Building resilience: climate change challenges for clinical laboratories
When a hospital laboratory in northern Laos was forced to close for a week after flooding, patients were left waiting for results and treatment. In Ghana, soaring temperatures pushed chemistry analyzers beyond their limits, repeatedly causing quality control failures. In Canada’s Arctic, thawing permafrost is cracking the foundations of health facilities, disrupting medical evacuations and making it harder to transport samples and supplies.
These lived experiences, shared by laboratory professionals in a recent paper published in the journal, Clinical Chemistry, “The Impact of Climate Change on Laboratory Medicine: A Global Health Perspective” illustrates how climate change is reshaping the work of clinical laboratories worldwide. The paper, led by Dr. Melissa Richard-Greenblatt, Assistant Professor in the Department of Laboratory Medicine & Pathobiology (LMP) at the University of Toronto and clinical microbiologist at The Hospital for Sick Children (SickKids), brings together perspectives from Canada, India, Laos, Ghana, Botswana and the United Kingdom to show how extreme weather events are affecting the foundations of healthcare diagnostics. It was important for Richard Greenblatt to include lived experiences as well as rural and indigenous voices in the study. “Even in well-resourced countries, rural areas face delays in turnaround times when extreme weather hits. The impact is magnified many times over in low-resource settings”.
“Laboratory medicine is a cornerstone of modern healthcare and it’s not immune to climate pressures,” says Dr. Richard-Greenblatt. “We need to recognize both the impact labs have on the climate and the impact climate has on labs”.
The paper highlights how disruptions in supply chains, power outages, equipment failures and surges in disease linked to heatwaves, floods or shifting environments can delay care and widen health disparities.
In India, monsoon rains have brought spikes in dengue, malaria and other vector-borne diseases, forcing labs to cope with an overwhelming volume of tests. In Botswana, extreme heat and drought have damaged laboratory equipment and raised the risk of malnutrition and infections. The challenges are not confined to low-income countries: in England, a 2022 heatwave that pushed temperatures above 40 C for the first time in recorded history drove hospital admissions for respiratory and cardiovascular conditions, adding pressure to clinical laboratory services.
Closer to home, Carol Devine, who contributed to the paper, has worked as a Humanitarian Advisor for Doctors Without Borders Canada on climate change, health, and sustainability and is currently the Chief Operating Officer of SeeChange. Devine underscored that Arctic communities face increasing respiratory illnesses, cardiovascular disease and mental health issues linked to rising temperatures. Thawing permafrost is undermining laboratory infrastructure in the North, while unpredictable weather has delayed or cancelled nearly a third of medical evacuations in Nunavut in recent years.
The contributors outlined ways laboratories can adapt to a changing climate, from investing in renewable energy sources and climate-resilient infrastructure to building local supply networks and stockpiling critical reagents. Point-of-care diagnostics, they noted, can provide rapid results in disaster zones or remote areas when central laboratories are inaccessible. Training and education also emerged as a priority - incorporating climate awareness into laboratory medicine curricula, they argue, will ensure future professionals can manage resources sustainably, reduce waste, and prepare for extreme weather disruptions.
“There’s so much we don’t yet appreciate that we can do in lab medicine to reduce our footprint,” Richard-Greenblatt says. “If we start building this into our daily practice, into the way we design studies and grants, the way we educate, we can make a real difference”.
Richard-Greenblatt’s interest in global health is longstanding. Originally from rural Quebec, she completed her PhD at the University of British Columbia, where research on tuberculosis took her to South Africa. She later completed a postdoctoral fellowship with Dr. Kevin Kain in LMP, followed by a clinical microbiology fellowship at the University of Pennsylvania before starting her career at Public Health Ontario. She is now working at SickKids. Along the way Richard-Greenblatt has worked with partners in South and Southeast Asia, Africa, and Canada through organizations such as Doctors Without Borders, Oxford Tropical Medicine Unit, Botswana-UPenn Partnership. Her focus has been largely on laboratory capacity building and identifying novel solutions to improve access to laboratory medicine services in low resource settings.
That global experience gave her the network to assemble the voices featured in the paper. But the urgency of the message, she insists, is universal. “At the end of the day, it’s about improving access to laboratory medicine. Climate change is now part of that equation, and we all have a role to play”.
Thank you to all the participants in the paper:
- Bernard Owusu Agyare, Senior Research Fellow, Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
- Saswati Das, Senior Research Fellow, Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
- Carol Devine, Chief Operating Officer, SeeChange Initiative, Montreal, Canada; Research Fellow, Dahdelah Institute for Global Health Research, York University, Toronto, Canada
- Margaret Mokomane, Senior Lecturer and Medical Microbiologist, School of Allied Health Professions, University of Botswana, Gaborone, Botswana
- Sheri Scott, Senior Lecturer and Medical Microbiologist, School of Allied Health Professions, University of Botswana, Gaborone, Botswana
- Manivanh Vongsouvath, Head of Microbiology Laboratory, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
This story showcases the following pillars of the LMP strategic plan: Dynamic Collaboration (pillar 2) and Impactful Research (pillar 3).
