World Health Organization issues new air quality standards in response to growing evidence of the health impacts of pollution

On September 22, for the first time in 16 years, the World Health Organization updated its Global Air Quality Guidelines (AQGs) , based on the rapidly growing scientific evidence that air pollutants can effect human health at even lower concentrations than previously understood. WHO’s new guidelines recommend air quality levels for 6 “classic pollutants”: particulate matter (PM), ozone (O₃), nitrogen dioxide (NO₂) sulfur dioxide (SO₂) and carbon monoxide (CO), and also highlight good practices for the management of certain types of particulates for which there is not yet sufficient evidence to set guideline levels (for example, black carbon/elemental carbon, ultrafine particles, particles originating from sand and dust storms). The press release states: “Clean air should be a fundamental human right and a necessary condition for healthy and productive societies. However, despite some improvements in air quality over the past three decades, millions of people continue to die prematurely, often affecting the most vulnerable and marginalized populations.”  The accompanying Fact Sheet provides key statistics, and a report in The Guardian   summarizes some of the most shocking , including:

“Every one of the 100 most populous cities in the world exceeded the new WHO guideline for tiny particle pollution in 2020, according to Greenpeace analysis. This includes Tokyo, Shanghai, New York, Lagos, London, and Delhi, with the latter exceeding the limit by 17 times.”

And what is one of the most dangerous kinds of pollution, even in cities?   “Mortality risk attributable to wildfire-related PM2·5 pollution: a global time series study in 749 locations” is a pioneering study published on September 1 in Lancet Planetary Health. It analyzes data from 749 cities in 43 countries and regions during 2000–16 and concludes that while wildfires are far from the only source of PM 2.5 pollution in cities, the PM 2.5 exposure from wildfires was more deadly, and longer-lasting, than fine particle pollution from other urban sources – probably because of the chemical makeup and smaller size of the particles in wildfire smoke.   

U.S. begins process to set new national heat standard to protect outdoor and indoor workers, communities

Extreme heat is the leading weather-related killer in the U.S..  In recognition of the likelihood of increasing dangers from climate change, U.S. President Biden announced a coordinated, interagency effort on September 20, described in a White House Fact Sheet titled Biden Administration Mobilizes to Protect Workers and Communities from Extreme Heat.  Regarding workers,  the Department of Labor, through the Occupational Safety and Health Administration (OSHA),  will launch a rulemaking process to develop a national workplace heat standard for both outdoor and indoor workers, including agricultural, construction, and delivery workers, as well as indoor workers in warehouses, factories, and kitchens.  This process, which is expected to take years,  will allow for a “comment period” on topics including heat stress thresholds, heat acclimatization planning, and exposure monitoring.  Along with setting the Heat Standard, OSHA will begin a new enforcement initiative which will prioritize heat-related interventions and workplace inspections on days when the heat index exceeds 80°F.  OSHA will also work to formalize a National Emphasis Program (NEP) on heat hazard cases, which will target high-risk industries, hopefully before Summer 2022. Finally, OSHA will form a Heat Illness Prevention Work Group within its  National Advisory Committee on Occupational Safety and Health (NACOSH), which will include a public representative, a  labour representative, and a management representative, along with others.

The initiative is summarized in  “As climate change warms workplaces, Biden directs safety agency to draft heat rules for workers” (Washington Post, Sept. 20)  and in “Extreme Heat Is Killing Workers, So the White House Is Adding Protections” (Vice Motherboard, Sept 23), which describes the regulation in Washington, California and Minnesota, as well as legislation currently under debate in Texas, which would eliminate requirements for 10-minute water breaks every four hours. A new national standard would set minimum levels under which state regulations could not descend.

Medical journals around the world call climate change the world’s leading health risk

The world’s leading medical journals stepped into the climate change debate again with warnings of the dangers of climate change – grounded in health concerns but including concerns for equity, food security, and environmental destruction.  On September 4,  more than 220 leading medical, nursing and public health journals around the world published the same editorial, titled “Call for emergency action to limit global temperature increases, restore biodiversity, and protect health”.

An excerpt:

“Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.  The science is unequivocal; a global increase of 1·5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.

Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this Comment appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.”

The comment continues to state that “Targets are easy to set and hard to achieve”, and calls existing actions “insufficient”.  It calls on governments to  make “fundamental changes to how our societies and economies are organised and how we live. The current strategy of encouraging markets to swap dirty for cleaner technologies is not enough. Governments must intervene to support the redesign of transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more. Global coordination is needed to ensure that the rush for cleaner technologies does not come at the cost of more environmental destruction and human exploitation.” 

The editorial initiative was coordinated by the U.K. Health Alliance. The list of journals in which this statement appears is here, and includes The Lancet, the British Medical Journal,  the New England Journal of Medicine, Occupational and Environmental Medicine, The Journal of Climate Change and Health, and more than 200 other titles.  Canadian participants include the Canadian Journal of Respiratory Therapy and the Canadian Medical Association Journal.    The Canadian Association of Physicians for the Environment (CAPE) did not participate (not having its own journal), but on September 7 issued a echoed the same urgent concerns  in “A vote against fossil fuel subsidies is a vote for our health”.

Climate Scientists sound the alarm in “Code Red” IPCC Report and WMO Atlas of mortality and economic damage

Alongside the continuing disaster of North America’s heat, drought, and wildfires has come Hurricane Ida on the Gulf Coast, U.S. Northeast, even as far as Quebec.  Only 4% of broadcast media in the U.S. linked Hurricane Ida to climate change – preferring to report on the flooding, storm surge, resulting power losses, evacuations, oil spills in the Gulf of Mexico, death and destruction.  Yet with less media attention, scientists worldwide have published recent studies unequivocally linking such weather extremes with climate change and human activity. Notable examples over the summer : 1.  Climate Change 2021: the Physical Science Basis, the first installment of the Sixth Assessment Report (AR6) by the U.N. Intergovernmental Panel on Climate Change (IPCC) Working Group I, 2. The WMO Atlas of Mortality and Economic Losses from Weather, Climate and Water Extremes (1970–2019) released by the World Meteorological Organization on  August 31, and 3. The WMO Air Quality and Climate Bulletin , launched on September 1.

The world’s scientists issue a Code Red warning in the IPCC 6th Assessment

At almost 4,000 pages, the full IPCC report, Climate Change 2021: the Physical Science Basis, is a comprehensive compilation and assessment of the latest research  by the world’s scientists. More readable and less technical: the  Summary for Policymakers , or the official Fact Sheet .  The U.N. press release announcement was accompanied by warnings of the “Code Red”   situation:  irreversible climate-related damage is already underway across the world, and immediate, strong and sustained reductions in emissions of carbon dioxide and other greenhouse gases are urgently needed. The report was summarized widely: for example, in “Global Climate Panel’s Report: No Part of the Planet Will be Spared”  (Inside Climate News, Aug. 9); by Carbon Brief here ;  or by The Guardian here .  

An  analysis of coverage by 17  international newspapers found that Canadian news outlets, with the exception of the Toronto Star, were particularly poor at explaining the IPCC report – as summarized in “When Dire Climate News Came, Canada’s Front Pages Crumpled “ in (The Tyee, Aug. 19).  However, outside of the mainstream media, here are some noteworthy examples of Canadian news coverage:

Climate scientist John Fyfe explains why new IPCC report shows ‘there’s no going back’” (The Narwhal, Aug. 12)

It’s Code Red  for the Climate. Will BC Do Anything about It?” (The Tyee, Aug. 10)

Two blogs by David Suzuki in Rabble.caClimate report shows world pushed to the brink by fossil fuels”  and “IPCC report could be a legal game-changer for climate“(Sept. 1)

“IPCC warns of climate breakdown, politicians warn of each other” (National Observer, Aug. 9)

“U.N. Climate Report scapegoats “human activity” rather than fossil-fuel capitalism”  (Breach Media), which states: “We should welcome the latest IPCC Report for its scientific insight. But we should also understand it as an ideological document that obscures the crucial systemic causes of climate change. For advice on what social forces could push forward climate solutions, readers will have to look beyond the thousands of pages generated by the IPCC.”

Extreme weather disasters caused US$ 3.64 trillion, 2 million deaths between 1970 and 2019

A second new international scientific report is The WMO Atlas of Mortality and Economic Losses from Weather, Climate and Water Extremes (1970–2019), released on  August 31 by the World Meteorological Organization. It aggregates and analyses statistics on world disasters, with continent-level breakdowns. It reports that there were more than 11,000 disasters attributed to weather, climate and water-related hazards between 1970 and 2019, accounting for just over 2 million deaths and US$ 3.64 trillion in economic losses. This represents  50% of all recorded disasters, 45% of related deaths and 74% of related economic losses over the last 50 years. Food for thought for those who say that fighting climate change is too expensive!  

