The effects of sea level rise on human health

Bangladesh Global average sea level has already risen by 19 cm since 1900, and is expected to rise by roughly a further 40-62 cm by the end of the century depending on future greenhouse gas emissions. One consequence of sea level rise is that the extreme high sea levels we experience during storms are also increasing. An increase in extreme sea levels has already been observed, and this will continue as overall sea level rises. The most destructive storm surges we experience can be expected to be worse than they were in the past. 

Sea level rise also contributes to the problem of salt water entering drinking water supplies in low-lying coastal areas. This increases the risk of health problems such as high blood pressure in local people who drink the water. Worryingly this can lead to preeclampsia in pregnant women. One of the worst affected countries is Bangladesh.

Salt water intrusion in Bangladesh

Dr Mohammad Hoque, Research Associate at the Department of Civil and Environmental Engineering, and Pauline Scheelbeek, Postgraduate researcher at the Department of Epidemiology and Biostatistics.

According to the World Health Organisation (WHO) guidelines, human consumption of salt should not exceed 5 grams per day. Evidence for the relationship between high/excessive salt intake (mainly due to consumption of processed foods) and cardio-vascular disease, such as heart disease, strokes and high blood pressure, has accumulated rapidly in the last few decades. In pregnant women excessive salt intake can cause gestational hypertension and (pre)eclampsia, the latter being one of the top five causes of direct maternal death.

In rural coastal Bangladesh, people eat few processed foods. However, drinking water in coastal regions has become extremely saline, such that people in the region get on average 50 - 100% of their recommended daily salt intake just from drinking water. Once dietary sodium is added to this, it is not difficult to see that the current salinity levels in drinking water have a significant impact on public health.

Last year, Imperial College found a clear dose response relationship between drinking water salinity and risk of hypertension in pregnant participants in Dacope, meaning that the saltier their drinking water was, the more likely they were to develop hypertensive disorders during their pregnancy.

The affected areas are located in the low-lying deltas of the Ganges, Brahmaputra and Maghna rivers. Given that these deltas range from 1 to 3 metres above mean sea level, they are inundated with water on a daily basis by the tides, which are up to a couple of meters in height. The people in coastal areas live on reclaimed land (polders), protected from high tides by embankments 2 to 4 m above the average sea level. The embankments are often overtopped and/or damaged by spring tides or cyclonic storm surges, and when this happens the inland areas are flooded with saline water. These floods contaminate the unprotected drinking water sources which are relied upon by local people.  

BangladeshClockwise from top: The low elevation of Bangladesh, where amsl stands for above mean sea level; land reclaimed by earthen embankment (red line) & sluice gates (yellow circles) in Dacope, southwest Bangladesh; inundation due to embankment damage by cyclone Aila (landfall on 27/05/ 2009). The damage was still present in 2011 (image date 11/04/2010).  Image Credit: Global Warming Art & Google Earth.

Future sea level rise is likely to increase the height of the twice daily tides in the area as well as the height of the most extreme storm surges. With more than 70% of the coastal population relying on unprotected water sources, such as rivers, canals and specially constructed ponds for their daily drinking water this would further increase the excessive salt intake and the associated health problems in these areas. A one metre of sea level rise would inundate nearly 20% of Bangladesh and may make millions of people homeless.

The Departments of Epidemiology, and Civil & Environmental Engineering at Imperial College London are collaborating with the Department of Geology, University of Dhaka and the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) in a field study of the impact of drinking water salinity on population health. As well as seeking to understand the controls on salinity in drinking water sources, they are also looking at adaptation measures, particularly in response to anticipated impacts of climate change.

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Field experiment site at a drinking water pond in Dacope, coastal Bangladesh. A platform was constructed in the pond which held the rain gauge and evaporation pan, along with access to monitoring tubes for the pond and underlying sediments.  The team are monitoring the rainfall and evaporation, and recording all the abstraction of water from the pond. They monitor the changes in water level, temperature and salinity of the pond and groundwater at 15 minute intervals using automatic logging devices. They also collect water samples regularly to measure the variation of salt concentration over time. Experiments conducted by Mohammad Hoque.

A possible intervention that is currently being investigated by the team is “managed aquifer recharge”. Rainwater and/or pond water is stored in the groundwater during the wet season so that it can be pumped up during the dry season, when salinity levels in conventional sources are usually at their highest. These installations are built by Dhaka University in collaboration with UNICEF. Besides the managed aquifer recharge initiative, various small scale rainwater harvesting projects are also being considered as an alternative for the high saline ponds, rivers and tube wells.

We are also conducting a so-called “intervention trial” whereby we look at the effect on health when people are offered lower-saline water from rainwater or managed aquifer recharge systems. The purpose of this is to find out whether the lower salinity drinking water has the effect of lowering the participants’ blood pressure, and with it the risk of hypertensive disorders and certain cardiovascular diseases.

We recruited all the participants last year and measured their blood pressure and their water sodium and potassium concentrations.  Some of the participants then switched to rainwater or managed aquifer recharge sources after the end of the rainy season last year. We expect the participants given fresher drinking water to have lower blood pressure than they did last year, and compared to those people who continued drinking conventional water sources, suc h as pon ds and tube-wells. In the data analysis other factors that could affect blood pressure, such as physical activity, diet and smoking habits were taken into account as well.

Previous work at Imperial College looked at the effect of salt water intrusion on the health of pregnant women in Bangladesh. The work is summarised in this video

Bangladesh 3The vulnerability of drinking water to salt water intrusion in South East Asia, shown as regions of low, medium and high risk. Bangladesh is one of the most vulnerable countries in the region, along with Vietnam. Image: Mohammad Hoque, Imperial College London. 

The work is funded by the Leverhulme Trust.

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(2) Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analy sis of causes of maternal death: a systematic review. Lancet 2006 April 1;367(9516):1066-74.

(3) Khan, A.E., Ireson, A., Kovats, S., Mojumder, S.K., Khusru, A., Rahman, A. and Vineis, P. (2011) Drinking Water Salinity and Maternal Health in Coastal Bangladesh: Implications of Climate Change. Environmental Health Perspectives 119(9), 1328-1332.