Climate changes respiratory health

Graphic image of man sneezing while surrounded by a circle of blended seasons – suffering the impacts of climate change on his respiratory health. Headline says ‘When seasons blur… breathing suffers’

Climate change is impacting the air we breathe.

Burning fossil fuels, deforestation, livestock production and industrial processes are all examples of human activities which increase greenhouse gas emissions and drive climate change.1 As a result, hot extremes have become more frequent and more intense, with global surface increasing faster since 1970 than in any other 50-year period over at least the last 2000 years.2

These extreme weather episodes pose a significant threat to health and life.1 Vulnerable groups, such as elderly individuals, pregnant women and children, people with disabilities, and those with chronic medical conditions are at the highest risk.1 Among its many devastating effects, climate change also impacts respiratory systems critical to human health.3

In this ever-changing world, patients will look to their primary healthcare providers to help them adapt. Healthcare professionals like you will be crucial in advising and supporting patients through these new challenges. And Haleon is here to support you. We’re committed to not only helping you understand this new health landscape, but to also support you as you help your patients navigate it too.

Icons highlighting the impact of climate change on health, including increases in respiratory conditions, heatstroke, and the spread of microorganisms

There is no single climate change event that impacts respiratory health.4-10

There are many facets to climate change and extreme weather, and their effects are felt across of wide spectrum of respiratory health conditions.4-10

These include:

  • Flooding encourages mould growth which contributes to asthma, allergic rhinitis and sinusitis4
  • Rapid weather changes have increased the risk of flu epidemics5
  • Rising temperatures and CO2 levels contribute to allergy season arriving earlier and lasting longer6
  • Air pollution and high temperature exacerbates asthmatic symptoms7
  • Lower temperature and humidity create favourable conditions for flu transmission8
  • Wildfire smoke contains microscopic particles which contribute to coughing and asthma flare-ups9
  • Heat waves increase mortality, with the elderly being particular at risk10

Select a climate change event to learn how it impacts respiratory health

  • Heatwaves

    Icons depicting the indirect (impact on health services, increased risk of accidents, increased transmission of diseases, potential disruption of infrastructure) and direct (heat illness, increased morbidity, hospitalisation) impacts of exposure to extreme heat.

    Heatwaves threaten many, but vulnerable patients will suffer the most11

    It has been very clear for some time now that climate change brings with it devastating heatwaves. Their intensity, frequency, duration, and geographic extent will continue to increase as climate change progresses.12

    Symptoms of heat exposure are severe. Heat exhaustion and heat stroke are conditions which can result in the body’s inability to control high temperatures.11 However, older, and more vulnerable patients are most at risk. These include children, pregnant women, outdoor and manual workers, athletes and the poor.11 Deaths and hospitalisations from heat can occur extremely rapidly (same day) or have a lagged effect (several days later) and result in accelerating death or illness in the already frail, particularly observed in the first days of heatwaves.11

    Temperature extremes can also worsen chronic conditions including respiratory illnesses.11 Heatwaves are often accompanied by thunderstorms which can trigger asthma attacks, known as ‘thunderstorm asthma’. This is due to changes in pollen distribution during storms; increased water absorption causes greater pollen release, and winds increases pollen range.13

    There’s also link between heatwaves and respiratory-related mortality, with elderly patients being significantly impacted.14

    As the world’s population ages, heatwaves are likely to pose an even greater threat to human health, making them an important weather event for healthcare professionals to understand.12

  • Dust storms

    Image of a dust storm over a road and desert plain. The dust cloud takes over half of the sky

    Desertification is rising, along with the health impacts of dust.15

    As climate change, deforestation, and other contributing human activities continue, communities face desert and sandstorms that are more intense, more often, and across wider geographical areas.15

    It’s known that the physical, biological, and chemical properties of dust particles can potentially have detrimental effects to health.15 Firstly, a significant proportion of dust particles are small enough to be inhaled into the respiratory tract, even reaching alveoli, where they can cause damage.16 Secondly, the composition of dust can also include a high diversity of microorganisms and allergens, including dust mites, pollen and a wide array of pathogenic bacteria, viruses, and fungi.16

    People exposed to sandstorms experience a wide range of respiratory symptoms. A study of 517 people in Riyadh, Saudi Arabia, showed that a large proportion of those exposed had respiratory complaints such as cough, runny nose, wheeze and asthma attacks, alongside other health issues like eye irritation, headache, and sleep disturbance.17

    Dust can remain in the air for days after a storm, impacting the health of those even far away from the source.15 When inhaled, particles land in airways, initiating an immune response that can lead to acute asthma exacerbations, and even the formation of granulomas.16

  • Allergens

    Circular diagram highlighting 5 factors related to climate change that can impact allergens and health: air pollution, vector-borne diseases, water-borne diseases, pollen pattern changes, and extreme weather

    The annual amount of pollen emitted each year could increase by up to 200%.6

    Climate change has significantly changed everything we know about aeroallergens. Their production, distribution, duration, release times and the amount released have all been impacted.6,18 Possibly more alarmingly, the allergenicity of allergens is also increasing.1 As extreme weather events intensify, current evidence shows that allergic diseases will become a more prevalent threat to health.18

