Taking action towards climate-resilient, low-carbon, health systems: Perspectives from Canadian health leaders and healthcare professionals.

Climate change poses significant public health and health system challenges including increased demand for health services due to chronic and acute health impacts from vector-borne diseases, heat-related illness, and injury from severe weather. As climate change worsens, so do its effects on health systems such as increasing severity of weather extremes causing damage to healthcare infrastructure and interference with supply chains. Ironically, health sectors globally are significant contributors to climate change, generating an estimated 5% of global emissions. Achieving "net zero" health systems require large-scale change with shared decision-making to coordinate a pan-Canadian approach to creating climate-resilient and low-carbon healthcare. In this article, we discuss healthcare professionals' and health leaders' perceptions of responsibility for practicing and advocating for climate-resilient and low-carbon healthcare in Canada.

Overwinter Changes in the Lipid Profile of Young-of-the-Year Striped Bass (Morone saxatilis) in Freshwater Ponds.

Young-of-the-year (YOY) striped bass (Morone saxatilis) suffer significant mortality during their first winter. While causes of this mortality are unclear, lipids may play role in adapting to winter stresses, including thermal change and food scarcity. To address this, YOY striped bass were placed in mesh cages in freshwater ponds in the fall (November) and were held until the end of winter, in March. Liver and white muscle tissue were sampled at the beginning and end of the study to compare concentrations of specific lipid classes and fatty acid composition. Muscle-tissue total lipid and triacylglycerol (TAG) was higher in March (late winter) samples. Additionally, concentrations of phosphatidylethanolamine (PE) were higher in the white muscle of striped bass sampled in March; this was accompanied by a decrease in proportions of 18:0 and 22:6n-3 in PE (from ~11 to 7% and 36 to 28%, respectively) and 18:1n-9 and 22:6n-3 in phosphatidylcholine (from ~15 to 10% and 24 to 18%, respectively). This suggests that these fish were not utilizing energy reserves in previously described ways and appear to rely more on other lipid classes or body tissues for overwinter survival than those analyzed in this study.

Environmental performance of blue foods.

Fish and other aquatic foods (blue foods) present an opportunity for more sustainable diets1,2. Yet comprehensive comparison has been limited due to sparse inclusion of blue foods in environmental impact studies3,4 relative to the vast diversity of production5. Here we provide standardized estimates of greenhouse gas, nitrogen, phosphorus, freshwater and land stressors for species groups covering nearly three quarters of global production. We find that across all blue foods, farmed bivalves and seaweeds generate the lowest stressors. Capture fisheries predominantly generate greenhouse gas emissions, with small pelagic fishes generating lower emissions than all fed aquaculture, but flatfish and crustaceans generating the highest. Among farmed finfish and crustaceans, silver and bighead carps have the lowest greenhouse gas, nitrogen and phosphorus emissions, but highest water use, while farmed salmon and trout use the least land and water. Finally, we model intervention scenarios and find improving feed conversion ratios reduces stressors across all fed groups, increasing fish yield reduces land and water use by up to half, and optimizing gears reduces capture fishery emissions by more than half for some groups. Collectively, our analysis identifies high-performing blue foods, highlights opportunities to improve environmental performance, advances data-poor environmental assessments, and informs sustainable diets.

Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care.

BACKGROUND: Both human health and the health systems we depend on are increasingly threatened by a range of environmental crises, including climate change. Paradoxically, health care provision is a significant driver of environmental pollution, with surgical and anesthetic services among the most resource-intensive components of the health system. OBJECTIVES: This analysis aimed to summarize the state of life cycle assessment (LCA) practice as applied to surgical and anesthetic care via review of extant literature assessing environmental impacts of related services, procedures, equipment, and pharmaceuticals. METHODS: A state-of-the-science review was undertaken following a registered protocol and a standardized, LCA-specific reporting framework. Three bibliographic databases (Scopus®, PubMed, and Embase®) and the gray literature were searched. Inclusion criteria were applied, eligible entries critically appraised, and key methodological data and results extracted. RESULTS: From 1,316 identified records, 44 studies were eligible for inclusion. The annual climate impact of operating surgical suites ranged between 3,200,000 and 5,200,000 kg CO2e. The climate impact of individual surgical procedures varied considerably, with estimates ranging from 6 to 1,007 kg CO2e. Anesthetic gases; single-use equipment; and heating, ventilation, and air conditioning system operation were the main emissions hot spots identified among operating room- and procedure-specific analyses. Single-use equipment used in surgical settings was generally more harmful than equivalent reusable items across a range of environmental parameters. Life cycle inventories have been assembled and associated climate impacts calculated for three anesthetic gases (2-85 kg CO2e/MAC-h) and 20 injectable anesthetic drugs (0.01-3.0 kg CO2e/gAPI). DISCUSSION: Despite the recent proliferation of surgical and anesthesiology-related LCAs, extant studies address a miniscule fraction of the numerous services, procedures, and products available today. Methodological heterogeneity, external validity, and a lack of background life cycle inventory data related to many essential surgical and anesthetic inputs are key limitations of the current evidence base. This review provides an indication of the spectrum of environmental impacts associated with surgical and anesthetic care at various scales. https://doi.org/10.1289/EHP8666.

