Annual Environment Health and Wellbeing Conference - EPA, HSE and ESRI - 21 November 2019, Radisson Blu Royal Hotel, Golden Lane, Dublin

1. Climate Change Adaptation Plan
Health Sector
2019-2024
Colm Ó Conaill, Department of Health
November 2019

2. Some Key Points
Context – busy health agenda
CC a multiplier on existing vulnerabilities – impact “felt most by our most vulnerable citizens” - the
elderly, children, those with pre-existing conditions, the urban poor, farmers and those living in
coastal areas.
Leadership
Cross-government challenge - Health in all policies, many health effects originate in other sectors
Cross-government opportunity - health impact a good way to engage people about CC
Plan development a great opportunity to bring together existing strands of CC work

3. • Adaptation: A change in natural or human systems in the response to
the impacts of climate change. These changes moderate harm or
exploit beneficial opportunities and can be in response to actual or
expected impacts.
• Mitigation: Action to reduce the likelihood of an event occurring or
reducing the impact if it does occur.

4. Why now?
• Climate change is the biggest
global health threat of the 21st
Century (The Lancet, 2018)
• Statutory Responsibility (Climate
Act 2015, Section 6)

5. Overview
• National context / framework
• Developing the Health Sector Plan
• Key areas for Adaptation Actions
• Monitoring and Evaluation
• What’s next?

6. Strong national framework
• Leadership and support from DCCAE
• National Adaptation Steering Committee, Climate Change Advisory Council
• Climate Act (2015)
• National Adaptation Framework (2018)
• Sectoral Planning Guidelines for CC Adaptation (2018)
• Climate Action Plan (2019)

7. Publications

8. The Plans
• Health (DOH)
• Flood Risk
Management (OPW)
• Water
Quality/Infrastructure
(DHPLG)
• Transport Infrastructure
(DTTS)
• Electricity and Gas
Networks &
Communication
Networks (DCCAE)
• Seafood, Agriculture &
Forestry (DAFM)
• Biodiversity & Built
and Archaeological
Heritage (DCHG) Natural and
Cultural
Capital
Critical
Infrastructure
Public Health
Water
Resource
and Flood
Risk
Management

9. Vision: reduced climate vulnerability
across the health sector
Applies to:
• Department of Health
• Agencies including HSE
• Orgs providing services for HSE
• Non-HSE health sector+ services
eg GPs, private hospitals, private
nursing homes

10. Process - the Team
• Joint DOH-HSE cross-functional Sectoral Adaptation Team
• Public Health Medicine, Emergency Management, Health Protection,
Estates Management, Finance, Communications, National Health
Sustainability Office

11. Acknowledgements
Name Department/Organisation Divison/Unit
Dr. Colette Bonner Department of Health Deputy Chief Medical Officer
Mark Fagan HSE Assistant National Director Finance
Dr. Ina Kelly HSE Consultant in Public Health Medicine/Medical Officer of Health
Lee Lyons Department of Health Policy and Strategy Division
Trish Markham HSE National Office for Emergency Management
Robert Mooney Department of Health Press & Communications Office - Expertise in Climate Change
research
Colm Ó Conaill Department of Health Policy and Strategy Division
Emma O’Donoghue Department of Health Health and Wellbeing Unit
Peter Smyth HSE Assistant National Director Estates
Michael Quirey HSE National Health Sustainability Office – HSE Estates

12. Developing the Plan
Sectoral Planning Guidelines for the
for Climate Change Adaptation (2018)
1. Preparing the Ground
2. Climate Impact Screening
3. Prioritisation
4. Priority Impact Assessment
5. Develop the Plan
6. Implement, Evaluate, Review

13. Collaborative and evidence-based
Joint DOH-HSE experienced team
Stakeholder engagement
Public consultation
Input from other Government sectors sought
Two literature reviews
International best practice
Concrete learning from past events eg EM
Facilitated workshops to conduct risk assessment

14. Climate predictions
• Climate information (observed and projected)
to support impact and risk assessment
• Wetter winters, drier summers
• Heavy rainfall events to increase by 20%
• More severe intensity with winter storms
• Increased temperatures, winter and summer,
with more likelihood of heatwaves
• Sea level rise

15. Decision-making on priorities
2 reviews of national and international literature
International good practice on adaptation action
Experience / expertise of team members eg learning from emergency response
……
…… identified 3 key areas of risk or vulnerability

16. Risks to the health sector in 3 key areas
• Population Health and Wellbeing
• Health service continuity
• Infrastructure Resilience

