U.K. Committee issues recommendations for heatwaves – including workplace changes

sweating office workerOn July 26, the U.K.’s Environmental Audit Committee published Heatwaves: adapting to climate change,  which examines the developing trend of heatwaves, the responsibility for heatwave protection, how to protect human health and well-being, and effects on  productivity and the economy.  The final statement on conclusions/recommendations states:  “Heatwaves can result in overheating workplaces and lower employee productivity. In 2010, approximately five million staff days were lost due to overheating above 26°C resulting in economic losses of £770 million. Given that extreme temperature events in Europe are now 10 times more likely than they were in the early 2000s, similar losses will occur more frequently. However, some businesses, particularly smaller businesses, do not have business continuity plans in place. The Government should make businesses aware of the developing threat of heatwaves and the economic consequences. Public Health England should also issue formal guidance to employers to relax dress codes and allow flexible working when heatwave alerts are issued. The Government should consult on introducing maximum workplace temperatures, especially for work that involves significant physical effort. Procurement rules should be updated so that schools and the NHS do not spend public money on infrastructure which is not resilient to heatwaves. The Department for Education should issue guidance for head teachers about safe temperatures in schools and relaxing the school uniform policy as appropriate during hot weather. ” At present, there is no set temperature limit for indoor work, (only that buildings be kept at a “reasonable” temperature)  and the government’s 2018 Heatwave Plan makes no mention of employer responsibilities or the dangers of heat stress for workers.

tuc logoSome of the Committee recommendations echo those contained in the  Trades Union Congress publication, Cool it! Reps guide on dealing with high temperatures in the workplace .  It documents examples of heat stress in workplaces, and provides checklists for union representatives in both indoor and outdoor workplaces. The Cool it! guide  recommends that a maximum indoor  temperature be set at  30°C (27°C for those doing strenuous work), and  “ a new legal duty on employers to protect outside workers by providing sun protection, water, and to organise work so that employees are not outside during the hottest part of the day.”  The guide also takes note of the  special circumstances of drivers.

Current heat-related guides and information from the government’s Health and Safety Executive are here.

Heat waves: How well are workers protected ?

construction drinking waterThe heat waves that have gripped much of the world in June and July have also been manifest in Canada, where as many as 70 people died in Quebec (mostly in Montreal), as temperatures stayed at over 40 degrees Celsius with the humidex. Many more are likely to have died, but Health Canada does not keep statistics on heat related deaths. In their July 7  press release  on the topic, the Canadian Association of Physicians for the Environment  quote figures from the Climate Atlas of Canada  which  state:  “Before 2005, Montreal had, on average, 8 days per year with temperatures over 30 degrees C.  With climate change, it is predicted that Montreal will experience more than 50 days per year with extreme temperatures by 2050.” For Toronto, the prediction is for 55 days per year with temperatures over 30 degrees after 2050.

In general, public attention and interventions are normally directed to  the most vulnerable in the population: the aged, chronically ill, homeless and those living alone, as in “Doctors urge population to stay cool after dozens die during heat wave in Central Canada”  in the National Observer   (July 10). But what about workers, who may not have the option to “cool off”?

On July 17, the U.S. advocacy group Public Citizen published  Extreme Heat and Unprotected Workers  , describing the state of regulation in the U.S., current and historical statistics on heat-related illness and death, particularly for construction and farm workers, the likely exacerbation of the situation due to climate change, and making the case for a federal heat stress standard. One example: The report states that from 1992 to 2016, heat killed 783 workers in the U.S. and seriously injured nearly 70,000.  Based on this hard-hitting analysis, Public Citizen, along with United Farm Workers Foundation and Farmworker Justice, joined more than 130 public health and environmental groups in submitting a petition to the U.S.  Occupational Safety and Health Administration, calling for the agency to require employers to protect their workers from heat by imposing mandatory rest breaks, hydration and access to shade or cooled spaces, among other measures.  The report is summarized by  Inside Climate News in “Heat Wave Safety: 130 Groups Call for Protections for Farm, Construction Workers ” .

In a July article  in  Morbidity and Mortality Weekly Report, published by the U.S. Centres for Disease Control (CDC) , researchers recommend using a heat index of 85 degrees F as a threshold for potentially hazardous worker heat stress, rather than the current U.S. standard of 91 degrees F (32.8C).  They base this recommendation on a review of 25 incidents of outdoor occupational heat-related illnesses, including 14 deaths, that were investigated by the U.S. Occupational Safety and Health Administration (OSHA) between 2011 and 2016.  They found a risk of illness at a heat index of just 29.4 C (85 F) –  and 6 deaths happened below 90 degrees F. The authors also noted: “Employers often obtain heat index information from publicly broadcasted weather reports or forecasts that do not necessarily reflect conditions at their work sites.”  Other  recommendations from the article:   “ a comprehensive heat-related illness prevention program should include an acclimatization schedule for newly hired workers and unacclimatized long-term workers (e.g., during early-season heat waves), training for workers and supervisors about symptom recognition and first aid (e.g., aggressive cooling of presumed heat stroke victims before medical professionals arrive), engineering and administrative controls to reduce heat stress, medical surveillance, and provision of fluids and shady areas for rest breaks.”

