2020 Lancet Countdown report on Health and Climate Change finds Canadians most at risk from extreme heat and air pollution

The Lancet Countdown Report on Health and Climate Change has been a landmark report since its first edition in 2015 (earlier reports are here ) .Compiled by an international team from more than 35 institutions including the World Health Organization and the World Bank, it documents the health impacts of climate change, and discusses the health and economic implications of climate policies. The global  2020 Countdown Report was released on December 2. Along with troubling statistics comes one core message:

“The COVID-19 pandemic and climate change represent converging crises. Wildfires and tropical storms in 2020 have tragically shown us that we don’t have the luxury of tackling one crisis alone. At the same time, climate change and infectious disease share common drivers. Responding to climate change today will bring about cleaner skies, healthier diets, and safer places to live–as well as reduce the risk factors of future infectious diseases.”

The Countdown project produces country-specific reports , with the Canada Briefing written by Drs. Claudel Pétrin-Desrosiers and Finola Hackett, and endorsed by the Canadian Medical Association.  The Canadian briefing presents updated information on two major issues: extreme heat and air pollution. Some highlights:

  • a record 2,700 heat-related deaths occurred among people over the age of 65 in Canada in 2018;
  • there were 7,200 premature deaths related to fine particulate air pollution from human-caused sources in Canada in 2018;
  • the work hours lost due to exposure to extreme heat was 81% higher in 2015-2019 than in 1990-1994 in Canada, with an average of 7.1 million extra work hours lost per year.

Although previous Canadian reports have called for carbon pricing, the 2020 report offers six recommendations which prioritize retrofitting and energy efficiency policies, along with funding for low-emissions transportation and active transportation.  The report also calls for: “…a recovery from COVID-19 that is aligned with a just transition to a carbon-neutral society, considering health and equity impacts of all proposed policies to address the climate and COVID-19 dual crises, directly including and prioritizing the disproportionately affected, including Indigenous peoples, older persons, women, racialized people, and those with low income.”

Courtney Howard, past president  of the Canadian Association of Physicians for the Environment writes “COVID-19 recovery is an opportunity to tackle worsening climate crisis: New report”  (The Conversation, Dec. 3).  The Canadian Medical Association announcement of the report is here ; and the CMA also released a recent survey  of its members, showing that 95% of respondents recognized the impacts of climate change, and 89% felt that  health professionals have a responsibility to bring the health effects of climate change to the attention of policy-makers . The World Health Organization sponsored the survey as part of a global initiative –  the Canadian results will be included  in a global WHO report scheduled for release in January 2021.

Scientists actually DO know how climate change contributes to California’s wildfires

Despite Donald Trump’s off-hand dismissal of climate scientists on his visit to California’s apocalyptic wildfires, there are plenty of scientists who ACTUALLY DO know how climate change contributes to these disasters. Below are some recent examples of this well-established relationship and impacts.  

Climate change is increasing the likelihood of extreme autumn wildfire conditions across California”  appeared in Environmental Research Letters in August. One of the co-authors, Daniel Swain, writes an ongoing blog, Weather West, which chronicles and explains “California weather and climate perspectives” from his perch at the University of California at L.A. Institute of the Environment and Sustainability. The Union of Concerned Scientists have also posted an Infographic: Wildfires and Climate Change, which summarizes trends, impacts and costs, including health costs.

Some mainstream media is giving voice to climate scientists :

 “How Can We Plan for the Future in California?” by transplanted Canadian climate scientist Leah Stokes, appeared in The Atlantic (Aug. 23). She is also interviewed by Democracy Now in “This is climate change : West Coast Fires Scorch Millions of Acres & Blot Out the Sun” (Sept. 10).

 “The Burning  West” special feature compilation of articles from Inside Climate News, which includes “California and Colorado Fires May Be Part of a Climate-Driven Transformation of Wildfires Around the Globe” (Aug. 22) and “10 Days of Climate Extremes: From Record Heat to Wildfires to the One-Two Punch of Hurricane Laura” (Aug. 29 ), and “A Siege of 80 Large, Uncontained Wildfires Sweeps the Hot, Dry West”  (Sept. 9), which catalogues the fire events to date.

“A Climate Reckoning in Fire-Stricken California” in the New York Times (Sept. 10,updated Sept. 14)  

These Are Climate Fires”: Oregon Firefighter Ecologist Says Devastating Blazes Are a Wake-Up Call” in Democracy Now (Sept. 14)

Climate change is worsening California’s hellish wildfires” in Yale Climate Connections (Aug. 24).

