Health effects of climate change in Canada
| ENVIRONMENTAL CHANGE | CLINICAL PRESENTATION | CLINICAL TREATMENT AND PREVENTION | PUBLIC HEALTH INTERVENTIONS |
|---|---|---|---|
| Heat | More cases of heat exhaustion and life-threatening heatstroke | Recognize and treat in office and in ED Counsel high-risk patients, including those at risk owing to their age (eg, children, the elderly); those with chronic diseases (eg, cardiorespiratory conditions, diabetes, CKD, Parkinson disease); those who take medications that impair the body’s physiologic adaptation to heat (eg, antihistamines, diuretics, psychiatric medications, anticholinergics); those who display social isolation or live in poor housing conditions (eg, no air conditioning, poor ventilation, top-floor rooms); homeless people; outdoor workers; and those who exercise vigorously22 | Heat health alert programs22 |
| Extreme weather events | Intense rainstorms and floods, causing direct injuries and contamination of water supplies | Treat injuries Treat PTSD Participate in emergency response teams | Infrastructure repair; maintain clean water supplies Emergency response |
| Increase in air pollution, especially ground-level ozone | Exacerbation of asthma, COPD, and cardiac disease | Treat exacerbations Counsel at-risk patients to reduce exposure by following the AQHI | AQHI program |
| Air pollution from more frequent forest fires due to drying of the forests and increased damage to forests by the western pine beetle | Forest fires are a direct threat to communities Wood smoke has been shown to lead to increased ED visits for respiratory problems23 | Treat respiratory cases | Fire alerts AQHI program |
| Ragweed and other allergenic plants grow faster and produce more pollen with warmer temperatures | Increased incidence of allergic rhinitis | Treat allergic rhinitis | NA |
| Extension of the range of Lyme disease as warmer temperatures are conducive to survival of the tick vector farther north24 | More cases of Lyme disease | Diagnose and treat primary Lyme disease with doxycycline (typical “target” rash of erythema migrans) Participate in surveillance | Public education programs for safe hiking in the bush and tick recognition and removal Surveillance programs |
| Increased air and water temperatures improve survival of pathogens; heavy rainfall and flooding facilitate transport of pathogens into drinking water supply | Increased incidence of water-borne and food-borne diseases17 | Diagnose and treat disease Participate in surveillance | Manage water run-off after heavy precipitation Monitor safety of drinking water |
| Climate changes provide optimal conditions for fungal spore elaboration and survival | Invasive fungal disease (eg, Cryptococcus gattii in British Columbia25) | Diagnose and treat disease Participate in surveillance | Surveillance programs |
| Extension northward of the range of dengue and malaria, in Latin America, the Caribbean, Asia, and Africa, affecting returning travelers (eg, malaria in some Caribbean vacation destinations)17 | More cases of malaria and dengue in returning travelers | Be aware of these diseases and treat Provide appropriate advice to travelers before departure | Public education for travelers |
| Social and economic effects in resource-based communities affected by climate change (eg, fishing, farming, and forestry communities) | Increased social and economic distress (owing to unemployment in affected communities) | Manage increased individual and family stress | Increased socioeconomic support |
| Climate effects in northern communities (eg, ice instability, redistribution and reduced accessibility of wildlife, reduced availability of fresh water)7 | Increased accidents, food insecurity, increased water-borne infections, sociocultural disruption due to reduction of traditional or country foods18 | Recognize diseases Support already-stressed communities | Increased public health support to already-vulnerable communities |
AQHI—Air Quality Health Index, CKD—chronic kidney disease, COPD—chronic obstructive pulmonary disease, ED—emergency department, NA—not available, PTSD—posttraumatic stress disorder.