Health Canada

Abstract The climate crisis is increasingly contributing to a mental health crisis. Policy and practice inadequately account for the mental health costs of climate change and the mental health benefits of climate action. The climate and mental health field is expanding rapidly but unevenly. Connecting Climate Minds (CCM), a global initiative, aimed to develop a guiding vision to ensure investment in and implementation of future research aligns with lived experience needs and appropriately informs policies. CCM convened 1184 contributors with diverse expertise across 126 countries, through 21 online and in-person dialogues. Their insights produced a Global Research and Action Agenda for climate change and mental health. This paper outlines the 53 research priorities structured into four high-level themes (impacts, risks and vulnerable groups; pathways and mechanisms; mental health benefits and risks of climate action; mental health interventions). It also outlines how to implement research and translate evidence to action.

Background:Improving air quality requires addressing sector-specific air pollution (SSAP). This study examined the relationship between long-term SSAP and Alzheimer’s disease and dementia mortality in Canada, and whether associations were modified by neighborhood greenness, educational attainment, and material deprivation.Methods:We used data from the 2006 Canadian Census Health and Environment Cohort with mortality follow-up through 2019, linked to the Canadian Vital Statistics—Death database. Annual exposures to ambient air pollutants (i.e., PM2.5, SO2, NO2, and O3) from multiple sectors were estimated using the Global Environmental Multiscale-Modelling Air Quality and Chemistry model (10 km resolution) with sector-specific contributions anchored to 2015 emissions profiles. Quantile g-computation models were used to estimate hazard ratios (HRs) for Alzheimer’s disease and dementia per quartile increase in SSAP.Results:Alzheimer’s disease mortality was most strongly associated with SSAP from residential fuel combustion (RES: HR = 1.29; 95% CI: 1.16, 1.43), and was also positively associated with emissions from on-road transportation (HR = 1.22; 95% CI: 1.12, 1.32), ore and mineral industries (ORE: HR = 1.17, 95% CI: 1.10, 1.24), air–marine–rail transportation (HR = 1.12; 95% CI: 1.06, 1.18), and manufacturing (MAN: HR = 1.06; 95% CI: 1.01, 1.11), while inverse associations were observed for the oil and gas sector (HR = 0.85; 95% CI: 0.81, 0.88). Dementia mortality was positively associated with oil and gas (HR = 1.06; 95% CI: 1.03, 1.09), and inversely associated with air–marine–rail transportation (HR = 0.88; 95% CI: 0.85, 0.92) and ORE (HR = 0.89; 95% CI: 0.85, 0.92). Associations were generally stronger in lower greenness areas and among individuals with lower educational attainment, although heterogeneity by sector was observed.Conclusion:SSAP mixtures were associated with Alzheimer’s disease and dementia mortality in Canada. The direction and magnitude of associations varied by sector and by environmental and sociodemographic context, supporting the value of targeted, sector-specific mitigation strategies to reduce neurodegenerative mortality risk.

Capillary electrophoresis (CE) often provides superior separation of macromolecules such as monoclonal antibodies (mAbs), a major biopharmaceutical class, compared with liquid chromatography. However, electropherograms frequently exhibit complex baselines and peak shapes that are not reliably handled by integration algorithms designed for chromatographic data, and manual integration is often required. Many concepts have been proposed to improve peak integration, ranging from incremental algorithmic refinements and signal-to-noise (S/N)-based approaches to artificial intelligence (AI)-driven strategies, but objective performance comparisons are not possible without shared reference data sets and agreed peak limits. To address this gap, we initiated a multinational collaboration involving industrial and academic laboratories to create a comprehensive reference data set for CE peak integration. A total of 227 challenging and practically relevant electropherograms were collected from diverse applications, converted to a standardized format, and independently integrated by multiple experts. Using dedicated software tools and a structured consensus process, mutually accepted reference integration limits were established for each data set. These reference electropherograms, together with the underlying integration rules, are now made available to the scientific community. Analysis of the reference data set identified general principles for reliable peak integration, including the importance of standardized zoom levels and consistent handling of small peaks near the noise level. The data set provides a common foundation for benchmarking commercial chromatography data systems (CDS) and for developing and validating new algorithmic and AI-based integration methods. We expect this work to speed up the development of practical, automated integration strategies for CE and that these core concepts can be applied to other separation techniques.