The WMO Atlas includes an extensive discussion of current and new statistical disaster databases, and how they can be used to reduce loss and damage.  It also includes a brief explanation of “attribution research”, which seeks to determine whether disasters are human-caused. ( A recent article in Inside Climate News is more informative on the issue of attribution science, highlighting the research of the World Weather Attribution network, which has already published its findings about the German flooding in July 2021).

Finally, on September 3, the WMO also published the first issue of its  Air Quality and Climate Bulletin ,  highlighting the main factors that influence air quality patterns in 2020 – including a section titled “The impact of Covid-19 on air quality.”   The Bulletin concludes that there is “an intimate connection between air quality and climate change. While human-caused emissions of air pollutants fell during the COVID-19 economic turndown, meteorological extremes fuelled by climate and environmental change triggered unprecedented sand and dust storms and wildfires that affected air quality…. This trend is continuing in 2021. Devastating wildfires in North America, Europe and Siberia have affected air quality for millions, and sand and dust storms have blanketed many regions and travelled across continents.” 

In another section, “Global mortality estimates for ambient and household air pollution”  the new Bulletin states that global mortality increased from 2.3 million in 1990 to 4.5 million in 2019 (92% due to particulate matter, 8% due to ozone). Regionally, present-day total mortality is greatest in the super-region of Southeast Asia, East Asia and Oceania, with 1.8 million total deaths.

Environmental racism in Nova Scotia and calls for changes to Canadian climate change policy

“Environmental Racism and Climate Change: Determinants of Health in Mi’kmaw and African Nova Scotian Communities”  was published in July by the Canadian Institute for Climate Choices. Author  Ingrid Waldron, HOPE Chair in Peace and Health at McMaster University, presents case studies of several communities, based on her nine-year research and advocacy ENRICH project at Dalhousie University.  The article links to the ENRICH Project Map, which locates polluting industries in Nova Scotia, showing the proximity of waste incinerators, waste dumps, thermal generating stations, and pulp and paper mills near Mi’kmaw and African communities. Specific communities described in some detail include historic sites such as the Sydney tar ponds and Africville, as well as lesser-known examples and more current disputes, such as Boat Harbour and the Alton Gas dispute near Shubenacadie.  

These are examples of environmental racism, “the idea that marginalized and racialized communities disproportionately live where they are affected by pollution, contamination, and the impacts of climate change, due to inequitable and unjust policies that are a result of historic and ongoing racism and colonialism.”   Such locations, combined with such “structural determinants” of health as income and employment, come together to make residents more susceptible and sensitive to climate change impacts, and Waldron concludes the article with recommendations for policies to achieve “health equity”.  These include: environmental justice legislation focused on eliminating differential exposure to, and unequal protection from, environmental harms, (such as Bill C-230, the private member’s bill by Lenore Zann). Waldron also states: “ health equity impact assessment must be incorporated into the environmental assessment and approval process to examine and address the cumulative health impacts of environmental racism in Indigenous and Black communities that are outcomes of long-standing social, economic, political, and environmental inequities.”  More broadly, her accompanying blog, states : “To be effective, climate policy must focus on undoing the structural inequities that lead to power imbalances within society and, consequently, differential exposure to climate devastation.”

Global heating, health, earnings, and environmental justice

Most Canadians experienced global heating directly this summer – and in British Columbia, the chief coroner attributed  570 of the 815 sudden deaths during the June extreme heat event to the record-breaking temperatures, as reported by the CBC.   July 2021 was Earth’s hottest month ever recorded, NOAA finds”  (Washington Post, Aug. 13) states that the combined land and ocean-surface temperature in July was 1.67 degrees Fahrenheit above the 20th-century average, with North America  2.77 F above average. The IPCC Report released in August includes long-term temperature trends in its overview of the physical impacts of climate change, and makes dire forecasts for the future.

Health, earnings, and environmental justice

Two new medical articles on the theme of heat and health appeared in the prestigious journal The Lancet, and are summarized in  Extreme heat-caused deaths have jumped 74% in the last 30 yearsin  Axios in August.   

Examining the economic impacts on workers, in mid-August the Union of Concerned Scientists (UCS) released  Too hot to work: Assessing the Threats Climate Change Poses to Outdoor Workers. The UCS report is summarized in  “If we ignore climate change, it will be hell on outdoor workers”  in HuffPost, re-posted by the National Observer on August 24. One of its unique findings: a forecast that  between now and 2065, (assuming no action to reduce global emissions), the exposure to hazardous levels of heat will quadruple, resulting in a potential loss of 10 percent or more of earnings annually for more than 7.1 million US workers.  Economy-wide, this translates into up to $55.4 billion of earnings at risk annually. In Health Costs of Climate Change , published by the Canadian Institute for Climate Choices published in June 2021, the estimate for Canada was that the labour productivity impact of higher temperatures is projected as “a loss of 128 million work hours annually by the end of century—the equivalent of 62,000 full-time equivalent workers, at a cost of almost $15 billion.”   

Too Hot to Work counts farm labourers and construction workers, but also truck drivers, delivery and postal workers, firefighters, police, and forestry workers as outdoor workers. Given that  Black/African American and Hispanic/Latino workers disproportionately comprise many U.S. outdoor occupations, the report highlights the environmental justice aspects of extreme heat . This  environmental justice aspect has been described anecdotally by many articles over the summer – notably, in the poignant text and photos of “Postcard From Thermal: Surviving the Climate Gap in Eastern Coachella Valley” (ProPublica, Aug. 17) , which contrasts the living conditions of the wealthy in California, living relatively unaffected, and the real suffering of the mainly immigrant workers who live close by and work on the farms and as service workers.

Heat, fire, death in British Columbia show us the reality of climate change

The town of Lytton British Columbia became a real-world symbol of climate change for Canada, setting temperature records for three days, reaching 49.6 C (121.1 F) on June 29th — the highest ever recorded in Canada. The next day, the town was virtually destroyed by sudden, irresistible wildfire.  As humans and animals have died in unprecedented numbers across the North American West from the heat, other effects were also recorded – wildfires and their smoke, damage to roads and rail lines,  power outages, destruction of crops, deaths of shellfish, a shortage of emergency responders, and the stress of their work.

Here is a sampling from the cascade of news coverage:   

“For third straight day, B.C. village smashes record for highest Canadian temperature at 49.6 C” (CBC News, June 29)

“Deaths Spike as Heat Wave Broils Canada and the Pacific Northwest” ( New York Times, June 30)

Most homes in Lytton destroyed by catastrophic fire minister says” (CBC, July 1)

“B.C. still a tinderbox as firefighters arrive from other provinces” (National Observer, July 6) – stating that there were 199 active wildfires in B.C. as of July 5 –  13 of which are “wildfires of note”, 5 of which merited evacuation orders.

“Stories of bravery amid ‘unimaginable horror’ of Lytton wildfire” (National Observer, July 8)

“Canadian inferno: northern heat exceeds worst-case climate models” (The Guardian, July 2)

B.C.’s heat wave likely contributed to 719 sudden deaths in a week, coroner says — triple the usual number” (CBC News, July 2) – quoting the Chief Coroner that the province had previously experienced three heat-related deaths in the past three to five years before the heat wave. )

“More than a billion seashore animals may have cooked to death in B.C. heat wave, says UBC researcher” (CBC News, July 5,6)

“B.C. heat wave ‘cooks’ fruit crops on the branch in sweltering Okanagan and Fraser valleys” (CBC News, July 6)

“B.C. Wildfires damaged  key rail lines, backlogging Canada’s freight supply chain”(CBC News, July 8)

“North America has its hottest June on record” (NYTimes, July 7) – “average temperature was more than 2 degrees Fahrenheit higher than the average from 1991-2020″  across North America”

Some Context and discussion:

“Just How Historic Was Western Canada’s Heat Wave? ‘Nothing Can Compare’” (The Tyee, July 3, reposted from Yale Climate Connections) 

“Hundreds died during B.C.’s heat dome. Who is responsible for deaths caused by extreme heat?” (CBC News, July 7) . The article cites a 9-page memorandum by the Vancouver City Planning Commission (VCPC) which makes recommendations to address heat and air quality concerns, with an emphasis on equity and housing concerns for the unhoused and poorly housed.  