Potential socioeconomic impacts from ocean acidification and climate change effects on Atlantic Canadian fisheries.

Ocean acidification is an emerging consequence of anthropogenic carbon dioxide emissions. The full extent of the biological impacts are currently not entirely defined. However, it is expected that invertebrate species that rely on the mineral calcium carbonate will be directly affected. Despite the limited understanding of the full extent of potential impacts and responses there is a need to identify potential pathways for human societies to be affected by ocean acidification. Research on these social implications is a small but developing field. This research contributes to this field by using an impact assessment framework, informed by a biophysical model of future species distributions, to investigate potential impacts facing Atlantic Canadian society from potential changes in shellfish fisheries driven by ocean acidification and climate change. New Brunswick and Nova Scotia are expected to see declines in resource accessibility but are relatively socially insulated from these changes. Conversely, Prince Edward Island, along with Newfoundland and Labrador are more socially vulnerable to potential losses in fisheries, but are expected to experience relatively minor net changes in access.

Avoiding a crisis of motivation for ocean management under global environmental change.

Climate change and ocean acidification are altering marine ecosystems and, from a human perspective, creating both winners and losers. Human responses to these changes are complex, but may result in reduced government investments in regulation, resource management, monitoring and enforcement. Moreover, a lack of peoples' experience of climate change may drive some towards attributing the symptoms of climate change to more familiar causes such as management failure. Taken together, we anticipate that management could become weaker and less effective as climate change continues. Using diverse case studies, including the decline of coral reefs, coastal defences from flooding, shifting fish stocks and the emergence of new shipping opportunities in the Arctic, we argue that human interests are better served by increased investments in resource management. But greater government investment in management does not simply mean more of "business-as-usual." Management needs to become more flexible, better at anticipating and responding to surprise, and able to facilitate change where it is desirable. A range of technological, economic, communication and governance solutions exists to help transform management. While not all have been tested, judicious application of the most appropriate solutions should help humanity adapt to novel circumstances and seek opportunity where possible.

Life cycle assessment of a novel closed-containment salmon aquaculture technology.

In salmonid aquaculture, a variety of technologies have been deployed that attempt to limit a range of environmental impacts associated with net-pen culture. One such technology employs a floating, solid-walled enclosure as the primary culture environment, providing greater potential control over negative interactions with surroundings waters while limiting energy use required for water circulation, thermo-regulation and supplemental oxygen provision. Here, we utilize life cycle assessment to model contributions to a suite of global-scale resource depletion and environmental concerns (including global warming potential, acidification potential, marine eutrophication potential, cumulative energy use, and biotic resource use) of such a technology deployed commercially to rear Chinook salmon in coastal British Columbia, Canada. Results indicate that at full grow-out, feed provisioning and on-site energy use dominate contributions across four of five impact categories assessed. For example, per tonne of salmon harvested, feed contributed approximately 72% to global warming potential, 72% to acidification potential, and accounted for 100% of biotic resource use. However, for both feed and on-site energy use, impacts are heavily influenced by specific sources of inputs; therefore efforts to improve the environmental performance of this technology should focus on reducing these in favor of less impactful alternatives.

Does aquaculture add resilience to the global food system?

Aquaculture is the fastest growing food sector and continues to expand alongside terrestrial crop and livestock production. Using portfolio theory as a conceptual framework, we explore how current interconnections between the aquaculture, crop, livestock, and fisheries sectors act as an impediment to, or an opportunity for, enhanced resilience in the global food system given increased resource scarcity and climate change. Aquaculture can potentially enhance resilience through improved resource use efficiencies and increased diversification of farmed species, locales of production, and feeding strategies. However, aquaculture's reliance on terrestrial crops and wild fish for feeds, its dependence on freshwater and land for culture sites, and its broad array of environmental impacts diminishes its ability to add resilience. Feeds for livestock and farmed fish that are fed rely largely on the same crops, although the fraction destined for aquaculture is presently small (∼4%). As demand for high-value fed aquaculture products grows, competition for these crops will also rise, as will the demand for wild fish as feed inputs. Many of these crops and forage fish are also consumed directly by humans and provide essential nutrition for low-income households. Their rising use in aquafeeds has the potential to increase price levels and volatility, worsening food insecurity among the most vulnerable populations. Although the diversification of global food production systems that includes aquaculture offers promise for enhanced resilience, such promise will not be realized if government policies fail to provide adequate incentives for resource efficiency, equity, and environmental protection.

Life cycle environmental impacts of three products derived from wild-caught Antarctic krill (Euphausia superba).

