149-160CC2008_ch5-10_Human_Health.pdf

Policy context and targets

Context description

In April 2009 the European Commission presented a White Paper on the framework for adaptation policies and measures to reduce the European Union's vulnerability to the impacts of climate change. The aim is to increase the resilience to climate change of health, property and the productive functions of land, inter alia by improving the management of water resources and ecosystems. More knowledge is needed on climate impact and vulnerability but a considerable amount of information and research already exists which can be shared better through a proposed Clearing House Mechanism. The White Paper stresses the need to mainstream adaptation into existing and new EU policies. A number of Member States have already taken action and several have prepared national adaptation plans. The EU is also developing actions to enhance and finance adaptation in developing countries as part of a new post-2012 global climate agreement expected in Copenhagen (Dec. 2009). For more information see: http://ec.europa.eu/environment/climat/adaptation/index_en.htm

Targets

No targets have been specified

Related policy documents

No related policy documents have been specified

Methodology

Methodology for indicator calculation

http://www.eea.europa.eu/publications/eea_report_2008_4/pp149-160CC2008_ch5-10_Human_Health.pdf

Methodology for gap filling

http://www.eea.europa.eu/publications/eea_report_2008_4/pp193-207CC2008_ch8_Data_gaps.pdf

Methodology references

No methodology references available.

Data specifications

EEA data references

• No datasets have been specified here.

External data references

• Effect of temperature on food poisoning

Data sources in latest figures

Uncertainties

Methodology uncertainty

http://www.eea.europa.eu/publications/eea_report_2008_4/pp193-207CC2008_ch8_Data_gaps.pdf

Data sets uncertainty

http://www.eea.europa.eu/publications/eea_report_2008_4/pp193-207CC2008_ch8_Data_gaps.pdf

Rationale uncertainty

Four main issues should be considered when evaluating the relationship between health outcomes and exposure to changes in rainfall and water availability and quality: (1) links between water availability, household access to improved water and the health burden due to diarrhoeal diseases; (2) the role of extreme rainfall (intense rainfall or drought) in facilitating water-borne outbreaks; (3) effects of temperature and runoff on microbiological and chemical contamination of coastal, recreational and surface waters; (4) direct effects of temperature on the incidence of diarrhoeal and other diseases. Climate variability and change also change the risks of fires and pest and pathogen outbreaks, with negative consequences for food, fibre and forestry (Menne et al., 2008).
Access to safe water remains an extremely important global health issue. The risk of outbreaks of water-borne diseases increases where standards of water, sanitation and personal hygiene are low.
Extreme precipitation events leading to floods or droughts can have direct and indirect health effects. Flooding can cause drowning, injuries (cuts, sprains, laceration, punctures, electric injuries, etc.), diarrhoeal diseases, vector-borne diseases (including those borne by rodents), respiratory infections, skin and eye infections, and mental health problems. Floods also have other effects with health consequences: damage to infrastructure for health care and water and sanitation, crops (and/or disruption of food supply) and property (lack of shelter), and disruption of livelihood and displacement of populations. Droughts or extended dry spells can impair provision of safe water leading to water-related health problems, for example through reducing the volumes of river flow, which may increase the concentration of effluent pathogens, posing a problem for the clearance capacity of treatment plants.
Climate change is also likely to affect the quality of coastal waters, by changing natural ecosystems or the quality of the waters draining into the coastal zone. This poses specific risks for the recreational use of bathing waters, particularly for transient tourist populations that may not have built-in resistance to endemic water-related diseases or may be faced with water quality that does not meet the stringent conditions imposed in the home country. The quality and safety of seafood is directly linked to the quality of the water in the coastal zone.
Intestinal infectious diseases that are transmitted through food or water are sensitive to climate and weather factors. Such diseases are the main causes of infectious diarrhoea and cause significant amounts of illness each year in Europe. Approximately 20 % of the population in western Europe is affected by episodes of diarrhoea each year (van Pelt et al., 2003). Such infections have a significant economic impact in terms of treatment costs and loss of working time (Roberts et al., 2003).
Various adaptation options are available, which include ensuring access to safe drinking water, providing sanitation services, and establishing common standards for surveillance systems and contingency plans for detecting and preventing water-borne disease outbreaks. Water-safety plans may need to be revised for changing climate conditions. Such plans will need to include ways of ensuring safe drinking water from source to tap through better risk assessment and management. Improved management of water demand in the context of fully-integrated planning for river-basin management will become imperative as a first coping mechanism, but is unlikely to satisfy all the needs created by demographic growth, rising living standards and economic development. Alternative strategies will need to be explored, including reusing treated wastewater, using grey water, harvesting rainwater and, where economically viable, desalination. Contamination of food products usually arises from improper practices at some point during the journey from farm to fork. Providing education and timely information on the best ways to handle food and avoid food-borne diseases to producers, food handlers and consumers is essential. Food-borne disease outbreaks can be prevented by using safe water and raw materials, keeping food clean and at safe temperatures, cooking food thoroughly, and keeping raw and cooked food separate.