But Sunnybrook’s Dr. Susan Deering wanted to learn more. The family physician, who specializes in elder care, set out to better understand the health impacts of climate change on older patients and what can be done to mitigate the risks.

“Since I work with seniors this was a really interesting place for me to dig in and explore the ideas being exchanged in this space,” says Dr. Deering, physician lead for Sunnybrook’s division of long term care.

Dr. Deering writes about some of those ideas in a recent article for the journal Canadian Family Physician. Given an aging population and global warming, she writes that doctors and health systems should “work together toward solutions that will help the most vulnerable among us adapt to climate change.”

How does climate change impact the elderly differently?

Our bodies go through many changes as we age, including the ability to sense and respond to shifts in temperature – what is known as thermoregulation.

“We all know seniors who always wear a sweater, even when it’s hot outside, because they constantly feel cold,” Dr. Deering says.

A decreased ability to thermoregulate makes it harder for seniors to adjust to even slightly warmer temperatures, let alone heat waves. Other changes that occur as part of the natural aging process add to the challenge.

“We don’t sweat as much as we get older and the blood flow to the skin decreases, so those cooling mechanisms that our bodies use when it’s hot are not there,” Dr. Deering explains.

In addition, older individuals are often on medication for conditions such as high blood pressure, congestive heart failure or dementia. Warmer temperatures can impact the potency or negative side effects of such medications unless the patient is increasing their fluid intake to compensate – something that seniors often find difficult to do.

Not drinking enough during warm temperatures can also lead to dehydration more quickly with older adults, Dr. Deering adds.

“They can compensate for a while but there’s a point beyond which things turn sour quickly, whether with confusion or disorientation or loss of consciousness.”

When it comes to dealing with poor air quality, older people’s lungs are at a disadvantage too.

“The cumulative effects of sickness like pneumonia or exposure to air pollution throughout our lives make our lungs less resilient as we age,” says Dr. Deering.

Lessons learned from experience

On top of being a clinician, Dr. Deering is an assistant professor at the University of Toronto’s Temerty Faculty of Medicine and is completing her Master of Public Health at U of T’s Dalla Lana School of Public Health.

She points to a growing body of evidence on the health impacts of climate change on older individuals – including Canada’s experience with the ‘heat dome’ in British Columbia in the summer of 2021. Analysis by the B.C. Coroner’s Service found that most of the 619 people who died following the extreme heat event were older adults with chronic diseases who lived alone. Dr. Deering describes those findings as “startling”.

Even without a heat wave outside, older adults can experience negative health effects when indoor temperatures rise. Research from the Netherlands and Germany found the elderly experienced symptoms like thirst, sleep disruption and slower physical function when indoor temperatures increased.

What can be done to help?

Ensuring older people have access to air conditioning and other ways to stay cool when it’s hot, and that they drink plenty of fluids, are crucial to avoiding heat-related illness.

Dr. Deering hopes to see other preventive measures adopted as well. She suggests primary healthcare providers take the time to educate their senior patients about the health impacts of heat before it becomes an issue in order to build up their resilience.

“Just beginning the conversation early with patients is a great place to start,” Dr. Deering says.

“When you have seniors come into your office in March or April, ask them if they have a plan to stay cool in case there is a summer heat wave, ask if they have social contacts who can check on them, and review their medications to see which ones might increase their risk of harm when it’s really hot.”

Public health campaigns and community programs to assist the elderly during extreme heat could also play an important role, Dr. Deering says. For people who are caring for at-risk seniors or responsible for checking in on them during hot temperatures, she says online tools like the one created by the National Collaborating Centre for Environmental Health are a useful guide for how to recognize and respond to heat-related illness.

Still, Dr. Deering believes primary care physicians are uniquely positioned to help seniors stay healthy amid climate change.

“People might ignore or miss a public health announcement, but they tend to trust and listen to their family doctor,” she says.

Whether it’s smoggy skies from raging wildfires or extreme heat events, Dr. Deering says acknowledging that climate change is also a health issue is essential.

“If we are going to get people moving on doing something about climate change, we have to recognize that the impact on our health is significant.”

The post Extreme weather impacts our health – especially as we age. But Sunnybrook’s Dr. Susan Deering has a prescription for how to adapt appeared first on Your Health Matters.

Environment Canada has issued air quality warnings for several parts of the country, including Ontario and Quebec, due to pollution caused by forest fires.

Many people are wondering what poor air quality means for their lungs and how they can stay safe and healthy during these conditions.

We asked Linda Rawe, a Respiratory Therapist and the Manager for Respiratory Therapy at Sunnybrook, to offer some insight.

How can poor air quality from wildfire smoke affect people’s health, including their lungs and breathing?

Initially some people might notice more superficial symptoms like itchy or dry eyes that they feel the need to constantly rub. Eyedrops can help alleviate that. They might also have a sore, irritated or dry throat with or without coughing and feel like they need a drink of water. Or they might be sneezing. In all these cases, it can feel like there are irritants.

But then some people might also have difficulty breathing, as though it’s hard to inhale deeply enough. Or they might get short of breath very quickly.

If people experience symptoms, when should they seek medical attention?

If people’s symptoms clear up once they go into their home or a building where they have less exposure to the poor air and they resolve very quickly, then I would say they are probably fine.

But if their shortness of breath doesn’t resolve when they are indoors, especially if they have a pre-existing condition, then they should seek medical attention either from their family doctor, a walk-in clinic or another urgent or emergency care provider.

Who is most at risk?

The very young and the elderly are at higher risk. With the very young, their lungs are still growing. And for the elderly, lung function, volume and respiratory reserves decline as you get older.

Those with pre-existing lung conditions like asthma, fibrosis (damaged lung tissue) or COPD (chronic obstructive pulmonary disease) would have the most issues with poor air quality – especially on exertion.

Pregnant people might also feel the effects more than others, especially later in pregnancy, because they can experience shallow breathing as the fetus presses up against the lungs and affects lung volume.

When people experience symptoms, how quickly can their lungs clear once the air gets better?

It depends on the person and whether they are healthy or have pre-existing lung conditions.

It also depends on how long they are outdoors during the poor air quality. If they are outdoors for hours or work outdoors, then it’s going to build up. But again, it varies for each person. For example, smokers may experience more impact because they have damaged the cilia (tiny hairs) in their lungs, affecting their ability to clear the particulates out of their lungs.

Are there steps people can take to protect themselves during periods of poor air quality?

The most important thing is to minimize your time outdoors. If you can, stay indoors – especially if there is air conditioning or an air filtering device.

As well, avoid exertion outdoors and remember that wearing a simple barrier like a medical mask can help.

Any other advice to offer?

Just be careful, and know that no one is immune to this. People think, ‘Oh, I’m young, I’ll be fine.’ And they go out and try to do their daily jog but it will affect them and they need to be careful.

And I’m a huge camper myself, but let’s make sure we don’t create any more forest fires when we’re outdoors. It’s very dry out there. Let’s heed the fire bans that are in effect.

The post Symptoms to watch for with poor air quality – and how to stay safe appeared first on Your Health Matters.