“The Future of Fire in Canada” (The Tyee, July 5) by Ed Struzik, a fellow at the Institute for Energy and Environmental Policy at Queen’s University, author of Firestorm, How Wildfire Will Shape Our Future.     

BC’s Municipalities Are Not Economically Ready to Weather Disaster” ( The Tyee, July  7)  

“A Deadly Summer in the Pacific Northwest Augurs More Heat Waves, and More Deaths to Come” (Inside Climate News, July 1)

“The link between extreme weather and climate change” a media brief (June 28) in which Clean Energy Canada compiles links to studies on the topic.

The Limits of Livability (Climate and Health Alliance in Australia, the Canadian Association of Physicians for the Environment, and the WONCA Working Party for the Environment, June 2021) – a report on the smoke impacts on health from forest fires and climate change, with case studies of major recent fires in Australia, Canada and Brazil .

From a workers’ perspective:

“The case for a Youth Climate Corps in Canada” (National Observer, June 1) – Seth Klein includes disaster response as one of the tasks for his proposed Youth Climate Corps, to treat the climate disaster as an emergency.

“Heat wave shows that climate change is a workers rights issue” ( Portside,July 2)

“Heat wave, wildfires underline need for climate action” (NUPGE, July 8) – statement by the National Union for Public and General Employees, whose members are firefighters and disaster workers.

“Orange skies: Biden raising federal pay to fight wildfires”  (AP news, June 30) summarizes the White House press release, “Biden-Harris administration acts to address the growing wildfire threat” (June 30) – addresses a broad range of strategies including increasing firefighter pay (which currently has a start rate of $13US/hour), and converting many seasonal positions to permanent status, acknowledging that wildfires are now an ongoing threat.

 “Constant, compounding disasters are exhausting emergency response” (Circle of Blue, July 6)   referring to the international scene and a call from the United Nations secretary general

“Let the Birds Eat Them’: Crops Shrivel as Heat Wave Hits Washington” (New York Times, July 3) – anecdotal reports of heat experiences, including for farm workers

And from the recent past:

“Hundreds Of Firefighters. 20 Bulldozers. Intentional Burns: Inside Washington’s $328M Push To Break Cycle Of Disastrous Fires” (InvestigateWest, April 16, 2021)

A People’s Framework for Disaster Response: Rewriting the Rules of Recovery after Climate Disasters , a report written by Saket Soni and Andrea Cristina Mercado,  published by Resilience Force in January 2020, takes an environmental justice perspective on the Florida response to hurricanes, with recommendations for victims and exploited disaster recovery workers.

Health impacts of smoke from wildfires call for more preparation as well as more research

Reports of the heat, drought and wildfires in the U.S. this summer are alarming, but Canada is also at risk. Though conditions are not as extreme as the U.S., British Columbia is under a warning for a prolonged heat wave, wildfire evacuations have already begun in Alberta,and Ontario’s wildfires are so much more numerous than normal that Alberta has responded to the province’s appeal for more firefighters. Against this backdrop, the Global Climate and Health Alliance (GCHA) released a report in early June: The Limits of Livability – The emerging threat of smoke impacts on health from forest fires and climate change.  Accompanying the main report are country briefs specific to  Australia , Brazil and Canada.  The  overview report documents the impacts of wildfires, emphasizes how unprepared we are, and warns that governments must act to prepare public health systems for the health impacts of recurring air pollution episodes. Lead author Dr. Frances MacGuire states : “The short term health effects of forest smoke are now well documented but the long term effects of extended exposure are unknown. It is clear that there are significant research gaps in understanding the full health impacts of smoke from increased wildfire risk in a warming world, and on primary and secondary health services.” 

The Country Brief for Canada  provides health statistics about the 2018 B.C. wildfires and the Summer of Smoke around Yellowknife Northwest Territories in 2014. One of the detailed medical papers referenced  is SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic, which appeared in  BMJ Open in 2021. The authors of the Country Brief call for greater urgency to combat climate change, as well as specific calls to 1. Strengthen the pan-Canadian emergency response, 2.  develop easy to understand emergency response plans for residents and communities, and 3.  Tackle inequalities in smoke exposure, including recognition of greater vulnerability of Indigenous people living in remote areas.   

Australia’s disastrous wildfires of 2019/20 resulted in a Royal Commission into National Natural Disaster Management Arrangements (also known as the Bushfire Royal Commission), and much of the Australia Country Brief summarizes the issues covered by the commission – notably, Indigenous practices and knowledge.  (Note that the Terms of Reference for the Commission included firefighter safety and training).  The Brief reports that the  Australian Institute of Health and Welfare has secured funding for a large-scale research project to study the medium-term health impacts of smoke and ash exposure, including mental health, for frontline responders and affected communities.

The Brazil Country Brief  is centred on the role of deliberate fires set for land clearance for agriculture. The Brief calls for a moratorium on deforestation and fires for clearing land, combined with strong supervision.

The high health costs of climate change in Canada, focused on heat stress and air pollution

The Health Costs of Climate Change was released in June by the Institute for Climate Choices, the second in their series on the costs of climate change. This report attempts to quantify how air quality, increased cases of Lyme disease, and heat will impact people’s health, using two different GHG scenarios until the year 2100. The report also discusses broader issues such as the socio-economic factors which determine unequal health results, mental health impacts, impacts on Indigenous culture and food security, and the impacts on health infrastructure.  Results show that Lyme disease will be the least costly of the projected impacts, but air pollution and heat threats will increase dramatically – even under the low-emissions scenario, heat-related hospitalization rates will increase by 21 per cent by mid-century and will double by the end of the century. The labour productivity impact of higher temperatures is projected as “a loss of 128 million work hours annually by the end of century—the equivalent of 62,000 full-time equivalent workers, at a cost of almost $15 billion.”  Unlike most reports which focus on the impacts of heat on outdoor workers only, the report acknowledges the impact on indoor space too, and offers some analysis and cost analysis of the installation of green roofs and shading on manufacturing facilities. It concludes with recommendations for government policy, and includes a 10-page bibliography of Canadian health research.  “Climate change is set to cost Canada’s health system billions”  (The National Observer, June 3) summarizes the report.   

The Lancet publishes a damning review of Trump’s legacy, including damage to occupational health and the environment

A special issue of the prestigious British journal The Lancet was released on February 11, titled Public policy and health in the Trump era, with an Editor’s introduction which captures the broad scope and tone:

“President Biden must contend with the continued COVID-19 pandemic and economic fallout in addition to Trump’s corrosive legacy. Each roll-back from regulation
and every retreat from global cooperation that defined the Trump era has become an action item on a daunting but crucial list: racism, income inequality, immigration
protection, universal health coverage, nutrition, the environment, workplace safety, reproductive rights, antiscience, and isolationism.”

Discussion of  “The environment, workplace, and global climate” starts on page 27, with a list of Trump’s regulatory rollbacks related to air pollution and emissions, and toxic chemicals and occupational hazards. It states that Trump used the Covid-19 pandemic as a “cover” for rollbacks, and comes to some shocking conclusions, based on official data:   “Between 2016 and 2019, the annual number of environmentally and occupationally related deaths increased by more than 22000, reversing 15 years of steady progress”,  and  “The Trump administration’s regulatory rollbacks have increased disease, injury, and death among workers in the USA. Its weakening of mine health and safety standards and mine enforcement programmes has led to increased injury deaths among workers employed in mining, quarrying, and oil and gas extraction .… and increased mortality from coal workers’ pneumoconiosis … Despite rising deaths from work-related silicosis, the administration terminated a silicosis prevention programme launched during the Obama era.”

The Report concludes with a long list of recommendations for Executive Action (which includes rejoining the Paris climate agreement) and for Legislative Action, including: “Implement the Green New Deal, end subsidies and tax breaks for fossil fuels, and ban coal mining and single-use plastics.”  The all- encompassing scope of the review is reflected in these concluding paragraphs:

“The path away from Trump’s politics of anger and despair cannot lead through past policies. President Biden must act for the people, not for the wealthy and the corporations they control. Resources to combat climate change, raise living standards, drop financial barriers to higher education and medical care, meet global aid responsibilities, and empower oppressed communities within the USA must come from taxes on the rich, and deep cuts in military spending…. For health care, overreliance on the private sector raises costs and distorts priorities, government must be a doer, not just a funder—eg, directly providing health coverage and engaging in drug development rather than paying private firms to carry out such functions.”

