Cover -- Half-title -- Title -- Copyright -- Contents -- Contributors -- Foreword -- 1 Global environmental changes: anticipating and assessing risks to health -- 1.1 Introduction -- 1.2 "Environment": the wider dimension -- 1.3 Six phases of human ecology over the past 100 millennia -- 1.3.1 Hunter-gatherers -- 1.3.2 Agriculture, settlements and cities -- 1.3.3 Commerce, conquest and microbial confluence -- 1.3.4 Industrialization -- 1.3.5 Modern times: urban consumerism -- 1.3.6 An increasingly full world: the advent of global environmental change -- 1.4 Environment and health: recent developments -- 1.5 Challenges to population health research -- 1.5.1 Concepts -- 1.5.1.1 Complexity and surprises -- 1.5.1.2 Uncertainties -- 1.5.1.3 Vulnerability and adaptation -- 1.5.2 Research methods -- 1.5.2.1 Analogue studies -- 1.5.2.2 Empirical studies of early health effects -- 1.5.2.3 Modelling -- 1.5.2.4 Geographical Information Systems and remote sensing -- 1.5.2.5 Monitoring -- 1.6 Conclusions -- References -- 2 Historical connections between climate, medical thought and human health -- 2.1 Environmental medicine before epidemiology -- 2.1.1 The Scientific Revolution and the "terraqueous globe" -- 2.1.2 Climate and disease during the early modern centuries: perceptions and realities -- 2.2 Thinking locally, acting globally -- 2.2.1 Miasm versus contagion -- 2.2.2 Enter cholera, enter Snow -- 2.2.3 Global environmentalism, 1850-1914 -- 2.2.4 The West takes the rest -- 2.3 Conquering heroes, stubborn foes -- 2.3.1 Tropical medicine and the germ theory misfits -- 2.3.2 Epidemiology at war: 1920-1950 -- 2.3.3 When was the revolution in epidemiology? -- 2.4 1950s-1989: two worlds-two programmes of post-war epidemiology -- 2.4.1 Horizontal epidemiology -- 2.4.2 Vertical epidemiology -- 2.4.3 Problems in the epidemiology of "disease campaigns".

2.5 Conclusion -- References -- Bibliography -- 3 The contribution of global environmental factors to ill-health -- 3.1 Introduction -- 3.2 Environment and health: prologue -- 3.2.1 Historical survey -- 3.2.2 Causal webs of environmental risk factors -- 3.3 Environment in the current health context -- 3.3.1 What is "environmental"? -- 3.3.2 What is "ill-health"? -- 3.3.3 What is "attributable risk"? -- 3.3.4 Global environment-health connections today -- 3.4 Environment and health: the future -- 3.4.1 Avoidable risk -- 3.4.1.1 Temporal factors modifying avoidable risk -- 3.4.1.2 The SALY (sustainability-adjusted life year) -- 3.4.2 Where do future dangers lie? -- 3.5 Conclusion: beyond redefining and reconceptualizing -- References -- 4 Surprise, nonlinearity and complex behaviour -- 4.1 Introduction -- 4.2 Complexities -- 4.2.1 Complex interactions -- 4.2.2 Modelling living systems -- 4.3 Models -- 4.4 Qualitative models -- 4.4.1 Concavity and convexity -- 4.4.2 Signed digraphs (loop analysis) -- 4.4.3 Time averaging -- 4.5 Summary -- Acknowledgements -- References -- 5 Epidemiological and impacts assessment methods -- 5.1 Introduction -- 5.2 Epidemiological study designs -- 5.3 Population-level or ecological studies -- 5.4 Individual-level studies -- 5.4.1 Cross-sectional studies and surveys -- 5.4.2 Case-control studies -- 5.4.2.1 Hantavirus and El Niño: a case-control design linking climate, ecology and infectious disease through the use of… -- 5.4.3 Cohort studies -- 5.5 Surveillance -- 5.6 Confounding and interaction -- 5.7 Exposure assessment -- 5.8 Analytical tools for epidemiological studies of global environmental change -- 5.8.1 Time series analysis -- 5.8.2 Examples of other innovative statistical methods -- 5.8.3 Geographical Information Systems (GIS) and satellite remote sensing -- 5.9 Health impact assessment methods.

