The potential impact of climate change on annual and seasonal mortality for three cities in Québec, Canada

<p>Abstract</p> <p>Background</p> <p>The impact of climate change and particularly increasing temperature on mortality has been examined for three cities in the province of Québec, Canada.</p> <p>Methods</p> <p>Generalized linear Poisson regression has been fitted to the total daily mortality for each city. Smooth parametric cubic splines of temperature and humidity have been used to do nonlinear modeling of these parameters. The model, to control for day of the week and for non-temperature seasonal factors, used a smooth function of time, including delayed effects. The model was then used to assess variation in mortality for simulated future temperatures obtained from an atmospheric General Circulation Model coupled with downscaling regression techniques. Two CO₂emission scenarios are considered (scenarios A2 and B2). Projections are made for future periods around year 2020 (2010–2039), 2050 (2040–2069) and 2080 (2070–2099).</p> <p>Results</p> <p>A significant association between mortality and current temperature has been found for the three cities. Under CO₂emission scenarios A2 and B2, the mortality model predicts a significant increase in mortality in the summertime, and a smaller, but significant decrease in the fall season. The slight variations in projected mortality for future winter and spring seasons were found to be not statistically significant. The variations in projected annual mortality are dominated by an increase in mortality in the summer, which is not balanced by the decrease in mortality in the fall and winter seasons. The summer increase and the annual mortality range respectively from about 2% and 0.5% for the 2020 period, to 10% and 3% for the years around 2080. The difference between the mortality variations projected with the A2 or B2 scenarios was not statistically significant.</p> <p>Conclusion</p> <p>For the three cities, the two CO₂emission scenarios considered led to an increase in annual mortality, which contrasts with most European countries, where the projected increase in summer mortality with respect to climate change is overbalanced by the decrease in winter mortality. This highlights the importance of place in such analyses. The method proposed here to establish these estimates is general and can also be applied to small cities, where mortality rates are relatively low (ex. two deaths/day).</p

Use of residential wood heating in a context of climate change: a population survey in Québec (Canada)

<p>Abstract</p> <p>Background</p> <p>Wood heating is recommended in several countries as a climate change (CC) adaptation measure, mainly to increase the autonomy of households during power outages due to extreme climatic events. The aim of this study was to examine various perceptions and individual characteristics associated with wood heating through a survey about CC adaptations.</p> <p>Methods</p> <p>A telephone survey (n = 2,545) of adults living in the southern part of the province of Québec (Canada) was conducted in the early fall season of 2005. The questionnaire used closed questions and measured the respondents' beliefs and current adaptations about CC. Calibration weighting was used to adjust the data analysis for the respondent's age and language under stratified sampling based on health regions.</p> <p>Results</p> <p>More than three out of four respondents had access to a single source of energy at home, which was mainly electricity; 22.2% combined two sources or more; 18.5% heated with wood occasionally or daily during the winter. The prevalence of wood heating was higher in the peripheral regions than in the more urban regions, where there was a higher proportion of respondents living in apartments. The prevalence was also higher with participants completely disagreeing (38.5%) with the eventual prohibition of wood heating when there is smog in winter, compared to respondents somewhat disagreeing (24.2%) or agreeing (somewhat: 17.5%; completely: 10.4%) with the adoption of this strategy. It appears that the perception of living in a region susceptible to winter smog, smog warnings in the media, or the belief in the human contribution to CC, did not influence significantly wood heating practices.</p> <p>Conclusion</p> <p>Increased residential wood heating could very well become a maladaptation to climate change, given its known consequences on winter smog and respiratory health. It would thus be appropriate to implement a long-term national program on improved and controlled residential wood heating. This would constitute a "no-regrets" adaptation to climate change, while reducing air pollution and its associated health impacts.</p

The burgeoning field of transdisciplinary adaptation research in Quebec (1998–): a climate change-related public health narrative