This report was authored by a Lancet Commission on Public Health and Policy in the Trump Era,  comprised of thirty-three experts from medical, public health and law schools, universities, Indigenous communities, clinical settings, public health agencies, unions, and legislative bodies, in the U.S., the U.K., and Canada. The Commission website states: “Convened shortly after President Trump’s inauguration in 2017, the Lancet Commission on public policy and health in the Trump era, offers the first comprehensive assessment of the detrimental legislation and executive actions during Trump’s presidency with devastating effects on every aspect of health in the USA. The Lancet Commission traces the decades of policy failures that preceded and fueled Trump’s ascent and left the USA lagging behind other high-income nations on life expectancy.”

Tidal wave of climate litigation: cases and trends examined in new report

On January 26  the United Nations Environment Programme and the Sabin Center at Columbia University published Global Climate Litigation Report: 2020 Status Review , revealing a “growing tidal wave of climate cases” which show “how climate litigation is compelling governments and corporate actors to purse more ambitious climate change mitigation and adaptation goals.”

The report states that as of July 1, 2020, at least 1,550 climate change cases have been filed in 38 countries around the world – nearly double the number of cases in the previous report published in 2017, which had documented 884 cases brought in 24 countries. The report summarizes key trends in cases – “ ongoing and increasing numbers of cases relying on fundamental and human rights enshrined in international law and national constitutions to compel climate action; challenging domestic enforcement (and non-enforcement) of climate-related laws and policies; seeking to keep fossil fuels in the ground; claiming corporate liability and responsibility for climate harms; addressing failures to adapt and the impacts of adaptation; and advocating for greater climate disclosures and an end to corporate greenwashing on the subject of climate change and the energy transition.” The report also notes emerging issues in the next five years, including increased attention to attribution studies,  and highlights significant and precedent-setting  cases throughout.

Global Climate Litigation Report: 2020 Status Review is current to July 1, 2020. Since then, at least three more important cases have been decided: 1.  in December 2020, a U.K. coroner ruled that “Air pollution a cause in girl’s death, coroner rules in landmark case” (The Guardian, January 2021); 2. an Appeals court in France overturned an expulsion order against an asthmatic man because he would face “a worsening of his respiratory pathology due to air pollution” in Bangladesh, his home country (the significance described in The Guardian in “Air pollution will lead to mass migration, say experts after landmark ruling” , with more details here). And 3. on January 29, 2021, a Dutch Appeals court brought an end to a case begun in 2008, when it upheld a decision against Royal Dutch Shell petroleum, finding it responsible for multiple oil spills and leaks which poisoned farmland in the Niger Delta. A Reuters report  quotes Friends of the Earth, saying “the ruling exceeded all expectations and marked the first time a multinational had been instructed by a Dutch court to uphold a duty of care for foreign operations.” The case is also summarized in “After 13 years, Justice: Dutch court orders Shell to pay for harm done to Nigerian farmers and in Deutsche Welle in “Dutch Court rules Shell liable for Niger Delta oil spills.

And in the United States, a potentially landmark case of climate liability is underway as of January 2021. According to a summary at NPR the city of Baltimore is presenting its claim for the cost of climate-related damages against more than a dozen major oil and gas companies including BP, ExxonMobil and Shell. According to NPR: “The Supreme Court will announce its decision later this year on the narrow question of whether the Baltimore case should be considered in state or federal court. If the justices decide in favor of the companies and the case proceeds in federal court, it’s possible that the lawsuit will be eventually dismissed without a trial. However, if the justices decide in favor of Baltimore, it is likely that the case will proceed in Maryland state court, which could require the companies in the case to turn over vast troves of documents about their businesses and marketing practices over the decades.” A multitude of legal documents have been compiled since the case began in 2018, and are available at the Sabin Center for Climate Change Law here.

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.

 

Climate change and health in Canada

The Prairie Climate Centre at the University of Winnipeg maintains the Climate Atlas of Canada, and on November 20  launched a new section of their website devoted to climate change and health in Canada.   So far, the webpages provide a general overview of the issues of air quality, diseases, extreme heat, and mental health  – supporteclimate-video.pngd by more detailed  articles – for example,  Climate Change, Air Quality, and Public Health ;  Wildfire Smoke and Health ; and a new 4-minutes video about wildfires, with impactful images which highlight the links between wildfires and mental health,  especially relating to first responders and medical providers.  The Prairie Climate Centre also published the Heat Waves and Health  report, released in August 2019, and now part of the new section.

2019 Lancet Countdown emphasizes climate impacts on children’s health

lancet childrenSince 2016, the prestigious medical journal The Lancet has published an annual report,  Countdown  on Health and Climate Change  .  The 2018 Countdown report focused on  work-related health impacts of climate change, especially heat effects, as summarized in the WCR here . The 2019 edition  just released in early November focuses on the impacts of climate change on the health of children, with this key message: it is possible to limit the global average temperature rise to well below 2ºC, a situation which “would transform the health of a child born today for the better, throughout their lives. Placing health at the centre of the coming transition will yield enormous dividends for the public and the economy, with cleaner air, safer cities, and healthier diets.”

In addition to the global report, the Lancet also publishes country-specific Policy Briefing reports.  The Policy Briefing for Canada  (in French here ) is written in cooperation with the Canadian Medical Association and the Canadian Public Health Association.  The four highlighted results for Canada are:

  1.  “Exposure to wildfires is increasing in Canada, with more than half of the 448,444 Canadians evacuated due to wildfires between 1980 and 2017 displaced in the last decade; lancet wildfires
  2. The percentage of fossil fuels powering transport in Canada remains high, though electricity and biofuels are gaining ground. Fine particulate air pollution generated by transportation killed 1063 Canadians in 2015, resulting in a loss of economic welfare for Canadians valued at approximately $8 billion dollars;
  3. Canada has the third-highest per capita greenhouse gas emissions from healthcare in the world, with healthcare accounting for approximately 4% of the country’s total emissions;
  4. The health of Canadians is at risk due to multiple and varied risks of climate change…… An ongoing, coordinated, consistent and pan-Canadian effort to track, report, and create healthy change is required.”

For each of the four problems, broad policy recommendations are made.

Some of the other countries for which Policy Briefs are available: Australia ;  European Union ; the United Kingdom ; and the United States . Each one reflects the unique challenges of the country concerned.  The full menu of all Country Briefs is here.

The Summer of 2019: Flooding, hurricanes, wildfires and heatwaves

The world has awoken to the real-life manifestations of climate change in 2019, and we have been bombarded with media images of extreme weather disasters.  July 2019 was approximately 1.2°C warmer than the pre-industrial era, according to a summary of international heat waves by the World Metorological Organization (WMO) on August 1.  The WMO also published “Unprecedented wildfires in the Arctic” (July 29) and “Widespread fires harm global climate, environment” on August 29, including information about the Amazon wildfires.   “Global heating made Hurricane Dorian bigger, wetter – and more deadly”  by scientists Michael Mann and Andrew Dessler appeared in The Guardian on September 4  and “Is climate change making hurricanes stall?” at the PBS website  both offer clear summaries of  the climate change connection to the most recent extreme weather disaster the world has seen.

In Canada, flooding was the predominant weather disaster: In a July 2019 press release, the Insurance Bureau of Canada  described the flooding events of April and May and estimated that spring flooding in Ontario, Quebec and New Brunswick caused close to $208 million in insured damage . In the same press release, the IBC advocates that all political parties in the upcoming federal election commit to a National Action Plan on Flooding.  ( The IBC  published Options for Managing the Flood Costs of Canada’s Highest-risk Residential Properties in June,  the result of national consultations with the  Working Group on the Financial Management of Flood Risk, co-chaired by Public Safety Canada and the IBC.  The report is summarized in the IBC press release  and in the National Observer  “Who should bear the financial risk of flooding? Report lays out three options” in the National Observer June 19 .  )

BCclimate-risk-assessmentIn what it calls the first report of its kind in Canada to examine climate risks at the provincial level, the British Columbia government published a Preliminary Strategic Climate Risk Assessment for British Columbia in July 2019. The report evaluates the likelihood of  15 climate risk events and considers their health, social, economic and environmental consequences, concluding that the greatest risks to B.C. are severe wildfire season, seasonal water shortage, heat wave, ocean acidification, glacier loss, and long-term water shortage.  A compilation of  forty-six articles concerning Wildfires is available from the National Observer, and includes “‘Climate change in action:’ Scientist says fires in Alberta linked to climate change” (June 10).

In late June, Healthy Climate, Healthy New Brunswickers: A proposal for New Brunswick that cuts pollution and protects health was released, written  by Louise Comeau and Daniel Nunes. The report describes how climate change will affect the physical and mental health of all New Brunswickers, especially children, seniors, the isolated, and those living on low incomes. The report combines climate projections and existing community health profiles for 16 New Brunswick communities, emphasizing the risks of more intense precipitation, flooding and heat waves.