California wildfires getting bigger, moving faster than ever” in the Toronto Star (Sept. 10)

Climate grief is burning across the American West” in Wired (Sept. 14)

Wildfire Impact on workers

On the Front Lines: Climate Change Threatens the Health of America’s Workers  was released in July by the Natural Resources Defense Council, and documents the “myriad threats” posed by wildfires, explaining “Increases in wildfires will put more emergency responders and recovery workers in dangerous situations and expose more outdoor and indoor workers to unhealthy wildfire smoke.” The report also explains some of the mental health aftermath and provides dozens of links to scientific research.

Pandemic, Wildfires & Heat Wave: Undocumented Farmworkers Face “Triple Threat” as West Coast Burns” in Democracy Now (Sept. 14).

A Human Tragedy”: Wildfires Reveal California’s Reliance on Incarcerated Firefighters” in Democracy Now (August 25).

In the US West Scorched by Wildfires, We Can Barely Breathe. It’s Going to Get Worse” from the Union of Concerned Scientists (Sept. 14) – an overview which briefly discusses outdoor workers and relies on a 2016 article from Climate Change to conclude: “All told, there are roughly 4.8 million outdoor workers across the western US who are exposed to wildfire smoke in an average year.” 

California Bill Clears Path For Ex-Inmates To Become Firefighters” at NPR (Sept. 11) , describing AB2147 , a Bill which lets prisoners who had worked in California’s prisoner-firefighting program petition the courts to dismiss their convictions after completing their sentences.

Job creation is a co-benefit of reducing air pollution

1.5 million jobs in Canada in 2050 by meeting Net-Zero emissions targets

The Healthy Recovery Plan released by the Canadian Association of Physicians for the Environment (CAPE) on July 14 quantifies the potential health benefits related to improved air quality in Canada, makes detailed recommendations for green recovery stimulus, and estimates the  job creation benefits of those recommendations: notably decarbonization of electricity generation and public transit by 2040, and decarbonization of vehicles, residential and commercial buildings, and healthcare by 2050.  

The report presents original research, conducted for CAPE by Navius Research, which simulated the health benefits of climate actions that meet Canada’s emissions reduction targets, using Health Canada’s own Air Quality Benefits Assessment Tool. Navius estimates that by meeting its climate targets, Canada will save 112,000 lives between 2030 and 2050 due to air quality improvements alone. Navius Research also simulated key economic impacts of an emissions scenario in line with Canada’s climate target of net-zero emissions by 2050, and found that clean jobs could increase from 210,000 full-time equivalent positions in 2020 to 1.5 million in 2050.

U.K. Employers group calls for air pollution reduction as part of a green recovery

Polluted air in the U.K.  is responsible for the loss of 3 million working days each year, according to research commissioned by the British Clean Air Fund, and conducted by CBI Economics, part of the British employers’ group, the Confederation of British Industry (CBI) . Breathing life into the UK Economy quantifies the economic benefits if the UK were to meet air quality guidelines recommended by the World Health Organization (WHO). The report estimates that improved health of workers would translate into a £1 billion gain for the economy in the first year, a £600 million gain to businesses from reduced absenteeism, and a £900 million increase in wages each year. The report also includes estimates for individual urban areas (London, Manchester, Bristol, and Birmingham).  Air pollution is a high profile issue in British politics, with U.K. unions campaigning since 2017 for a legal obligation on employers to address air pollution from their activities.  The Clean Air Fund press release which accompanied the release of the report quotes the CBI position: “Not only is there a clear moral responsibility to address air pollution and the impact it has on human health and the environment, there’s also a striking economic rationale. That is why the CBI has been absolutely clear that a focus on green recovery should be central to our COVID-19 response…. From mass energy efficiency programmes to building new sustainable transport infrastructure, the green economy offers incredible opportunities for the UK. Improving air quality should be a key part of the UK’s journey to net zero.” 

