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Dec 18, 2015

Respiratory Health is already affected by climate change: time to adapt our health practice?

As COP21 conference is drawing to an end in Paris, the World Health Organisation (WHO), estimates that some 250,000 additional deaths could be caused by climate change each year by the 2030s. In this context, the Organisation warns the international community in Paris that health protection should be on top of the climate change agenda (1). Respiratory health is particularly affected by climate changes, in relation to heat, increased air pollution, but also shifts in infectious diseases and allergens. Respiratory health preservation should take into account climate change projections and become an important concern for public health around the world.

A 2013 literature review gives an overview of how climate change is already affecting respiratory health (2). Respiratory infections are more likely to spread under high humidity environment in tropical areas. Experts think that climate change could potentially increase the incidence of childhood pneumonia for example under tropical climates. Moreover, population displacements which will be inevitable shall increase the rate of infection transmissions, including tuberculosis. Environmental events such as increased air pollution and wild fires exacerbate asthma, COPD and premature deaths. Increased ozone exposure, for example, affects lung function and increases asthma related hospitalization and mortality risks for COPD patients. It was shown that for each 1°C increase in mean temperature during the 2006 heat wave in Portugal, COPD morbidity increased by 5.4% (3). Another important factor is the extension of the pollen release period and increased pollen production (due to warmer weather and also higher C02 level). They increase the incidence of asthma and allergic rhinitis.

Measures to reduce the impact of human activity on environmental and climate changes are necessary, however the change is inevitable and adaptation is also crucial. Health professionals and organizations have a key role to play, first to alert the politics and recent examples in UK Australia show that their health arguments can help raise public awareness and make a difference in energetic politics (1). It may also be time to rethink our respiratory health approach altogether, favouring a prophylactic approach over a purely therapeutic approach, including shift of lifestyle habits, but also immunisation especially for at-risk populations. Since, as we can read in the 2013 ERS White Book, “population protection by vaccination against infections has been one of the major achievements of public health and is of considerable importance in controlling respiratory diseases.” If we cannot control the climate, let’s try to adapt our health practices.

2. Tim K Takaro; Kim Knowlton; John R Balmes Climate Change and Respiratory Health Current Evidence and Knowledge Gaps Expert Review of Respiratory Medicine
3. Monteiro A, Carvalho V, Oliveira T, Sousa C. Excess mortality and morbidity during the July 2006 heat wave in Porto, Portugal. Int J. Biometeorol 2013;57:155-67.