Tag: wellness

Doc­tor’s orders: turn on the AC

Pre­scrip­tions let low­income ten­ants apply for sub­sidies to lessen heat risk

Dr. Samantha Green, right, with volunteer Anushen Selvasegar, has been issuing prescriptions for air conditioners for Toronto Community Housing residents.

This article was written by Ben Spurr and was published in the Toronto Star on August 4, 2025.

In a small room off the lobby of a St. James Town highrise on Fri­day, Dr. Sam­antha Green was busy hand­ing out life­chan­ging pre­scrip­tions.

Throughout the morn­ing, a steady stream of ten­ants in the Toronto Com­munity Hous­ing build­ing came to sit at a fold­out table across from Green, another doc­tor and a med­ical stu­dent, who asked them ques­tions about their health and income status. After a short con­sulta­tion, two dozen res­id­ents walked away with a pre­scrip­tion — not for medi­cine, but for something that could be just as vital to their well­being amid Toronto’s increas­ingly stifling sum­mer heat: a new air con­di­tioner.

Accord­ing to the City of Toronto, res­id­ents on Ontario Works or the Ontario Dis­ab­il­ity Sup­port Pro­gram can apply for fin­an­cial aid to buy a cool­ing unit, if they get a doc­tor’s note say­ing it’s med­ic­ally neces­sary.

Green, a fam­ily phys­i­cian with the Unity Health Net­work, said des­pite the fact that heat can pose a ser­i­ous health risk, par­tic­u­larly to low­income groups, many social assist­ance recip­i­ents and health­care work­ers don’t know about the sub­sidy. She’s been try­ing for years to raise aware­ness about it, but said it’s been “slow going,” so she decided to start host­ing pop­up AC clin­ics.

“It just occurred to me that a faster way to do this would be to actu­ally part­ner with local com­munity organ­iz­a­tions and go to com­munit­ies and provide pre­scrip­tions, where appro­pri­ate, for air con­di­tion­ers,” she explained.

Green held the first pop­up last month at another build­ing in St. James Town, an apart­ment com­munity near Bloor Street East and Sher­bourne Street, where many res­id­ents are low­income.

That day she pre­scribed 18 air con­di­tion­ers. Over two hours at 375 Bleecker St. on Fri­day, she and her col­leagues issued about 24 pre­scrip­tions.

The atmo­sphere at the pop­up was more com­munity gath­er­ing than med­ical appoint­ments. A group of women in head scarves chat­ted in the middle of the small room, while a boy played on a tab­let in the corner, and volun­teers set out plates of candy.

The con­sulta­tions Green held with each ten­ant didn’t involve a phys­ical exam — instead, she col­lec­ted inform­a­tion about access to cool­ing devices and any med­ical con­di­tions that might put them at increased risk from high heat. She told the Star level of care is no less than what patients would receive before get­ting a pre­scrip­tion at a walk­in clinic.

Rahul Kamtam was among those who got an AC pre­scrip­tion. He has been dia­gnosed with schizo­phrenia and said dur­ing heat waves the tem­per­at­ure in his fifth­floor apart­ment soars, mak­ing it hard to read or con­cen­trate.

Being able to cool down the heat would be a boost for his men­tal health.

Kamtam said he didn’t see any­thing unusual about a phys­i­cian issu­ing pre­scrip­tions for air con­di­tion­ers.

“This is also kind of a med­ic­a­tion, right? When your tem­per­at­ure is going up, you take fever med­ic­a­tion to bring your tem­per­at­ure down, and AC is almost doing the same thing,” he said.

Accord­ing to inform­a­tion pos­ted by the city, which admin­is­ters pro­vin­cial assist­ance pro­grams, to get the cost of a cool­ing unit covered, OW and ODSP cli­ents need a pre­scrip­tion that includes a dia­gnosis indic­at­ing the device is part of a treat­ment plan, and that without it the per­son could be hos­pit­al­ized or “face severe risk to life.”

One AC unit or port­able fan per fam­ily will be covered up to a max­imum cost, every four years. Although the cov­er­age limit isn’t lis­ted, num­bers gathered by Health Pro­viders Against Poverty, which partnered with Green on the pop­up, sug­gest it’s about $400. Med­ical con­di­tions that require a cool­ing device include can­cer, chronic heart or lung con­di­tions, HIV, dia­lysis and severe asthma, accord­ing to the city web­site. The cool­ing applic­a­tions fall under dis­cre­tion­ary bene­fits, and are approved on a case­by­case basis.

The province cov­ers the cost of OW and ODSP dis­cre­tion­ary bene­fits. Low­income res­id­ents who aren’t on pro­vin­cial social assist­ance can also apply to the city for cool­ing device cov­er­age through its Hard­ship Fund. Toronto says that in 2024 it issued about 650 sub­sidies. It has also launched a pilot project to give air con­di­tion­ers to low­income seni­ors.

This sum­mer, Toronto has exper­i­enced a suc­ces­sion of heat warn­ings with tem­per­at­ures that feel in the high 30s or low 40s.

Green said giv­ing people a chance to keep cool under those con­di­tions is essen­tial. High tem­per­at­ures can cause heat exhaus­tion and heat stroke, which can be deadly, and can also exacer­bate under­ly­ing chronic con­di­tions like heart dis­ease, chronic kid­ney dis­ease and res­pir­at­ory dis­ease, she said.

Heat kills more people world­wide than any other form of extreme weather, and the threat is grow­ing “expo­nen­tially” because of cli­mate change, accord­ing to the World Health Organ­iz­a­tion. Young and older people, as well as those on low incomes or suf­fer­ing from chronic dis­ease, are at higher risk.

So are people liv­ing in dec­ades­old apart­ment build­ings. Many of Toronto’s highrises were built in the 1960s or ’70s and were designed to keep heat in dur­ing cold win­ters, said Lidia Fer­reira, a com­munity engage­ment spe­cial­ist with Com­munity Resi­li­ence to Extreme Weather, which worked with Green on Fri­day’s pop­up.

“But right now, we have a totally dif­fer­ent envir­on­ment. So every sum­mer, it’s get­ting hot­ter and hot­ter,” she said.

