Interagency special report on the impacts of climate change on human health in the united states

1. Interagency special report on the impacts of climate change on human health in the united states All-Authors Webinar February 12, 2014

2. agenda • Overview and Status • Public engagement and FRN • Peer review process and NRC request • Revised timeline • Revised outline • Brief updates from chapters • Lit review guidance • Modeling • Upcoming meetings and next steps • Recap ACTION ITEMS for authors

3. Overview and statusthe Special Report is: • An Interagency Product coordinated by the Interagency Workgroup on Climate Change and Human Health (CCHHG) and written by federal experts (NIH, CDC, NOAA, EPA, others), with contractor support • A Scientific Assessment of existing research on the impacts of observed and projected climate change on human health in the United States, with a strong focus on impact quantification • An Interim Report with an estimated publication date in late 2015 – after the Third NCA and before the Fourth NCA. It will build upon current draft NCA and 2008 US CCSP climate and health-focused SAP 4.6. • A Product with High Visibility USGCRP agencies and INCA identified climate impacts on human health as a high priority topic for a Special Report.. The report is featured in the President’s Climate Action Plan and would be considered a Highly Influential Scientific Assessment (HISA) by OMB peer review guidelines.

4. Overview and statussome recent milestones (details later) • November 21, 2013: Scoping Workshop • December – January: • Draft Report outline completed (see attachment) • Identified majority of chapter/section authors • Author teams are meeting to further refine scope and approach • Modeling teams have provided some feedback on scenarios and methods • January22, 2014: Briefed the USGCRP Principals. Ongoing discussions are focused on the peer review process • February 7, 2014: FRN for public engagement issued • February 13, 2014: Registration for the Public Forum begins

5. Public Engagement • A Federal Register Notice was issued on behalf of the USGCRP on Friday, February 7 • Comments on the Draft Prospectus • Call for Information • Call for Contributing Author Nominations • Public Forum • http://globalchange.gov/component/content/article/990

6. Public engagementa. Comments on the Draft Prospectus The Draft Prospectus describes proposed plans for scoping, drafting, reviewing, producing, and disseminating the Interagency Special Report on the Impacts of Climate Change on Human Health in the United States. 30-day public comment period: March 1 -31, 2014 Comments on the Draft Prospectus can be made at: http://globalchange.gov/component/content/article/990

7. Public engagementB. Call for information Submissions must be recent, relevant, scientific and/or technical research studies on observed and/or projected climate change impacts on human health in the U.S. that have been peer-reviewed and/or published or accepted for publication in the peer reviewed literature. All scientific literature must be received within the 30-day public comment period (March 1 -31, 2014) at:http://globalchange.gov/component/content/article/990 Literature submitted through the FRN will be screened and sent to chapter teams for review. This process will be discussed further when we cover the lit review.

8. Public engagementC. contributing author nominations Contributing authors will assist in the preparation of specific sections of the report, working closely with chapter author leads and teams. Submissions must demonstrate that nominees are accomplished writers with demonstrated technical backgrounds, such that they can aid in the development of a robust scientific, technical assessment as subject matter experts in one or more of the focus areas 30-day public comment period: March 1 -31, 2014 http://globalchange.gov/component/content/article/990

9. Public engagementC. contributing author nominations • Contributing authors are intended to be external (non-Federal) subject matter experts • Drawing from the final pool of screened nominees, a third-party contractor will obtain the services of 8-12 subject matter experts for specific chapters or sections • Contributing authors will be selected independently based on 1) their expertise and qualifications, 2) where specific subject matter experts can be best utilized to fill the gaps in our outline, and 3) their willingness and availability • Contributing authors may have varying responsibilities • Timing: The nomination period ends March 31, so selection will take place in April. We can expect contributing authors to join chapter teams by late April/ early May.

10. Public engagementD. Public Forum – the basics • WHAT: The goal is to foster public participation in scoping the topics addressed by the Special Report and informing the author teams’ approach to assessing the science. In other words, we’re seeking outside input to inform our process and the content on the Special Report. • WHEN: March 13, 2014 10:00 a.m. – 5:00 p.m. • WHERE: EPA William Jefferson Clinton East building, Room 1153 1301 Constitution Avenue N.W., Washington, D.C. 20460

11. Public engagementD. Public Forum – the basics • WHO: The Public Forum is meant to be an open venue to engage with external (non-Federal) experts from, for example, academic, private, NGO, and tribal communities. • HOW: The event is open and free to the public, but with limited space available. The first 120 people to register may attend in person. Registration will be available beginning February 13, 2014 at: http://globalchange.gov/component/content/article/990.

