A new study in PNAS links global warming with an increase in cases of nephrolithiasis. From one of the many press releases: UK Telegraph
Researchers say that as temperatures rise, the driest parts of the US could see a 30 per cent increase in kidney stone disease…warmer temperatures could extend America’s existing “kidney stone belt”, an area of the South East where men have been found to be twice as likely to develop kidney stones as in the North East.
Margaret Pearle, professor of urology at U of Texas Southwestern is the third author on the paper (but apparently wrote it) and is quoted,
“This study is one of the first examples of global warming causing a direct medical consequence for humans. When people relocate from areas of moderate temperature to areas with warmer climates, a rapid increase in stone risk has been observed. This has been shown in military deployments to the Middle East for instance.
Eric Berger quotes Dr. Paul Epstein of Harvard Medical School as saying the new study is “an elegant piece of work.” He isn’t kidding.
Image copyright PNAS.
There is little doubt about the relationship between kidney stones and weather/climate. That is not the point of this post, most of us are not urologists and have no interest in making light of a very painful experience. However, what is important to us is just how scientists, who do not do climate science as their day job, approach a problem such as this. What are their data sources, explanations for methodology choices, and justification for conclusions? Moreover, do their methods stand up to the same “rigorous” standards of climate scientists so often discussed here at Climate Audit?
The PNAS paper has a nice (and very short) section dedicated to materials and methods, which I will liberally quote/paraphrase for consumption — just make sure not to dehydrate yourself along the way.
Data
GCM’s have shown an increase of about 1 degree C in Mean Annual Temperature (MAT) over the past 30 years. The UN IPCC AR4 model data is chosen (SRESa1b scenario, 850 ppm by 2100), and the annual MAT across the US was determined from the mean of the 19 IPCC SRESa1b scenario GCMs. The expected rises in midcontinent US MAT are on the order of 4-7°C by 2100.
Mean monthly surface air temperatures (TAS) were computed for each model and regridded to a 0.5°x0.5° mesh over North America. To minimize GCM bias, monthly model increments of TAS (model departure from the mean of 20th-century model, 20c3m, results) were determined, and the annual average increment was calculated for each model. These were downscaled to U.S. climate divisions (1–10 of these per state) by using intersection–area weighting, and future TAS values were computed by adding the increment to observed temperature normals (1895–2006) for each division.
When you have coarse atmospheric datasets like the UN IPCC AR4 data and want to combine them in some sort of bias-corrected weighted mean fashion, regridding to finer resolution would seem to add some unwanted artifacts. But, you may settle for knowing about these 1895-2006 climate normals?
The climate normals represent an instrumental record that is effectively population weighted within each division (weather stations are near people) and therefore most closely indicate the temperature experienced by the population. This can be important in areas with significant topographic relief.
I could not find a reference for the above reasoning. Fortunately, the authors provide an example to clear the fog:
Las Vegas, NV, has an observed divisional normal TAS (mean monthly surface air temperature) of 17.4°C. A direct average of SRESa1b TAS for that division at 2050 predicts an unreasonably low 15.4°C, which reflects an average of mountain and desert temperatures. The 2050 mean TAS increment of 2.8°C added to the normal gives a predicted MAT of 20.2°C, more consistent with expected temperatures in the populated desert valleys in that climate division.
That’s it folks. Somewhere in the middle of the paper, they go into uncertainties (couple token sentences) in the UN IPCC climate models but only to say that the other scenarios, A1B and SRESa2, the warming is even more severe (=kidney stones from the Sixth Circle).
But in the next paragraph, it turns out that the current kidney stone dataset is not so good for a variety of reasons. These include undiagnosed, asymptomatic stones, lack of correct documentation of recurring events, or those who just plain don’t go to the hospital. In fact, there could be up to a 35% error in the baseline prevalence of kidney stone disease! See, reconstructing climate records is nothing compared to ascertaining a census of those suffering of kidney stones.
There are of course countless medical conditions that are related to temperature and climate. If this is the first such study connecting possible medical conditions to potential warming, then it surely won’t be the last. The press coverage throughout the mainstream media and blogosphere is clearly adding well-deserved attention to the plight of stone sufferers, perhaps too much.