Another heat warn­ing set to blanket city

Thursday could feel as hot as 44 C

This article was written by Anastasia Blosser and Elissa Mendes, and was published in the Toronto Star on July 24, 2025.

It was nice while it las­ted.

After nearly a week of tem­per­at­ures in the low to high 20s, more hot and humid weather is on Toronto’s hori­zon, accord­ing to Envir­on­ment Canada, which has issued another heat warn­ing for the city.

The weather agency said tem­per­at­ures will be the hot­test Thursday, when the heat event is expec­ted to kick off.

“While day­time high tem­per­at­ures will not be as extreme on Fri­day and into the week­end, night time lows are expec­ted to remain warm throughout,” Envir­on­ment Canada added in its warn­ing.

Tem­per­at­ures are expec­ted to hover around the high 20s to low 30s but the humid­ity could make it feel as hot as 44, accord­ing to the heat warn­ing. There will also be on­and­off rain throughout the next week, the local fore­cast says.

It has already been shap­ing up to be a hot sum­mer for the city with there already being mul­tiple stretches of heat warn­ings over the past month.

The sun will stick around on Thursday with a high of 34 C, which could feel like 42 because of the humid­ity. At night, clouds will roll in, bring­ing a 40 per cent chance of showers with them. The low will be 24 C.

Fri­day will also be cloudy with a 60 per cent chance of showers and high of 29 C. Skies will remain cloudy at night and tem­per­at­ures will drop to a low of 20 C.

Kick­ing off the week­end, skies will begin to clear on Sat­urday with a high of 28 C and low of 18 C.

Sunday will bring a mix of sun and cloud with 30 per cent chance of showers and cloudy peri­ods in the even­ing. There will be a high of 28 C and a low of 19 C.

Monday will be sim­ilar, with a mix of sun and cloud and a high of 30 C. Later in the day, there will be cloudy peri­ods and a low of 20 C.

Tues­day will be cloudy with a 30 per cent chance of showers and high of 28 C.

As tem­per­at­ures climb, Envir­on­ment Canada is urging people to drink water often — and before you feel thirsty.

As well, you should plan out­door activ­it­ies for the coolest parts of the day, limit dir­ect sun and heat expos­ure and wear light and loose cloth­ing with a wide­brimmed hate.

Open your win­dows if it’s cooler out­side than indoors, but oth­er­wise, keep your blinds and shades closed, the agency said. You should also turn on air con­di­tion­ing or a fan, or move to a cooler part of your home.

Also, watch out for signs of heat exhaus­tion, which might include a head­ache, nausea, dizzi­ness, thirst, dark urine and intense fatigue. People who sus­pect heat exhaus­tion should stop activ­it­ies and drink water, the agency said.

On the other hand, heat stroke is a med­ical emer­gency, with signs includ­ing red and hot skin, dizzi­ness, nausea, con­fu­sion and a change in con­scious­ness. If you see signs of heat stroke, call for emer­gency med­ical atten­tion and try to cool the per­son down.

Toronto­n­ians can also use the city’s inter­act­ive cool spaces map to find pub­lic pools, com­munity centres and other free spots to beat the July heat.

How to exercise when wildfire smoke causes poor air quality

This opinion was written by Alex Hutchinson and was published in the Globe & Mail on July 21, 2025.

A runner jogs in Toronto as wildfire smoke is seen in early June. Athletes’ heavy breathing can mean inhalation of bigger doses of air pollutants.

Afew years ago, researchers crunched data on air quality in counties where Major League Baseball and National Football League teams play. Sure enough, fielders racked up more errors and quarterbacks threw more interceptions when playing in dirty air.

As air quality worsens and wildfires once again sweep across Canada, we hear a lot about the long-term health effects of air pollution: inflammation, airway irritation and other issues that can lead to heart, lung and other ailments. For athletes, whose heavy breathing gives them a bigger dose of pollutants, problems show up more immediately, forcing them to grapple with difficult decisions about how and when to modify or cancel workouts and competitions.

A recent review in Current Sports Medicine Reports sifts through the evidence on how air pollution interacts with exercise, and how best to minimize its effects. The study was led by U.S. Navy researcher Keifer Walsh and includes contributors from several other institutions, including environmental physiologist Michael Koehle of the University of British Columbia.

Here are five strategies they suggest for getting in your workout when the air is bad.

AVOID IT

By far the best option is to avoid bad air entirely. Traffic is a major source of pollution, and sunlight triggers a rise in ozone levels, so early mornings before rush hour tend to see the cleanest air. Unfortunately, wildfire smoke doesn’t follow this pattern.

Pollutant levels drop exponentially as you move away from major roadways, so side streets, parks, or recreational paths that don’t run directly along highways are your best bet for avoiding traffic-related pollution.

Shifting your workout indoors is another alternative – as long as the air is clean and properly ventilated. That’s a good bet in newer buildings but not a given, with potential effects illustrated in recent research: a 2023 study found that competitive chess players made 26.3 per cent more errors for every increase of 10 micrograms per cubic metre of fine particulate matter in indoor air.

GO SHORTER AND HARDER

Breathing heavily during a workout makes you suck in up to four times as much pollution as you would at rest. But that doesn’t mean that pushing harder is always worse, because the patterns of airflow in your lung may affect how the pollution is absorbed into your body. Previous research by Koehle and others found that the effects of vigorous exercise in polluted air are no worse than moderate exercise.

On the other hand, the longer you’re out there, the greater your exposure will be. This suggests that if you want to exercise outdoors on a day when the air quality is iffy, you’re better off pushing a little harder than staying out longer.

MASK UP

The evidence for the anti-pollution effects of N95 masks isn’t as clear as you might think, primarily because there hasn’t been much research on the topic. Still, logic suggests that they could help reduce the dose of particulates.

For vigorous exercise, properly fitting masks can feel hot and uncomfortable, but Walsh and his colleagues suggest that they might be particularly useful before a competition or workout.