This paper presents a public health narrative on Quebec’s new climatic conditions and human health, and describes the transdisciplinary nature of the climate change adaptation research currently being adopted in Quebec, characterized by the three phases of problem identification, problem investigation, and problem transformation. A transdisciplinary approach is essential for dealing with complex ill-defined problems concerning human–environment interactions (for example, climate change), for allowing joint research, collective leadership, complex collaborations, and significant exchanges among scientists, decision makers, and knowledge users. Such an approach is widely supported in theory but has proved to be extremely difficult to implement in practice, and those who attempt it have met with heavy resistance, succeeding when they find the occasional opportunity within institutional or social contexts. In this paper we narrate the ongoing struggle involved in tackling the negative effects of climate change in multi-actor contexts at local and regional levels, a struggle that began in a quiet way in 1998. The paper will describe how public health adaptation research is supporting transdisciplinary action and implementation while also preparing for the future, and how this interaction to tackle a life-world problem (adaptation of the Quebec public health sector to climate change) in multi-actors contexts has progressively been established during the last 13 years. The first of the two sections introduces the social context of a Quebec undergoing climate changes. Current climatic conditions and expected changes will be described, and attendant health risks for the Quebec population. The second section addresses the scientific, institutional and normative dimensions of the problem. It corresponds to a “public health narrative” presented in three phases: (1) problem identification (1998–2002) beginning in northern Quebec; (2) problem investigation (2002–2006) in which the issues are successively explored, understood, and conceptualized for all of Quebec, and (3) problem transformation (2006–2009), which discusses major interactions among the stakeholders and the presentation of an Action Plan by a central actor, the Quebec government, in alliance with other stakeholders. In conclusion, we underline the importance, in the current context, of providing for a sustained transdisciplinary adaptation to climatic change. This paper should be helpful for (1) public health professionals confronted with establishing a transdisciplinary approach to a real-world problem other than climate change, (2) professionals in other sectors (such as public safety, built environment) confronted with climate change, who wish to implement transdisciplinary adaptive interventions and/or research, and (3) knowledge users (public and private actors; nongovernment organizations; citizens) from elsewhere in multi-contexts/environments/sectors who wish to promote complex collaborations (with us or not), collective leadership, and “transfrontier knowledge-to-action” for implementing climate change-related adaptation measures

La créativité dans le soutien territorial à l’innovation au Québec. Le rôle des catalyseurs et des cercles de créativité

Le Centre de recherche sur le développement territorial (CRDT) de l’Université du Québec à Chicoutimi (UQAC) a exploré deux mécanismes territoriaux de créativité. D’abord fut exercée une enquête auprès d’un échantillon représentatif de « catalyseurs de créativité ». Dans la littérature scientifique, les fonctions de ces catalyseurs souvent appelés intégrateurs, médiateurs, facilitateurs ou « empannatore » s’avèrent mal connues, bien que leur rôle soit bel et bien pointé. L’enquête auprès d’une soixantaine de catalyseurs s’est déroulée dans cinq technopoles du Québec, soit Laval, Sherbrooke, Rimouski, Saguenay et Saint-Hyacinthe en 20091. Deuxièmement, nous avons expérimenté « in vivo » la formule des « cercles de créativité » sur un territoire. Ce mécanisme d’interaction bien connu pour identifier et résoudre des problèmes, devient largement recommandé dans la littérature récente pour sa capacité théorique à participer au processus territorial de soutien à l’innovation. Notre expérimentation d’une dizaine de cercles de créativité s’est effectuée par l’entremise d’un Forum qui a mobilisé plus de 300 participants au Saguenay – Lac-Saint-Jean en décembre 2008.Ministère du Développement économique, de l'Innovation et de l'Exportation (MDEIE), dans le cadre du partenariat de recherche UQ-MDEIEINTRODUCTION , 9; 1) SOUTIEN TERRITORIAL À L’INNOVATION, 9; 2) INNOVATION MOTRICE, 10; 3) CHAMPS D’INTERACTION , 13; 4) MODÈLE GÉNÉRAL, 13; 5) CAPITAL TERRITORIAL DE CRÉATIVITÉ , 14; CHAPITRE 1 - CATALYSEURS DE CRÉATIVITÉ 17; 1) PRÉSENTATION DE L’ENQUÊTE , 17; 2) MÉTHODOLOGIE , 18; 3) ANALYSE DES DONNÉES , 21; 4) RÉSUMÉ DE L’ENQUÊTE, 65; CHAPITRE 2 CERCLES DE CRÉATIVITÉ , 69; 1) PRÉSENTATION DU FORUM, 69; 2) CONCEPT D’APPRENTISSAGE COLLECTIF, 71; 3) DIAGNOSTIC POSÉ PAR LES PARTICIPANTS, 73; 4) SOLUTIONS PROPOSÉES PAR LES PARTICIPANTS, 82; 5) CONDITIONS GAGNANTES MENTIONNÉES PAR LES RÉPONDANTS, 93; 6) ÉVALUATION DES CERCLES DE CRÉATIVITÉ, 97; 7) RÉSUMÉ DU FORUM, 112; CONCLUSION GÉNÉRALE ET RECOMMANDATIONS, 117; LISTE DES ANNEXES, 125; LISTE DES GRAPHIQUES, 195; LISTE DES TABLEAUX, 199; LISTE DES SCHÉMAS, 201; BIBLIOGRAPHIE, 203