12. Public engagementD. Public Forum – details • The agenda, which still needs to be developed, will potentially include a brief introduction of chapter approaches, panel discussions by subject experts in response to those approaches, and opportunities for questions/input from registered attendees • Webinar: https://epa.connectsolutions.com/publicforum • At least one representative from each chapter will need to attend, ideally the chapter lead(s). In-person attendees still need to register, but space is limited. • While input from participants during the webinar will be used to inform development of the Special Report, comments must still be submitted through the FRN process to be included in the public comment record.

13. Public engagementD. Public Forum - Agenda ACTION ITEM – NEEDED ASAP! We need to identify and invite appropriate subject matter experts, from outside of the Federal government, who would be able to inform the report scope and approach. E-mail with suggestions: crimmins.allison@epa.gov • Ideally they would attend in person • No funding for travel or speaking • How the day might flow: • A CCHHG rep provides a quick overview and outlines forum goals • For each chapter: • Brief (~10 minute presentations) from chapter team representative • ~35 minute panel discussions with 2-3 outside presenters to get input on the approach outlines by chapter team reps. This could include input on what the most important issues are, what sources of data we’re missing, etc. • 10-15 minutes of open questions and discussion with all participants

14. Peer review process • Assessed Literature will come primarily from the existing peer-reviewed scientific literature. Use of grey literature will be consistent with USGCRP guidance . All literature will be screened for eligibility – more on this later. • Additional quantitative analysis must be submitted to a peer reviewed publication by October 31, 2014. If deemed inappropriate for submission as novel work, then the analysis will need to go through an appropriate peer review (either contractor-led or internal agency peer review) • Thefull report will follow appropriate federalguidelines and will undergo rigorous peer review, public review, and final interagency review necessary for this type of document (HISA). The CCHHG is exploring options for the National Research Council (NRC) to conduct peer review of full report.

15. Agenda time check • Overview and Status • Public engagement and FRN • Peer review process and NRC request • Revised timeline • Revised outline • Brief updates from chapters • Lit review guidance • Modeling • Upcoming meetings and next steps • RecapACTION ITEMS for authors

16. timeline

17. outline 1 Executive Summary 2 Introduction and Background • 2.1 This Report: Scope and Methods (motivation and approach) • 2.2 Climate Change in the U.S.: Context for an Assessment of Health Impacts • 2.3 Detecting and Attribution of climate-sensitive health stressors • 2.4 Modeling Capabilities of Climate-Sensitive Health Stressors • 2.5 Uncertainty 3 Changes in Exposure and Health Outcomes • 3.1 Key Findings • 3.2 Observed and Projected Climate Impacts on Human Health related to: • 3.2.1 Thermal Extremes: Heat and Cold Waves • 3.2.2 Extreme Weather and Climate Events • 3.2.3 Air Quality Impacts • 3.2.4 Vectorborne and Zoonotic Disease • 3.2.5 Waterborne and Foodborne Diseases • 3.2.6 Food Safety • 3.2.7 Mental Health and Stress-Related Disorders • 3.2.8Other Health Threats • 3.3 Vulnerable Regions and Subpopulations • 3.4 Synthesis/Conclusions/Data Gaps and Challenges • 3.5 Traceable Accounts 4 Conclusions and Looking Forward • 4.1 Implications for Public Health in the U.S. • 4.2 Summary of Progress towards National Level Impact Assessments • 4.3 Future Research

18. Outline for health impact chapters • Highlight 3-5 key findings based on the assessment of the scientific literature reviews and any additional quantitative analyses, each with an associated traceable accounts • 1. Introduction/Purpose/Background - summarize the key questions, relationship between climate change and the impact, and potential to affect public health risks. • 2. Summary of the State of the Science - highlight recent findings, updates, and/or publications, particularly those that are quantitative in nature • 3. Observed Impacts and Indicators - primarily focusing on national impacts • 4. Projected Impacts - identify areas where probabilistic changes in risk can be characterized and where uncertainty has been better characterized since SAP 4.6. • AdditionalQuantitative Analyses Some chapters will include additional quantitative analysis of projected impacts • 5. Vulnerable Populations - identify any segments of the population (e.g. based on age, gender, race, occupation, socioeconomic status, existing health levels, geography, etc) that are at increased risk for the health-related climate impacts. • 6. Traceable Accounts - describe the process and rationale the authors used in coming to conclusions and their confidence in these conclusions.

