seas, oceans, and public - setac brussels · · 2017-05-24•my background • oceans and human...
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Seas, Oceans, and Public Health in Europe
Fleming LE, McDonough N, White M, McMeel O, Domegan C, Wujits S, Blauw A, Vera Prieto J, Parga M, Calewaert J-B,
Garside R, Gazo M, Depledge M
• My Background
• Oceans and Human Health
– Overview
• US
• Europe
• New Focus: Health and Wellbeing at the Coasts
– Beyond “Blue Gym”: the evidence base
• Future Challenges and Opportunities
Outline
Who am I? How did I get here??
• MD MPH PhD MSc
– Epidemiology/Environmental & Occupational Health
• University of Miami
– Medical School
• Central America
– Marine School
• Oceans & Human Health
• University of Exeter
– European Centre for Environment and Human Health
Oceans and Human HealthContext and Principles
• Interconnections/Interdependence between Health of Humans and the Oceans/Seas
• Complexity of the science, challenges, contexts
• Multi/Inter Disciplinary, Institutional, Sector
• Benefits, Opportunities, and Risks
• Time is NOW
•Planetary Health
RISKS & REMEDIES from the OCEANS
National Need:
• To Increase
Understanding of Human
Health Risks & Remedies
from the Seas
International Need:
• To Increase Understanding of Human and Ecosystem Interactions with the Seas and Oceans
• Both Risks AND Benefits/Opportunities
Risks:
• Storms, Climate Events• Infectious Diseases• Harmful Algal Blooms
(HABs) & Other Toxins• Anthropogenic Chemicals• Fisheries Destruction
May 2009
Increased CO2 and Sea Surface Temperature (SST)
• Sea Level Rise & Increased Temperatures & Ocean Acidification
• Extreme Weather
• Human Health Impacts?– Drowning, trauma, migration
– Infectious & Vectorborne Diseases
– Threat to Fisheries & Agriculture, Food Security
– Marine Microbial
• Harmful Algal Blooms (HABs), Other Microbes
– Depression, Mental Illness
– ?”Distal” and Complex Effects
• ?Chemicals, Ocean Acidification, Mixtures, Food Security, etc
• Most Vulnerable are the Developing Nations!
Natural Events/Global Climate Change
Harmful Algal Blooms (HABs)
Florida Red Tide
One Health
Baden, Fleming et al
Microbes & Infectious Diseases
Antimicrobial Resistance (AMR)
and the Environment
• 3GC Resistant E.Coli
– Ingested > 6 Million Swimming Sessions in England
& Wales in 2012 (Leonard 2015)
– Surfers 4x greater risk of Ingestion (Leonard 2017)
Anthropogenic Pollution
Anthropogenic Contamination
–Synthetic Organic Chemicals include:• Metals (Hg)
• Pesticides & Herbicides (DDT), PCBs
• Pharmaceutically Active Compounds
–Characterized by persistence, bioavailability, bio-accumulation, toxicity
–Found in fish, shellfish, birds, marine mammals, human populations
Coastal Populations & Food
Chain
Dr Eric
DeWailly et al
(University of
Quebec)
Anthropogenic Pollution
Mixtures!!! Chemicals, HABs, Microbial Pollution, Climate Change,
Acidification, Ocean Currents, Demographic Change, etc
Seafood Depletion
Benefits & Opportunities:
• Seafood
• Modelling/Forecasting
• Pharmaceuticals & Other Bioactive Compounds & Biotechnology
• Marine Organisms as Biomedical Models
• Ocean Literacy
• Coastal Living/Blue Gym
“Seafood (fish and shellfish harvested from capture fisheries and aquaculture production in marine and freshwater environments) contributes at least 15% of average animal protein consumptionto 2.9 billion people” (Smith 2010)
Seafood Benefits
Growth of Aquaculture/Mariculture
Florida Modeling/Prediction
Florida Red Tide
Improving Predictions
Carvalho 2010
Remedies from the Seas
Current successful examples: – Bryostatin 1 (potent anticancer agent from marine
invertebrate); – Ecteinascidin 743 (potent anti cancer drug from the
Caribbean sea squirt); – Discodermolide (potential anti cancer drug from a
marine sponge)– Brevenal (possible cystic fibrosis agent from Florida
Red Tide brevetoxin natural derivative)
Bourdelais, Baden, Abraham et al
Aplysia (Sea Hare)
Simple Brains Enabled Nobel Award Winning Studies of Memory & Learning
Aquatic Animal Models
Ocean Literacy
Health and
Wellbeing from the
Environment
Rockpool rambles Sailing
Coastal walks
Swimming
Kayaking
Surfing Diving
Bluegym.org.ukBlue Gym = Campaign + Research
Rigorous scientific studies
(Secondary Data, Intervention & Mechanistic studies)
Mike Depledge PhD et al
1999 United States
2005
2006
2012
2007
Oceans & Human Health Centers: Inter-disciplinary Research, Training, Pilot
Projects, Facilities Cores, Shiptime
2017New NSF NIEHS OHH Centers Call!!