In Canada, Professor Glenn Kenny of the University of Ottawa is an expert on the effects of heat stress  on older people, and on workers.  Some of the studies on which he has collaborated: “Heat Exposure in the Canadian Workplace” (2010) in the American Journal of Industrial Medicine , in which he points out the strengths and weaknesses of the Threshold Limit Values (TLVs) based upon Wet Bulb Globe Temperature (WBGT), the standard used in most Canadian jurisdictions;  “Do the Threshold Limit Values for work in hot conditions adequately protect workers?”  (2016) ; and   “An evaluation of the physiological strain experienced by electrical utility workers in North America” (2015) in the Journal of Occupational and Environmental Hygiene .

What are the existing heat standards for workers? A fact sheet from The Canadian Centre for Occupational Health and Safety (CCOHS), Temperature conditions: Legislation , provides  a summary chart of Canadian legislation, ranging from Alberta, (which has guidelines only), to Ontario, which  has the most specific standards, set out in clause 25(2)(h) of the Occupational Health and Safety Act   .  Also useful: CCOHS Fact Sheet: Humidex and work  and Thermal Comfort for Office work.  From the Occupational Health Clinics for Ontario Workers (OHCOW) – Humidex Based Heat Response Plan (2014).

In the U.S.,  Occupational Safety and Health Administration (OSHA) maintains a web portal for working in indoor and outdoor heat  and the National Institute for Occupational Safety and Health portal on heat stress   is here.  NIOSH also publishes information on Hazards to Outdoor Workers   which includes heat, sun exposure, vector- borne diseases by ticks, mosquitos, and a separate fact sheet for Lyme disease(none of which have been updated since 2010) .  In February 2016, the NIOSH published  Criteria for a Recommended Standard: Occupational Exposure to Heat and Hot Environments,   which updated the  previous version from 1986.

Occupational health risks created by climate change: U.S. doctors get Guidelines, France releases expert report

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Warmer temperatures have brought the Black-legged tick  to Ontario, bringing an increase of Lyme’s Disease, especially for outdoor workers.

A  Guidance Document was released by the  American College of Occupational and Environmental Medicine in February 2018.  Responsibilities of the Occupational and Environmental Medicine Provider in the Treatment and Prevention of Climate Change-Related Health Problems  (also appearing  in the Journal of Occupational and Environmental Medicine ) is intended to set standards for physicians specializing in workplace health.  The Guidance Document  provides concise and very current information about  the direct physical impacts related to climate change (heat stress and ultraviolet exposure, air quality, and allergic sensitivities) as well as indirect impacts (disaster zone exposure, stress and mental health, and waterborne and vector-borne disease).  Most of this information is not new:  two previous major reports have covered the same ground: The Lancet Countdown Report for 2017,  (which links climate change and specific health conditions for the population at large, not just workers, and which included a report for Canada ), and the landmark U.S . Global Change Research Program report, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment (2016)  .

What is important about this new Guidance Document?  It focuses on the workplace, and sets standards for the role of occupational health physicians which include a responsibility to protect workers.  For example:  “Provide guidance to the employers on how to protect working populations in the outdoors or in the field who are potentially exposed to the extreme temperatures…. Quickly identify employees with acute and chronic cardiovascular and respiratory illnesses within the organization who will be significantly affected by increasing temperature and worsening air quality, an increase in ozone, particulate matter, and high pollen count  ….Provide effective guidance to employers about seasonal activity and address the increasing risk of vector-borne disease among the working population…. Deliver support to the employees at risk for mental illness due to disasters, loss, and migration by providing more comprehensive programs through their employment….  The article concludes with: “ OEM providers are called to be on the forefront of emerging health issues pertaining to working populations including climate change. The competent OEM provider should address individual and organizational factors that impact the health and productivity of workers as well as create policies that ensure a healthy workforce.”

