"I believe that we have a generational responsibility to address the multiple threats of climate change.
Massachusetts needs to be ready, and our plan will make sure that we are."
Deval L. Patrick
Governor of Massachusetts

There is widespread agreement among climate scientists that the Earth’s climate is changing due to human activity. Anticipated changes in climate, including extreme weather events, heat-related illness and an increase in vector-borne diseases, will affect human health and welfare in Massachusetts. Climate change will affect the quality of the air we breathe, the condition of our homes and buildings, the quality and quantity of food and water we consume, and the incidence of vector-borne illnesses.

In January of 2014, the Patrick Administration announced the establishment of a $50 million investment aimed at addressing vulnerabilities due to climate change in public health, transportation, energy and infrastructure. To assess the impact of climate change at the local level, Governor Patrick directed the Massachusetts Department of Public Health (DPH) to identify areas of special concern.

“Climate change will impact every aspect of life in the Commonwealth. The question now is not whether the climate is changing, but how we are going to adapt as a state to the impacts on our economy, public health, and the natural environment." –
State Representative Frank Smizik
Chair of the House Committee on Global Warming & Climate Change

DPH’s Bureau of Environmental Health (BEH) has an overall mission of protecting the public from adverse environmental exposures. As part of this mission, DPH/BEH responds to local environmental concerns and provides Massachusetts communities with epidemiologic and toxicological health assessments. As part of the Patrick Administration’s climate change initiative, DPH/BEH is working with local and municipal health partners and other state and federal agencies to address the environmental and community health impacts of climate change. Below is a summary of ongoing efforts at DPH/BEH.

Climate Change Report to Strengthen Local Health Response to Climate Change

Although the public health infrastructure in Massachusetts is relatively well-established, climate change is expected to increase resource burdens associated with changes in chemical exposure, sanitation, and infectious disease incidence. Recognizing the critical need to adequately prepare for the health impacts of climate change, the U.S. Centers for Disease Control and Prevention (CDC) initiated the Climate Ready States and Cities Initiative (CRSCI) to assess the capacity of state and local health departments to address the consequences of climate change. In 2010, DPH was one of ten state and local health departments awarded a three-year cooperative agreement to conduct a needs and capacity assessment of local boards of health across the Commonwealth.

While climate change is a global problem, evidence strongly suggests that the health effects of climate change will be most evident at the local level. Unlike other states with a more centralized public health infrastructure, the Massachusetts public health system below the state level is organized into local health departments and boards of health, representing each of the 351 cities and towns. The focus of the CRSCI program is to better understand and support the needs of the local health departments to prepare for the health impact of climate change.

In 2013, DPH/BEH conducted a comprehensive survey assessing the capacity of local health departments to address climate change in Massachusetts. The final report provides the results of the survey, as well as recommendations for adapting to climate change. The final report is available here:

Establishing an Agency-Wide Climate Change Advisory Committee

Massachusetts Executive Order No. 484, "Leading by Example - Clean Energy and Efficient Buildings," required state agencies to reduce their consumption of energy derived from fossil fuels, and provide a model for businesses and private citizens. As part of this effort, DPH formed an advisory committee on climate change, co-chaired by Suzanne Condon, Associate Commissioner and Director of BEH, and Andy Epstein, then Special Assistant to former DPH Commissioner John Auerbach. This committee, known as the “Green-Team,” was directed to raise awareness and lead conservation efforts within DPH. Agency-wide staff is organized into sub-groups to specifically address conservation efforts relating to energy use, recycling, public health impacts, and outreach. As part of these efforts, the "Green-Team" encouraged DPH staff to reduce energy (i.e., turn off lights and electronic devices when not in use), and to increase recycling efforts.

Massachusetts Climate Change Adaptation Advisory Committee

In May 2009, the Massachusetts Secretary of Energy and Environmental Affairs (EEA) created the Massachusetts Climate Change Adaptation Advisory Committee, under the authority provided in the state's 2008 Global Warming Solutions Act. The committee was created to study strategies to adapt to climate change and make recommendations to mitigate future effects. The panel included representatives of transportation, built infrastructure, industrial and manufacturing organizations, consumer groups, utilities, conservation groups, and local government. The committee also included experts in public health, insurance, forestry, agriculture, and public safety. DPH/BEH was a key participant in this project and co-chaired the subcommittee on Health and Human Welfare along with the state Department of Environmental Protection. The subcommittee analyzed information on public health infrastructure, vector-borne diseases, heat stress, allergens, respiratory and cardiovascular disease, extreme weather, indoor and outdoor air quality, water quality and sanitation, agriculture and food systems and information related to vulnerable populations. For each of these areas, the workgroup identified existing resources, vulnerabilities, and adaptation strategies to protect human health. A full copy of the report may be found here.

In 2012, EEA formed an Adaptation Subcommittee to further enhance coordination and communication among state agencies and external stakeholders involved in implementing climate change adaptation recommendations. The Subcommittee is composed of stakeholders from state and federal agencies, municipalities, regional planning agencies, non-governmental organizations and academia. In 2013, the Subcommittee worked on implementing the recommendations from the Adaptation Report, shared information on projects and modeling efforts for vulnerability assessments, and sponsored a climate tools workshop for agency staff.

Participating in Environmental Public Health Tracking Climate Change Activities

In 2003 DPH was awarded funds from the CDC to establish an Environmental Public Health Tracking (EPHT) program, and an online portal providing access to health and environmental information for all Massachusetts communities. CDC's EPHT Climate Change Content Workgroup is developing national measures to assess public health impacts of climate change. Current efforts include developing a measure for tracking heat related illness/hospitalizations and mortality. The climate change workgroup is also working with the National Weather Service to evaluate the criteria used to issue heat watches, warnings and related advisories.

