Credit: Faruk Tokluoğlu from Pexels
February 12, 2025 by Christopher Buse Sandra Smiley and Tim K. Takaro, The Conversation
In British Columbia, like elsewhere in Canada, the impacts of climate change on health and health services are apparent. In recent years, the province has experienced a range of climate change-related extreme weather events, with considerable negative consequences.
The 2021 heat dome caused wide disruptions to emergency services and led to more than 600 heat-related deaths. Wildfires have resulted in increased reports of illness and the evacuation of tens of thousands of people from their homes.
B.C.’s health system, still recovering from the staffing issues and burnout of the COVID-19 pandemic, has stepped up to respond to these emergencies.
Health systems are made up of people who are often members of the same disaster-stricken communities they serve. However, to date, existing studies have focused primarily on health service provision during climate-related emergencies, rather than their specific impacts on health system workers.
In order to understand the unique challenges they face during these events, we interviewed health service workers from across B.C. and in a wide range of roles, including doctors, nurses, allied health professionals and emergency responders.
Mental and physical health risks
Although the nature of their experiences varied depending on their position, a majority of our interviewees reported experiencing some form of physical or mental health threat during and after climate-related emergencies.
These health service workers—and particularly those in front-line positions like paramedics, home health workers and clinical staff—described being exposed to heat and poor air quality. This was the case for those working in the community as well as in health facilities, especially when facilities were not equipped with cooling and air filtration technologies.
Health service workers also described suffering negative mental health impacts like stress, trauma and anxiety. Participants reported experiencing burnout due to the challenges related to organizing logistics during an emergency, compounded by long hours and back-to-back periods of intense activity.
Climate-related events that overwhelmed infrastructure—such as the 2021 heat dome, during which wait times for an ambulance stretched up to 16 hours in some areas—caused trauma to health service workers, who were placed in situations where they were unable to provide sufficient care to all who needed it.
System problems aggravate impact
Interviewees also explained that these mental and physical health impacts were aggravated by pre-existing health system challenges, like the ongoing COVID-19 pandemic and staffing shortages. As described by one interviewee, concerns about COVID-19 transmission complicated clinical decision-making and created ethical dilemmas:
“It was really challenging during the heat dome to provide adequate cooling for people when you’re supposed to follow infection prevention and control guidelines about not having fans… How do I prioritize the acute risk of heat versus the more delayed risk of COVID infection?”
Meanwhile, staffing shortages meant health service workers had to work longer shifts and with greater frequency during climate-related events. They also experienced challenges getting to and from work because of flooded or blocked roads, or concerns for their family and homes. All of these factors can contribute to burnout.
Adaptations to protect workers
The good news is that adaptations are being implemented to protect against the risks shouldered by health service workers during climate-related emergencies. In our interviews, we heard about measures like facility upgrades, emergency response training, climate change education, mental health supports and the development of occupational health and safety plans.
However, these adaptations are not happening uniformly across B.C.’s health system. In many cases, participants knew of occupational health, safety and emergency response plans for climate-related events, but were unfamiliar with or had not received direct guidance on how to follow them.