19. Brief updates from chapter leads

20. Introductory Chapter Description • Essential • Provides necessary context, framing, and scoping of the report • Comprehensive • Addresses a wide range of issues, from climate modeling through uncertainty and attribution of health impacts • Ambitious • Introduction will aim to address many complex issues of health implications of climate change • Attribution of health impacts to weather and/or climate change • Use of climate models for health impact assessments • Addressing uncertainty in climate and health models

21. extreme heat analysis plan • Focus: Develop quantitative results • Mortality: • Team led by Harvard and Columbia University researchers (J. Schwartz and P. Kinney) • Extending methods from the peer-reviewed literature • Non-linear relationships being estimated from climate-based clusters of cities • Potential impacts of adaptation will be addressed quantitatively • Modeling work is underway • Morbidity: • Working to develop national-scale projections based on new study results • Currently evaluating options

22. Air Quality Analysis Plan • Goal: Characterize the human health impacts attributable to future climate-induced air quality changes • Ambient air (quantitative) • Climate model regional photochemical model health impact tool • Quantify ozone (and perhaps PM2.5) related premature deaths and illnesses • Modeling details (2030 analytical year) • Global climate model: GISS Model E2 • Regional climate model: WRF 3.2.1 • Climate scenario: RCP 6.0 • Photochemical air quality model: CMAQ v5.02 • Benefits tool: BenMAP-CE 1.02 configured with ICLUS population projections • Indoor air (qualitative) • Aeroallergens (qualitative)

23. Vector-Borne and Zoonotic Diseases • Identified an inter-agency writing team with adequate SME background for the task • Held several conference calls to discuss chapter content and writing process • Have reviewed and discussed chapter content • State of the science • Types of models • Two case studies: Lyme disease and West Nile • Highest priority future needs • Other key elements per the general chapter outline provided • Have assigned general writing tasks • Will continue to meet to refine writing tasks and hold one another accountable to the deadlines • Will reach out to engage other important stakeholders and SMEs as dictated by the process

24. waterborne and foodborne disease • Initial Interagency Team established-NOAA, EPA, CDC • Regular Conference calls • Modeling • Focus on Vibrios and Harmful Algal Blooms • Tackling season, decadal and longer term time climate forecasting scales • Modeling methods still under discussion • Seeking Regional (Great Lakes) focus on water quality and climate modeling • Chapter outline refined and writing assignments (mostly) made • Covering foodborne only as related to the above

25. Agenda time check • Overview and Status • Public engagement and FRN • Peer review process and NRC request • Revised timeline • Revised outline • Brief updates from chapters • Lit review guidance • Modeling • Upcoming meetings and next steps • RecapACTION ITEMS for authors

26. Literature review guidanceoverview: • Literature review guidance attached • Literature reviews will include • comprehensive search of the literature (Jan-Feb) • collection and incorporation of information submitted by the public through the FRN (March-April) • screening and assessment of eligibility (thru March/April) • synthesis of collected literature (April - May) • Main literature search being conducted by NIEHS, final literature review will be responsibility of chapter teams

27. Literature review guidance Literature Search and Collection NIEHS & EPA Review Teams • Three sources of literature: Identification Literature identified by NIEHS through database searching Literature submitted by the public in response to the call for information Literature identified by review teams through other sources

28. Literature review guidance literature from NIEHS and FRN sources • NIEHS literature search • Update to the 2012-2013 Health Sector Literature Review and Bibliography for the third NCA • Search will include references published after 2006 through mid October 2013 • Conducting eligibility screening in February • Literature submitted through FRN process • Public comment period ends March 31 • NIEHS/EPA conducting eligibility screening in April

29. Literature review guidance Products delivered by NIEHS/EPA • Bibliographic database (e.g., Endnote file) • All References, including those that get excluded (screened out) during the NIEHS eligibility screening process • Microsoft Excel spreadsheet containing basic bibliographic information and study characteristics, for example: • exposure/health outcome groups • type of paper (i.e., Quantitative or Meta-Analysis, Qualitative Review) • type of health impact (e.g., cardiovascular disease) • geographical location • environmental features (e.g., coastal, urban, rural) • type of modeling • time scale of analysis

