climate change , human health anD well-being in yakutia ©

Resume. The study was designed as a community survey conducted face­to­face with an in­person interview. The 145 subjects living in 8 rural settlements were reviewed. Data presented show that in total the most impressive changes are registered for the following signs: thinner ice on rivers, water and ice in rivers more muddy, the number of sunny days greater, more difficult to predict good weather and beginning of spring, rivers and sea covered with ice later, hunting, fishing, gathering mushrooms and berries is not so successful and quantity of mosquitoes is greater than it has been 5 years ago. Everyday activities of hunters, fishermen and herders living in Yakutia have changed during the last 5 years due to climate change. People living in the central part of Yakutia are affected to a greater extent, which is associated with faster warming. Those changes are supposed to be the sources of the problems with long­term and short­term weather forecast, difficulties to travel along tundra and forest, reindeer grazing, problems with fishing, hunting, gathering mushrooms and berries. Tendencies of infant mortality and morbidity in the studied regions are not associated with climate change and though the morbidity in Yakutia has a tendency to grow both in adults’ and in children’s populations mostly due to increase in prevalence of the diseases of the respiratory, circulatory and digestive system, this fact can hardly be associated with climate change.


InTRODucTIOn
The pattern of average ambient temperature along the timeline of millions of years is known to have the downward trend with fluctuations of incremental range [5].This pattern rather supports the idea that the average temperature can be sometimes higher than it has been previously than the idea of long-term total global warming.It is known that the global trend for the average temperature curve during the last 120-140 years is upward (Fig. 1).
As it is well known, projected climate change-related exposures are likely to affect the health status of millions of people, particularly those with low adaptive capacity, through at least: 1. increases in malnutrition and consequent disorders, with implications for child growth and development; 2. increased deaths, disease and injury due to heatwaves, floods, storms, fires and droughts; 3. the increased burden of diarrhoeal disease; 4. the increased frequency of cardio-respiratory diseases due to higher concentrations of ground-level ozone related to climate change; 5. the altered spatial distribution of some infectious disease vectors.

OBJEcTIVEs Of THE sTuDY
to reveal climate-dependent problems in everyday 1.
activities of people living in rural areas of Yakutia; to analyze the demographic and health status tenden-2.
cies possibly associated with climate change.

MATERIALs AnD METHODs
The study was designed as a community survey conducted face-to-face with an in-person interview by a specialist of the Yakutsk Research Centre.Fig. 2 shows the places where the survey was performed.The total of 145 subjects living in 8 rural settlements (Mytaakh, Magaras, Kujerelyakh, Ert, Asyma, Orto-Surt, Tiksi, Andryushkino) were reviewed.
Of those 145 respondents 15 inhabit Bulunsky, 15 -Nizhnekolymsky and 130 -Gorny uluses.The settlements were situated in two different parts of Yakutia: in its central part and in the northern part.
To be enrolled into the research fishermen, hunters and herders had to meet the following inclusion criteria: belong to any ethnic group, 1.
be a male, 2.
be a herder, fisherman or hunter, 3.
be a resident of the same area for at least 5 years, 5.
sign an informed consent, 6.
The questionnaire consisted of twenty seven questions that the respondent had to answer in a set format.All questions are very simple and closed-ended.The respondent had to pick an answer from a given number of three options.While evaluating the difference of percents of respondents answered "yes" in the northern and central parts of Yakutia the third option -"don't know" -was used as a marker for exclusion of the respondent from calculations concerning this question, so the answers were considered to be di chotomous.To determine the significance of differences a two sided t-test for percents was used (Statistica for Windows ver.6, StatSoft, AX204B521115F60, independent samples).

REsuLTs
The results of the survey are presented in tables 1 and 2.
Data presented in table 1 show that in total the most impressive changes are registered for the following signs: thinner ice on rivers, water and ice in rivers more muddy, the number of sunny days greater, more difficult to predict good weather and beginning of spring, rivers and sea covered with ice later, hunting, fishing, gathering mushrooms and berries is not so successful and quantity of mosquitoes is greater than it has been 5 years ago.
Comparison of answers of the respondents living in the northern and in the central parts of Yakutia makes it possible to conclude that situation in the central part has a more strongly pronounced negative trend (Table 2).Significantly more often respondents' answers "yes" to questions №№ 1, 3, 5, 9, 11, 12, 15, 16, 17, 19, 20, 21, 22, 23, 24, 25, 26 in the central part of Yakutia being compared with greater number of "yes" in reply to only few questions (6,10,13,27)  us really believe in that the influence of climate change on human well-being is more profound in the center of Yakutia.
Trying to find links between climate change and human health and taking into account higher vulnerability of children than adults we compared mortality and morbidity of infants living in the uluses covered by the survey (Table .3).High variability of data, which is obviously the result of influence of other factors (small population mostly), doesn't allow us to assert such a link.
Although the incidence of the diseases associated with climate change is going upward in Yakutia both for children (Table 4) and for adults, and the index of mor-bidity for population of Yakutia is getting higher during the last years (2010-1858.7, 2011-1863.3 per thousand), analysis of data for years 2011-2012 presented by the Federal Supervising Office for Protection of Consumers and Maintenance of Human Well-Being in the Republic of Sakha (Yakutia) and the Federal Center of Hygiene and Epidemiology in the Republic of Sakha (Yakutia) [6] shows that in terms of climate change-related exposures affecting the health status of people [2] the position of Gorny ulus was better than the positions of Nizhnekolymsky and Bulunsky uluses, particularly for infectious and parasite diseases, diseases of the circulatory system and the mortality index.The results of the survey confirm the pattern of the surface air temperature changes over the period 1970-2004, drawn from a subset of about 29,000 data series from 577 studies, where the central and south-ern uluses of Yakutia belong to areas with greater temperature changes (+1-2 °C) than the northern uluses (0.2-1.0 °C) (see Fig. 3, marked with a polygon).
It is known that the northern uluses of Yakutia are inhabited by Natives in greater extent.The prevalence of diseases among the Natives is high, especially for digestive diseases, diseases of the genitourinary system, of the circulatory system, of the respiratory system [3], which fact supposes existing climate change-related exposures affecting the health status.Our results can be interpreted as not supporting this hypothesis.

cOncLusIOns 1 .
Everyday activities of hunters, fishermen and herders living in Yakutia have changed during the last 5 years due to climate change.People living in the central part of Yakutia are affected to a greater extent, which is associated with faster warming.Those changes are supposed to be the sources of the problems with long-term and short-term weather forecast, difficulties to travel along tundra and

Table 1
in the northern part makes Number of answers "yes", "no", don't know" given by 145 inhabitants of Bulunsky, Nizhnekolymsky (both northern) and Gorny (central) uluses of Yakutia

Table 2
Difference between percent of answers "yes" for inhabitants of northern and central uluses of Yakutia

Table 3
Infant mortality and morbidity in uluses, covered by the survey, and in Yakutia in total[3]

Table 4
[1]idence of selected diseases in children aged 0 -14 years in Yakutia in terms of the International Statistical Classification of Diseases and Related Health Problems 10th Revision[1]

. surface air temperature changes over the period 1970-2004. A subset of about 29 000 data series was selected from about 80 000 data series from 577 studies [4]. The polygon shows the points related to Yakutia
forest, reindeer grazing, problems with fishing, hunting, gathering mushrooms and berries.2. Tendencies of infant mortality and morbidity in the studied regions are not associated with climate change and though the morbidity in Yakutia has a tendency to grow both in adults' and in children's populations mostly due to increase in prevalence of the diseases of the respiratory, circulatory and digestive system, this fact can hardly be associated with climate change.