    With regards to allergenic pollen specifically, changes in its distribution and abundance are leading to increased exposure and exacerbation of allergic disease.18

    • More CO2 in the atmosphere can result in larger, faster growing plants, more intense flowering, and greater pollen potency.19
    • Air pollution, such as from urbanisation and vehicle emissions, has been linked to increased rates of allergy presentation.19
    • Climate change is increasing the length and severity of the pollen season.19

    For patients, especially those already susceptible to allergies, these changes can result in significant impacts to their respiratory health, and will potentially affect millions.18 Existing respiratory allergies will be exacerbated and many people previously unaffected by allergies are predicted to develop them as climate change progresses.18

    Whilst management of hay fever and other allergies continue to be mainstays within pharmacy services, pharmacists may well be among the first healthcare professionals to feel the impact of climate change and air pollution on patient’s respiratory health.

  • Wildfires

    Image of a wildfire tearing through a forest, scorching trees and producing smoke clouds

    Wildfires can affect respiratory health long after the fire’s put out.20

    With climate change comes heatwaves, drought and increased frequency and severity of wildfires.21

    Wildfire smoke contains small airborne particles, called PM2.5, known to cause respiratory diseases.22 PM2.5 is particulate matter smaller than 2.5 microns and are a pollutant of great health concern as they can be inhaled and penetrate deeply into lungs and may also enter the bloodstream.20 Increased exposure and inhalation of smoke and PM2.5 can have severe impacts on respiratory health. Exposure has been associated with asthma-related emergency room visits, hospitalisations, and even premature deaths.23

    Impacts to respiratory health can be short- or long-term.20

    Short-term:20

    • Eye, nose, throat, and lung irritation
    • Runny nose
    • Coughing
    • Sneezing
    • Shortness of breath

    Long-term:20

    • Asthma
    • Chronic bronchitis
    • Decreased lung function
    • Cardiovascular damage
    • Increased mortality in people with lung and/or heart disease

    Wildfire smoke has devastating effects for many, but children, the elderly and those with co-morbidities are especially vulnerable.20 As accessible frontline healthcare providers, pharmacists are an important protector of patient respiratory health, making them an indispensable resource in the immediate proximity of wildfires and beyond.

  • Air pollution

    Diagram showing an air pollution cycle: greenhouse gases and air pollution contribute to the greenhouse effect which impacts climate change, which in turn causes more air pollution

    Polluted air is the new normal for 90% of humans on earth24

    At least 90% of the world’s population lives in areas with low air quality, where concentration of pollutants exceeds guidelines established by World Health Organization.24

    Air pollution comes from several sources but is amplified by human activities that release greenhouse gases and drive climate change.1 Wildfires, dust storms, pollen, heat waves which drive human energy usage, all increase biologic and anthropogenic sources of air pollution, resulting in a feed-forward loop of pollution and poor air quality.1

    The health impacts of air pollution are severe and felt globally.25 They often include respiratory problems such as symptoms driving emergency room visits and hospitalisations, alongside chronic conditions like COPD, asthma, and lung cancer.25

    Air pollution is a mixture of both particles and gases,1 and can be categorised as indoor or outdoor pollution due to differences in composition and source. The impacts of each can be different too.

    Kerosene cookers

    Indoor pollution:

    • Mostly caused by inefficient and polluting fuels and technologies used for cooking or heating in the home26
    • Exposure leads to noncommunicable diseases including stroke, ischaemic heart disease, COPD, and lung cancer26
    • Devastating health effects: In 2020, 3.2 million people died prematurely from illnesses attributable to household air pollution (21% due to lower respiratory infection, 19% from COPD and 6% are from lung cancer)26
    Image of forest fire

    Outdoor pollution:

    • Comprised of particulate matter, ozone, desert dust, pollutants from forest fires25
    • Global health impact: In 2017, air pollution is estimated to have been responsible for ~ 5 million deaths worldwide, 70% of which was caused by outdoor environmental air pollution25

  • Floods

    Aerial image of a flooded town, with brown water encircling 5 homes and buildings

    Floods can create ideal environments for health-hazardous mould growth.27

    Floods are common disasters worldwide and account for the highest death rate among natural disasters.28

    Whilst floodwaters pose immediate dangers to human health, they also result in long-term health effects due to displacement from homes and worsened living conditions.29 The respiratory health of those impacted by floods is particularly at risk; from UK and US reports, acute respiratory infection was the most common infectious disease seem among patients after flooding.29 Disruption to housing, overcrowding and direct contact with flood waters can all drive transmission of respiratory pathogens.29

    Following a flood, water damage in homes can create perfect growing environments for many species of moulds and fungi, some of which may be harmful to health.27 Exposure to these biological agents, especially in close indoor environments, is associated with the development and exacerbation of conditions such as COPD, asthma, and allergic rhinitis, conditions that will be familiar to pharmacists globally.27

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