According to the World Health Organization, climate change is one of the biggest global health threats of this century. Many people don’t realize that climate change can also affect those with allergies and asthma. 

Rising temperatures, increased air pollution, and longer pollen seasons can all have an effect on the symptoms of people with allergies and asthma. 

In this article, we’ll explore climate change and asthma and how individuals can manage their asthma now and into the future.

What is Climate Change?

Climate change refers to any large shifts in temperatures and weather patterns over a long period of time. While some of these shifts are natural,  the main driver of climate change since the 1800s has been human activity. Burning fossil fuels (like coal, oil, and gas), manufacturing, and agriculture all produce heat-trapping gases such as carbon dioxide which trap heat in the atmosphere. 

How Does Climate Change Affect Asthma?

There are a few main ways that climate change affects asthma.

Air Quality

Because climate change can lead to longer pollen seasons and higher temperatures, this can be especially bad for people with asthma. As temperature rises, air pollution also increases, making it difficult for those with asthma to breathe. 

The climate change-induced increase in ground-level ozone has been shown to reduce lung capacity, increase asthma symptoms and worsen overall air quality. Ozone is a powerful lung irritant and can trigger asthma attacks.

Allergy Season

Warmer temperatures also make it easier for mold, dust mites, and other air pollutants to thrive, which can worsen asthma symptoms. Pollen counts tend to be higher for longer periods of time in regions with climate change. This means that people with asthma have a greater risk of being exposed to allergens and developing asthma attacks.

Similarly, extended or shortened seasons due to climate change can have an effect on asthma. For instance, climate change may cause warmer winters and earlier springs. This could lead to longer and more severe allergy seasons, triggering increased asthma symptoms due to higher levels of allergens in the air for a longer period of time. 

Natural Disasters

In addition, climate change has been linked to an increase in severe weather events such as hurricanes, floods and heat waves that can cause disruption for those with asthma. 

Climate change is also causing more frequent and intense droughts, which can lead to wildfires that create smoke-filled air that makes it difficult for those with asthma to breathe.  The combination of heat and air pollution can also worsen asthma symptoms. 

Climate Change and Asthma: How to Protect Yourself

 It is clear that climate change has a direct effect on asthma, exacerbating existing conditions and creating new health risks for those with the condition. Research on asthma and climate change has found that the best way to protect yourself is to reduce your exposure to climate-related triggers. 

Reducing exposure to air pollution and pollen can help lessen asthma symptoms. This includes staying indoors in air-conditioned environments during air quality alerts and high pollen days, changing the filter regularly if using an air conditioner, and washing exposed skin and clothes when returning from outdoors. 

Additionally, you can reduce mold exposure by avoiding damp indoor environments and thoroughly drying the area after a flood or leak.

Finally, it is important to stay informed on climate change and asthma-related research to ensure that you are taking all necessary steps to protect yourself. With climate change only projected to worsen, understanding the connection between climate change and asthma can help you reduce your asthma triggers and lessen the risk of exacerbations. 

Preparing for Allergy, Asthma, and Climate Change

As most asthmatics know, many things are outside of our control. While you may not be able to change climate conditions, you can still take steps to reduce your risk of asthma exacerbations due to climate-related factors. Here are some tips for how you can best prepare for climate change and allergies:

1. Monitor pollen and other allergen levels in your local climate. Knowing the forecasted levels of allergens, such as mold, pollen, and dust mites, can help you plan ahead. This can be especially important if climate change is expected to bring more allergens into your area.
2. Reduce your exposure to outdoor allergens by limiting outdoor activities during high-allergen days or times of day.
3. Make sure you have a good air filtration system in your home to reduce allergens inside.
4. Stay informed about climate change and air pollution trends, as they can have an impact on asthma-related symptoms.
5. Talk to your doctor if you are concerned about climate change and how it may affect your asthma or allergies. Optomizing your asthma control plan is an excellent way to manage your asthma in a changing climate.

Learn How Climate Change Can Effect You With Allergies and Asthma.

Asthma challenges for Patients

Asthma as a disease is not evenly spread across the U.S.

There are definitely hotspots as shown in this study:  https://www.aafa.org/asthma-capitals/

Geography doesn’t change the basic problem in the lungs.

How do we find out the biggest challenges in dealing with these lungs?

We need to talk to asthma sufferers.

This survey revealed some of the big problems asthma patients face:  https://www.aaaai.org/about-aaaai/newsroom/news-releases/asthma

Let’s dig in and see what they found.

The study was titled: 

NEW STUDY SHEDS LIGHT ON THE CHALLENGES AND BARRIERS OF SEVERE ASTHMA MANAGEMENT

Surveys were administered to asthma sufferers and the results were summarized.

