I remember the first time I heard mention of increased wildfires as a health effect of climate change—it seemed somewhat inconsequential, a footnote compared to the heat-stress, floods, malnutrition and population displacement mentioned elsewhere. No more than that.
A few weeks ago my computer screen lit up with images of wildfires across the west: pictures of a smoky Saskatoon skyline taken from University Bridge, a hilltop in Pemberton aflame, thousands evacuated in Northern Alberta, Saskatchewan and British Columbia. Tales of ash burying patio furniture in Nanaimo, friends in construction feeling short-of-breath as they worked through the smoke in Vancouver, and the sad news that a 61-year-old tree-faller from Gibsons was killed on the job at a wildfire burning near Sechelt.
"When we went outside, the rain that had collected in watering cans and puddles was black."
Many studies show an association between bushfires and respiratory health and a study published in the British Medical Journal this year actually showed that a large fire near Athens led to a 50% increase in the total daily number of deaths, a 6 per cent increase in daily number of cardiovascular deaths, and a 92 per cent increase in the number of respiratory deaths. Rare disastrous fire episodes also present the possibility of severe trauma, such as occurred during the Victoria “Black Sunday” wildfires in Australia in 2009, when 3500 homes were destroyed and 173 people killed. After the Black Sunday wildfires residents of the highly affected communities were overall very resilient, but had higher rates of PTSD, depression, and severe psychological distress than less affected communities. The health effects of wildfires are certainly not inconsequential.
My respect for the ability of wildfires to affect day-to-day life skyrocketed last year, when the Northwest Territories, where I live, had one of its worst wildfire years on record. Between June 15th and August 31st we had frequent hazy skies and a near-permanent smell of campfire in the air.
Yellowknife’s levels of PM2.5, the small particles that most affect respiratory health, exceeded the 24-hour ambient standard of 28 µg/m3 on 40 different days. Most memorable was the “Smoke Apocalypse” on July 3rd, when black clouds rolled in around 5PM and the “Land of the Midnight Sun” actually went as dark as night while our PM2.5 topped out at 728 µg/m3. When we went outside, the rain that had collected in watering cans and puddles was black.
As an ER doctor, I certainly felt as though I saw more wheezy people in the ER than usual, and we’re now undertaking a study to see if the numbers bear that out. Aside from itchy eyes, cough and cabin fever, for a number of people that I spoke with the fires held an additional symbolism: they were representative of their worst fears of climate change now coming to pass.
"Moving upstream, health professionals the world over are realizing that addressing climate-change is our job."
The NWT is already over 2°C warmer than it was 50 years ago, and our dippy roads, tippy houses and cliff-hanging lakes are such physical evidence of change that I haven’t encountered a “climate-change denier” since moving to the north four years ago. For many though, last year’s smoke and flames brought climate change viscerally into the here-and-now in a way that more subtle shifts had not. I’m getting the sense that the same is now happening to individuals affected by wildfires in other provinces. This would jive with studies showing that stress and anxiety around climate change is growing. Mental health professionals and family physicians would do well to start to consider including questions about climate-related stress in their history-taking.
Normal (left) and smoky (right) view of our house in the North West Territories.
From a practical standpoint, we know more fires are coming. How are we going to weather these summers of smoke? Here are some ideas:
- Visit the Air Quality Health Index (AQHI) site and figure out if you’re part of an “at risk population”…that will help you determine what to do when you hear the AQHI in the media
- Talk to your local recreation leaders about possibilities for temporarily waiving admission fees to indoor recreation facilities that have good air filters. Everyone will feel better if they get a chance to do their regular exercise
- Be opportunistic about clean air windows—if the air is clear, grab your gear and get out and do your favourite summer activities
- Help organize a buddy-system to make sure vulnerable people—elders, and those with pre-existing respiratory conditions can access the care they need
What is the treatment for climate-related anxiety and worsening respiratory problems? My prescription: Climate action.
Moving upstream, health professionals the world over are realizing that addressing climate-change is our job. The British Medical Association and the Royal Australasian College of Physicians have both divested from fossil fuels. Dr Jim Yong Kim, former head of global health at Harvard and now the President of the World Bank, has also endorsed fossil fuel divestment, and suggests immediate elimination of fossil fuel subsidies, a strong price on carbon, climate-smart urban planning, protecting fresh water and prioritizing climate-resilient agriculture as key steps towards a healthy climate.
What can you do as a concerned citizen about Climate-health in Canada? As a health professional, this is my list, yours may look different, but there's something for everyone to do:
- Do rounds on climate-change and health at your institution
- Encourage your institution to support the right to a healthy environment
- Find the people in your community who are already working on climate-health and offer to be the voice of health on their team. Active transport, carbon pricing, local agriculture, and fresh water protection are great targets with immediate health benefits
- Start a “Green Team” at your institution
- Lead by example and reduce your carbon footprint: ride your bike, hang to dry, combine trips to conferences with vacations or staycation
- “Divest for Health”: encourage your alma-mater, the Canadian Medical Association, and other institutions to divest from fossil fuels and invest in the low-carbon industrial revolution
- Become an active ally to Canada’s Indigenous peoples. Culturally and legally, they are our climate-health MVPs
- Communicate your desire for action on climate-health to your decision makers: by email, by phone, in person. Be polite. Be evidence-based. Be persistent
- Learn the skill-sets of protest. Take your kids to lawful climate-health demonstrations--what could be better than arts and crafts followed by a democracy party?
- Connect with others and let creativity and love power your work. This moment in time can feel stressful but just think—not every generation gets the chance to save the world
Wildfires are the climate change alarm going off with gusto. If we heed this call and decide collectively to start in earnest down the road of the green transition—we may end up giving thanks for this blazing, smoky set of alarms.
Dr. Courtney Howard is an emergency physician in Yellowknife, a mom, and a board member for the Canadian Association of Physicians for the Environment (CAPE, follow on Twitter @CAPE_Doctors). Dr. Howard grew up in North Vancouver and has worked in ERs all over Canada including the North West Territories, as well as in the Horn of Africa. (Follow Dr. Howard @Courtghoward).
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