Extreme Heat in Canada and Beyond: 

heatreportcoverThe Prairie Climate Centre at the University  of Winnipeg released Heat Waves and Health  in August – a brief and practical guide to the health impacts of heat waves, drought and wildfires in Canada. The report predicts future heat waves in Canada, based on data newly updated the Climate Atlas of Canada   .  Previous projections were published as Chapter 4 in the federal government’s 2019 report Canada’s Changing Climate Report :  “Changes in Temperature and Precipitation Across Canada” .

Heat is a much more widespread danger in the United States, with Phoenix Arizona experiencing 128 days at or above 100 degrees Fahrenheit in 2018 –  one of the hottest and fastest-warming cities in the country, according to an article in the New York Times,  “As Phoenix heats up, the night comes alive” . The Times article describes how citizens and workers must re-schedule their lives and their job duties to avoid the killing heat of the day.  Phoenix is also the main focus of a lengthly  article,  “Can we survive extreme heat” in the Rolling Stone (Aug. 27) .

killer-heat-report-cover-thumbnailKiller Heat in the United States: Climate Choices and the Future of Dangerously Hot Days   was released in July by the  Union of Concerned Scientists, directed to a non-technical audience, and includes interactive maps and downloadable date here . The report offers national and regional projections and in Chapter 5, addresses the particular implications for outdoor workers, as well as city and rural dwellers, and those in low-income neighbourhoods. A more technical version of the research appeared as “Increased frequency of and population exposure to extreme heat index days in the United States during the 21st century” in the Open Access journal Environmental Research Communications .

The accuracy and sensitivity of occupational exposure limits to heat is examined in “Actual and simulated weather data to evaluate wet bulb globe temperature and heat index as alerts for occupational heat related illness”. This important article, published in the  Journal of Occupational and Environmental Hygiene in January 2019, analysed the cases of  234 outdoor work-related heat-related illnesses reported to the U.S. Occupational Safety and Health Administration in 2016 and concluded that wet bulb globe temperature (WBGT) should be used for workplace heat hazard assessment. When WBGT is unavailable, a Heat Index alert threshold of approximately 80 °F (26.7 °C) could identify potentially hazardous workplace environmental heat.

Finally, “Can the Paris Climate Goals Save Lives? Yes, a Lot of Them, Researchers Say” in the New York Times (June 5)  summarizes a more technical article which appeared in the journal Sciences Advances on June 5 .  “Increasing mitigation ambition to meet the Paris Agreement’s temperature goal avoids substantial heat-related mortality in U.S. cities”  reviews the literature about heat-related mortality and concludes that achieving the 1.5°C threshold of the Paris Agreement  could avoid between 110 and 2720 annual heat-related deaths in 15 U.S. cities.

New Brunswick launches consultation on industrial emissions – updated

The Government of New Brunswick opposes the federal government carbon tax and maintains a “We can’t afford a carbon tax” page on the government website – which estimates the costs (but none of the benefits) of the federal carbon backstop in effect in the province.  On June 13, New Brunswick introduced its own Made-in-New Brunswick  Regulatory Approach for Large Emitters ,  an output-based pricing system which will cover roughly 50 per cent of greenhouse gas emissions in the province and will require large industrial emitters, including electricity generators, to reduce their greenhouse gas emissions intensity by 10 per cent by 2030.

The CBC summarized the plan and reaction in “Province proposes carbon tax on tiny fraction of emissions from big industrial polluters”  (June 13) . CBC states that the proposed system would tax only 0.84 percent of greenhouse gas emissions from the province’s biggest emitters, such as Irving Oil,  far below the 20 per cent in the existing federal system. However, it covers the same industrial sectors, applies to the same gases and applies the same price scale of $20 per tonne this year, rising to $50 per tonne in 2022.

A Discussion paper , Holding Large Emitters Accountable: New Brunswick’s Output-Based Pricing System  forms the basis of a public comment period about the proposed system, which runs from June 13 to July 12.  One public response has been published by the Ecofiscal Commission in Exception to the Rule: Why New Brunswick’s Industrial Carbon Pricing System is Problematic (June 19) , which contends that under the proposed regulations, “firms can very easily achieve their emissions intensity benchmark, because it will be essentially set to current levels.”

The Conservation Council of New Brunswick reaction was quoted by the CBC, and also states that the proposed regulations are too weak.  Emphasizing the importance of the issue, on June 25 the Council released Healthy Climate, Healthy New Brunswickers: A proposal for New Brunswick that cuts pollution and protects health,  by Louise Comeau and Daniel Nunes. The Council characterizes the report as “the first comprehensive look at how climate change will affect the physical and mental health of all New Brunswickers, but particularly the very young, seniors, the isolated, and those living on low incomes.”  The report combines climate projections and existing community health profiles for 16 New Brunswick communities, emphasizing the risks of more intense precipitation, flooding and heat waves. It includes recommendations for action and attempts to end on a hopeful note. The report is available in English and French versions from this link .

Updates on New Brunswick’s carbon tax:  On July 8, CBC reported “New Brunswick Premier Blaine  Higgs  abandons  planned carbon tax court fight” , which explains that the province will save taxpayers’ money by supporting Saskatchewan’s Supreme Court of Canada challenge to the carbon tax as an intervenor, since Saskatchewan’s arguments are the same as New Brunswick’s.   Also in  July, an historical and political analysis appeared in Policy Options, “ New Brunswick’s timid foray into carbon pricing”, as part of the week-long series , The Evolution of Carbon Pricing in the Provinces .

 

Canadian nurses’ unions issue a call for action on the climate health emergency

Nurses climatechange-cover-368x480The Canadian Federation of Nurses Unions (CFNU) is the umbrella organization representing approximately 200,000 nursing and front-line health professionals in unions across Canada. At their Biennial Convention in Fredricton in June, representatives passed Resolution #3, calling on the CFNU and its Member Organizations: …  to recognize within their position statements that climate change is “a global crisis and health emergency”; …to support sustainable health care practices to reduce greenhouse gas emissions in health care settings; …to “engage with community stakeholders, such as the Canadian Labour Congress, in initiatives and campaigns that raise the public’s awareness about the serious health implications of climate change”; and to call on the federal and provincial governments to undertake the necessary policies to meet Canada’s obligations under the United Nations Framework Convention on Climate Change (the Paris Agreement)….”

Also at the convention, the CFNU released a  discussion paper: Climate Change and Health: It’s Time for Nurses to Act . It is described as “a starting point for for advocacy and leadership”. It summarizes the well-established health impacts related to climate change in the Canadian environment – for example, heat stress, increased allergies and asthma, cardiorespiratory distress from air pollution due to wildfires, Lyme disease. It includes a special focus on mental health and anxiety impacts.  It also highlights three practical examples from  2018 : wildfire smoke exposure in B.C., flooding in Atlantic Canada, and heat waves in Ontario and Quebec.

The report concludes with these six recommendations for nurses:

  1. Work with your employers, unions and associations to reduce emissions and to “green” your workplace.  (sub-recommendations include “Promote the divestment of pension plans from high-emission sectors and the investment in clean technologies and low-emission sectors;”)
  2. Know about climate change science, and help educate patients and the general public about it.  (sub-recommendations include “Campaign for the ecological determinants of health to be included in nursing education to prepare future generations of nurses, who will see the greatest effects of climate change. Nursing education should support a basic level of climate change literacy.”)
  3. Call for meaningful federal and provincial actions to reduce and eliminate climate change-causing emissions to ensure Canada leads the world in implementing its obligations under the UN Framework Convention on Climate Change (The Paris Accord). (Sub-recommendation: Promote transitioning away from fossil fuels towards renewable energy. ….. By investing in renewal energy rather than in fossil fuels we are committing to a healthier future.)
  4. Be aware and plan for the emerging needs of patients resulting from climate change and help them take action to support a healthy planet. (Sub-recommendation: “ Be aware and prepare your workplaces for future influxes of climate refugees coming to Canada. This population may have experienced trauma or extreme environmental conditions and taken risks to enter this country.”)
  5. Be prepared for extreme weather events.
  6. Promote active transportation and local healthy agriculture and food systems to reduce emissions.