POP PILLS

Oxidative stress triggered by irritants such as ozone contribute to some of the negative effects of air pollution. To combat this, some experts have suggested taking antioxidants may help. There’s a smattering of inconsistent and sometimes contradictory evidence for this claim – just enough to convince the Canadian Academy of Sport and Exercise Medicine and the Canadian Society for Exercise Physiology to endorse the idea of athletes taking vitamins C, E and beta-carotene for a week or more leading up to competitions in places with high ozone levels.

GET USED TO IT

Now we’re getting to the truly controversial ideas. There are a few studies, both labbased and in the real world, suggesting that if you train in air with high ozone levels, you’ll eventually be able to compete better in similarly polluted air. For example, an analysis of 85,000 college track athletes found that those who had been exposed to high ozone levels a week before a competition better handled elevated levels in the meet itself.

If you’re a professional athlete, file this away as one of the unpalatable sacrifices you might choose to make in your relentless climb to the top. For the rest of us, let this idea of “acclimating” to pollution serve as a cautionary tale. When your phone buzzes with an air quality warning that threatens to derail your workout plans for the day, it’s incredibly frustrating. Maybe you can adapt, using one of the strategies above – but if not, a rest day is probably better than a “getting used to pollution” day.

Canadian Lung Association CEO on the health effects of wildfire smoke, and how to protect yourself

This article was written by Alanna Smith and was published in the Globe & Mail on July 15, 2025.

With wildfires growing more intense and frequent, many Canadians are wondering about the short and long-term health effects

Raging wildfires in Western Canada have blanketed skies with acrid smoke, prompting air quality statements or warnings in Saskatchewan, Manitoba, Ontario and Quebec.

Residents in these provinces were advised on Monday to limit time outdoors to avoid health effects. In the morning, Toronto’s Air Quality Health Index rating was more than 10, which is considered “very high risk.”

Poor air quality has pushed sports groups, summer camps and other organizations hosting outdoor events to reconsider their programming, with some cancelling or transitioning indoors.

With wildfires growing more intense and frequent, many Canadians are wondering about the short- and long-term effects of wildfire smoke on their health, in addition to how to protect themselves.

Sarah Butson, chief executive of the Canadian Lung Association, addresses these questions in an interview with The Globe and Mail.

Thick smoke from wildfires, particularly those threatening communities in Manitoba and Saskatchewan, is choking skies across Canada. Can you explain how wildfire smoke affects health?

For the average adult, you may experience some discomfort, some mild cough, some wheeze, maybe even a bit of difficulty breathing. But, for the one in five with lung disease, who know this all too well, the air that we breathe can really complicate their existing lung disease.

They may have an onset of their symptoms. It may trigger difficulty breathing, or even worsen their breathing altogether and ultimately lead to potential hospitalization and use of health services.

And what about the impact of long-term exposure to wildfire smoke, considering it’s becoming a frequent feature of Canadian summers?

We know that there is no real safe level of wildfire smoke.

We also know that we may be breathing different things in, so there may be smoke from wildfire, but there may be smoke from other contaminants that are getting burnt as part of that wildfire. One of the main considerations is particulate matter, often referred to as PM2.5, that can penetrate deep into the lungs and even into the bloodstream.

That’s really where we see the lead to potential various health issues and concerns – respiratory but whole body concerns as well from headaches all the way to cardiovascular and neurological concerns.

How can people protect themselves and their loved ones? For example, if a parent is debating sending their kid to an outdoor camp or soccer game when wildfire smoke is present, how can they navigate this decision?

Knowledge is power in this instance. And one of the greatest tools that we have at our disposal is utilizing the Air Quality Health Index.

If it’s a low risk, usually between a one and three, there’s no changes that need to be made. If it’s moderate risk between four and six, there might be some mild modifications. It’s when we start to get into that seven to 10-plus range where it’s strongly considered to make some changes in your behaviour – to cancel or reschedule outdoor activities.

If you can, stay inside at that moment where you’re seeing seven-plus and try to ensure that the quality of the air that you’re breathing indoors is as clean as it can be. If you do have to go outside, then we encourage folks to take precautions as needed. Maybe that means wearing an N-95 mask.

Having said that, for someone living with lung disease, that might differ. There might one number that is an advisory for the general public, but if you know that you may be at higher risk of being triggered, then you may want to take action at a lower number.

For people who are more vulnerable to the effects of wildfire smoke, including those with lung conditions, are there other measures that can be taken to limit the risks?

It can be a scary feeling to walk outside and feel like you can’t grab that oxygen in the air around you. What we can do in these instances is arm ourselves with that information to make the best decisions that we can, to wear a mask, to check the AQHI, to check-in with loved ones that you know might be within those vulnerable populations, to try to stay indoors.

Those who live with lung disease know how challenging a respiratory condition can make all of your day-to-day activities. Whether it be asthma or COPD [Chronic Obstructive Pulmonary Disease], wildfires can be a great reminder that if you have an action plan, to keep that action plan up-to-date, to make sure that you’ve got your prescriptions filled as necessary, to really monitor and track how you’re doing.

For more information on how to protect your lungs from wildfire smoke, read the Canadian Lung Association’s online guide.

Wild­fire smoke, urban smog can dam­age heart

New study says expos­ure increases risk

A new study has found that living in a large city centre like Toronto is a risk factor for respiratory problems because of emissions from cars and factories, which include fine particulate matter.

This article was written by Omar Mosleh and was published in the Toronto Star on July 2, 2025.

Long­term expos­ure to air pol­lu­tion, includ­ing from smog and wild­fire smoke, can dam­age the heart.

That’s accord­ing to a new study, which arrives as extreme heat and wild­fire smoke con­tinue to cause health impacts in Toronto, with wild­fires becom­ing more fre­quent, last­ing longer and burn­ing more intensely.

The research found that longterm expos­ure to air pol­lu­tion, in par­tic­u­lar fine par­tic­u­late mat­ter, was linked to higher levels of dif­fuse myocar­dial fibrosis, a type of heart scar­ring that can lead to higher risk of heart fail­ure.

