**3. Environmental pollution: air and water**

The effects of air pollution on public health have become increasingly acute, heterogeneous, complex, and unpredictable [9–12]. In recent years, natural disasters such as wildfires and non-natural disasters such as human-made pollution have caused fundamental changes in air quality, leading to special measures and precautions deemed necessary to protect populations from air pollutants [13, 14]. Various effects of air pollution, both in the indoor and outdoor setting, on health include but are not limited to: asthma, chronic obstructive pulmonary disease (COPD), cardiovascular diseases, and an array of pulmonary malignancies [15–18]. Although naturally evolving changes in climate and temperature have some effect on air quality, direct human contribution to air pollution may play and even greater role [19, 20]. For example, humans are thought to be responsible for approximately 95% of all wildfires in California and in Mediterranean Europe [21, 22]. Wildfires diminish air quality by scorching thousands of acres

### *Impact of Climate Change on International Health Security: An Intersection of Complexity… DOI: http://dx.doi.org/10.5772/intechopen.96713*

of land – creating arid, dry, desert like soil, and a deterring vegetative and agricultural growth. Wildfires are only one example of many human activities that contribute to poor air quality [7, 23].

The continued growth of industrial activity, both in the United States and globally, has contributed to a sharp increase in air pollution, especially among the urban areas [24, 25]. This was accompanied by the general decline in measured air quality around the globe [26, 27]. Nowadays, air quality indexes are common in daily weather reporting, in addition to weather alerts for air quality standards [28, 29]. Despite the successful deployment of these largely descriptive and informative measures, much remains to be accomplished. For example, asthma amongst newborns and young children has increased sharply in the recent past [30].

Neville Island, PA is an inland island near Pittsburgh, PA where three major rivers meet, with at the apex of the city's heaviest population density [31]. The island houses more than 50 corporate industrial sites, coal processing facilities, and oil company foundries. The pollutants from these companies are ingested and breathed by the nearby population of the Allegheny County. During awareness campaigns in 2003, Neville Island was said to pollute river water with as many as 13 toxic chemicals hazardous to human health, reportedly released each night after the closing of the factories. Notably, the island is located just upstream to the County's major water treatment plant. Consequently, a broad range of pollutants (both airborne and non-airborne) find their way directly into the city water systems. Statistically, the County is among the highest in the nation for still births, childhood asthma, COPD, and pulmonary malignancy [31–33].

Historically, governmental regulations pertaining to air pollution tended to represent a more reactive (versus proactive) approach [34–36]. This is not universal, however. For example, the State of California has instituted aggressive standards for vehicle emission regulations. As a result, over a 20-year period there was a 65% decrease in reactive organic gases, and a 54% decrease in oxides of nitrogen [37]. Of importance, these positive changes occurred despite a 22% growth in population and a 38% increase in overall motor vehicle usage throughout the state [23]. There was an associated sharp and well-defined decrease in air pollution related breathing disorders among children. This included favorable changes in terms of asthma and bronchitis, with significant (21%-39%) reductions. With strict and appropriately enforced regulatory standards, a significant decline in adverse consequences of air pollution can clearly be achieved [23].

Still, environmental regulations are still poorly defined and/or neglected in many areas globally. Under such circumstances, countries like China experience a significant number of adverse health effects of air pollution, to the point of the issue becoming one of the most serious national public health threats [38]. Coal-burning power generation is among the leading culprits of air pollution in China [39]. The magnitude of coal-related pollution in China can be appreciated from recent data showing that in 2010, there were more than 10 million tons of fine particles (e.g., diameter under 2.5 μm) released in the Beijing-Tianjin-Hebei region alone [40]. The impact of such massive air pollution on human health and health security (locally, regionally, nationally, and internationally) is truly difficult to grasp. Even more importantly, it has been estimated that the pollution from the approximately 200 coal-fired power plants in the capital region of Beijing-Tianjin-Hebei may be associated with nearly 10,000 premature deaths and approximately 70,000 outpatient visits or hospitalizations during a single calendar year [40–42]. Despite the need for urgent reform at the global level, governments have been slow to act, including the recent unilateral (and hopefully temporary) withdrawal of the United States from the Paris Climate Pact [43].
