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”.

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.

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.”