Winter can pose significant challenges, especially for individuals experiencing homelessness. Lack of access to shelter and proper clothing can lead to severe frostbite and potential amputations due to prolonged exposure to freezing temperatures and wind chill. Since 2018, Montreal has recorded 46 cases of frostbite amputations across various regional health authorities, averaging about six cases annually.
Although Montreal hospitals do not specifically document the housing status of patients with frostbite, Dr. Ali Izadpanah, a certified plastic surgeon and director of Montreal’s regional burn center at the CHUM, noted that a significant portion of patients treated for severe frostbite are homeless. While frostbite incidents can occur to individuals engaged in outdoor activities, the risk is significantly higher for those without shelter.
Despite the typically harsh winter conditions in Montreal, no frostbite amputations have been reported so far this year. The peak years for frostbite amputations were 2023 and 2025, each with 12 cases. The decrease in cases this year is attributed to the introduction of additional temporary warming shelters citywide and the implementation of a new frostbite treatment drug protocol known as iloprost.
The iloprost treatment, initially developed in Whitehorse, Canada, is now widely used in Quebec. It is particularly effective for Stage 2 and 3 frostbite cases, preserving blood flow to prevent tissue damage and reduce the likelihood of amputation. Previously, Stage 3 frostbite cases carried a high amputation risk, which has significantly decreased with the use of iloprost.
While the reduction in frostbite amputations is a positive trend, the homeless population remains vulnerable to frostbite due to factors such as chronic health conditions and exposure to extreme weather. Organizations like the Old Brewery Mission provide critical support and care for individuals affected by frostbite, emphasizing the importance of early detection and comprehensive medical services within homeless shelters.
The drop in amputations is seen as a positive development, but advocates stress the need for long-term solutions such as increased housing support to prevent homelessness and its associated health risks. Addressing the root causes of homelessness is considered essential in mitigating frostbite challenges among vulnerable populations.