Dangers of air pollution for road workers increases in summer

Asphalt roads make city air pollution worse in summer, study finds “ appeared in The Guardian (Sept. 2), summarizing U.S. research that found a 300% increase in emissions of secondary organic aerosols (SOA) when asphalt was exposed to hot summer conditions. The full academic article appeared in Science Advances in September.  Dr Gary Fuller, air quality expert at Imperial College London is quoted in The Guardian: “We have historically thought of traffic pollution as coming from vehicle exhausts. This has been the focus of policy and new vehicles have to be fitted with exhaust clean-up technologies. ..With heavier and heavier vehicles, the combined total of particle pollution from road surface, brake and tyre wear is now greater than the particle emissions from vehicle exhaust but there are no policies to control this.” Also quoted, Drew Gentner of Yale University and one of the study’s co-authors : “Hotter, sunnier conditions will lead to more emissions. Additionally, in many locations, asphalt is predominantly applied during the warmer months of the year.” Bad news and added danger for construction workers.

A more general discussion of the extent and impacts of pollution was published by  the European Environment Agency (EEA) on September 8. Healthy environment, healthy lives: how the environment influences health and well-being in Europe reports that environmental pollution caused more than 400,000 premature deaths in the EU per year, and 13% of deaths in Europe were the result of environmental pollution, with air pollution the leading cause.  

NRDC report details climate change threats to workers’ health and champions workers’ action

On the Front Lines: Climate Change Threatens the Health of America’s Workers  was released on July 28  by the Natural Resources Defense Council, with input from the BlueGreen Alliance, American Federation of Teachers, Communications Workers of America, and Service Employees International Union in the U.S. (press release here and a blog summary here). The authors analyse the extensive existing literature and include first-hand stories from outdoor and indoor workers to describe the physical, mental health, and wage-related impacts of heat stress, wildfires, drought, floods, hurricanes, and the spread of infectious diseases. Over 200 reports and articles are cited. The report calls for amendments to the Occupational Safety and Health Act in the U.S.- including a federal heat standard – with sufficient budgeting and staff for effective enforcement, with a broader overall call: “Adapting to our new climate means overhauling existing safeguards to respond to an intensified set of occupational hazards; extending occupational health and safety protections to all workers; and ensuring workers have the training, job security, flexibility, and empowerment they need to collectively demand protection from climate change. Because climate disruption is sure to create cascading failures through multiple sectors and to bring some nasty surprises, occupational health and safety activists and professionals must also build a better way to track, analyze, and quickly act on existing and emerging health threats to workers.”

Every worker health and safety accomplishment came about by agitating and organizing

Although the report also calls on legislators, regulators and employers to act, the emphasis is on the role of collective action by workers, noting that “Every worker health and safety accomplishment came about by agitating and organizing.” The report also stresses the need to protect workers’ right to organize: “Legislators at all levels of government must honor the right of workers to a safe and healthy workplace by strengthening and enforcing legal protections for unionization and collective bargaining. To stay safe on the job, workers and their representatives must have adequate knowledge, training, and freedom from retaliation to help shape and improve occupational health programs, refuse hazardous work, report workplace injuries and illnesses, and file complaints with state or federal inspectors.”

Students benchmark the climate change content of curriculum in Canadian medical schools

The Health and Environment Adaptive Response Task Force (HEART)  is a group within the 8,000 member Canadian Federation of Medical Students . Its core purpose is to advocate for improvements in the medical curriculum to include the crucial links between health and climate and environmental change. In January 2020,   HEART released  Canada’s first-ever National Report on Planetary Health Education , meant to establish a benchmark on planetary health education in Canadian medical schools, and to provide schools with best practices and recommendations for improvements. Some of the practical examples cited: incorporating  “the effects of air pollution with respiratory health teaching, discussing climate-related displacement within teaching on refugee and migrant health, and exploring the increasing burden of heat stress on health-care systems. Furthermore, case-based sessions can highlight the effects on specific individuals. Examples could include considering isolated older people at risk of heat stroke or of being in extreme weather events, or discussing the effects of flooding or poor water quality on Indigenous communities.”

The HEART analysis identified the University of Alberta, the Northern Ontario School of Medicine and Dalhousie University as leaders, “where environmental issues are covered at greater length through lectures, assignments and extracurricular opportunities.”  The report is based on survey responses from  “nearly 50 students”  and 10 faculty members representing all 17 Canadian medical schools, and includes brief best practice examples.

The students also published a Commentary in Lancet Planetary Health on January 7   , “Training Canadian doctors for the health challenges of climate change”, which announces their report and aligns themselves with the Fridays for Future youth movement. It also puts their advocacy within the context of  global campaigns by medical students (for example, the International Federation of Medical Students Associations ) and the Call to Action on Climate Change and Health  in Summer 2019 by the Canadian health professionals’ associations, led by the Canadian Association of Physicians for the Environment.