UCalgary instructor and family physician provides insight into health risks of extreme weather

It may only be May, but Calgary has already seen its fair share of extreme weather events, from heat waves to days of wildfire smoke hanging over the city. With both heat and smoke expected to be a common feature on the summer weather forecast, it’s important Calgarians understand the associated health risks.

As a family doctor, Dr. Sonja Wicklum, MD, answers a lot of questions from her patients — especially the vulnerable — about the weather.

She says when it comes to wildfire smoke, there is a close correlation between it and tobacco smoke.

“We’re exposed to particulate matter, different gases, volatile organic compounds, and even some metals in the smoke,” explains Wicklum, clinical assistant professor at the Cumming School of Medicine.

Due to the composition of the smoke, there are respiratory impacts, especially for those with respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD), as well those with cardiovascular disease, pregnant women, the elderly, and the young.

Take precautions in smoky situations

Wicklum says there are precautions people can take to mitigate some of the health risks. The best thing people can do to avoid the smoke is to be savvy and know the conditions taking place outside. Wicklum recommends the WeatherCAN app to check the air quality health index.

“When we are seeing a high-risk index of seven to 10+, it is important to limit outdoor exposure and strenuous activity,” she says. Individuals at higher risk should restrict their outdoor exposure and strenuous activity at air quality ratings of four to six.

People can further protect themselves by having an HVAC system or air purifier to filter out any of the smoke particles that get into the home.

Wicklum has been advising her patients with respiratory diseases like asthma to use their inhalers more to prevent getting into breathing trouble.

Individuals who need to go outside during high-risk periods should consider wearing an N95 mask to filter out the fine particulate matter contained in the smoke.

Extreme heat can also cause health concerns

For extreme heat, the main health concern is heat exhaustion and heat stroke when the body cannot regulate its temperature properly.

“You just get to a body temperature where you can’t sweat away enough of the heat,” says Wicklum. During a heat wave, the most important thing individuals can do is keep hydrated and stay out of the direct sunlight.

Wicklum says it is also important to have devices like air conditioning or a fan to help the skin perspire and reduce body temperature.

For vulnerable populations like the homeless and the elderly, access to water and cooling solutions is critical.

“We also need to be proactive to ensure we have adequate air-conditioned shelter spaces and for our home health-are teams to have cooling be a part of their assessments of vulnerable individuals,” says Wicklum.

Sustainable health-care delivery

Ultimately, as climate change precipitates more extreme weather events, Wicklum says it will be important for health-care professionals to provide climate-friendly care.

“We now use the term 'planetary health' in medicine,” she says. “So, when you come into your family doctor or the emergency room in the coming years, we will put into context the fact that we live on a planet with limited resources.”

Wicklum sees health care being delivered in a more sustainable way. For example, one of the most common inhalers for asthma, Ventolin MDI, contains a propellant that is a powerful greenhouse gas. To counteract this, her clinic is converting patients over to breath-activated inhalers. A person sucks in the medication, eliminating the need for propellant.

The Cumming School of Medicine has signed on to the Declaration on Planetary Health as part of the Association of Faculties of Medicine of Canada. Wicklum adds medical schools will be teaching students and physicians to practise medicine in a way that is mindful of the environment.

“This language of considering what is good for us as humans but also what is good for the planet is something you’re hopefully going to be hearing more often in clinics in the coming years.”