The adverse neurological effects of methylmercury are well characterized in animal models and humans. Neurodevelopmental effects in infants and children following prenatal exposure to methylmercury have been the critical endpoint used for many years in risk assessment for the derivation of toxicological reference values. Most risk assessments of methylmercury have continued to rely on the same epidemiological birth-cohorts from New Zealand, the Faroe Islands, and the Seychelles, in which neurodevelopmental effects of methylmercury were examined during the 1980s and 1990s. New epidemiological studies have since emerged, prompting several organizations to reassess whether current reference values remain protective. As these evaluations proceed, clarity on the basis for derivation of the existing values will be critical particularly if different toxicological reference values are recommended. This review summarizes the history, pivotal data, and methodologies used by different regulatory bodies and expert committees (US EPA, ATSDR, Health Canada, JECFA, and EFSA) to derive toxicological reference values for neurodevelopmental effects of prenatal methylmercury exposure. Although methodologies differed in the choice of points of departure, uncertainty factors, and dosimetry conversions, there is good agreement between the toxicological reference values derived by these organizations. Nonetheless, there remain important uncertainties and data gaps particularly related to how observational epidemiology data were used in derivation of the toxicological reference values. Discussion of these uncertainties should help inform future work on methylmercury and have broader implications for other chemical risk assessments relying on similar types of observational data.

Climate change is increasingly impacting healthcare facilities worldwide, with those in low and middle-income countries generally facing high risks due to higher vulnerability and lower adaptive capacity. This scoping review examines resources to strengthen the climate resilience of healthcare facilities in low and middle-income countries. We used Arksey & O’Malley (2005) and Levac et al. (2010) scoping review methodology to systematically search four academic databases (Scopus, PubMed, CINAHL, and Lilac), as well as Google Scholar, and the grey literature (websites from the World Health Organization, Green Climate Fund, Global Adaptation Mapping Initiative, Health Care Without Harm, and the Global Environmental Facility) between 2015 and 2024. A coding framework guided the data extraction, which was analyzed quantitatively and qualitatively (Braun and Clarke Thematic analysis). We identified 33 resources for building the climate resilience of healthcare facilities in low and middle-income countries. The resources varied in their intended audience, composition, and purpose. They produced various outputs (i.e., guidelines, checklists, or adaptation plans) that are presented in a typology to allow users to select the best resource or tool for their purposes. Our analysis identified 14 domains for building climate-resilient healthcare facilities in low and middle-income countries. We present a range of indicators under each domain for measuring the climate resilience of healthcare facilities to enable monitoring and evaluation of climate resilience-building efforts. There are a growing number of diverse resources that can be used to build climate resilience at the healthcare facilities level in low and middle-income countries. This scoping review offers a comprehensive typology of 33 resources that vary in their focus and application, enabling stakeholders to identify and apply the most appropriate tools for their specific contexts. The 14 key domains identified by this review and associated indicators provide a structured framework for assessing and enhancing climate resilience efforts within healthcare facilities. By offering a range of action-oriented resources and measurable indicators, this review supports ongoing efforts to safeguard healthcare services in low and middle-income countries against the growing impacts of climate change, contributing to the global discourse on sustainable, climate-resilient health systems.

We seek to understand how uncertainty in spatiotemporal models of PM2.5 concentration influences exposure, equity, and health metrics in Canada. We evaluated the accuracy of seven longitudinal PM2.5 concentration data sets from 2002 to 2014 and conducted equity and health impact analysis using each. Specifically, we estimated population exposure improvements over time, exposure disparities for vulnerable subpopulations, and PM2.5-attributable mortality across several combinations of inputs. Nationally, reductions in population exposure to PM2.5 were consistently observed in all models between 2002 and 2014 in Canada, with larger reductions among subpopulations of visible minority status, suggesting that PM2.5 exposure and absolute exposure disparities improved over this period. Agreement between PM2.5 models is strongest for PM2.5-attributable mortality, whereas exposure time trends and contrasts between subpopulations differ more widely. Nationally, estimated PM2.5-attributable mortality ranged from 7,400 to 26,000 deaths in 2014 across combinations of seven PM2.5 models, four Canadian risk estimates, and counterfactuals of 0 and 2.5 μg/m3. PM2.5-attributable death estimates are sensitive to inputs of mortality risks, counterfactuals, and PM2.5 models. Improving estimates of Canadian PM2.5 exposure remains important for reducing uncertainty in health studies, particularly for accountability, equity, and epidemiological studies that rely on spatial or temporal contrasts.