17. Decision-making on priorities
Early Stakeholder consultation focused on these 3 themes
2 risk assessment workshops using MEM 2010 to consider likelihood +
magnitude of potential health impact (through the 3 main lenses)
Special attention to particular health vulnerabilities in Ireland, related to
our geography, environmental influences on health, and health behaviour.
Result was 6 climate scenarios with potentially most profound impact

18. 6 priority climate stimuli / scenarios
Severe weather events
 Windstorms
 extreme heat and heatwaves,
 flooding and high precipitation
 extreme cold snaps
Slow onset climate mediated effects
 UV Radiation
 Air Pollution

20. Extreme weather
events e.g. storms
Changes in
precipitation
Rising sea level
Warmer weather
including heat waves
Disrupted power supplies
Disrupted water supplies
Disrupted sanitation leading
to environmental
contamination
Unsafe roads, buildings and
other infrastructure
Drought
Loss of habitable land
↑ indoor and outdoor
temperatures
Changed environmental fate of
zoonotic pathogens and vectors
Disrupted communications
Flooding
Changed environmental
transport of pathogens and
vectors
Drowning
Physical injury including
CO poisoning
↑Heat-related mortality
↓Cold-related mortality
↑Infectious diseases
Mental Health effects
from displacement,
isolation, physical,
emotional and economic
stress and loss
Exacerbations of asthma
& COPD
↑Respiratory allergens
↓ Air Quality
Disrupted emergency
systems
Disrupted essential
healthcare
Unmet basic human
needs including water,
food, shelter
↑ UV exposure opportunities
↑UV related carcinoma
Changing climate
effects
Environmental effects Health impacts
Predicted health impacts for Ireland include:
20

21. Adaptation Actions
1. Leadership and Oversight
2. Severe Weather Events
3. UV Radiation
4. Air Pollution
5. Monitoring, Research and Evaluation

22. Leadership and Governance
• New Climate Change Oversight Group
• Early stakeholder consultation
• Priority focus on research and data

23. Severe Weather Events
• Public Health Heatwave Plan
• Survey of health infrastructure resilience
• Severe weather planning to be incorporated into business continuity
planning
• Sharing lessons learned widely, as standard

24. UV Radiation
• Public awareness of increasing rate of skin cancers
• Current projections do not include climate change
• Implementation of National Skin Cancer Prevention Plan, in particular
increasing awareness in high risk groups

25. Air Pollution
• Build Irish-specific climate change epidemiology relating to air pollution
• Improve public education for vulnerable populations (asthma, COPD)
• Advocate for policies in other sectors to reduce emissions

26. Monitoring, Research & Evaluation
1. Agree performance indicators
2. Identify and progress research agenda
3. Review adaptation plan after 3 years

27. Next Steps
• Leadership & Governance in DOH and HSE
• Establish CC Oversight Group
• Early stakeholder consultation
• Priority focus on research and data
• Mitigation
• Health in All Policies / Co-benefits / Health inequalities
• UN Sustainable Development Goals (SDGs)

28. Sources of Information
• https://www.dccae.gov.ie/en-ie/climate-action/Pages/default.aspx
• https://www.dccae.gov.ie/en-ie/climate-action/publications/Documents/4/National%20Climate%20Change%20Adaptation%20Framework.pdf
• https://www.dccae.gov.ie/en-ie/climate-action/topics/climate-action-at-a-national-level/climate-change-advisory-council-(ccac)/Pages/default.aspx
• https://www.dccae.gov.ie/en-ie/climate-action/publications/Pages/National-Policy-Position.aspx
• https://www.dccae.gov.ie/en-ie/climate-action/topics/climate-action-at-a-national-level/climate-action-and-low-carbon-development-act-/Pages/default.aspx
• https://www.dccae.gov.ie/en-ie/climate-action/topics/climate-action-at-a-national-level/climate-action-and-low-carbon-development-act-/Pages/default.aspx
• http://www.climatecouncil.ie/aboutus/
• https://www.dccae.gov.ie/en-ie/climate-action/topics/adapting-to-climate-change/national-adaptation-framework/Pages/default.aspx
• https://www.dccae.gov.ie/documents/Climate%20Action%20Plan%202019.pdf
• https://www.dccae.gov.ie/en-ie/climate-action/publications/Pages/default.aspx
• https://www.hse.ie/eng/about/who/healthbusinessservices/national-health-sustainability-office/files/sustainability-strategy-for-health.pdf