30. Literature review guidance Literature Search and Collection NIEHS & EPA Review Teams • Three sources of literature: Identification Literature identified by NIEHS through database searching Literature submitted by the public in response to the call for information Literature identified by review teams through other sources

31. Literature review guidance Review Team responsibilities ACTION ITEM Establish a Review Team (at least 2 people) within each chapter team to: • Screen and assess eligibility of additional literature sources using NIEHS approach (will be provided separate from the guidance document) • Add any new literature identified by the author teams from other sources to the Bibliographic database (e.g., Endnote file) • Coordinate literature review documentation

32. Literature review guidance Chapter Team responsibilities Chapter teams: • Should add columns to the Excel spreadsheet with any additional bibliographic or study characteristics they find useful for summarizing the results of the studies. Some additional fields are suggested in the appendix. • Should document information quality considerations (next slide) using either the bibliographic spreadsheet or separate document

33. Literature review guidance ensuring information quality • Chapter teams should assess for risk of bias—e.g., Selection Bias and Confounding, Performance Bias, Attrition/Exclusion Bias, Detection Bias, Reporting Bias. • Also consider the extent to which studies exhibit the following: • Soundness - The extent to which the scientific and technical procedures, measures, methods or models employed to generate the information are reasonable for, and consistent with, its intended use. • Applicability and Utility - The extent to which the information is relevant for its intended use. • Clarity and Completeness - The degree of clarity and completeness with which the data, assumptions, methods, quality assurance, sponsoring organizations and analyses employed to generate the information are documented. • Uncertainty and Variability - The extent to which the variability and uncertainty (quantitative and qualitative) in the information or in the procedures, measures, methods or models are evaluated and characterized. • Evaluation and Review - The extent of independent verification, validation and peer review of the information or of the procedures, measures, methods or models

34. Literature review guidance Roles and Responsibilities • NIEHS/EPA • Screen and assess the eligibility of literature from: • Literature Search • Public Submissions via FRN • Provide Bibliographic Database and Excel Spreadsheet • Provide search strategy and screening process documentation • Review Teams (2 people designated within each chapter team) • Screen and Assess eligibility of any additional literature using the NIEHS screening process (provided separately) • Manage Bibliographic database (e.g., Endnote file) • Coordinate literature review documentation • Chapter Teams • Read and Review studies • Add study characteristics to Excel spreadsheet if necessary • Document information quality considerations

35. Literature review guidance timeline

36. Chapter guidance coming soon • Quick-reference guidance on writing styles, formats, and scope • Risk assessment guidance for chapter authors • Likelihood • Confidence • Traceable accounts • Assessing the state of the science (e.g. use of a figure to show progress towards national scale projections within each topic area) • Scenarios for new modeling analyses

37. Development of Health-Specific Socio-economic scenarios • Future projections of climate-health impacts require assumptions on baseline conditions • Population, health status, regulatory status, socioeconomic status, land use, etc., in addition to emissions of greenhouse gases • The climate modeling community has changed its approach to scenarios from relatively constrained choices (E.g., Special Report- Emissions Scenarios (SRES) of IPCC AR4 • This assessment is an opportunity to pioneer development of health-specific scenarios • More information will be provided at the second all-authors webinar in several weeks

38. Upcoming meetings and next steps • February 13 – registration for the public forum • In 2-4 weeks – second webinar to provide chapter guidance from steering committee • March 13 – public forum • End of March – close of public comment period • March – April – review teams receive NIEHS bibliographic database for synthesis by review team • April – contributing authors assigned – review teams assess literature • May or summer– Review teams present literature review results and synthesis at drafting workshop

39. Recapping Action items requested of authors • Identify non-Fed experts to present/ participate in the Public Forum on March 13 – needed ASAP! E-mail with suggestions: crimmins.allison@epa.gov • Establish a review team (at least 2 people) within each chapter team to screen and assess eligibility of additional literature identified by authors and to coordinate documentation of literature review • Be aware of upcoming meetings (second all authors call, Public Forum, second drafting workshop) and timeline

40. For more information • Allison Crimmins crimmins.allison@epa.gov 202.343.9170