5.9.1 Modelling future risks to health -- 5.10 Conclusion -- Acknowledgements -- References -- 6 Retrospective studies: analogue approaches to describing climate variability and health -- 6.1 Introduction -- 6.2 Climate change, climate variability and epidemiology -- 6.3 Analogues: a definition -- 6.3.1 Analogue climate scenarios -- 6.3.2 Analogues using long-term changes in mean climate variables -- 6.3.3 Event analogues -- 6.3.4 Spatial analogues -- 6.3.4.1 Analogues for temperature-related mortality and acclimatization -- 6.3.5 Situation analogues -- 6.4 El Niño Southern Oscillation and interannual climate variability -- 6.4.1 The El Niño climate phenomenon -- 6.4.2 El Niño and health studies -- 6.4.3 El Niño and mosquito-borne disease -- 6.4.3.1 Malaria -- 6.4.3.2 Murray Valley encephalitis and Ross River virus disease in Australia -- 6.4.3.3 Dengue -- 6.4.3.4 Rift Valley fever -- 6.5 Is El Niño a useful analogue for climate change? -- 6.6 Discussion and conclusions -- References -- 7 Detecting the infectious disease consequences of climate change and extreme weather events -- 7.1 Introduction -- 7.2 Assessing the evidence for climate-change impacts on disease -- 7.3 Detecting climatic changes, changes in disease vectors and human health -- 7.3.1 Climatic changes -- 7.3.2 Detection of climate (change) effects on vectors -- 7.3.3 Detection of climate (change) effects on human disease -- 7.3.4 Changes in disease distribution, transmission intensity and seasonality -- 7.4 Examples of physical and biological signs of climate change -- 7.4.1 Shifting isotherms and shrinking glaciers -- 7.4.2 Plant migrations -- 7.4.3 Insects and ticks -- 7.4.4 Mosquito-borne diseases -- 7.4.5 Extreme weather events and infectious diseases -- 7.5 Implications for future research -- 7.6 Conclusions -- Acknowledgements -- References.

8 Integrated Assessment modelling of human health impacts -- 8.1 Introduction -- 8.2 Integrated Assessment -- 8.3 Integrated Assessment models -- 8.4 IA modelling of population and health -- 8.4.1 Three examples -- 8.4.1.1 Future food production and risk of hunger -- 8.4.1.2 Stratospheric ozone depletion, ultraviolet irradiation and skin cancer incidence -- 8.4.1.3 Climate change and vector-borne diseases -- 8.4.2 Economic analysis of health impacts in IAMs -- 8.5 Critical methodological issues in IA modelling of human health -- 8.5.1 Validation in the absence of good data -- 8.5.2 Cumulating uncertainties -- 8.5.3 Blending qualitative and quantitative knowledge -- 8.5.4 A matter of scale -- 8.6 The way ahead -- References -- 9 Remote sensing, GIS and spatial statistics: powerful tools for landscape epidemiology -- Acronyms -- 9.1 Introduction -- 9.2 Background -- 9.3 Basics of RS, GIS and spatial analysis -- 9.3.1 Remote sensing -- 9.3.2 Resolution -- 9.3.3 Geographical Information Systems -- 9.3.4 Spatial analysis: tools -- 9.4 Applications to health -- 9.4.1 Low resolution -- 9.4.2 High resolution -- 9.4.3 Lyme disease -- 9.4.4 Malaria -- 9.4.5 Hantavirus -- 9.4.6 Tsetse flies -- 9.4.7 Combining high-and low-resolution data -- 9.5 Future systems, future applications -- 9.5.1 Spatial resolution -- 9.5.2 Spectral resolution -- 9.6 Conclusions -- References -- 10 Monitoring the health impacts of global climate change -- 10.1 Introduction -- 10.2 Background -- 10.3 Aims and challenges of monitoring health impacts of climate change -- 10.3.1 Early detection of health impacts of climate change -- 10.3.2 Indirect health impact assessment -- 10.3.3 Improved understanding of vulnerability -- 10.3.4 Generation and validation of predictive mathematical models -- 10.3.5 Assessment of the effectiveness of adaptation strategies.

10.4 Which health impacts should be monitored? -- 10.5 What kinds of measurements are relevant? -- 10.5.1 Climate -- 10.5.2 Health outcomes -- 10.5.3 Intermediate stages and environmental data -- 10.5.4 Socioeconomic factors affecting vulnerability -- 10.5.5 Other confounding variables and effect modifiers -- 10.6 Direct effects of thermal extremes on health -- 10.7 Natural disasters caused by extreme weather events: storms and floods -- 10.7.1 Currently available information -- 10.8 Food-and water-borne illness -- 10.8.1 Food-borne illness -- 10.8.1.1 Currently available information -- 10.8.2 Water-related illness -- 10.8.2.1 Currently available information -- 10.9 Vector-borne disease -- 10.9.1 Lyme borreliosis -- 10.9.1.1 Currently available information -- 10.9.2 Tick-borne encephalitis -- 10.9.2.1 Currently available information -- 10.9.3 Leishmaniasis -- 10.9.3.1 Currently available information -- 10.9.4 Malaria -- 10.9.4.1 Currently available information -- 10.10 Conclusions -- Acknowledgements -- References -- 11 Epidemiology, environmental health and global change -- 11.1 Introduction -- 11.2 The epidemiological approach -- 11.2.1 General features of environmental epidemiology -- 11.2.2 Some shortcomings -- 11.3 Vulnerability -- 11.3.1 Definitions -- 11.3.2 Manifestations -- 11.3.3 Causes of vulnerability -- 11.3.4 Implications for epidemiology -- 11.4 Conclusion -- References -- 12 Dealing with scientific uncertainties -- 12.1 Introduction -- 12.2 Classifying "uncertainties" -- 12.3 Risk, duty-of-care and adaptive action: the policy-making landscape -- 12.3.1 The example of climate change and its impacts -- 12.4 Dealing with risks -- 12.4.1 The changing interpretation of risk -- 12.4.2 Implications for science -- 12.4.3 Deliberative and inclusionary science -- 12.5 Conclusion -- References -- Bibliography -- Index.