The study, pub­lished in the med­ical journal Radi­ology and led by Uni­versity Health Net­work clini­cian­sci­ent­ist Dr. Kate Han­neman, used an advanced ima­ging tech­nique called car­diac MRI on 694 par­ti­cipants in Ontario who were

exposed to fine par­tic­u­late mat­ter over one year.

Heart dam­age was observed even when levels were below global air qual­ity guidelines, such as in Toronto, and there is no safe expos­ure limit for air pol­lu­tion, accord­ing to the research.

“Even in patients that are largely from Toronto and out­side of Toronto, in Ontario, where our qual­ity is much bet­ter than other areas of the world … We’re still see­ing this asso­ci­ation,” Han­neman said.

Fine par­tic­u­late mat­ter, or PM2.5, are fine particles that are inhaled by the lungs and can cause res­pir­at­ory prob­lems, espe­cially among people with pre­exist­ing con­di­tions such as asthma. They are released by nat­ural sources, such as wild­fire smoke, as well as human activ­it­ies, includ­ing burn­ing fossil fuels. Fine par­tic­u­late mat­ter is also present in smog and is released in fire­works.

The study focused on car­di­ovas­cu­lar effects from long­term cumu­lat­ive expos­ure, so one or two days of wild­fire smoke wouldn’t be a factor. However, sus­tained expos­ure, such as what was seen in the sum­mer of 2023, could pose ser­i­ous health risks, Han­neman said. Sus­tained expos­ure could be days to weeks.

Accord­ing to a bul­letin from Toronto Pub­lic Health, 2023 was the first time wild­fire smoke had a sig­ni­fic­ant impact on Toronto’s air qual­ity, last­ing 12 days.

There are steps indi­vidu­als can take to pro­tect them­selves from air pol­lu­tion, includ­ing lim­it­ing out­door activ­ity on smoky days, clos­ing win­dows, installing a high­effi­ciency par­tic­u­late air fil­ter in the home, and wear­ing a mask if going out­side can’t be avoided.

Liv­ing in a large city centre like Toronto is a risk factor because of emis­sions from cars and factor­ies, which include fine par­tic­u­late mat­ter as well as other pol­lut­ants like nitro­gen diox­ide. “That kind of expos­ure is largely depend­ent on where you live, being in a city, or liv­ing right next to some sort of refinery or something that’s burn­ing fossil fuels,” Han­neman said.

The study found that the greatest health effects were in women, smokers and patients with hyper­ten­sion. It included 493 patients with dilated car­di­omy­opathy, which weak­ens the heart’s abil­ity to pump blood, as well as 201 healthy indi­vidu­als.

Fine par­tic­u­late mat­ter is asso­ci­ated with increased risk of car­di­ovas­cu­lar dis­eases, includ­ing heart fail­ure and stroke, the study said. An estim­ated 31 per cent of car­di­ovas­cu­lar dis­ease is attrib­ut­able to envir­on­mental factors such as air pol­lu­tion, accord­ing to the World Health Organ­iz­a­tion.

Haz­ard­ous heat wave

Dan­ger­ously high tem­per­at­ures to hit as sum­mer offi­cially begins

A polar bear at the Toronto Zoo beats the heat with an afternoon swim. Friday, the first day of summer, is expected to reach a high of 27 C, but will feel closer to 34 C with humidity. That heat and humidity will build throughout the weekend.

This article was written by Kate Allen and was published in the Toronto Star on June 20, 2025.

A heat wave is on its way to Toronto, the first of the sum­mer — and the first shove into weather that is not only steam­ier but more dan­ger­ous.

Fri­day — the first day of sum­mer — is expec­ted to reach a high of 27 C, but will feel closer to 34 with humid­ity. That heat and humid­ity will build throughout the week­end, climb­ing to 34 C by Monday. There’s also little relief expec­ted at night with lows fore­cast to hover in the low 20s.

A transit officer stays hydrated at the corner of Queen and Spad­ina as high heat and humid­ity is set to des­cend on the city.

Heat kills more people world­wide than any other form of extreme weather, accord­ing to the World Health Organ­iz­a­tion — a risk grow­ing “expo­nen­tially” because of cli­mate change. But des­pite its high death toll, experts also refer to heat as “the silent killer.”

Heat mas­quer­ades as many other health prob­lems, mak­ing it easy to over­look. And unlike floods, wild­fires and hur­ricanes, heat is invis­ible. For both of these reas­ons, experts say, pub­lic aware­ness of the risks is low.

Stud­ies world­wide show that deaths spike dur­ing heat waves. But most of these are not caused dir­ectly by heat: they are caused by other con­di­tions, like car­diac events, res­pir­at­ory dis­eases, kid­ney dis­ease and mood dis­orders.

That’s because the body’s response to heat expos­ure helps fight to pro­tect core tem­per­at­ure, but puts stress on other organs: the heart pumps harder and faster, for example, and dehyd­ra­tion taxes the kid­neys. It’s also because some chronic health con­di­tions impair people’s abil­ity to recog­nize they are over­heat­ing and respond to pro­tect them­selves.

Some of the most import­ant and start­ling evid­ence of this comes from Canada. Dur­ing the West Coast heat dome in 2021, Brit­ish Columbia’s Cor­oner chose to invest­ig­ate all pos­sible heat­related

Heat mas­quer­ades as many other health prob­lems, mak­ing it easy to over­look deaths. That decision revealed inform­a­tion sur­pris­ing even to doc­tors: of the 619 people who died, six in 10 were on regis­tries for mood and anxi­ety dis­orders, and schizo­phrenia was asso­ci­ated with a higher risk of death than any other chronic dis­ease.

The reas­ons for this are com­plex, but many factors likely play a role. Anti­psychotic med­ic­a­tions impact heat reg­u­la­tion, para­noia and social isol­a­tion make it harder to recog­nize risk and get help, and people with schizo­phrenia may be more likely to live on low incomes in sub­stand­ard hous­ing without access to air con­di­tion­ing.

People with sub­stance use dis­orders, epi­lepsy, chronic obstruct­ive pul­mon­ary dis­ease, depres­sion, asthma, mood and anxi­ety dis­orders, and dia­betes were also overrep­res­en­ted among those who died in the heat dome com­pared to deaths in the gen­eral pop­u­la­tion of people over 65.

