Cold-related injuries in Canada:

On this page

• Background
• Prevention
• Key findings
• Cold-related deaths
• Cold-related hospitalizations
• Cold-related emergency department visits
• Cold-related ED visits from the Canadian Hospitals Injury Reporting and Prevention Program
• Limitations
• References
• Footnotes

Some groups of people may be at higher risk for these injuries such as:

• babies and children
• older adults
• people experiencing homelessness
• people living with certain medical conditions
• those taking medications (like for heart, neurological, or psychiatric conditions) ^{Footnote 4}, ^{Footnote 6}, ^{Footnote 7}, ^{Footnote 8}, ^{Footnote 9}, ^{Footnote 10}

For more information on extreme cold and cold injury prevention, visit:

• Extreme cold
• Seven steps to cold weather safety
• Winter weather safety tips
• Cold-related emergencies — Canadian Red Cross

Key findings

Deaths and injuries described in this blog are from exposure to natural, cold temperatures. This is defined in the International Classification of Diseases (ICD) 10-X31 as “exposure to excessive natural cold”.

Every year, there are over 125 cold-related deaths in Canada. Most of these deaths are among adults aged 50 years and older. Cold-related deaths and hospitalizations increased between 2011 and 2023. Males represent the majority of cases.

Data from cold-related ED visits show that people aged 15 to 39 years are more represented compared to other age groups. This is in contrast to deaths and hospitalizations that affect more older adults.

The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) collects case data from emergency departments across Canada. In CHIRRP, substance use was reported in nearly a quarter of cold-related injuries. Alcohol was the most common substance reported.

Between 2011 and 2023, annual rates ranged between 2.1 to 4.9 deaths per 1,000,000 people in the population. Deaths increased overall by 4.1*% (95% CI: 1.0, 7.2) over the 13 years.

Notes

• Source: Statistics Canada – Canadian Vital Statistics

Figure 1: Population rates of cold-related deaths (ICD-10: X31) in Canada, 2011 to 2023

Notes

• Source: Statistics Canada – Canadian Vital Statistics
• AAPC: Average annual percentage change. (*) The AAPC is significantly different from zero at the α = 0.05 level.

Table 2: Cold-related hospitalizations (ICD-10: X31) in Canada (excluding Quebec), fiscal years 2011 to 2023

Notes

• Source: Canadian Institute for Health Information – Discharge Abstract Database

Figure 2: Annual hospitalization rates for cold-related injuries (ICD-10: X31) in Canada (excluding Quebec) by age group, fiscal years 2011 to 2023

Notes

• Source: Canadian Institute for Health Information – Discharge Abstract Database
• AAPC: Average annual percentage change. (*) The AAPC is significantly different from zero at the α = 0.05 level.

Table 3: Cold-related emergency department visits (ICD 10: X31) reported in Alberta, Ontario and Yukon by age group, fiscal years 2011 to 2023

Notes

• Source: Canadian Institute for Health Information – National Ambulatory Care Reporting System

Figure 3: Annual emergency department visit rates of cold-related injuries (ICD-10: X31) in Alberta, Ontario and Yukon by age group, fiscal years 2011 to 2023

Notes

• Source: Canadian Institute for Health Information – National Ambulatory Care Reporting System
• AAPC: Average annual percentage change. (*) The AAPC is significantly different from zero at the α = 0.05 level.

Cold-related ED visits from the Canadian Hospitals Injury Reporting and Prevention Program

Data come from the Public Health Agency of Canada’s Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). CHIRPP only includes injury data from select EDs across Canada (^{Footnote 11}). Records in CHIRPP have narratives that describe situations that caused the injuries.

Between April 1, 2011 and July 17, 2024, there were 1,650 cold-related cases ^{Footnote i} reported in CHIRPP. This represents 75.8 cases per 100,000 CHIRPP records. To compare heat-related injuries represent 39.7 cases per 100,000 CHIRPP records.

People experiencing homelessness

150 cases (9.1%) of cold-related injuries involved a patient who was experiencing homelessness^{Footnote ii}. Among these cases:

• 78.0% (n = 117) were male, among which 30- to 39-year-olds had the highest count (n = 53)
• Among females, the 20-29-year and 40–49-year age groups had the highest counts at 10 cases each.

Sample narrative: “ Living on the streets and walking in wet shoes. […] No dry shoes to wear.”

Substance use

Nearly a quarter of all cold-related injury cases indicated that a substance was taken (23.5%; n = 387). The most commonly reported substances were:

• alcohol (68.9%)
• stimulants (22.7%)
• marijuana (10.3%)

In over one-fifth of these cases (21.4% - n = 83) at least 2 different substances were taken (polysubstance). The most common combinations were:

• alcohol and marijuana (22.9%)
• alcohol and stimulants (20.5%)

Alcohol was present in 72.3% of polysubstance cases (n = 60).

Sample narrative: “ Drinking alcohol, found by passerby’s. Passed out in snowbank wearing limited clothing.”

Limitations

Data from Statistics Canada’s Canadian Vital Statistics in 2023 are considered preliminary and may change over time.

For hospitalizations and ED visits, data are from Canadian Institute for Health Information (CIHI). CIHI data includes the Discharge Abstract Database (DAD) and the National Ambulatory Care Reporting System (NACRS) database. These data are reported at the population level. As noted, some provinces and territories do not have complete data coverage.

CHIRPP is a sentinel surveillance system. It collects data from select EDs across Canada. It does not represent all cold-related injuries in Canada. Most CHIRPP hospitals are located in major cities (^{Footnote 11}). Injuries involving Indigenous peoples including First Nations, Inuit and Métis, and people who live in rural areas may be under-represented.

References

Footnotes