- climate change, anthropogenic and microbial pollution, HABs, other…
Europe – a Maritime Continent• 4 seas & 2 oceans
• 91,000km coastline (EU + Norway)
• 50% EU population lives within 50km of coastline
• 50% EU territory underwater
• Trade: 90% external, 40% internal
• 40% World’s Merchant Fleet
• 5.4 M jobs
• GVA > €500 Billion/year
1 EU Blue Growth Strategy: COM(2012)494 final; N McDonough ESF Marine Board
Integrated Maritime Policy
Marine Strategy Framework Directive
Common Fisheries Policy
Blue Growth
REACH Directive(chemicals)
Bathing Water Directive
Floods Directive
Shellfish Waters Directive
EU Climate and Energy Package
EU Biodiversity Strategy 2020
Water Framework Directive
Habitats & Birds Directives
Stockholm Convention (POPs)
EU Aquaculture Strategy
London Convention (Dumping at Sea)
Convention on Biological Diversity
EU Strategies, Policies and Directives
EU Blue Growth Strategy
Blue energy
Aquaculture
Maritime tourism
Marine mineral resources
Marine biotechnology
Goal to reach 7 million jobs by 2020 with 5 Sectors
36 Member Organizations from 19 European countries
Moore, McDonough et al 2014
EMB Position Paper 19 (2014). Linking Oceans and Human Health: A Strategic
Research Priority for Europe.
“…many of our perceptions of the relationships between the marine environment and human health are limited and still relatively unexplored,
leaving critical knowledge gaps for those
seeking to develop effective policies for the sustainable use of marine resources and environmental and human health protection.”
Rome Declaration GoalsOct 2014
1. Valuing the ocean
2. Capitalizing on European leadership
3. Advancing ocean knowledge
4. Breaking barriers
“A coordinated, cross-disciplinary and integrated programme on Oceans and Human Health, targeted at understanding and managing the risks and benefits to human physical and mental wellbeing from interactions with the seas.”
ANNEX BG-06-2017: Interaction between people, oceans and seas: a strategic approach towards
healthcare and well-being (2016/2017)
€2M CSA in Oceans and Human Health:
• Multi-stakeholder Forum
• Solutions & interventions
• Professional skills & competences Blue Economy
• Global cooperation
• Strategic Research Agenda for Europe
Dr Will Stahl-Timmins
Prof Michael Depledge
The tide is turning
Linking Oceans and Human Health: A Strategic Research Priority for Europe. European Marine Board, www.marineboard.eu;
Oceans and Human Health (2014). Edited by R.E. Bowen, M.H. Depledge, C.P. Carlarne and L.E. Fleming. Wiley Blackwell, Oxford, UK.
Rich History of
Oceans & Human Health
Dr Richard Russell (1687– 1759)
Royal Sea Bathing Hospital (Est.1791)
Dr Fortescue Fox
(1934 & 1938 Lancet)
Charlier & Chaineux
(2009) Thalassotherapy
Dr Edouard Delcroix (1891-1973)
Thalassotherapy
Coast & health: Main pathways
< Stress
> Exercise
> Social
> Environ.