Many people were on mul­tiple chronic dis­ease regis­tries. Ontario’s cor­oner does not track heat­related deaths the way B.C. does, though advoc­ates have called for it, say­ing gran­u­lar data like this would help under­stand and pre­vent heat deaths.

Another sur­pris­ing fact emerged from the B.C. cor­oner’s decision to invest­ig­ate all heat­related deaths: almost all of them happened indoors, in people’s homes.

While the pub­lic may asso­ciate heat waves with a bak­ing hot sun, the big­ger risk factor is actu­ally a roof: as the panel con­vened to study the B.C. heat dome deaths later wrote, “High indoor tem­per­at­ure was the primary cause of injury and death dur­ing the extreme heat event.”

The longer the body is exposed to extreme heat, the more stress it is under. That’s why overnight tem­per­at­ures are just as import­ant as day­time highs, if not more so. Giv­ing the body a break to cool off and recover is crit­ical. The major­ity of those who died in B.C. did not have access to air con­di­tion­ing. So even as out­door tem­per­at­ures cooled off overnight, hot air remained trapped inside these homes, with tem­per­at­ures con­sist­ently exceed­ing 26 C, the panel found.

That num­ber is import­ant: 26 C is con­sidered the upper limit of safe indoor tem­per­at­ures. The city of Toronto is mid­way through a study on whether to imple­ment a max­imum tem­per­at­ure bylaw that would require land­lords to keep rental apart­ments below a cer­tain threshold; its final report will land well after the sum­mer months. The city has stud­ied and debated the same idea on and off since 2014.

An infant and an octo­gen­arian don’t have much in com­mon. But they do share an increased vul­ner­ab­il­ity to heat, and for some of the same reas­ons.

Chil­dren and older adults don’t sweat as much, one of the body’s primary heat­fight­ing tools. They also might be less aware if they are over­heat­ing, and have less abil­ity to move to a cooler envir­on­ment.

Chil­dren don’t have much con­trol over their daily activ­it­ies: they are required to be in school five days a week, for example. Most Toronto Dis­trict School Board schools don’t have full air con­di­tion­ing, and advoc­ates say extreme heat in the classroom is a grow­ing danger to kids’ health and abil­ity to learn.

For older adults, agil­ity chal­lenges or cog­nit­ive impair­ments may impede their abil­ity to leave home to seek cooler envir­on­ments. The city’s heat relief net­work includes lib­rar­ies, com­munity centres and malls, but even when older adults are able to access these loc­a­tions they are not typ­ic­ally open overnight, when cool­ing off is espe­cially import­ant.

The city announced a pilot pro­gram in May to provide air con­di­tion­ing to low­income seni­ors liv­ing in apart­ment build­ings, but the $200,000 alloc­ated to this pro­gram will cover only 300 to 400 air con­di­tion­ing units, accord­ing to the city.

A Star invest­ig­a­tion showed that ser­i­ous work­place injur­ies in Ontario spike on the hot­test days of the year. As most would expect, out­door work­ers exposed to the sun are at risk — but indoor work­ers in hot envir­on­ments are at risk too, Health Canada says.

Examples of crit­ical injur­ies repor­ted to the province on hot days, the Star’s report­ing showed, included jan­it­ors in car parts factor­ies, work­ers in pet food facil­it­ies and other indoor man­u­fac­tur­ing jobs.

The Ontario gov­ern­ment pro­posed a new heat stress reg­u­la­tion to pro­tect work­ers, recog­niz­ing that heat is a rising risk to work­ers because of cli­mate change. But those new rules never mater­i­al­ized. The min­is­ter of labour has said the cur­rent health and safety laws are “robust,” while labour lead­ers and oppos­i­tion MPPs believe stronger pro­tec­tions are neces­sary.

There is noth­ing inher­ent about poverty itself that cre­ates health risks from extreme heat. The risk comes from the dis­ad­vant­ages that attend liv­ing on a low income: poorly con­struc­ted hous­ing and either no air con­di­tion­ing or not enough money to pay to run it; neigh­bour­hoods with fewer trees, rais­ing tem­per­at­ures from the urban heat island effect; worse access to health care and green spaces.

The city also provides $300 per house­hold to people on social assist­ance through the “Hard­ship Fund”; last year, it issued approx­im­ately 650 sub­sidies for air con­di­tion­ers.

Health Canada warns that people who are phys­ic­ally act­ive, like run­ners and cyc­lists, should take par­tic­u­lar pre­cau­tions in extreme heat. Sched­ule workouts at cooler times of the day (usu­ally early morn­ing or late even­ing, rather than mid­day), exer­cise in the shade and move indoors to an air­con­di­tioned envir­on­ment if pos­sible. Also take extra water breaks, and wear loose­fit­ting, breath­able cloth­ing.

“Try not to expect the usual per­form­ance from your­self dur­ing extreme heat,” Health Canada says.

Preg­nancy is its own type of mara­thon. The body is already work­ing over­time to gest­ate a baby, such as pump­ing more blood per minute, and heat stress adds another layer of effort to these sys­tems.

Extreme heat has been linked to higher risks of preg­nancy com­plic­a­tions includ­ing pre­eclamp­sia and gest­a­tional dia­betes. But it has also been linked to worse birth out­comes, includ­ing higher risks of still­births and pre­term birth.

A recent report from Cli­mate Cent­ral, a non­profit research group, ana­lyzed “preg­nancy heat-risk days”­extremely hot days asso­ci­ated with an increased risk of pre­term birth — in cit­ies and coun­tries world­wide.

Toronto saw an aver­age of 15 of these days annu­ally over the last five years, the report found: cli­mate change had added seven of those 15 days. World­wide, most coun­tries at least doubled the aver­age annual num­ber of preg­nancy heat­risk days over that period, com­pared to a world without cli­mate change.