Concern has been voiced in recent years regarding the environmental implications of the Antarctic krill fishery. Attention has focused primarily on ecological concerns, whereas other environmental aspects, including potentially globally problematic emissions and material and energy demands, have not been examined in detail. Here we apply life cycle assessment to measure the contributions of krill meal, oil, and omega-3 capsules to global warming, ozone depletion, acidification, eutrophication, energy use, and biotic resource use. Supply chains of one krill fishing and processing company, Aker BioMarine of Norway, were assessed. Impacts of krill products were found to be driven primarily by the combustion of fossil fuels onboard the fishing vessel and a transport/resupply vessel. Approximately 190 L of fuel are burned per tonne of raw krill landed, markedly higher than fuel inputs to reduction fisheries targeting other species. In contrast, the biotic resource use associated with extracting krill is relatively low compared to that of other reduction fisheries. Results of this study provide insight into the broader environmental implications of the krill fishery, comparisons between products derived from krill and other species targeted for reduction, opportunities for improving the fishery's performance, and a baseline against which to measure future performance.

Forecasting potential global environmental costs of livestock production 2000-2050.

Food systems--in particular, livestock production--are key drivers of environmental change. Here, we compare the contributions of the global livestock sector in 2000 with estimated contributions of this sector in 2050 to three important environmental concerns: climate change, reactive nitrogen mobilization, and appropriation of plant biomass at planetary scales. Because environmental sustainability ultimately requires that human activities as a whole respect critical thresholds in each of these domains, we quantify the extent to which current and future livestock production contributes to published estimates of sustainability thresholds at projected production levels and under several alternative endpoint scenarios intended to illustrate the potential range of impacts associated with dietary choice. We suggest that, by 2050, the livestock sector alone may either occupy the majority of, or significantly overshoot, recently published estimates of humanity's "safe operating space" in each of these domains. In light of the magnitude of estimated impacts relative to these proposed (albeit uncertain) sustainability boundary conditions, we suggest that reining in growth of this sector should be prioritized in environmental governance.

Not all salmon are created equal: life cycle assessment (LCA) of global salmon farming systems.

We present a global-scale life cycle assessment of a major food commodity, farmed salmon. Specifically, we report the cumulative energy use, biotic resource use, and greenhouse gas, acidifying, and eutrophying emissions associated with producing farmed salmon in Norway, the UK, British Columbia (Canada), and Chile, as well as a production-weighted global average. We found marked differences in the nature and quantity of material/energy resource use and associated emissions per unit production across regions. This suggests significant scope for improved environmental performance in the industry as a whole. We identify key leverage points for improving performance, most notably the critical importance of least-environmental cost feed sourcing patterns and continued improvements in feed conversion efficiency. Overall, impacts were lowest for Norwegian production in most impact categories, and highest for UK farmed salmon. Our results are of direct relevance to industry, policy makers, eco-labeling programs, and consumers seeking to further sustainability objectives in salmon aquaculture.

Life cycle considerations for improving sustainability assessments in seafood awareness campaigns.

It is widely accepted that improving the sustainability of seafood production requires efforts to reverse declines in global fisheries due to overfishing and to reduce the impacts to host ecosystems from fishing and aquaculture production technologies. Reflective of on-going dialogue amongst participants in an international research project applying Life Cycle Assessment to better understand and manage global salmon production systems, we argue here that such efforts must also address the wider range of biophysical, ecological, and socioeconomic impacts stemming from the material and energetic throughput associated with these industries. This is of particular relevance given the interconnectivity of global environmental change, ocean health, and the viability of seafood production in both fisheries and aquaculture. Although the growing popularity of numerous ecolabeling, certification, and consumer education programs may be making headway in influencing Western consumer perceptions of the relative sustainability of alternative seafood products, we also posit that the efficacy of these initiatives in furthering sustainability objectives is compromised by the use of incomplete criteria. An emerging body of Life Cycle Assessment research of fisheries and aquaculture provides valuable insights into the biophysical dimensions of environmental performance in alternative seafood production and consumption systems, and should be used to inform a more holistic approach to labeling, certifying, and educating for sustainability in seafood production. More research, however, must be undertaken to develop novel techniques for incorporating other critical dimensions, in particular, socioeconomic considerations, into our sustainability decision-making.

Fueling global fishing fleets.

Over the course of the 20th century, fossil fuels became the dominant energy input to most of the world's fisheries. Although various analyses have quantified fuel inputs to individual fisheries, to date, no attempt has been made to quantify the global scale and to map the distribution of fuel consumed by fisheries. By integrating data representing more than 250 fisheries from around the world with spatially resolved catch statistics for 2000, we calculate that globally, fisheries burned almost 50 billion L of fuel in the process of landing just over 80 million t of marine fish and invertebrates for an average rate of 620 L t(-1). Consequently, fisheries account for about 1.2% of global oil consumption, an amount equivalent to that burned by the Netherlands, the 18th-ranked oil consuming country globally, and directly emit more than 130 million t of CO2 into the atmosphere. From an efficiency perspective, the energy content of the fuel burned by global fisheries is 12.5 times greater than the edible-protein energy content of the resulting catch.

The future for fisheries.

Formal analyses of long-term global marine fisheries prospects have yet to be performed, because fisheries research focuses on local, species-specific management issues. Extrapolation of present trends implies expansion of bottom fisheries into deeper waters, serious impact on biodiversity, and declining global catches, the last possibly aggravated by fuel cost increases. Examination of four scenarios, covering various societal development choices, suggests that the negative trends now besetting fisheries can be turned around, and their supporting ecosystems rebuilt, at least partly.