Climate-Change-Toolkit-for-Health-Professionals-2019-234x300The Discussion paper was launched as part of a panel which included Dr. Courtney Howard, president of the Canadian Association of Physicians for the Environment.  CAPE issued their latest Call to Action  in February 2019 , in collaboration with the Canadian Medical Association , the Canadian Nurses Association, the Urban Public Health Network , and the Canadian Public Health Association.  On April 30, CAPE released a Climate Change Toolkit for Health Professionals, which is available for download in either English or French , and offers eight stand-alone modules with seven factsheets. Topics include Climate Change Health Impacts Globally and Across Canada; Taking Climate Change Action at Health Facilities ; Preparing for Climate Change in our Communities;  and Engaging in Climate Change as Health Professionals, which highlights, for example,  CAPE’s role in the campaign to phase-out coal in Alberta. As part of their active advocacy campaign, CAPE  makes frequent media statements and was part of the health delegation which met with the federal Minister of Health on June 7 .

Climate change and health: more evidence of the dangers of extreme heat for workers

european health reportThe Imperative of Climate Action to Protect Human health in Europe was released on June 3  by the European Academies Science Advisory Council, urging that adaptation and mitigation policies give  health effects a greater emphasis, as well as proposing priorities for health policy research and data coordination in the EU.   The report also acts as a comprehensive literature review of the research on the present and future health impacts of climate change in EU countries.  It documents studies of direct and indirect health effects of extreme heat, forest fires, flooding, pollution, and impacts on food and nutrition.  Some of these impacts include communicable infectious diseases, mental illness, injuries, labour productivity, violence and conflict, and migration. It identifies the most vulnerable groups as the elderly, the sick, children, and migrating and marginalized populations, with city dwellers at greater risk of heat stress than rural populations.

construction drinking waterHeat as a Health risk for workers:  Although the report doesn’t highlight outdoor workers such as farmers and construction workers as a high risk group, it does weigh in on heat effects on labour productivity for indoor and outdoor workers.   For example,  “Even small increases in temperature may reduce cognitive and physical performance and hence impair labour productivity and earning power, with further consequences for health. Earlier analyses had concentrated on the effects of heat on rural labour capacity, but now it is appreciated that many occupations may be affected. For example, recent analysis by the French Agency for Food, Environmental, Occupational Health and Safety (ANSES 2018) concludes that productivity and health of workers in most business sectors will be affected in European countries by 2050. The effects of indoor high temperatures in terms of altered circadian rhythms were recently reported (Zheng et al. 2019) as part of a broader discussion of the literature on indoor high temperatures and human work efficiency. For temperature rises greater than 2°C, labour productivity could drop by 10–15% in some southern European countries (Ciscar et al. 2018). Meta-analysis of the global literature confirms that occupational heat strain has important health and productivity outcomes.”Canada Post Strike 20160705

Also: “with 1.5°C global temperature change, about 350 million people worldwide would be exposed to extreme heat stress sufficient to reduce greatly the ability to undertake physical labour for at least the hottest month in the year; this increases to about one billion people with 2.5°C global temperature change .”

And also: Hot and humid indoor environments may result in “mould and higher concentrations of chemical substances. Health risks include respiratory diseases such as allergy, asthma and rhinitis as well as more unspecific symptoms such as eye and respiratory irritation. Asthma and respiratory symptoms have been reported to be 30–50% more common in humid houses.”

Calls to improve heat standards for U.S. workers : A report in 2018,  Extreme Heat and Unprotected Workers , stated that  heat killed 783 workers in the U.S. and seriously injured nearly 70,000 between 1992 and 2017. The report was published by  Public Citizen, a coalition of social justice groups and labour unions. They continue to  campaign  for a dedicated federal standard regarding heat exposure – most recently with a  letter to the U.S. Department of Labor on April 26, 2019 which states: we “call on you to take swift action to protect workers from the growing dangers of climate change and rising temperatures in the workplace. …. The Occupational Safety and Health Administration has an obligation to prevent future heat-related injuries, illnesses and fatalities by issuing a heat stress standard for outdoor and indoor workers.”  The campaign is described in   “Worker advocates burned up over lack of federal heat protections” in FairWarning (May 9), with examples of some U.S. fatalities.  Notably, the death of a  63-year-old postal worker in her mail truck in Los Angeles in July 2018  resulted in  H.R. 1299,  the Peggy Frank Memorial Act, which was introduced in the House of Representatives in February 2019 and would require any Postal Service delivery vehicle to include air conditioning within three years. (It has languished in the House Standing Committee on Oversight and Reform since.)

The article also reports that in April,  California released a draft standard: Heat Illness Prevention in Indoor Places of Employment  which, if approved, would make California the first U.S. jurisdiction to cover both indoor and outdoor job sites. The proposed standard would require water and rest breaks for workers when indoor temperatures reach 82 F degrees, with additional requirements when temperatures hit 87 F. It is noteworthy that this is a slow process – even in progressive California, which has had heat protection for farm workers on the books since 2006,  the Advisory Committee leading this initiative has been meeting since 2017, and the draft standard still under consideration has been revised numerous times .

United Nations reports warn of health impacts of climate change, thawing Arctic

geo6 final 2019The Fourth United Nations Environment Assembly (UNEA) convened from March 11 – 15 in Nairobi, Kenya, under the sombre cloud of the crash of Ethiopian Airlines which killed many, including Canadians, on their way to attend the meetings.

The flagship report, produced by 250 global scientists and experts, is the Sixth Global Environmental Outlook, which the UN press release calls “the most comprehensive and rigorous assessment on the state of the environment completed by the UN in the last five years .. warning that damage to the planet is so dire that people’s health will be increasingly threatened unless urgent action is taken.”  It warns that, without such urgent action,  cities and regions in Asia, the Middle East and Africa could see millions of premature deaths by 2050, with pollutants in freshwater systems leading to deaths through increased  anti-microbial resistance, as well as impacts on  male and female fertility and impaired neurodevelopment of children, from endocrine disruptors.  A 28-page  Summary for Policymakers   is available in multiple languages besides English, including French .  GEO6-NA_cover_large

The official documents from the UNEA meetings are compiled here , including the closing press release summary, “World pledges to protect polluted, degraded planet as it adopts blueprint for more sustainable future” .

Other reports relevant to Canada:

1.The Assessment and Data Report for North America is one of the regional reports, all of which are compiled here .

2.  Global Resources Outlook 2019: Natural Resources for the Future We Want    examines the economic benefits and environmental costs of resource use, and finds that all resource sectors combined (including agriculture, mining, forestry ) account for 53% of the world’s carbon emissions. Extraction and primary processing of metals and other minerals  is responsible for 20% of health impacts from air pollution and 26% of global carbon emissions. The report warns that without change,  resource demand would more than double to 190bn tonnes a year, greenhouse gases would rise by 40% and demand for land would increase by 20%.   A summary of the report appeared in The Guardian.

3.   With a forecast even more dire than the 2018  IPCC report, Global linkages: A graphic look at the changing Arctic  warns that even if global emissions were to halt overnight, winter temperatures in the Arctic would still increase 4 to 5°C by 2100 because  of  greenhouse gases already emitted and ocean heat storage. The UNEA report warns of the dangers of thawing permafrost, predicting that by  2050, four million people, and around 70% of today’s Arctic infrastructure, will be threatened.  However, a critique by  the Carbon Brief    disputes this particular conclusion within the UNEA report, and states that  if humanity can mobilize to hit a -2 degrees C target, “future Arctic winter warming will be around 0.5 to 5.0°C by the 2080s compared to 1986-2005 levels, much lower than the 5.0 to 9.0°C values stated in the report.” … “This means that much of the future warming in the Arctic will depend on our emissions over the 21st century, rather than being ‘locked in’, as the report claims.” The Carbon Brief analysis is summarized in The  Energy Mix .

 

Climate change and health: a new call to action for doctors

Two new articles appeared in the January issue of the New England Journal of Medicine, recognizing the health impacts of climate change and the gap in environmental justice. Most frequently cited, sometimes with alarmist headlines, is  “The Imperative for Climate Action to Protect Health” (Jan. 17)  (registration required). The authors state that the World Health Organization may have underestimated the health effects of climate cop24_health_climate_change_reportchange when it predicted in a 2018 report that climate change will kill 250,000 people per year between 2030 and 2050.  The NEJM authors Haines and Ebi state: “We think the impact is more difficult to quantify because there is also population displacement and a range of additional factors like food production and crop yields, and the increase in heat that will limit labour productivity from farmers in tropical regions that wasn’t taken into account, among other factors. ”  They point to the need for investment and policies to promote adaptation to reduce health risks.