How to take the heat off this sum­mer

Doc­tors share tips to stay cool as city faces high tem­per­at­ures and humid­ity

Studies suggest an average of 120 people die of heatrelated incidents every year in Toronto — and the danger only escalates the more humid it gets, experts say.

This article was written by Kevin Jiang and was published in the Toronto Star on June 19, 2025.

It was the height of an excep­tion­ally humid heat wave last July when an eld­erly patient was rushed to the emer­gency room with what looked like a heart attack.

Pain coursed through their chest and they could hardly breathe, said Dr. Edward Xie, the emer­gency phys­i­cian who treated the patient. It was the end res­ult of sev­eral days spent mired in extreme heat and humid­ity.

“They needed to be admit­ted to the hos­pital for basic­ally the equi­val­ent of a heart attack,” Xie, who is also an asso­ciate pro­fessor at the Uni­versity of Toronto, said. “It was a lot of strain on the heart. Their body was basic­ally shut­ting down because it couldn’t keep up with cool­ing itself.”

Like many Toronto­n­ians, this eld­erly patient lived in an apart­ment without air con­di­tion­ing, Xie said. With no way to escape the oppress­ive heat and humid­ity, they were left to grow “sicker and sicker” over the course of sev­eral days — made worse by their pre­exist­ing heart and lung con­di­tions.

“I basic­ally have the same story every year,” he con­tin­ued. “On very hot days, this is the most com­mon present­a­tion of people who don’t have heat pumps or air con­di­tion­ing.”

Like clock­work, a stream of patients present to the emer­gency room whenever the ther­mo­stat breaches 30 C, espe­cially when it’s humid out, Xie said. Stud­ies sug­gest an aver­age of 120 people die of heatre­lated incid­ents every year in Toronto — and the danger only escal­ates the more humid it gets, experts say.

Our bod­ies have two main meth­ods of cool­ing down when it’s hot out.

We wet our skin with sweat, dis­sip­at­ing heat when the per­spir­a­tion evap­or­ates. At the same time, our hearts beat faster and our blood ves­sels just under the skin dilate, send­ing hot blood cours­ing toward our skin and outer extremit­ies where it can cool off, explained Dr. Sam­antha Green, a fam­ily phys­i­cian and expert on the health con­sequences of cli­mate change.

Humid­ity throws both those mech­an­isms out of whack.

It becomes far more dif­fi­cult for sweat to evap­or­ate when the air is already filled with mois­ture, Green said. With its abil­ity to cool down dimin­ished, our bod­ies heat up quicker, rais­ing our risk of heat stroke.

“As humid­ity increases, the effect­ive­ness of sweat­ing decreases. And at around 90 per cent humid­ity, (sweat­ing becomes) inef­fect­ive,” Green said.

This comes with another prob­lem. Our bod­ies sweat more when it’s humid out, to com­pensate for the reduc­tion in effi­ciency, Xie said.

Excess sweat­ing can also dam­age our kid­neys, which require us to be prop­erly hydrated to func­tion prop­erly.

Else­where, our hearts are strain­ing harder than usual to pump blood toward the skin and extremit­ies to make up for our dwind­ling abil­ity to cool ourselves, Green said.

There’s a com­plic­ated method of meas­ur­ing tem­per­at­ure while tak­ing into account humid­ity — as well as wind and solar radi­ation — called wet bulb globe tem­per­at­ure.

It’s gen­er­ally believed a wet bulb read­ing greater than 35 C is the upper limit for human sur­viv­ab­il­ity, said Peter Crank, an assist­ant pro­fessor of geo­graphy and envir­on­mental man­age­ment at the Uni­versity of Water­loo.

“At that point, the envir­on­ment around you is essen­tially so warm and so humid in com­bin­a­tion, that your body is no longer able to main­tain thermal reg­u­la­tion,” he said.

For ref­er­ence, Wed­nes­day, when tem­per­at­ures climbed above 28 C with a rel­at­ive humid­ity above 80 per cent, had a wet bulb of around 20 C, accord­ing to weather fore­cast­ing tool Met­eo­lo­gix.

The people at greatest risk of high heat and humid­ity include the eld­erly; people with chronic heart, lung and kid­ney con­di­tions; people who work out­doors; and people without air con­di­tion­ing, the experts say.

These indi­vidu­als must take extra care to cool down, Green said. If pos­sible, she advises find­ing a cool space near you and vis­it­ing reg­u­larly — the City of Toronto has an inter­act­ive map of cool spaces on its web­site. “If that’s not pos­sible, stay cool by tak­ing a cool shower,” she said. If your home has no air con­di­tion­ing, con­sider installing win­dow cov­ers to block out the sun dur­ing the day and keep your win­dows open dur­ing the night, she said.

A fan can help as well, so long as the indoor air tem­per­at­ure remains below 35 C.

It’s import­ant to drink extra water when it’s hot out, Xie said. Just avoid alco­holic, caf­fein­ated or sug­ary bever­ages, as these can dehyd­rate you fur­ther.

You may also con­sider apply­ing an ice pack to areas of the body with more blood sup­ply, such as the back of the neck, under the armpits or near the groin, Green added.

HOW THE STAR ANALYZED THE WORKPLACE HEAT DATA

This article was written by Kate Allen and was published in the Toronto Star on June 7, 2025.

Two sum­mers ago, while writ­ing about unpre­ced­en­ted heat waves grip­ping the North­ern Hemi­sphere, I learned three things.

I learned that heat waves are the dead­li­est form of extreme weather, killing more people than any other nat­ural dis­aster.

I learned that heat is nick­named “the silent killer,” because most of these deaths are dir­ectly attrib­uted to heart attacks, res­pir­at­ory dis­eases and other under­ly­ing health con­di­tions. And I learned that this toll is largely avoid­able: experts told me the right pro­tec­tions can shield people from risks.

So I decided to find out: is extreme heat harm­ing Ontari­ans? And could I find evid­ence of it?

I decided to focus on work­ers first. Over the last 18 months, I obtained more than a dec­ade’s worth of data on work­place injur­ies and fatal­it­ies, received hun­dreds of internal gov­ern­ment doc­u­ments through free­dom of inform­a­tion laws, and spoke to doc­tors, sci­ent­ists, work­ers and their fam­il­ies.