?
A B C
All 3 rooms are identical (2-3 star, size, furniture, en-suite,
price) except view from the balcony
£47.96£72.85£60.81
Choosing a hotel room…….
Mean Willingness to Pay (per night)
White et al., 2010, J Environ Psych
The effects are strongest in
poorer communities a
aWheeler, White, Stahl-Timmins & Depledge (2012). Health & Place, 18, 1198-1201; bWhite, Alcock, Wheeler & Depledge (2013). Health & Place, 23, 97-103
Self-Reported Health Census Data (England, n = 48 million)
Census Data & Health
Error bars:
95% CI0
0.2
0.4
0.6
0.8
1
1.2
1.4
<1km 1-6km 6-20km 20-50km >50km
Age
sta
nd
ard
ise
d %
of
po
pu
lati
on
w
ith
"go
od
he
alth
"
Home distance to coast
ref
<1km 3 million
1-6km 8 million
Same pattern when people
move home b
Controlling for area:
income, education,
unemployment & crime
Stress reduction from coastal visits
3.90
3.95
4.00
4.05
4.10
4.15
4.20
4.25
4.30
Urban parks Countryside Coast Urban parks Countryside Coast
Str
es
s r
ed
uc
tio
n
All activities (n = 11,680) Walking (n = 5,592)
ref
* p < .05
*
*
ref
*
*
Monitor of Engagement with the Natural Environment [MENE] (Visits n = 11,680)
White, M.P., Pahl, S. Ashbullby, K., Herbert, S.& Depledge, M.H. (2013). Restoration from recent nature visits. Journal of Environmental Psychology, 35, 40-51.
Controlling for: Age, gender, SES, activity type, visit duration, companions, distance travelled & mode of transport
Activity Energy expenditure at the coastline of England
Elliott, White, Taylor,, & Herbert. (2015). Energy expenditure on recreational visits to natural environments. Social Science & Medicine.
* Log-transformed MET minutes (metabolic equivalents of task x duration of leisure visit).
Coasts are associated with the highest energy expenditure via
recreational physical activity.
Basic Experimental
Paradigm
Stressor
T1
Mood
Physio.
T2
Mood
Physio.
Green
Space
Blue
Space
Grey
Space
Lab work: Applied Settings & Different Populations
Dental surgeries (+ VR)(Films, Sounds, +
During Exercise)
White, Pahl, et al
RCT Real Dental Care – 72 patients
Standard Care
Virtual Wembury
*
* p < .05
- Lab findings extend to real
situations (tooth extractions/fillings)
Virtual City
0
0.5
1
1.5
2
2.5
3
3.5
Experienced Pain Recalled Pain
Pa
in
Standard Care City VR Beach VR
*
Tanja-Dijkstra, Pahl, White, Andrade, May, Stone, Bruce, Mills, Melissa Auvrey, Gabe & Moles (2016). The soothing sea: A virtual walk on the coast reduces experienced and recollected pain. Pain
Coast & health: Main pathways
< Stress
> Exercise
> Social
> Environ.
ComplexMixtures?