PS. The SE United States has actually undergone slight cooling over the past century.
It sounds like Hippocrates was expecting this exact situation to develop when he discussed the ethical practice of medicine. An interpretation of one of the points is highlighted in Wikipedia entry with plenty of irony attached:
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. … interpretation … To avoid attempting to do things that other specialists can do better. The “stones” referred to are kidney stones or bladder stones, removal of which was judged too menial for physicians, and therefore was left for barbers (the forerunners of modern surgeons). Surgery was not recognized as a specialty at that time. This sentence is now interpreted as acknowledging that it is impossible for any single physician to maintain expertise in all areas. It also highlights the different historical origins of the surgeon and the physician.
Couldn’t invent a better parallel.
Climate Audit 
49 Comments
To quote another blog: “everybody panic!” Perhaps we could note that millions of people have voluntarily moved to the South/Southwest, in spite of stones.
Where is the press release on how global warming will reduce the number of death’s due to frost bite? I’m sure that is worth thousands of deaths?
Somebody needs to be reminded of what words like “study”, “example”, and “cause” actually mean in the english language.
This is indeed a “study” (Webster defines as “a careful examination or analysis of a phenomenon, development, or question”) though I question how careful they were with their examination. What it is not is an “example” (Webster defines as “an instance serving to illustrate a rule or precept or to act as an exercise in the application of a rule”). For this “study” to be an “example” of “global warming causing a direct medical consequence for humans”, they would have had to actually document an instance where global warming actually HAS caused a direct medical consequence for a human. What they have instead done is speculate. They take instances where humans move from cold to hot climates (nearly instantaneous change) or where troops deploy to a hot environment (also instantaneous change) and project the same consequences without any evidence to support it onto a change expected to occur over the course of a lifetime.
They make no effort to show that global warming has caused anything, and they make no effort to account for the fact that changing one’s environment by 2C over the course of a few days or weeks is very different than changing it by 2C over the course of 50 years. Looks like these guys belong right up there with climate scientists for their rigorous examination of such an unprecedented event in our lives.
Another case of two things appearing to happen coincidentally. There is some warming, I think about 0.6 degrees C over the last century. There also appears to be an increase in kidney stones in that part of the USA. So one must cause the other, right?
Such coincidental studies are of little value and usually cause increased stress in certain parts of the population more than anything else.
Holy Shnikees, I live in Salt Lake City, right in the heart of that big red blob. There aren’t any other big red blobs on the map; I’m doomed!
Aaaah! Chest… tight… can’t… breathe… (Oh, wait, wrong symptoms) Back… pain… severe… can’t… move…
Here’s an idea for a paper, low humidity is a contributing factor to dehydration, dehydration is a contributing factor to kidney stones. Data to support my claim? Sorry that’s IP, NA, DOA, FUBR, and any other acronyms I can think of.
All I can seriously say is WOW.
From the UK Telegraph we have:
http://www.telegraph.co.uk/earth/main.jhtml?xml=/earth/2008/07/15/eakidney115.xml
If climate change causes other discomforts could not the net population migration reverse in the US from South to North and thus ending up with fewer cases of kidney stones.
The old urban legend of needing 8 glasses of water a day could be brought out of mothballs to save the day. Are not the scientists saying that increased kidney stones arise because the urine has higher levels of salt? Why would not a citizenry, aware of this problem adapt to mitigate it and avoid (habitual?) dehydration?
A turkey farmer once told me that a turkey is a stupid animal and will drowned in a rainstorm because they are too stupid to protect their nostrils. Now if climate change causes more frequent and intense rainfalls, would not the turkey, left to its own devices, experience more drownings? But as I have been told the turkey is stupid animal.
The text says SouthEast, but the red blob is in the west/southwest… Sorry, but this is just silly on so many levels.
It is funny how all these global warming disasters have happened in the last 10 years.
Except there has not actually been any warming in the last 10 years. Something to think about.