Drinking Water and Potential Threats to Human Health in Nunavik: Adaptation Strategies under Climate Change Conditions

In Nunavik, chlorine-treated water is delivered daily, by tank truck, to the houses, where it is stored in tanks. A large part of the Inuit population continues to depend on an untreated water supply, however. This traditional activity poses certain risks in a region with an abundant presence of migratory animals. Nunavik has also experienced significant climate warming since the beginning of the last decade. The main goal of this study, which took place in 2003 and 2004, was to evaluate drinking habits that may place Nunavik residents at an increased risk of gastroenteric diseases in the context of climate change. During the Amundsen cruise in fall 2004, we observed that raw water from the collection sites most frequently visited (brooks, lakes, rivers) was of good quality in most of the villages. Regular monitoring of these sites is necessary, however, and the public should be warned when the sites become contaminated. Of particular concern was the water from the individual storage containers, which was much more contaminated than the water at the collection sites. To develop or improve the climate change adaptation strategies in this area, we propose 1) establishing an appropriate environmental monitoring system, 2) improving wastewater disposal and municipal water systems, 3) involving nursing staff in microbiological testing of the water at community sites, 4) raising public awareness of the risks related to raw water consumption, and 5) gathering strategic health information during the periods of the year when cases of gastroenteric diseases are most frequent, in order to establish whether there is a link between these disorders and water quality.Au Nunavik, de l’eau traitée par chloration est livrée à domicile tous les jours au moyen d’un camion-citerne, après quoi cette eau est stockée dans des réservoirs. Cependant, une grande partie de la population inuite continue de s’approvisionner en eau non traitée. Cette activité traditionnelle pose certains risques dans une région caractérisée par une abondance d’animaux en migration. Aussi, depuis le début de la dernière décennie, le Nunavik a enregistré un réchauffement climatique considérable. Cette étude, qui s’est déroulée de 2003 à 2004, avait pour but principal d’évaluer les habitudes de consommation d’eau qui sont susceptibles de mettre les habitants du Nunavik davantage à risque de subir des maladies gastro-entériques dans le contexte du changement climatique. Dans le cadre de la croisière de l’Amundsen à l’automne 2004, nous avons constaté que l’eau brute des lieux de collecte les plus souvent visités (les ruisseaux, les lacs et les rivières) était de bonne qualité dans la plupart des villages. Cela dit, la surveillance régulière de ces emplacements s’avère nécessaire et le grand public devrait être averti en cas de contamination. L’eau des contenants de stockage individuels représentait une source de préoccupation particulière, car elle était bien plus contaminée que l’eau des lieux de collecte. Afin d’élaborer ou d’améliorer les stratégies d’adaptation au changement climatique dans cette région, nous proposons ce qui suit : 1) établir un système de surveillance environnementale adéquat, 2) améliorer le système d’élimination des eaux usées et le réseau municipal d’alimentation en eau, 3) faire appel au personnel infirmier pour faire les tests microbiologiques de l’eau aux emplacements communautaires, 4) sensibiliser le grand public davantage aux risques liés à la consommation d’eau non traitée, 5) recueillir des renseignements stratégiques sur la santé pendant les périodes de l’année où les maladies gastro-entériques sont plus fréquentes afin de déterminer s’il existe un lien entre ces maladies et la qualité de l’eau