The paper reported that asthma sufferers:

1. Struggle to understand how best to manage asthma on a day-to-day basis;
2. Often have feelings that the public does not appreciate how seriously asthma impairs their health;
3. Share concerns about medication safety, especially ICS; and,
4. Have substantial emotional impacts of having severe asthma, especially anxiety and reluctance to hospitalization.

When I set out to improve asthma outcomes with Asthmaniac, I reflected on 31 years of medical practice when developing priorities for how to proceed. 

I appreciated for a long time that asthma is a complex chronic disease.  

In order for patients to succeed in controlling it, they require understanding and must act on that understanding in order to take action at the right time.  

I designed the blog on Asthmaniac to address these core topics, using text, podcasts and videos.  

I wondered when a group of asthma sufferers would be surveyed about the biggest issues they face, and this paper reports just such concerns.

For each topic area discovered in this study, I will discuss strategies Asthmaniac uses to address them.

1. Day-to-day management of asthma.
2. Public perceptions of asthma
3. Concerns about medication, especially ICS safety
4. Emotion impacts on social and health status.

Point 1.  

We have known for decades that patients need tremendous support in managing daily symptoms.  

Ambulatory expiratory flow (PEF) and symptoms surveys (ACT) are a few methods devised to put numeric tools in patients’ hands that reflect the biologic status of their airways.  

It is believed that such tools allow patients to take the correct action, earlier when acute bronchospasm starts. 

These tools require specific education and in most primary practices, time constraints get in the way of delivering that education as often and as personalized as needed.  

Asthmaniac solution: 

1. Simplify Asthma Action Plan; 
2. Make Action Plan readily accessible on the smartphone; 
3. Enhance knowledge competence as described 

4.B.2 below (see Blog and Podcast directory; make directory visible on social media sites and on all pages of Asthmaniac.com).

Point 2. 

Public perceptions of asthma.  

The challenges of a pandemic complicate public messaging about any particular disease.  

There are no scientific studies showing us how public  under appreciation of asthma affects employment, social stigmatisation, school adherence, physical activity adherence.  

In absence of data, we leverage intuition and forge ahead.  

Asthmaniac solution: 

1. Develop content for a page that can become indexed by internet search methods that underscores the impacts of asthma on patient life (see new page titled Social Impact of Asthma). 
2. Address these perceptions with each patient to at least reinforce that these impacts are real, challenging, and generally under-appreciated (add this question to our pre-post patient insights survey).

Point 3. 

Medication safety.  

Patient concern about inhaled corticosteroids (ICS) seems to predominate.  

These concerns are not necessarily the same as those we physicians are thinking about.  

Nonetheless, ICS is essential in moderate and severe asthma control.  

To assure compliance with its use, we must address these concerns.  

Asthmaniac solution: 

1. Talk about the role of steroids generally and ICS specifically in asthma; 
2. Reinforce the goal of prescribing the lowest amount needed for each patient to avoid safety and side effect concerns; 
3. Consider the use of new pharmacologic agents in severe patients (like in e-asthma) that will allow reduction in oral and inhaled steroid use.

Point 4.  

We know from large samples of patients with chronic disease that the presence of one disease is highly associated with a second one.  

Considering the anxiety asthma sufferers share about losing control of their asthma, it is not surprising that they would be at higher risk for other chronic diseases linked to anxiety.  

So, WE MUST GET THIS ANXIETY UNDER CONTROL.  

In absence of any controlled studies, I believe areas to attack in gaining control of asthma anxiety are:

1. Controlling asthma:  Asthma attacks are very frightening.  Preventing them will go a long way in allowing patients to settle emotionally.
2. Dramatically increased patient understanding of their disease and how to manage it daily will also be settling.  Knowledge deficits are specifically identified by patients as a major problem (see point 1).

Asthmaniac solution: 

1. make sure patients can access (through affordable, phone based care) rescue inhalers, oral steroids, controller medication and trigger medication (the core functionality of Asthmaniac.com) 
2. Continually improve knowledge competence for self-management through phone/computer based contemporary media that is easily and affordably consumed (podcasts, video-casts, and online webinars that are announced to patients with email and text notifications). 
3. Assess anxiety in each patient and develop a personalised response plan for each patient.  This will have to be a new component in the pre-post patient insights survey.

I believe specifically and clearly addressing the concerns highlighted in the group of asthma sufferers surveyed in this study will lead to better outcomes for all asthma sufferers that can access the Asthmaniac.com method. 

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And keep Breathing Easy!

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