The legend suggests 1 ‘change in linear risk’ of 12%.
I assume this means that instead of having a 1 in a 100 chance of getting a stone (or whatever the real odd actually is) global warming will cause a 1.12 in a 100 chance of getting a stone.
Hardly a change that anyone will notice, unless you are in the business of treating these stones and need to plan for an increased demand.
Having suffered from these little beasties more than once, I feel qualified to make an observation.
If you cut the worst of these kidneys stones in half with a diamond saw — those really nasty stones with the branch-like fingers on them — you will see a series of growth layers that are not unlike the growth rings of a tree.
So what we have here is the possibility for enabling another offshoot branch of climate alarmism science: dendro-climatic urology.
Now, just think of the possibilities for applying Mannian Mathematics to the problem of predicting the future temperatures of the Southeast using dendro-climatic urology!
There are pathology labs all over the Southeast which could supply a very complete distribution of kidney stones for sampling and analysis.
Not only that, the medical community has a strong tendency to keep records. They keep data and records all over the place.
Maybe we can further the existing science of dendro-climatology by hooking it up with the new science of dendro-climatic urology thus killing two birds with one stone!
Global warming and kidney stones seems like it has media staying power. A match made in heaven. A number 1 hit so to speak. Buy shares in lithotripter stocks! I propose the creation and wide distribution of personal lithotripter devices to battle the effects of climate change. It would be prudent to teach children as yound as 5 about the danger of climate change kidney stones.
Finally a way to arouse the public to the dangers of global warming. I mean who wants kidney stones.
If you picked all the nits off this sweater there’d be nothing left, but my fave is “GCM’s have shown an increase of about 1 degree C in Mean Annual Temperature (MAT) over the past 30 years.” And lady, if you consulted the record (surface station rigor notwithstanding), you’d of course discover that the mean increase over the last century was about .6 degree C.
So, the “significance” of this study is not that anything can get peer-reviewed published these days if it has an AGW slant, or that the press will lap it up (if they’ll report an AGW-causes-earthquakes piece by some subtle-as-a-trainwreck grifter, they’re certainly not going to question a fairly sophisticated sophistry by a credentialed medico). The significance is that the AGW bandwagon shows not the slightest indication of a fuel shortage. If climate had this much positive feedback, the Warmers might actually be on to something.
——————
But: As someone who passed three kidney stones in 6 months (long before they could be dissolved by ultra-sound) – peeing blood every time – before going under the knife for a 7-hour urethraplasty, let me tell you – there is no way to add “too much well-deserved attention to the plight of stone sufferers.” The pain is simply indescribable.
It is true that kidney stones do follow a North-South progression. The strange thing is that MS follows the opposite pattern, cold winters = more MS. I have mused many times as to whether the two were linked; i.e. plasm calcium levels implicated in MS.
Autism also seems to have a similar geographic distribution to the map shown.
Gee, do ya think that lifestyle differences between US regions might also play a role?
Brings to mind the old comment, from the 1930s or thereabouts, that observation of the audience at a burlesque theater would lead to the conclusion that striptease causes male pattern baldness.
Since these are medical doctors delving into climate science, are they still bound by the Hippocratic oath?
Relevant is an interpretation of point 5.
Sounds like Hippocrates was expecting this exact situation to arise.
The whole thing is ridiculous, but even if it were true, surely it would be cheaper and more effective to just distribute free water, gator-aid, or whatever in the areas expected to be affected. As opposed to limiting CO2 emissions.
Sadlov, 14: Yeah, that may be a factor. When I lived in hotter climates, I drank much more beer. Maybe beer or whiskey is causing the kidney stones? Or maybe it’s the bugs. Of all the stupid cause/effect, possibly spurious, relationships, this takes the cake!
I would like to see an overlay graph of the “hardness” of the water. In my experience, water in the US Southwest is pretty hard.
Oh, here’s one …
Seems to match up rather well with the incidence of kidney stones. And with more people living longer, it stands to reason you would have more kidney stones since 50 years ago many would have died before they had their first stone who would now live to have one.