There is also a call to action in a new report from France’s Agency for Food, Environmental and Occupational Health & Safety.  The full expert analysis is available only in French ; an English abstract is here .  The report  predicts the occupational risks associated with climate change, from now till  2050, and identifies the main drivers of change: rising temperatures, changes in  the biological and chemical environment, and a change in the frequency and intensity of extreme events.  What’s new in this report?  It highlights the breadth of impact of climate change, stating that it will affect all occupational risks, except those associated with noise and artificial radiation.  The report also makes recommendations,  urging immediate workplace awareness campaigns and training about the health effects of climate change, with a preventive focus. From the English summary: “The Agency especially recommends encouraging all the parties concerned to immediately start integrating the climate change impacts that are already perceptible, or that can be anticipated, in their occupational risk assessment approaches, in order to deploy suitable preventive measures.”  The full report (in French only):  Évaluation des risques induits par le changement climatique sur la santé des travailleurs  (262 pages) is dated January 2018 but released in April. It was requested by France’s Directorate General for Health and the Directorate General for Labour, to support the country’s 2011 National Adaptation to Climate Change Action Plan (PNACC).

The Lancet measures the impact of climate change on public health, productivity and more

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The Lancet Countdown: Tracking Progress on Health and Climate Change is a global, interdisciplinary research collaboration which has published an annual review since 2016.   The Lancet Countdown’s 2017 Report  tracks 40 indicators across five areas, and concludes that the human symptoms of climate change are unequivocal and potentially irreversible. Of particular interest, Indicator 1.3 states that  “global physical labour capacity in populations exposed to temperature change has decreased by around 5.3% between 2000 and 2016.”  Other alarming statistics:  between 2000 and 2016, the number of vulnerable people exposed to heatwave events has increased by around 125 million; without further action against climate change, over 1 billion people may be at risk of become climate change migrants by the end of the century.  The full report is available here (registration required, free).

In addition to the global report,  the Lancet Countdown produces country-specific reports;  the Briefing for Canadian Policy-makers was  written in partnership with the Canadian Public Health Association.  It  makes several  recommendations for Canadian action, including • Phase out coal-powered electricity in Canada by 2030 or sooner, with a minimum of two thirds of the power replaced by non-emitting sources, and any gap made up by lowest-emitting natural gas technology. Track and cost the health benefits of the transition in Canada and globally; • Develop a National Active Transport Strategy for Canada to coordinate improvements to walking, cycling and transit environments. This should receive priority funding, with healthcare cost savings calculated in order to demonstrate the cost offset of the investments. • Enhance support for telecommuting and telehealth options. Within health systems, gather and analyze data on kilometers, greenhouse gas emissions, air pollution and costs saved by telehealth in order to help drive systems change. • Increase funding for research into the local health impacts of resource extraction, with a focus on impacts on Indigenous populations.• Integrate Health Impact Assessments as a core component of the federal Environmental Assessment process.Lancet_twitter_card_5

Pollution cost Canada $2 billion in Lost Labour Output alone

The June 2017 report, Costs of Pollution in Canada: Measuring the impacts on families, businesses and governments reviews and synthesizes existing studies to produce the most comprehensive assessment of pollution and its costs  in Canada to date. Some quick facts: the cost of climate change-related heat waves in Canada is estimated to have been $1.6 billion in 2015; Smog alone cost Canadians $36 billion in 2015. But the report also provides detailed estimates, organized in three categories: 1.  Direct Welfare Costs: (Harm to health and well-being such as  lower enjoyment of life, sickness and premature death); 2.  Direct Income Costs – (Direct out of pocket expenses for families (e.g. medications for asthma), businesses (e.g. increased maintenance costs for buildings) and governments (remediation of polluted sites); and 3. Wealth impacts.

Direct Welfare Costs of pollution, the most studied and understood,  are estimated as at least $39 billion in 2015, or about $4,300 for a family of four.  The Direct Income Costs   that could be measured amounted to $3.3 billion in 2015, but the study cautions that this many important costs could not be measured, and full impacts on income were likely in the tens of billions of dollars.  In this category, the study estimates  Lost Labour Outputs, using a metric derived from the 2016  OECD study,  The  Economic Consequences of Outdoor Air Pollution.  The OECD estimates outdoor air pollution to cost 0.1% of national GDP, which, when applied to Canada’s  2015 GDP of approximately  $1,986 billion, implies a costs of about $2 billion in lost labour output alone. And finally, Wealth impacts, or costs on value of assets , are said to be the least understood of pollution costs, about which, “We simply do not know how much pollution costs us in terms of lost wealth”.

Costs of Pollution in Canada: Measuring the impacts on families, businesses and governments was prepared by the International Institute for Sustainable Development (IISD), with funding from the Ivey Foundation; the full report is available in English- only. Summaries are in English  and French.Short  videos were derived in cooperation with the Conference Board of Canada to focus on key topics:  e.g. extreme weather, contaminated sites, and smog .