The other article in January’s New England Journal of Medicine is an overview of the issue and a more direct call to action for doctors.  ” Climate Change: A health emergency ”   by Drs. Caren G. Solomon and Regina C. LaRocque states:    “Disruption of our climate system, once a theoretical concern, is now occurring in plain view — with a growing human toll brought by powerful storms, flooding, droughts, wildfires, and rising numbers of insect borne diseases. Psychological stress, political instability, forced migration, and conflict are other unsettling consequences. In addition, particulate air pollutants released by burning fossil fuels are shortening human life in many regions of the world. These effects of climate disruption are fundamentally health issues, and they pose existential risks to all of us. People who are sick or poor will suffer the most….As physicians, we have a special responsibility to safeguard health and alleviate suffering. Working to rapidly curtail greenhouse gas emissions is now essential to our healing mission….  The authors’ call to action includes: “working with medical students on climate action, supporting the undergraduate divestment movement, joining forces with like-minded health professionals, and speaking with our legislators. “

In Canada, the Canadian Association for Physicians and the Environment (CAPE)   is leading the way on such education and advocacy – a compilation of their press releases  reveals the broad range of their actions. Most recently, on January 15, CAPE announced  that the Ontario Court of Appeal has granted intervenor status to the Intergenerational Climate Coalition, of which  CAPE is a member, to defend the constitutionality of the federal pricing of climate emissions, challenged by the Ontario provincial government in a case to be heard in April 2019.  Other members of the Intergenerational Climate Coalition are Generation Squeeze,  Saskatchewan Public Health Association, the Public Health Association of BC, the Canadian Coalition for the Rights of Children , and the Youth Climate Lab.  The same group announced in December 2018  that it has intervenor status in the Saskatchewan government’s challenge to the federal carbon tax plan.

UPDATE: 

A February 5 press release states: “Together, representatives from the Canadian Association of Physicians for the Environment (CAPE) , the Canadian Medical Association (CMA)  , the Canadian Nurses Association (CNA), the Canadian Public Health Association (CPHA) and the Urban Public Health Network (UPHN) are calling for action: asking federal parties to recognize that climate change is the greatest public health challenge of the 21st century, and to make climate solutions a priority in the 2019 federal election.”

Dr. Gigi Osler, President of the Canadian Medical Association (CMA) is quoted  : “Climate change is no longer some abstract idea that may harm future generations or people on the other side of the globe; it’s a reality that’s already harming the physical and mental health of Canadians. We cannot afford to treat climate change as a wedge issue. We must treat it as the public health crisis that it is.”

Lancet Report details health impacts of climate change with new estimates re heat impacts on labour

The latest landmark Report of the Lancet Countdown  was released at the end of November 2018, updating the global research on the health impacts of climate change.    The title of the press release reveals the focus : Extreme heat damaging our health and livelihoods and threatening to overwhelm hospitals around the world  . Using new methodology, the report estimates work hours lost to extreme heat: “153 billion hours of work were lost in 2017 due to extreme heat as a result of climate change. China alone lost 21 billion hours, the equivalent of a year’s work for 1.4% of their working population. India lost 75 billion hours, equivalent to 7% of their total working population.” lancet 2018 map heat and labour

Although the 2018 report emphasizes the increasing threats related to heat, it  measures 41 indicators related to disease, air pollution, extreme weather, and addresses economic and social impacts – including food security and climate migration.  Regarding energy, it states “ In 2017, renewable energy provided 10.3 million jobs – a 5.7% increase from 2016. But fossil fuel extraction industries increased to 11 million – an 8% increase from 2016.” The report estimates  deaths from air pollution by source attribution, with coal estimated to account for 16%  of deaths globally.  It also includes a new indicator mapping extremes of precipitation, identifying South America and southeast Asia among the regions most exposed to flood and drought and, on food security, the report points to 30 countries experiencing downward trends in crop yields, reversing a decade-long trend.

In addition to the main global report, national Briefings for Policymakers are provided for the Brazil, China, the EU, India, the Netherlands, Spain, U.K. and the U.S., as well as Canada. An excellent summary of the main report and the Canadian sub-report appears from the Canadian Association of Physicians for the Environment.

The Briefing for Canadian Policymakers  is written in collaboration with the Canadian Medical Association and the Canadian Public Health Association. It provides a Canada-specific view of  health impacts, and makes recommendations: for example, “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 ;…  increase ambition in reducing greenhouse gas emissions and air pollution in Canada and twin this with an emphasis on Just Transition Policies to support an equitable transition for people who work in the fossil fuel industry as the energy economy transforms;…. Apply carbon pricing instruments as soon and as broadly as possible, enhancing ambition gradually in a predictable manner, and integrate study of resulting air pollution-related health and healthcare impacts into ongoing policy decisions.” The report provides Canadian context for  the under-appreciated topic of  “Climate Change, Mental Health and Ecological Grief”, with examples from the Arctic and sub-Arctice: Rigolet, Nunatsiavut, and a study of  the SOS Summer-of-Smoke , when the area around  Yellowknife experienced  prolonged smoke and fire exposure in 2014.

Finally, the global Countdown report warns  that “A lack of progress in reducing emissions and building adaptive capacity threatens both human lives and the viability of the national health systems they depend on, with the potential to disrupt core public health infrastructure and overwhelm health services.”  It points to the growth of health-related advocacy groups , the divestment from fossil fuels, (including by the Canadian Medical Association), and the need for climate change-related training for health professionals.    The Canadian report also addresses this need for training for health professionals, stating:  “A well-trained workforce is required to respond to these challenges. The Canadian Public Health Association’s Ecological Determinants Group on Education has been working to integrate an ecosocial approach into public health education, including facilitating the participation of the Canadian Federation of Medical Students in an International Federation of Medical Students’ Associations initiative which seeks to see climate change and health gain a foothold in curricula by 2020 with fuller integration by 2025.”

The Lancet Countdown: Tracking Progress on Health and Climate Change is a global, interdisciplinary report funded by the Wellcome Trust, and researched through the collaboration of  27 academic institutions and inter-governmental organizations. The full report is here  (registration required).

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

tick_lyme_government of ontario

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 .

Climate change has consequences for mental health in the workplace

Mental Health and Our Changing Climate: Impacts, Implications, and Guidance  is a report released at the end of March by the American Psychological Association, Climate for Health, and ecoAmerica. The goal is to raise public awareness of the issue and to provide “climate communicators, planners, policymakers, public health professionals, and other leaders the tools and tips needed to respond to these impacts and bolster public engagement on climate solutions.”  Although it doesn’t directly address workplace issues, much of the discussion is relevant.  For example, the report catalogues the acute mental health impacts that result from the horror and disruption of natural disasters or extreme weather events such as Hurricane Katrina –  depression,  disrupted social relationships, domestic violence, and heightened intergroup aggression.  The report also highlights women as being at higher risk: “because, on average, women have fewer economic resources than men, women may also be more affected, in general, by the stress and trauma of natural disasters.” (p.39).

Extreme weather and disasters focus attention, but there are also chronic impacts resulting from longer- term climate changes – the key example given is a proven increase in violence and inter-personal aggression associated with higher temperatures.   Certain occupational groups are highlighted for their high risk to climate-related anxiety, including first responders to natural disasters, but also including health care-givers, and those directly employed in natural settings – conservation officers, park rangers.

The final section of the report deals with tips to build resilience at the individual and community level.  It urges that training be provided for first responders so that they can identify and deal with appropriate compassion for the victims of natural disasters.

New U.S. medical consortium forms to bring the message mainstream: climate change is harming our health

Eleven medical societies in the United States, representing over 400,000 medical practitioners, have joined together to form The Medical Society Consortium on Climate & Health .  Their launch document  on March 15  was  Medical Alert! Climate Change is harming our health , directed at the general public to sound the alarm that climate change health impacts are here and now.

The report gives only a nod to the threats in the workplace, given its goal to reach a general audience. It warns that “anyone can be harmed by extreme heat, but some people face greater risk. For example, outdoor workers, student athletes, city dwellers, and people who lack air conditioning (or who lose it during an extended power outage) face greater risk because they are more exposed to extreme heat. People with chronic conditions such as cardiovascular and respiratory diseases, and those who work or play outside, are especially vulnerable to extreme heat.. ..”  The report also touches on the other major health-related impacts, such as spread of infectious diseases borne by ticks and mosquitos, air pollution,  effects of forest fires, polluted air and food, mental health burden, etc.

The Consortium  states that “most physicians are aware of the adverse health effects of climate change and feel a responsibility to inform the public, patients and policymakers about them. A majority of survey respondents report they are already seeing health harms from climate change among their own patients – most commonly in the form of increased cardiorespiratory disease (related to air quality and heat), more severe and longer lasting allergy symptoms, and injuries attributed to extreme weather.”