BlueHealth is funded by the European Union’s Horizon 2020 researchand innovation programme, grant agreement No 666773
BlueHealth: Linking Up Environment, Health and Climate for Inter-Sector Health Promotion and Disease Prevention in a Rapidly Changing
Environment
Project overview
Lora Fleming (UNEXE)
Introducing BlueHealth
An international multi-partner project
BlueHealth Survey
Developing understanding
• Comprehensive pan-European survey
• Administered to 13,000 people in 14 EU countries• All partner countries and Bulgaria,
Czech Republic, Finland, France and Portugal
+ 4,000 in Australia, Canada, California, Hong Kong
• Will shed light on• Physical activities near water
sources• Effects on mental health• Differences between countries
13k+
Ian Alcock, Kat Ashbullby, Debbie Cracknell, Lewis Elliot, Bonny Hartley, Andrea Harvey, Ian Frampton, Sahran Higgins, Amanda Hignett, Julie Hollenbeck, Rebecca Jenkin, Rebecca Lovell, Cassie Phoenix, Karin Tanja-Dijkstra, Tim Taylor, Kayleigh Wyles, BlueHealth Partners
www.ecehh.org.uk
The “Blue Gym” Team
Michael Depledge Ben WheelerSabine PahlLora Fleming
EU Blue Growth Strategy
Blue energy
Aquaculture
Maritime tourism
Marine mineral resources
Marine biotechnology
Goal to reach 7 million jobs by 2020 with 5 SectorsEnvironmental Sustainability+
Risks, Benefits and Opportunitiesto
Human Health & Wellbeing?
Rome Declaration:
“Policy Goal 1: Valuing the Ocean”
1) A coordinated interdisciplinary and integrated programme
on Oceans and Human Health, understanding and
managing the risks and benefits of our interactions with the
seas
2) Advanced and agreed mechanisms for attaching
monetary and non-monetary value systems to marine
ecosystem services and benefits for use in management and
decision-making
3) A major increase in the promotion of ocean education
and literacy, using best practice in communication, training
and social marketing
What do we need now?
Other Recommendations• Broad Definition of Oceans and Human Health
– Ocean Acidification
• Inclusivity, Diversity & Collaboration = Creativity– Oceanographic and Natural Sciences– Medical and Public Health Communities– Social Sciences– Governments, Businesses, NGOs, Communities, Citizens of All Ages– Equality & Access
• Across the Atlantic– Galloway Agreement and others
• Around the World– Hong Kong – Rosas (Girona, Catalunya)
In collaboration with
• Engagement of Stakeholders• + >30 experts: marine biology, medicine/public
health, toxicology, veterinary, nutrition, conservation, anthropology
• Interdisciplinary research• Dissemination & Knowledge exchange• Protection marine environment & health of citizens
Cooperative University-Town-MPAChair of Oceans and Human Health
8.02 - Linking Oceans and Human Health: a new trans-disciplinary research challenge
• Monday 8 May, 8:30 - 10:15, The Arc– OHH Europe Research and Development
– Risks• Red tide aerosols
• AMR
– Benefits/Opportunities• BlueHealth/Blue Gym
• Marine Biogenic Aerosols
– ECR Presentations
Please Come and Participate!
With thanks to my current and future Oceans & Human Health Colleagues, including: T Appleby, G Armbrust, M Austen, L Backer, D Baden, R Barciela, J Benson, E Berdalet, B Bowen, A Boxhall, J Brandão, R Caldwell, C Carlarne, Y Cheng, D Cracknell, K Davidson, M Depledge, J Doyle, S Dupont, W Elliot, S Elmir, H Enevoldsen, E Faustman, M Friedman, R Gabriel, T Galloway, W Gaze, MB Gidley, A Goksøyr, M Gribble, C Hadjichristodoulou, A Harvey, C Hattam, P Hess, P Hoagland,J Hollenbeck, A Ianora, K Irvine, K Jakobsson, C Janssen, B Kirkpatrick, K Kohler, E Laws, E Lewis, J Lloret, L Madson, N McDonough, D McGillicuddy, J Mees, M Moore, S Moore, K Olden, A Ortiz, S Pahl, E Papathanasopoulou, B Reguera, A Reich, K Rein, D Rice, D Sarigiannis, SL Smith, G Nichols, F Regoli, C Sinigalliano, A Smalley, H Solo Gabriele, W Stephan, R Stumpf, N Taylor, T Taylor, R Thompson, M Thorndyke, V Trainer, F Tyson, S Vardoulakis, V Vasconcelos, P Walsh, S Warber, M White, K Wyles, N Young, BlueHealth Partners
Thank You
Funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 666773
@BlueHealthEU
www.bluehealth2020.eu
Thank you
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