Can we trust Wikipedia to be more accurate in this case than in matters of climate?
Hmmm. However, NKUDIC (National Kidney and Urologic Diseases Clearing House – US) reports:
Note the big jump after global warning started to get serious!
I have heard it said that after the human race is nearly wiped out by AGW related catastrophies, the few humans left will be living in stone age conditions. In light of this breathtaking paper, perhaps it will become known as the kidney stone age.
How much money and human effort is being spent on this and similar types of research in to the possible effects of unproved levels of warming, which could have been invested in addressing real world problems? You see it all the time now in all sorts of areas. It is incredibly depressing.
I saw and read many talks about global warming, but as to me mankind will find the right desicions and solve this problem
A quick search reveals this study about Cold-related cardiac mortality in King County, Washington. Part of the abstract is
When can we expect to see the headline “Global Warming Saves Lives”. No doubt there are many other studies out there related to deaths from influenza, hypothermia etc all of which decrease with increasing temperature. I doubt though that any of them would dare to directly link decreasing mortality to AGW.
Personally, given a choice, I’d opt for the kidney stone.
Lots of Brits have moved out to live in Spain where it’s much warmer but I’ve not heard of them getting more kidney stones.
Kidney stones take years to develop. I don’t see the study controlling for where the patients lived while the stones were developing, just where they lived when the stones were discovered.
It reminds me of this paper recently published at PLoS ONE http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0002502
Here is the first sentence of the abstract “The flora of California, a global biodiversity hotspot, includes 2387 endemic plant taxa. With anticipated climate change, we project that up to 66% will experience >80% reductions in range size within a century.”
In both cases they take a projection of non validated computer models as a starting point of their studies. And in the flora article they are brave enough to take the close to 100 years projection as a sort of empirical fact. A projection based on a projection. What is next? This kind of articles belong more to science fiction magazine than to a serious scientific journal.
how do you say in English? If we had ham we could have ham and eggs for breakfast.
In Spanish we say “If granma had wheels she would be a bycicle”
Terry,
Here’s a copy of a response I made to a thread on Watt’s Up recently –
Earlier this year the UK Department of Health and the Health Protection Agency published a report ‘Health Effects of Climate Change in the UK 2008′
It has a whole chapter on heat and cold related deaths from which the following excerpt is taken;
“Despite the increasing temperature, the trend in annual heat-related mortality per million
aged 65+ fell significantly in Scotland and non-significantly in other regions:
South-East England from 258 in 1971 to 193 in 2003
rest of England and Wales from 188 to 93
Scotland from 125 (in 1974) to only 8 in 2003 (p
Dave, your post was cut off by the rogue < sign which causes havoc. Please use the special quicktag above to replace that thing and then the rest of your post won't be cut off.
Oops. My #28 seems to have got mangled – perhaps I put too many links in it. Will try again
“Global warming. Is thereanything it can’t do?!”
(with apologies to Homer Simpson)
Terry #24,
Here’s a copy of a response I made to a thread on Watt’s Up recently
Earlier this year the UK Department of Health and the Health Protection Agency published a report ‘Health Effects of Climate Change in the UK 2008′
It has a whole chapter on heat and cold related deaths from which the following excerpt is taken;
“Despite the increasing temperature, the trend in annual heat-related mortality per million
aged 65+ fell significantly in Scotland and non-significantly in other regions:
South-East England from 258 in 1971 to 193 in 2003
rest of England and Wales from 188 to 93
Scotland from 125 (in 1974) to only 8 in 2003 (p
Dang – Third time lucky?
Terry #24,
Here’s a copy of a response I made to a thread on Watt’s Up recently
Earlier this year the UK Department of Health and the Health Protection Agency published a report ‘Health Effects of Climate Change in the UK 2008′
It has a whole chapter on heat and cold related deaths from which the following excerpt is taken;
“Despite the increasing temperature, the trend in annual heat-related mortality per million
aged 65+ fell significantly in Scotland and non-significantly in other regions:
South-East England from 258 in 1971 to 193 in 2003
rest of England and Wales from 188 to 93
Scotland from 125 (in 1974) to only 8 in 2003
Winter temperatures tended to rise and the trend in cold-related mortality per million
aged 65+ fell in all regions
South-East England from 9,174 to 5,903
rest of England and Wales from 9,222 to 6,088
Scotland from 9,751 in 1974 to 6,166 in 2003.”
