Global change, climate change, and asthma in children: Direct and indirect effects - A WAO Pediatric Asthma Committee Report
Year: 2024
Type: review
Abstract: The twenty-first century has seen a fundamental shift in disease epidemiology with anthropogenic environmental change emerging as the likely dominant factor affecting the distribution and severity of current and future human disease. This is especially true of allergic diseases and asthma with their intimate relationship with the natural environment. Climate change-related variables including increased ambient temperature, heat waves, extreme weather events, air pollution, and rainfall distribution, all can directly affect asthma in children, but each of these variables also indirectly affects asthma via alterations in pollen production and release, outdoor allergen exposure or the microbiome. Air pollution, with its many and varied respiratory consequences, is likely to have the greatest effect, as it has increased globally due to rapid increases in fossil fuel combustion, global population, crowding, and megacities, as well as forest burning and trees succumbing to an increasingly hostile environment. Human activities have also caused substantial deterioration of the global microbiome with reductions in biodiversity for molds, bacteria, and viruses. Reduced microbiome diversity has, in turn, been associated with increases in Th2 allergic responses and allergic disease. The collective effect of these changes has already shifted allergy and asthma disease patterns. Given that changes in climate have been relatively small to date, the unavoidable, much greater shifts in climate in the future are concerning. Determining the relative scale of the direct versus indirect effects of climate change variables is needed if effective avoidance and adaptive measures are to be implemented. This would also require much more basic, epidemiological, and clinical research to understand the causal mechanisms, the most relevant climate factors involved, the regions most affected and, most importantly, effective and actionable adaptation measures. We suggest that allergy and respiratory health workers should follow current guidance to reduce present risks related to climate change and watch for new recommendations to reduce future risks. Since the respiratory system is the one most affected by climate change, they also need to call for more research in this area and show strong leadership in advocating for urgent action to protect children by reducing or reversing factors that have led to our deteriorating climate.
Authors: Peter N. Le Souëf, Yuichi Adachi, Eleni Anastasiou, Ignacio J. Ansotegui, Héctor A. Badellino, Tina Banzon, Cesar Pozo Beltrán, Gennaro D'Amato, Zeinab A. El-Sayed, Rene Maximiliano Gómez, Elham Hossny, Ömer Kalayci, Mário Morais-Almeida, Antonio Nieto-Garcia, David B. Peden, Wanda Phipatanakul, Jiu-Yao Wang, I-Jen Wan, Gary Wong, Paraskevi Xepapadaki, Nikolaos G. Papadopoulos
Institutions: The Kids Research Institute Australia, The University of Western Australia, Toyama Red Cross Hospital, National and Kapodistrian University of Athens, IDCQ Hospitales y Sanidad, S.L.U., Universidad de Ciencias Empresariales y Sociales, Boston Children's Hospital, Harvard University, Hospital Infantil de México Federico Gómez, Ospedale Antonio Cardarelli, Federico II University Hospital, University of Naples Federico II, Ain Shams University, Universidad Católica de Salta, Hacettepe University, Hospital CUF Descobertas, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, University of North Carolina at Chapel Hill, China Medical University, National Yang Ming Chiao Tung University, Ministry of Health and Welfare, Taipei Hospital, Chinese University of Hong Kong, Prince of Wales Hospital, University of Manchester
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,640
OpenAlex ID: W4404164322