Combining insight from a previously-published community-based interview study with new quantitative analysis of air quality and health services data, the “SOS-Summer of Smoke” study, published today in BMJ Open, shows that in 2014, 385 wildfires led to a two and a half month smoke exposure that was associated with a doubling of ER visits for asthma as well as of primary care visits for pneumonia and cough as compared to previous summers. Dr. James Orbinski, Director of the Dahdaleh Institute for Global Health Research at York University was the principal investigator of the project, with Dr. Courtney Howard, Community Fellow in Planetary Health at the Dahdaleh Institute leading the research.

According to the report, there was a 48% increase in community dispensation of salbutamol, a medication given to ease breathing. Interview data showed that one community pharmacy ran out of supplies. Situated in a part of the subarctic which is 2.5°C warmer than it was 70 years ago, this represents one of the longest and most severe smoke exposures in the global medical literature base. The pristine baseline air quality in the Northwest Territories allows the influence of smoke to be more directly attributed to wildfires than in most other studies.

As families  in Perth, Australia, evacuate due to wildfires in the midst of a COVID-19-related lockdown, the authors highlight that it is time to envision wildfire responses that anticipate worsening conditions as Canada continues to warm, as well as to prepare for the possibility of overlapping COVID-19 and wildfire responses in the summer of 2021.

Lead author, emergency physician, and Community Fellow in Planetary Health at the Dahdaleh Institute for Global Health Research, Dr Courtney Howard says:

“I felt I was seeing more patients with asthma in the emergency department in 2014--and indeed our asthma-related visits doubled. Health professionals should prepare for increasingly severe wildfire seasons by prescribing refills of breathing medications for vulnerable patients and helping them to access HEPA filters, as well as ensuring their patient populations understand how to interpret the Air Quality Health Index, where to find clean air shelters, and their community’s evacuation or shelter-in-place plan. We found that people who knew what to do were less anxious--The prescription for both improved mental and physical health during severe wildfires is preparation.” 

This is the final product of a years-long Health Canada-funded collaboration between the Yellowknives Dene, the Ka’ga’a Tu First Nation, Ecology North, Yellowknife physicians, and academics from southern Canada. Two minute videos on clean air shelters, firesmarting communities, and the mental health impacts of wildfires and climate change have been produced to help other communities prepare for future Summers of Smoke.

Principal Investigator Dr James Orbinski, inaugural director of the Dahdaleh Institute for Global Health Research at York University, says:

“We have entered the age of converging planetary health emergencies. To respond meaningfully, we must work to adapt to the already very real planetary health impacts of ecological change, and simultaneously work to mitigate and radically reduce greenhouse gas emissions enough to keep impending future impacts to a manageable and sustainable minimum. We must view all of this work through an equity lens and decrease the impacts of colonialism and discrimination as we build the systems we need to keep human beings and our biosphere healthy into the future.”

Check out some videos that were also produced for the project:

Fire Smarting. For Community Distribution with Melaine Simba from the Ka'a'gee Tu First Nation

Clean Air Shelters with Ryan Harrison of the Yellowknives Dene

Smoke, Climate Change, and Mental Health. For Community Distribution with Courtney Howard

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