EXPERT ANALYSIS FROM AAAAI/WAO JOINT CONGRESS

ORLANDO (FRONTLINE MEDICAL NEWS) – Climate change is not just eroding coastlines and threatening seaside cities and taking lives with increasingly powerful hurricanes, but appears to be contributing to increases in allergy and asthma, an expert told the audience at the joint congress of the American Academy of Allergy, Asthma and Immunology and the World Asthma Organization.

Longer pollen seasons, allergens unleashed by felled trees and ripped-up plants, mold growth following floods, and irritants launched into the air by wildfires are some of the concerns that should be alarming physicians and policy makers, said Nelson A. Rosario, MD, PhD, professor of pediatrics at Federal University of Paraná (Brazil).

“This is related to disease,” he said. “I’m trying to convince you that something is happening. This is not a matter of believe it or not.”

And evidence suggests that his fellow allergists and their patients agree.

A 2015 international survey found that 80% of rhinitis patients blamed climate change for contributing to their symptoms.

In a survey published in 2016, 63% of AAAAI members said that climate change was relevant to patient care either “a great deal” or in “a moderate amount.” Only 11% said that climate change wasn’t relevant at all. Asked how patients have been affected by climate change, about two-thirds said “increased care for allergic sensitization and symptoms on exposure to plants or mold.”

Science supports these views, Dr. Rosario said.

A 2011 study of North American pollen seasons found that some cities had significant increases of 11-27 days, compared with 15 years before.

This year, a New England Journal of Medicine article pointed out the respiratory dangers of increasing wildfires, noting the carbon dioxide, particulate matter, trace minerals, and thousands of other compounds that are unleashed ( 2018 Mar 8;378[10]:881-3 ).

And a 2017 review noted the impacts of the consequences of climate change, from increased allergies due to heavy precipitation events, asthma prompted by intense tropical cyclones, and allergic conditions caused by extremely high sea levels.

Dr. Rosario suggested that, rather than wait for official agencies to take action, physicians need to adapt and help their patients adapt. A team of doctors wrote in 2013 that while “improved governmental controls” could lead to cleaner air, they “meet strong opposition because of their effect on business and productivity.” So, they said, the allergy community should adjust, by “anticipating the needs of patients and by adopting practices and research methods to meet changing environmental conditions.”

Dr. Rosario urged physicians to think of the climate-change effects on allergy and asthma as a “collective action” problem, not an individual one.

“The consequences will come,” he said. “There must be international cooperation.”

fpnews@frontlinemedcom.com

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