Health risks of climate change: an assessment of uncertainties and its implications for adaptation policies.

BACKGROUND: Projections of health risks of climate change are surrounded with uncertainties in knowledge. Understanding of these uncertainties will help the selection of appropriate adaptation policies. METHODS: We made an inventory of conceivable health impacts of climate change, explored the type and level of uncertainty for each impact, and discussed its implications for adaptation policy. A questionnaire-based expert elicitation was performed using an ordinal scoring scale. Experts were asked to indicate the level of precision with which health risks can be estimated, given the present state of knowledge. We assessed the individual scores, the expertise-weighted descriptive statistics, and the argumentation given for each score. Suggestions were made for how dealing with uncertainties could be taken into account in climate change adaptation policy strategies. RESULTS: The results showed that the direction of change could be indicated for most anticipated health effects. For several potential effects, too little knowledge exists to indicate whether any impact will occur, or whether the impact will be positive or negative. For several effects, rough 'order-of-magnitude' estimates were considered possible. Factors limiting health impact quantification include: lack of data, multi-causality, unknown impacts considering a high-quality health system, complex cause-effect relations leading to multi-directional impacts, possible changes of present-day response-relations, and difficulties in predicting local climate impacts. Participants considered heat-related mortality and non-endemic vector-borne diseases particularly relevant for climate change adaptation. CONCLUSIONS: For possible climate related health impacts characterised by ignorance, adaptation policies that focus on enhancing the health system's and society's capability of dealing with possible future changes, uncertainties and surprises (e.g. through resilience, flexibility, and adaptive capacity) are most appropriate. For climate related health effects for which rough risk estimates are available, 'robust decision-making' is recommended. For health effects with limited societal and policy relevance, we recommend focusing on no-regret measures. For highly relevant health effects, precautionary measures can be considered. This study indicated that analysing and characterising uncertainty by means of a typology can be a very useful approach for selection and prioritization of preferred adaptation policies to reduce future climate related health risks.

Quantitative risk assessment of CO2 transport by pipelines--a review of uncertainties and their impacts.

A systematic assessment, based on an extensive literature review, of the impact of gaps and uncertainties on the results of quantitative risk assessments (QRAs) for CO(2) pipelines is presented. Sources of uncertainties that have been assessed are: failure rates, pipeline pressure, temperature, section length, diameter, orifice size, type and direction of release, meteorological conditions, jet diameter, vapour mass fraction in the release and the dose-effect relationship for CO(2). A sensitivity analysis with these parameters is performed using release, dispersion and impact models. The results show that the knowledge gaps and uncertainties have a large effect on the accuracy of the assessed risks of CO(2) pipelines. In this study it is found that the individual risk contour can vary between 0 and 204 m from the pipeline depending on assumptions made. In existing studies this range is found to be between <1m and 7.2 km. Mitigating the relevant risks is part of current practice, making them controllable. It is concluded that QRA for CO(2) pipelines can be improved by validation of release and dispersion models for high-pressure CO(2) releases, definition and adoption of a universal dose-effect relationship and development of a good practice guide for QRAs for CO(2) pipelines.