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Through interactions among environmental, individual, and biological factors, climate change is contributing to the rising impact of occupational asthma, according to an expert review in the March issue of the
Journal of Occupational and Environmental Medicine.
"Asthma is a growing global health challenge, exacerbated by the multifaceted impacts of climate change," according to the report by J.P.M. van der Valk, MD, PhD, of Franciscus Gasthuis and Vlietland, Rotterdam, the Netherlands, and colleagues. They analyze climate-related factors contributing to the rising impact of asthma in occupational and other settings.
Accelerating climate change has led to ongoing temperature increases around the world. Rising temperatures contribute to rising sea levels, intense heat waves, severe thunderstorms and flooding, more frequent wildfires, and other environmental changes.
Extreme temperatures, air pollution, prolonged pollen seasons, and higher levels of mold in indoor and outdoor air all contribute to an increased frequency and severity of asthma exacerbations (attacks). A recent study from California reported a 19% increase in hospital visits for children with severe asthma exacerbations during prolonged heatwaves.
"Asthma may serve as a 'canary in the coalmine' reflecting the cumulative effects of planetary stressors on human health," Dr. van der Valk and colleagues write. They outline the ways that climate change interacts with individual predisposing factors to increase long-term asthma risk. Immune system changes include a shift in the balance between Th1 and Th2 cell responses, leading to airway narrowing and increased inflammatory responses.
Certain occupational groups face high risks of climate-related asthma exacerbations—particularly outdoor occupations such as construction, road, and agricultural workers. Other groups are at risk due to poor indoor air quality, including teachers and childcare providers.
The authors discuss steps to help mitigate and adapt to climate effects on asthma and related health risks. "By understanding the link between asthma symptoms and exposure to indoor and outdoor allergens as well as air quality, patients can better anticipate and manage their condition."
Dr van der Valk and coauthors emphasize the need for a "Planetary Health" approach to the interconnected ecological and social changes affecting the global burden of asthma. They conclude: "Recognizing the health implications of climate change enables policymakers to adopt targeted strategies, including sustainable urban planning, resilient infrastructure adaptation, and inclusive urban housing initiatives."