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.   

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.

A study of Canadian manufacturing plants demonstrates the economic damage of extreme hot or cold weather

Researchers at the Sustainable Prosperity Institute at the University of Ottawa released a Working Paper on November 24,  forecasting how manufacturing productivity will be affected by weather extremes. Based on longitudinal data from 53,000 manufacturing plants across Canada, the authors find that the productivity of the plants is reduced in extreme weather – both hot or cold. They highlight the importance of labour input as a main contributor to the productivity loss.

The authors’ summary appears in a blog, Estimating the impact of climate change on the Canadian economy,  which explains that the typical manufacturing plant in Canada currently experiences 4 extreme cold days and 14 extreme hot days per year, but under a scenario of high GHG emissions by the end of the century, that typical plant would experience one extreme cold day, but over 80 extreme hot days each year. They state: “Using medium and high greenhouse gas scenarios for 2050s and 2080s, we find that the annual losses of manufacturing output due to extreme temperature would go from 2.2% today to 2.8-3.5% in mid-century and to 3.5-7.2% in end of century.”  The authors claim to be the first to estimate the effect of extreme temperatures on establishment performance in Canada, and the first to estimate the potential economic impact of climate change in a cold environment. The full results and discussion appear in a 50-page Working Paper, “Manufacturing Output and Extreme Temperature: Evidence from Canada” by economists  Philippe Kabore and Nicholas Rivers.

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 ILO report estimates productivity effects of working at over 35 degrees C.

ILO warmer planet coverReleased on July 1 by the International Labour Organiztion (ILO),  Working on a warmer planet: The impact of heat stress on labour productivity and decent work  presents estimates of the current and projected productivity losses at national, regional and global levels, and recommends policy and workplace actions.  The report  defines heat stress as “heat in excess of what the body can tolerate without suffering physiological impairment.” Roughly, it occurs at temperatures above 35°C, in high humidity. A growing body of research  show that it restricts workers’ physical capabilities and work capacity and thus, productivity, and can lead to  potentially fatal heatstroke.

The report projects that the equivalent of more than 2 per cent of total working hours worldwide will be lost every year by 2030. Agriculture and construction are the two sectors which will be worst affected , especially in south Asia, where job losses due to heat are projected to be 43 million jobs by 2030, and western Africa, where 9 million jobs are predicted to be lost. Other sectors especially at risk are environmental goods and services, refuse collection, emergency, repair work, transport, tourism, sports and some forms of industrial work. And as with so other climate change impacts, low-income countries are expected to suffer the worst, and people in the poorest regions will suffer the most.

Solutions:  From the report introduction: “Solutions do exist. In particular, the structural transformation of rural economies should be speeded up so that fewer agricultural workers are exposed to high temperatures and so that less physical effort has to be expended in such conditions. Other important policy measures that can help are skills development, the promotion of an enabling environment for sustainable enterprises, public investment in infrastructure, and improved integration of developing countries into global trade. At the workplace level, enhanced information about on-site weather conditions, the adaptation of workwear and equipment, and technological improvements can make it easier for workers and their employers to cope with higher temperatures. Employers and workers should discuss together how to adjust working hours, in addition to adopting other occupational safety and health measures. Accordingly, social dialogue is a relevant tool for improving working conditions on a warming planet.”

The report chapters include a global overview, as well as chapters for Africa, The Americas (composed of 4 sub-regions: North America, Central America, South America, and  The Caribbean) , Arab States, Asia and the Pacific, and Europe and Central Asia. The Americas discussion reiterates our favoured situation, with  low levels of heat stress and relatively high labour standards, although the patterns remain consistent:   “Whereas the impact of heat stress on labour productivity in Canada is practically zero, the United States lost 0.11 per cent of total working hours as a result of heat stress in 1995 and is projected to lose 0.21 per cent in 2030. The expected productivity loss in 2030 is equivalent to 389,000 full-time jobs. This effect is concentrated in the southern states of the country and concerns mostly outdoor workers, such as construction workers and farm workers in California.”

Outdoor workers and cancer:   Working on a warmer planet includes a highlight section regarding North American farm workers which cites the “Sun Safety at Work Canada” programme , which began in 2016 and is funded  by the Canadian Partnership Against Cancer.  In 2014, as many as 7,000 skin cancers in Canada were attributed to work-related sun exposure, and outdoor workers have a 2.5-3.5 times greater risk of developing skin cancer than indoor workers.  The Sun Safety at Work program focuses on skin cancer but also includes information about  heat stress and eye damage in its Resource Library  Downloadable publications for employers and individuals include fact sheets, videos and presentations .

Other recent, relevant reading: 

“Changes in Temperature and Precipitation Across Canada” : Chapter 4  in the federal government’s Canada’s Changing Climate Report, released in 2019. It assesses observed and projected changes for Canada.

The Urban Heat Island Effect at the Climate Atlas of Canada website discusses the issue and provides links to some of the adaptive municipal programs.

Healthy Climate, Healthy New Brunswickers: A proposal for New Brunswick that cuts pollution and protects health, by Louise Comeau and Daniel Nunes, released by The Conservation Council of New Brunswick on June 25. It predicts that  average temperatures in the 16 communities studied could rise 1.9 to 2.1 degrees Celsius between 2021 and 2050, and the number of days over 30 degrees are modelled to increase in the range of 122 to 300 per cent .

Life and Death under the Dome” (May 23) in the Toronto Star  , documents the summer of 2018 when at least  66  deaths in Montreal were attributed to heat.

Climate Change and Health: It’s Time for Nurses to Act   published by the the Canadian Federation of Nurses Unions includes heat stress in its overview of health-related dangers of climate change in Canada, and highlights the heat waves in Ontario and Quebec in 2018.

Internationally: 

The Imperative of Climate Action to protect human health in Europe” released on June 3  by the European Academies Science Advisory Council  is mostly focused on the general population, but does include discussion of heat stress and of its effects on productivity.

Can the Paris Climate Goals Save Lives? Yes, a Lot of Them, Researchers Say” in the New York Times (June 5) summarizes an article from the journal Sciences Advances (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.