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).

4th U.S. Climate Assessment provides new estimates of economic costs of climate change

The U.S. Global Change Research Program, a consortium of 13 federal government departments and agencies,  released volume 2 of the 4th National Climate Assessment  of Climate-change Impacts on the United States on November 23. This report is exceptional for the  unequivocal, comprehensive, and detailed information contained, and a new emphasis on the economic impacts of climate change, described as “broader and more systematic”, providing an advancement in the understanding of the financial costs and benefits of climate change impacts.  For example, the report estimates a worst-case scenario for 2090 where extreme heat results in “labor-related losses”  of  an estimated $155 billion annually;  also,  $141 billion from heat-related deaths, $118 billion from sea level rise and $32 billion from infrastructure damage by the end of the century. Other key themes: the negative impacts of climate change on trade, the disruption of supply chains for U.S. manufacturers,  likely loss of productivity for U.S. agriculture, unequal impacts of climate change on vulnerable populations, and the impact on Indigenous peoples.

In an article from the New York Times, climate expert Michael Oppenheimer  says, “This report will weaken the Trump administration’s legal case for undoing climate change regulations and it strengthens the hands of those who go to court to fight them.”   Small wonder the administration chose to release it on the eve of American Thanksgiving, when public attention would be distracted.

Volume 2, just released, is based on the scientific findings of the  4th National Climate Assessment, Volume 1,  which was released in 2017.  Volume 2 is over 1500 pages, and is composed of 16 national-level topic chapters, 10 regional chapters, and 2 response chapters. Each of the 29 individual chapters is downloadable from this link.  The Overview is here.   A Guide  briefly explains the modelling assumptions and sources of information used; more specific detail is in Appendix 3: Data tools and  scenario products   .

Media reaction and summaries include: “Climate Change Puts U.S. Economy and Lives at Risk, and Costs Are Rising, Federal Agencies Warn” in Inside Climate News  (Nov. 23);  “New National Climate Assessment Shows Climate Change is a Threat to our Economy, Infrastructure and Health” from the Union of Concerned Scientists (Nov. 23);  “U.S. economy faces hit, climate change report warns”  from the New York Times, reposted to Portside (Nov. 24) ; or “3 big takeaways from the major new US climate report”  in Vox (Nov. 24) .

4th climate assessment labour

From the 4th National Climate Assessment U.S. – Chapter 1 Overview


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.

Suicide and heat waves: the mental health effects related to climate change

thermometer and sunHigher temperatures increase suicide rates in the United States and Mexico”  was published in Nature Climate Change online on July 23, warning that up to 26,000 more people could die by suicide in the United States by 2050 if humans don’t reduce emissions of greenhouse gas pollution. The study has been widely reported and summarized: for example, in The Atlantic (July 23).  The authors used new statistical techniques, including analysis which correlates social media posts about depression with temperature conditions. Part of this social media analysis is based on the work of Patrick Baylis of the University of British Columbia, whose academic paper “Temperature and Temperament: Evidence from a Billion Tweets” was published by the Energy Institute at Haas, University of California at Berkeley, in November 2015.

A second article published in July 2018 is  “Associations between high ambient temperatures and heat waves with mental health outcomes: a systematic review”  appeared in the British journal  Public Health. It  reports on a literature review of 35 studies, and the authors conclude that: “High ambient temperatures have a range of mental health effects. The strongest evidence was found for increased suicide risk. Limited evidence was found for an increase in heat-related morbidity and mortality among people with known mental health problems. …. Mental health impacts should be incorporated into plans for the public health response to high temperatures, and as evidence evolves, psychological morbidity and mortality temperature thresholds should be incorporated into hot weather–warning systems.”

A 2014 article examined weekly suicide death totals and anomalies in Toronto between 1986–2009 and Jackson, Mississippi, from 1980–2006. The authors found that for both cities, warmer weeks had an increased likelihood of being associated with high-end suicide totals.  “Association of Weekly Suicide Rates with Temperature Anomalies in Two Different Climate Types” from the International Journal of Environmental Research and Public Health is here .

The  growing literature about the impacts of climate change on mental health has been summarized in an article in Forbes magazine, “Weather And The Warm Season Are Among Factors Associated With Suicide” (June 2018) and in the  April 2018 issue of  Corporate Knights magazine. The Corporate Knights article, “Deep Impact” is by Professor Helen Berry , the inaugural Professor of Climate Change and Mental Health at the University of Sydney, in Australia.   Although her brief overview emphasizes  mental health impacts of climate-change related disasters such as floods,  it also  provides links to recent articles linking mental health with chronic climate conditions such as heat waves and drought. Some examples of Professor Berry’s research: “The importance of humidity in the relationship between heat and population mental health: Evidence from Australia” in PLoS One (2016) ; “The Effect of Extreme Heat on Mental Health – Evidence from Australia”  from the International Journal of Epidemiology (restricted access) (2015); and “Morbidity and mortality during heatwaves in Metropolitan Adelaide”  in the Medical  Journal of Australia (2007).

Professor Berry and co-author   Dominic Peel  provoked public discussion in 2015 with an article in the British Journal of Psychiatry, “Worrying about climate change: is it responsible to promote public debate?


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.