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.

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).