The goal of the consortium is to educate,  and to advocate for reduced fossil fuel consumption and increased clean energy.  Their website offers a library of publications    related to the growing literature on climate change and health. The website  also compiles resources from their member societies, such as the American College of Physicians and the American Academy of Pediatrics,  about how to green medical workplaces.   In this, they join a number of existing associations such as Practice Greenhealth   and Healthcare without Harm, an international organization with Canadian membership.

In Canada, the Canadian Association of Physicians for the Environment , which was established in 1994,   shares a similar mission for policy advocacy, and maintains an active blog  and Facebook presence.  The Canadian Medical Association has a number of policy and position documents on environmental impacts on health; their most recent policy statement on Climate change and Health  was issued in 2010, yet still seems remarkably relevant.

 

Alberta keeps its options open with renewable energy targets and preliminary approvals for 3 oil sands projects

In addition to a commitment to phase out coal-fired power by 2030, on September 14,  the Government of Alberta announced a firm target to generate 30 per cent of its electricity from renewable sources such as wind, hydro and solar by 2030. The government press release  associates this target with a projection that “at least $10.5 billion in new investment will flow into the provincial economy by 2030. This will mean at least 7,200 new jobs for Albertans as projects are built.” The health benefits of shutting down coal plants are highlighted in Breathing in the benefits: How an accelerated coal phase-out can reduce health impacts and costs for Albertans, a joint report from the Pembina Institute, the Canadian Association of Physicians for the Environment, the Lung Association of Alberta and NWT, and the Asthma Society of Canada, released on September 14.

On September 19,  the government appointed a Task Force, to be chaired by Gordon Lambert,  to make recommendations on targeting investments in climate technology to help transition to a lower-carbon economy. Submissions are invited; a report will be submitted by the end of November, summarizing the findings of the engagement and providing recommendations for a provincial Climate Change Innovation and Technology Framework.  Also underway: an Energy Efficiency Advisory Panel   which was launched in June 2016 (see the Discussion Document here )  and an Oil Sands Advisory Group  .     But not all is renewable in Alberta:  on September 15, the government announced  early stage approval of 3 new oil sands projects, representing “ about $4 billion of potential investment into Alberta’s economy and about 95,000 barrels per day of production”.  The proposed developments will still undergo further environmental reviews and will fall under the oil sands 100 megatonne greenhouse gas emissions limit, announced with Alberta’s Climate Leadership Plan.

Air Pollution and Coal: A Public Health issue around the world

On May 18, the Canadian Association of Physicians for the Environment, along with the Canadian Public Health Association (CPHA), the Heart and Stroke Foundation of Canada, the Registered Nurses’ Association of Ontario (RNAO), the Canadian Lung Association, the Ontario Public Health Association (OPHA)  joined a global call   for the G7 nations to accelerate the transition away from coal­-fired electricity, to bring “ immediate and significant air pollution-­related health benefits and health care savings. A coal phase-­out also slows climate change, thereby reducing current and future illnesses and deaths from heat waves, droughts, malnutrition, flooding, air pollution and wildfires.” The Lung Association of America  recently ranked air pollution in U.S. cities and found that  Bakersfield, California, was the most polluted city for both short-term and year-round particle pollution, while Los Angeles-Long Beach was the worst for ozone pollution.  In the U.K., air pollution was cited as a “public health emergency” in a report published by a Select Committee of the Environment, Food and Rural Affairs Ministry  .  The World Health Organization (WHO)  ranked the world’s most polluted cities on May 12,  with four of the five worst cities in India. WHO surveyed 3,000 urban areas; the data shows only 2 per cent of cities in developing countries have air quality that meets WHO standards, compared to 44 per cent in developed countries. A WHO official also stated, “Probably some of the worst cities … are not included in our list, just because they are so bad that they do not even have a good system of monitoring of air quality, so it’s unfair to compare or give a rank.”

Climate Change and Health, including Mental Health

The U.S. Global Change Research Program released its landmark synthesis report, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment   in April 2016.   Chapter 8,”Mental Health and Well-being”,  states  that mental health risks can be caused by climate-related or weather-related disasters, as well as ongoing anxiety over climate change. Extreme heat exacerbates physical and mental problems.  Groups at highest risk are “children, the elderly, women (especially pregnant and post-partum women), people with pre-existing mental illness, the economically disadvantaged, the homeless, and first responders.” Communities  that rely on the natural environment for sustenance and livelihood or with direct exposure to climate change are also at high risk. For follow-up reading, consult the 13- page list of references at the end of the chapter. For an overview of the entire report, see Fact Sheet: What Climate Change Means to your Health and Family  .

Climate change, Natural Disasters, and Mental Health

The WMO Statement on the Status of the Global Climate presents a depressing catalogue of statistics, including that 2015 was the  hottest year on record, with CO2 concentrations breaching the symbolic benchmark of 400 ppm. The Global Footprint Network released the 2016 edition of the National Footprint Accounts  , reveals that the global Carbon Footprint is 16 percent higher than previously calculated.    The UN Office for Disaster Risk Reduction (UNISDR), the Catholic University of Louvain Brussels, and the U.S.  Agency for International Development released analysis of the human cost of disasters , showing that  98.6 million people worldwide were affected in 2015, and that climate was a factor in 92% of those events.  Canada’s Parliamentary Budget Office estimates  that over the next five years, the Disaster Financial Assistance Arrangements program can expect claims of $229 million per year because of hurricanes, convective storms and winter storms and $673 million for floods, for a total of $902 million in Canada. To this litany of bad  news, add another cost: the mental health cost of climate change.

The issue is addressed in a recent three-part series of articles in the Toronto Star and raises the profile of the effects of climate change on the mental health of those most exposed and affected by it.  “Climate change is Wreaking Havoc on our Mental Health, Experts say”  (Feb. 28), discusses the mental health toll on environmental scientists and activists, provides links to studies, and applauds the American Psychological Association (APA) for taking the issue seriously (unlike the Canadian association). “For Normally Stoic Farmers, The Stress of Climate Change can be too much to bear”   (Feb. 28) highlights the plight of farmers, already recognized as having one of  the highest rates of occupation-related depression and suicide, and expected to worsen with increased frequency of  weather disasters of flooding and drought.    “Aboriginal Leaders are Warning of the Mental Health Cost of Climate Change in the North”   (Feb 29) portrays Northerners as front line victims of climate change .  The author of the series, Tyler Hamilton, calls on the Mental Health Commission of Canada and the Canadian Psychological Association to acknowledge the issue and develop a position on the grounds that climate change stress is  both a public health concern and a factor in economic productivity.

Better Health for Workers: Green Offices, Factories and Hospitals can Help, but What is the Future for Outdoor Workers?

“Green Buildings and Health”appears in the September issue of Current Environmental Health Reports, and investigates indoor air quality in offices, factories, and hospitals, as well as homes. The authors, from the Harvard T.H. Chan School of Public Health, state that evidence points to superior air quality in green buildings versus non-green buildings, resulting in direct health benefits for the occupants. They propose a framework for identifying direct, objective and leading “Health Performance Indicators” for use in future studies of buildings and health.

Concerning outdoor workers, a study led by Sir David King, the U.K. Foreign Secretary’s Special Representative for Climate Change, is relevant. Climate Change: A Risk Assessment  is a broad study, but includes discussion of heat stress, and the elevated risk which workers face. Using the U.S. Occupational Health and Safety thresholds regarding Wet Bulb Globe Temperatures (WBGT),  , the King report defines an environment as ‘too hot to work’ if the average daily maximum WBGT is 36°C or more for a month. The report states that climate change will likely increase the probability of crossing that temperature threshold in North India, Southeast China, and Southeast USA.

Other studies examining the impact of climate change on human health were released over the summer:

“Unraveling the Relationship between Climate Change and Health “  in the New York Times (July 14); “Health and climate change: policy responses to protect public health” in The Lancet (June)(registration required); and Climate Change and Public Health, a book edited by Barry S. Levy and Jonathan A. Patz, available from Oxford University Press  . It has a chapter on occupational health. Finally, “Health and climate benefits of different energy-efficiency and renewable energy choices” was published in Nature Climate Change (August 31) The study by Harvard’s Center for Health and the Global Environment showed that “energy efficiency measures and low-carbon energy sources can save a region between $5.7 million and $210 million annually, based on the accepted dollar value of human life. Those benefits depend on the type of low-carbon energy involved and the population density of the area surrounding a coal-fired power plant whose emissions are reduced by a clean energy project.”