Face masks are an important public health measure whose use became wide-spread during the pandemic. Manufactured nanomaterials (MNMs) have been incorporated into face masks to enhance their anti-microbial and self-cleaning properties. However, the potential toxicity of certain MNMs raises concerns regarding their use in facemasks. Limited research has addressed the airborne shedding potential of MNMs as it relates to inhalation uptake. This work aimed to address this gap by investigating the potential airborne release of TiO2 from the outer surface of three general purpose face masks, under two sets of conditions: physically stable and physically agitated. The surface of the face masks was analyzed to determine the mass fraction of TiO2 and the composition of the particles detected. Particle shedding was quantified via particle counters, particle sizers, electron microscopy, and inductively-coupled-plasma mass spectrometry (ICP-MS). Compositional analysis showed that all tested masks contained different levels of Ti ranging from 80 to 4870 µg/g of mask, with TiO2 particles detected on the surface of the fibers. Particle shedding was observed only for two of the masks under agitation with low average concentrations of 130 and 520 #/cm3. Further analysis of the shed particles did not indicate the presence of TiO2 nanoparticles. Overall, these findings suggest that while TiO2 was present in the face masks, its airborne release under typical conditions may be unlikely. Although additional efforts are needed to characterize a wider range of facemasks and expand on these data, this study contributes to the understanding of inhalation uptake from MNMs shedding to inform future risk assessments.

Open spina bifida (OSB), also known as myelomeningocele, is a neural tube defect where the spine of a developing fetus is exposed. Repair of the defect before birth improves outcomes for both mother and child. A novel minimally invasive robotic in-utero approach is proposed, requiring new tools to enable surgeon planning and training. This work presents a dynamic virtual simulator of the da Vinci Xi Robotic Surgical System with an interactive fetal environment that allows surgeons to practice simulated OSB repair. The simulator is built in the Asynchronous Multi-Body Framework (AMBF) and integrated with the da Vinci Research Kit (dVRK). The directional and rotational control mappings were consistent with the respective controls tested on a real operative da Vinci Xi robot (R2 ≥ 0.979). Kinematics were further validated with path tracing tasks which yielded similar trajectory deviation errors between the simulator and the real Xi robot. Surgeons completed a suturing task using the simulator and evaluated the performance, agreeing that simulator robot controls are realistic, fetal model and suturing are somewhat realistic, and that the simulator is useful as a training tool. This simulator has potential applications in research, surgical training and preoperative planning for robotic approaches to fetal surgical procedures.

SummaryPer- and polyfluoroalkyl substances (PFASs) are persistent environmental contaminants. Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), representing carboxylate and sulfonate subclasses, are among the most frequently detected PFASs in biomonitoring studies. We characterized the hepatotoxicity and immunotoxicity of PFOS and PFOA in male and female C57BL/6-Elite mice exposed via oral gavage for 28 (1.5 mg/kg/day) or 56 days (0.166–1.5 mg/kg/day). Both compounds caused pancreatic atrophy, hepatomegaly, elevated serum biomarkers of liver injury, and decreased serum triglyceride levels across sexes and exposure durations. Liver transcriptomics revealed enrichment of PPAR signaling, lipid metabolism disruption, and AGE-RAGE pathways. Immunotoxicity assessments showed PFOS-induced cytokine suppression (interleukin-4 [IL-4], IL-17α, tumor necrosis factor-alpha [TNF-α], and monocyte chemoattractant protein-1 [MCP-1]) in males, while females exhibited minimal cytokine changes but altered thymocyte development. Overall, PFASs caused sex-independent hepatic and pancreatic toxicity but sex-dependent immune effects. Limitations include asymmetric dosing and lack of estrous monitoring; future studies should integrate histopathology and gene expression confirmatory analysis.