This story is the first in a series on what I found. Here’s how we did it:

Data

The ana­lyses in this story are based on two data sets: one on work­place injur­ies and one on tem­per­at­ure.

The injury data set is a daily count of crit­ical injur­ies and fatal­it­ies repor­ted to the Ontario Min­istry of Labour between 2012 and 2024, which the min­istry provided at the Star’s request.

All employ­ers covered by Ontario’s Occu­pa­tional Health and Safety Act (OHSA) are required to imme­di­ately report fatal­it­ies and crit­ical injur­ies. Almost every employer in the province is covered by OHSA; the few excep­tions include fed­er­ally reg­u­lated work­places like banks, ser­vants in private res­id­ences and some farms. Injur­ies of non­work­ers are required to be repor­ted in lim­ited cir­cum­stances, such as when there is a “reas­on­able con­nec­tion” between the haz­ard that caused the incid­ent and a real­istic risk to worker health and safety.

The tem­per­at­ure data set is from an Envir­on­ment and Cli­mate Change Canada weather sta­tion in down­town Toronto, and con­tains the daily max­imum and min­imum tem­per­at­ure and total rain­fall amounts for the same 13­year period.

Caveats

The crit­ical injury data provided by the min­istry does not say where in the province the injury happened, who it happened to or what type of work they were doing.

We chose to use the tem­per­at­ure in Toronto for a few reas­ons.

One is the dens­ity of the work­force. Almost half of the province’s work­ers are in the imme­di­ate Toronto region, and 71 per cent are in the Greater Golden Horse­shoe.

Heat waves are also caused by big, slow­mov­ing atmo­spheric sys­tems that tend to affect large regions. One study that examined three heat waves in south­ern Ontario between 2010 and 2012 found that the rate of emer­gency room vis­its at rural hos­pit­als increased sig­ni­fic­antly in those peri­ods, sug­gest­ing that the health effects of extreme heat events are shared broadly in the region, bey­ond the major urban centres.

Using Toronto tem­per­at­ures as a proxy for the whole province is more likely to be mask­ing the true rela­tion­ship than inflat­ing or invent­ing it. Mis­meas­ure­ment of one vari­able in this type of ana­lysis tends to weaken an asso­ci­ation, rather than cre­ate a false one.

Ana­lyses

To exam­ine the rela­tion­ship between tem­per­at­ure and injur­ies, the Star first did a simple descript­ive ana­lysis of the data. It showed crit­ical injury reports remain roughly flat across most tem­per­at­ures, with an aver­age of approx­im­ately five per day. That changes when the mer­cury hits 32 C: above this threshold, the aver­age num­ber of injur­ies jumps up to 6.3 per day. On days above 35 C, it jumps to an aver­age of seven, though there are few days this hot.

To exam­ine this more rig­or­ously, I shared the data with Peter Smith, senior sci­ent­ist and pres­id­ent of the Insti­tute for Work & Health.

Smith’s ana­lysis used a “case cros­sover” study design, which has par­tic­u­lar value here because it con­trols for fluc­tu­ations in the work­force: for example, that dif­fer­ent days of the week have more people work­ing, and that between May and Septem­ber the size of the labour force changes because of sea­sonal jobs. Smith had used the same study design in two pub­lished, peer­reviewed stud­ies on heat and injury risk.

The basic ques­tion is this: if a worker suffered a crit­ical injury on a Wed­nes­day in May, did the tem­per­at­ure on that Wed­nes­day dif­fer from other Wed­nes­days in the same month? Each crit­ical injury is ana­lyzed as a sep­ar­ate event, with case and com­par­ison days examined as their own groups. Smith’s ana­lysis also adjus­ted for amount of pre­cip­it­a­tion and for whether the case or ref­er­ent day was a pub­lic hol­i­day.

Find­ings

Smith’s ana­lysis showed a con­sist­ent rela­tion­ship between very hot days and increased risk of crit­ical injur­ies too. It also showed a doseresponse rela­tion­ship: the higher the tem­per­at­ure, and the more hot days in a row, the greater the risk.

Smith’s ana­lysis used days between 21 C and 24 C as a ref­er­ence range. On days over 32 C, com­pared to the ref­er­ence range, he found risk of injury increases 24 per cent. Days above 29 C, and con­sec­ut­ive days above 29 C, also showed an increased risk, as did higher min­imum tem­per­at­ure (e.g., hot nights as com­pared to cool nights). These res­ults were all stat­ist­ic­ally sig­ni­fic­ant: it is unlikely the rela­tion­ship between heat and crit­ical injur­ies observed in this ana­lysis happened by ran­dom chance alone.

There were too few fatal­it­ies in the data set to draw clear con­clu­sions. But my report­ing also found that the way Ontario tracks work­place fatal­it­ies over­looks deaths that might be heat­related, and that legal groups have said for years the province is dra­mat­ic­ally under­count­ing all heat­related deaths, and argued for bet­ter track­ing.

How wildfire smoke is affecting air quality

This article was written by Claire McFarlane, Sophia Coppolino, and Temur Durrani, and was published in the Globe & Mail on June 7, 2025.

Runners jog past Riverside Park in Toronto’s east end as wildfire smoke rolls into the city on Friday. Experts say the Air Quality Health Index is a tool that can be used to guide your timing of potentially risky outdoor activities such as walking your dog. SAMMY KOGAN/THE GLOBE AND MAIL

Special statement issued for large swaths of Ontario as more than 210 fires expose people to toxic fumes

Hazardous fumes and thick smoke have blanketed Western Canada, extending toward large parts of Ontario and even beyond the country’s border – an ominous sign that wildfire season is well under way.

More than 210 wildfires are actively burning across Canada as strong, shifting winds and warmer-than-normal temperatures have clashed with tinder-dry conditions.

The encroaching flames have triggered rare province-wide states of emergency in both Saskatchewan and Manitoba, where around 32,000 people combined have been forced to evacuate from their homes. Dozens of other fires are aflame in Alberta and British Columbia.