A new look at weather-related health impacts through functional regression.

A major challenge of climate change adaptation is to assess the effect of changing weather on human health. In spite of an increasing literature on the weather-related health subject, many aspect of the relationship are not known, limiting the predictive power of epidemiologic models. The present paper proposes new models to improve the performances of the currently used ones. The proposed models are based on functional data analysis (FDA), a statistical framework dealing with continuous curves instead of scalar time series. The models are applied to the temperature-related cardiovascular mortality issue in Montreal. By making use of the whole information available, the proposed models improve the prediction of cardiovascular mortality according to temperature. In addition, results shed new lights on the relationship by quantifying physiological adaptation effects. These results, not found with classical model, illustrate the potential of FDA approaches

Aggregating the response in time series regression models, applied to weather-related cardiovascular mortality.

In environmental epidemiology studies, health response data (e.g. hospitalization or mortality) are often noisy because of hospital organization and other social factors. The noise in the data can hide the true signal related to the exposure. The signal can be unveiled by performing a temporal aggregation on health data and then using it as the response in regression analysis. From aggregated series, a general methodology is introduced to account for the particularities of an aggregated response in a regression setting. This methodology can be used with usually applied regression models in weather-related health studies, such as generalized additive models (GAM) and distributed lag nonlinear models (DLNM). In particular, the residuals are modelled using an autoregressive-moving average (ARMA) model to account for the temporal dependence. The proposed methodology is illustrated by modelling the influence of temperature on cardiovascular mortality in Canada. A comparison with classical DLNMs is provided and several aggregation methods are compared. Results show that there is an increase in the fit quality when the response is aggregated, and that the estimated relationship focuses more on the outcome over several days than the classical DLNM. More precisely, among various investigated aggregation schemes, it was found that an aggregation with an asymmetric Epanechnikov kernel is more suited for studying the temperature-mortality relationship

EMD-regression for modelling multi-scale relationships, and application to weather-related cardiovascular mortality.

In a number of environmental studies, relationships between nat4ural processes are often assessed through regression analyses, using time series data. Such data are often multi-scale and non-stationary, leading to a poor accuracy of the resulting regression models and therefore to results with moderate reliability. To deal with this issue, the present paper introduces the EMD-regression methodology consisting in applying the empirical mode decomposition (EMD) algorithm on data series and then using the resulting components in regression models. The proposed methodology presents a number of advantages. First, it accounts of the issues of non-stationarity associated to the data series. Second, this approach acts as a scan for the relationship between a response variable and the predictors at different time scales, providing new insights about this relationship. To illustrate the proposed methodology it is applied to study the relationship between weather and cardiovascular mortality in Montreal, Canada. The results shed new knowledge concerning the studied relationship. For instance, they show that the humidity can cause excess mortality at the monthly time scale, which is a scale not visible in classical models. A comparison is also conducted with state of the art methods which are the generalized additive models and distributed lag models, both widely used in weather-related health studies. The comparison shows that EMD-regression achieves better prediction performances and provides more details than classical models concerning the relationship