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publications
Needless to say the UK Guardian ran a story about the report under the headline ‘Climate change soon could kill thousands in UK says report’ and made no mention of the above quoted research included in the report.
http://www.guardian.co.uk/politics/2008/feb/12/greenpolitics.health
I hear you. I’ve had several bouts over the last 20+ years (since I was in my late 20s) of small stones that were all passed normally. But the pain was, well… My older sister has also had them, and three kids. She emphatically told me that the kidney stones were more painful than childbirth, which I’ve heard from many other people. Most of these bouts occurred while I lived in northern Virginia. I moved to Western Washington state in 2002, and had another bout late last year, the worst one yet, but still a passable stone.
re 27
In Quebec French, it is slightly different – “And if my grandmother had wheels, she’d be a trolleybus”
I think this sentence alone exemplifies the sorry state of science these days. Who the hell peer-reviewed that paper ??? Since when does a model “show” anything more than the actual data ??? Intellectual rigor has gone completely out the window. We can make jokes about it, but it is a fact that more and more scientific papers are published every year (more than a million papers, can you imagine?). It’s already obvious that a significant fraction of them are just plain useless (if you’re a regular reviewer, it just jumps in your face). But what is depressing is that more and more seem just plain wrong, and nobody seems to notice or care (meaning the people who should notice and care, like reviewers, for example). The thing is, if you let incompetent scientists gain positions of power and influence (by becoming journal Editors, for example), they will themselves let more incompetent scientists into the system (if only by fear of being surpassed by more competent ones). A particular field can soon become totally corrupted by incompetence (not giving any names here…), in the sense that good scientific practice isn’t followed any more, and lack of rigor becomes endemic.
(apologies to Dylan & the so afflicted)
Francois hits the nail on the head. The Peter Keeting phenomena.
No doubt the correlation between obesity and temperature would look pretty good too. Now, maybe kidney stones and carrying a little too much weight could be interrelated. Who’s a thunk it?
It’s been known for a long time that cold weather is much more of a killer than hot weather.
There was another UK study a few years ago (2000) trying to link traffic emissions to mortality rates which found no link between air pollution and death rates but a clear link between cold snaps and increased number of deaths – typically there would be an immediate spike in deaths from cardiovascular probelms (heart attacks, strokes etc) and a secondary spike a week or so later from pulmonary causes (bronchitis, emphysema etc).
They concluded:
“This showed cold weather associated with 2.77 excess deaths per million during 24 days following a 1°C fall for 1 day, but no net excess deaths with SO2 (mean 28.0 ppb) or CO (1.26 ppm)”.
Note that just a 1°C fall for 1 day was enough to noticeably increase the death rate.
I’ve no doubt at all that warmer weather is better for the UK. (and I’ve not seen any stories of increased kidney stones during this warmer period).
There is also an article out there in cyberspace titled:
Would global warming make us dumber?
I’m sure Gavin would happily tell these folks that nobody would use a GCM for anything smaller than continental scales.
This brings to mind the fact, of which many of those who shun salt are unaware, that the south eastern states’ water does not naturally contain iodine. As a result, generations of southerners developed sometimes huge goiters until they started putting iodine in salt, which stopped the epidemic. If the goiter epidemic resurfaces, global warming can be the culprit.
Adoption Group: Cat Invasion Due to Global Warming
http://www.livescience.com/animals/070606_gw_pets.html
As distressing as it is to see urologists attempting to do the work of climate scientists, one can only be grateful we have not yet experienced the opposite.
And apologies to grandma…
No urologist I’ve consulted has ever mentioned weight as an issue. Not keeping hydrated is the number one cause to the most common stones. Diet is to blame to a lesser extent, but it depends on the type of stone and the individual.
OK, enough on this.