DPH/BEH has been working with CDC to list climate change measures on the national EPHT tracking network. Such measures include heat-stress related Emergency Department visits and hospitalizations as well as heat-related mortality. The portal will provide over 30 years (1979-2011) of weather data on temperature distribution, heat index, and number of extreme heat days and events. The portal will also provide information on populations vulnerable to heat, including demographic and socioeconomic indicators of vulnerability.

Heat Stress Vulnerability Assessment

In 2010, DPH/BEH was one of five states that participated in the EPHT Academic Partners in Excellence (APEX) project, led by the University of California at Berkeley. The Heat Vulnerability Index (HVI) was created to locate populations with vulnerability to heat in metropolitan areas across the United States. The HVI contains a number of factors related to heat-related illness and death. These factors include: quantity of green space, prevalence of chronic disease (e.g., heart disease, diabetes), and the percentage of residents who are disabled or live alone. The aim of the APEX study was to characterize the health status of potentially susceptible individuals living in heat-vulnerable areas . While additional research is underway, preliminary findings of the study suggest that the HVI metric may be a useful tool to identify vulnerable populations.

Other Climate Change Activities at BEH

Tracking Harmful Algae Blooms (HABs) and Health Impacts

In 2008, DPH/BEH was one of 10 states awarded funding from CDC to conduct harmful algae bloom (HAB) monitoring and surveillance of health impacts. In fresh water bodies HABs are caused by rapidly expanding populations of cyanobacteria (sometimes referred to as blue-green algae), capable of producing toxins harmful to people and animals. In a warming climate, HABs have the potential to rapidly increase in response to higher water temperatures and cyclical growth-promoting nutrient levels.

Incidental ingestion of low-levels of the toxins produced by HABs may cause minor gastrointestinal symptoms, while ingesting higher levels may cause liver or neurological damage. The goal of the project is to prevent exposures to HABs through recreational activities and contamination of food and drinking water. Potential health impacts from HABs are evaluated by collecting and analyzing environmental and health data. During the 5-year project, DPH/BEH collected samples on a weekly basis for a minimum of 12 weeks at five locations across the state per year. DPH/BEH continuously responds to reports of HAB exposure, and collects data on the reported health effects.

Monitoring of Pathogens in Marine Shellfish

As a coastal state, Massachusetts experiences significant variability in both the frequency and magnitude of severe weather events such as storms, flooding, , and hurricanes . As an area rich in freshwater and marine resources, these variations must be monitored to assess their potential impact on public health. As seafood is a major industry in Massachusetts, DPH/BEH has been monitoring the potential impact of climate change on a number of pathogenic marine microorganisms responsible for foodborne illnesses. Notably, DPH has worked in partnership with the Department of Fish and Game, Division of Marine Fisheries (DMF) to address Paralytic Shellfish Poisoning (PSP), a foodborne illness caused by consumption of shellfish that contain a concentrated toxin. Foodborne illnesses may increase in frequency following significant changes in climate (e.g., increases in severe rain fall and flooding). DPH/BEH has been an active participant of an intra-agency working group on foodborne illness control, and has been monitoring changes with support from the U.S. FDA. The FDA provides funding to support the MA Rapid Response Team that investigates foodborne illness outbreaks.

DPH/BEH has also been heavily involved in the surveillance of illness associated with Vibrio parahaemolyticus (Vp), a naturally-occurring bacterium found in warm, shallow brackish waters. Vp is a known human pathogen and a causative agent in foodborne illnesses that result from the consumption of raw oysters. While Vp has traditionally caused illnesses in regions with much warmer climates (e.g., Gulf Coast, West Coast), it has recently started to impact Massachusetts. With water temperatures continuing to increase, the frequency of foodborne illnesses associated with Vp has increased. In an effort to best address this emerging public health concern, DPH and DMF developed a Vp Control Plan requiring strict harvest controls for oysters. This Plan is updated annually.

Addressing Indoor Air Quality and Enforcing the State Sanitary Code

As a result of climate change, the frequency and severity of extreme weather events has also increased. It is expected that increases in flooding and damage to homes and buildings will occur. DPH/BEH has been actively working with communities in Massachusetts on how best to respond to these severe weather events. Efforts related to monitoring indoor air quality and sanitation are described below.

DPH/BEH routinely provided training and technical assistance to local boards of health on matters relating to indoor air quality in public buildings. For example, DPH’s technical staff will conduct indoor environmental investigations of schools and other public buildings that will include an evaluation of moisture levels, as well as potential exposure to volatile organic compounds and respirable particulate matter. As a result of an increased frequency of severe weather events, DPH’s technical staff has participated in regional planning exercises to prepare for flooding of habitable structures in Massachusetts. For example, in response to flooding events in March 2010, DPH/BEH provided technical information to local boards of health on best-practices for cleaning or remediating mold contamination.

Following an extreme weather event, DPH/BEH staff is also responsible for the protection of public health through the enforcement of the State Sanitary Code’s housing regulations. As part of this regulatory responsibility, staff will work with the community on a number of environmental health matters relating to education, technical consultation, and enforcement of public health regulations . BEH staff has worked with local health officials to assist in the enforcement of 105 CMR 410.000: Minimum Standards for Fitness for Human Habitation and to ensure that the appropriate actions were taken to remediate water-damaged building materials, including mold contamination.

Additional Information on Climate Change

This information is provided by the Bureau of Environmental Health within the Department of Public Health.