This weekend, crews in Manitoba, where more than 18,000 people have been displaced, will be contending with 27 large wildfires.

Given forecasts of little to no rain, the province is anticipating more flares to begin and has warned several communities to be ready to flee at a moment’s notice.

Saskatchewan has nearly doubled its count of evacuees, reaching nearly 15,000 this week. Officials are grappling with 24 raging fires, and more than 900,000 hectares have burned.

Alberta, meanwhile, has at least 50 smaller fires; about 5,000 people have been evacuated. British Columbia is facing around 65 wildfires, and a handful of communities near the Alberta border have been ordered to vacate their properties, with strong winds in the northeast showing potential for more extreme fire activity by Sunday.

WHERE IS THE SMOKE AND WHERE WILL IT GO?

Steven Flisfeder, a meteorologist from Environment and Climate Change Canada, says wildfire smoke is contributing to poor air quality from northeastern British Columbia all the way to central and southern Quebec.

A special air-quality statement was issued for the Greater Toronto Area and large swaths of Ontario on Friday.

Environment Canada said it expects poor visibility and high concentrations of wildfire smoke to remain in the air across many major cities, including Toronto and Ottawa, for the next several days.

Smoke from Canadian wildfires has also been drifting into parts of the United States and as far as Europe. The U.S. Environmental Protection Agency has issued air-quality warnings for several states, including Minnesota, New York and Florida, and Europe’s Copernicus Atmosphere Monitoring Service said the smoke has travelled as far east as Greece.

While conditions could change, Mr. Flisfeder said this wildfire season appears to be mirroring the 2023 season, which started early and affected a large portion of Canada.

How wildfire smoke moves depends on how much of it is in the atmosphere and the amount of wildfire activity on the ground, he said.

It also depends on the general atmospheric pattern – where the smoke is lifted higher into the atmosphere, where it is pushed closer to the earth’s surface and how it is pushed in any given direction.

BlueSky Canada, a project of the University of British Columbia, has created a public smoke forecast map that tracks wildfire smoke across Canada.

The map is based on satellite observations. Information about fuel types, weather, temperature, relative humidity and precipitation are then fed into an automated system that predicts the path of wildfire smoke, said Kat Pexa, a smoke information specialist with BlueSky.

The service is predicting a continued eastward drift of smoke from wildfires burning in Saskatchewan and Manitoba on Friday.

WHAT IS THE AIR QUALITY HEALTH INDEX?

The Air Quality Health Index is a scale from one to 10+ used by the federal government. It is calculated using a formula that takes into account pollutants, nitrogen dioxide and ground-level ozone, Mr. Flisfeder said.

Most people without pre-existing health conditions are typically at low risk of developing symptoms from being exposed to air that falls between one and three on the scale, he said.

When the air quality reaches between four and six, the general population may experience symptoms such as cough or throat irritation.

If the air quality reaches between seven and 10, “that’s when everybody in the general public should start to consider reducing their activity, especially strenuous activity outdoors, and especially if you start to feel those symptoms coming on,” Mr. Flisfeder said.

A reading of 10 or more is a signal to limit outdoor activities.

Mr. Flisfeder recommends using the index as a tool to decide how to adjust daily activities and also when to check in on family, neighbours and community members who may be vulnerable and need a reminder to take precautions.

WHAT ARE THE SYMPTOMS OF WILDFIRE SMOKE EXPOSURE?

Wildfire smoke contains fine particulate matter – toxic, microscopic particles that can be inhaled and travel deep into the lungs.

The health effects of wildfire smoke are correlated with the amount of exposure, according to Health Canada.

Early signs of smoke inhalation include coughing and irritation of the eyes, nose and throat. More severe cases may be accompanied by shortness of breath or wheezing.

Children, seniors and people with chronic conditions, such as asthma, heart disease or diabetes, are at greater risk of experiencing severe symptoms, said Angela Yao, an environmental health expert.

For pregnant women, a growing body of research links wildfire smoke exposure with low birth weight and an elevated risk of respiratory infections for babies, Dr. Yao said.

HOW TO NAVIGATE DAILY ACTIVITIES WHEN THE AIR QUALITY IS POOR

Dr. Yao recommends using airquality ratings to guide your timing of outdoor activities such as walking your dog.

“Some people are more sensitive, some are less sensitive,” Dr. Yao said, referring to people’s responses to smoke exposure.

“The overarching advice is really to listen to your body and take it easy when the air quality is not as good.”

While Health Canada indicates there is no safe level of wildfire smoke exposure, symptoms typically subside when air quality improves.

“I think we should be cautious but not too panicked,” Dr. Yao said. “The best way is to know all the tools we can use to protect ourselves and know there is ways to do that.”

However, severe symptoms of smoke inhalation, such as difficulty breathing, are a sign to seek medical attention, experts say.

A study conducted after the 2023 wildfire season found asthma-related emergency room visits rose by 40 per cent among children one to two days after smoke blanketed Ontario.

Adult visits increased by 48 per cent for a week after smoke exposure.

HOW TO PREVENT WILDFIRE SMOKE INHALATION

Experts emphasize the importance of remaining inside buildings with air-filtration or HVAC systems and avoiding any strenuous outdoor activities when the air quality is poor.

For buildings without air filtration systems, studies have shown that setting up a DIY system using a furnace filter and box fan in one room is an effective way to clean the air.

Keeping windows shut and doors closed will reduce contaminating filtered indoor air with smoke.

Still, as temperatures rise it’s important to stay cool by turning on air conditioning at home or visiting air-conditioned public spaces, such as community centres, shopping malls or public libraries, Dr. Yao said.

“If your place gets too hot, then you need to prioritize cooling because that’s usually more dangerous if it gets overheated,” she said.

Those at greater risk of suffering severe symptoms from wildfire smoke inhalation, including seniors, should monitor their symptoms and keep medications to treat existing health conditions on hand.

Wearing a well-fitted, dry mask is an effective way to reduce smoke inhalation, Dr. Yao said. For individuals sensitive to smoke, she recommended wearing a N95 or KF94 mask when outdoors in poor air quality.