Climate change and respiratory disease: European Respiratory Society position statement

Air pollution and climate change as grand challenges to sustainability

There is a cross-disciplinary link between air pollution, climate crisis, and sustainable lifestyle as they are the most complex struggles of the present century. This review takes an in-depth look at this relationship, considering carbon dioxide emissions primarily from the burning of fossil fuels as the main contributor to global warming and focusing on primary SLCPs such as methane and ground-level ozone. Such pollutants severely alter the climate through the generation of greenhouse gases. The discussion is extensive and includes best practices from conventional pollution control technologies to hi-tech alternatives, including electric vehicles, the use of renewables, and green decentralized solutions. It also addresses policy matters, such as imposing stricter emissions standards, setting stronger environmental regulations, and rethinking some economic measures. Besides that, new developments such as congestion charges, air ionization, solar-assisted cleaning systems, and photocatalytic materials are among the products discussed. These strategies differ in relation to the local conditions and therefore exhibit a varying effectiveness level, but they remain evident as a tool of pollution deterrence. This stresses the importance of holistic and inclusive approach in terms of engineering, policies, stakeholders, and ecological spheres to tackle.

Effect of Environmental and Socioeconomic Factors on Increased Early Childhood Blood Lead Levels: A Case Study in Chicago

This study analyzes the prevalence of elevated blood lead levels (BLLs) in children across Chicagoland zip codes from 2019 to 2021, linking them to socioeconomic, environmental, and racial factors. Wilcoxon tests and generalized additive model (GAM) regressions identified economic hardship, reflected in per capita income and unemployment rates, as a significant contributor to increased lead poisoning (LP) rates. Additionally, LP rates correlate with the average age of buildings, particularly post the 1978 lead paint ban, illustrating policy impacts on health outcomes. The study further explores the novel area of land surface temperature (LST) effects on LP, finding that higher nighttime LST, indicative of urban heat island effects, correlates with increased LP. This finding gains additional significance in the context of anthropogenic climate change. When these factors are combined with the ongoing expansion of urban territories, a significant risk exists of escalating LP rates on a global scale. Racial disparity analysis revealed that Black and Hispanic/Latino populations face higher LP rates, primarily due to unemployment and older housing. The study underscores the necessity for targeted public health strategies to address these disparities, emphasizing the need for interventions that cater to the unique challenges of these at-risk communities.

An investigation of the effects of meteorological factors on the incidence of tuberculosis

To explore the influence of meteorological factors on the incidence of tuberculosis (TB) in Yingjisha County, Kashgar Region, Xinjiang, and to provide a scientific basis for the prevention and control of TB. The Spearman correlation analysis and distribution lag nonlinear model analysis were conducted on the number of daily reported cases of TB from 2016 to 2023 to study the association effect of various meteorological factors and the daily incidence number of TB in Yingjisha County. A total of 13,288 TB cases were reported from January 2016 to June 2023, and June to October is the peak period of annual TB incidence. Spearman correlation analysis revealed that average daily temperature (AT) and average daily wind speed (WS) were positively correlated with TB incidence (rAT = 0.110, rWS = 0.090); and average daily relative humidity (RH) and TB incidence was negatively correlated (rRH = - 0.093). When AT was - 15 °C, the RR reached a maximum of 2.20 (95% CI: 0.77-6.29) at a lag of 21 days. When RH was 92%, the RR reached a maximum of 1.05 (95% CI: 0.92-1.19) at a lag of 6 days. When WS was 5.2 m/s, the RR reached a maximum of 1.30 (95% CI: 0.78-2.16) at a lag of 16 days. There is a non-linearity and a certain lag between meteorological factors and the occurrence and prevalence of TB in the population, which is mainly manifested in the fact that the risk of incidence of TB decreases with the increase of the daily AT, has a hazardous effect within a certain range of humidity as the average daily RH rises, and gradually increases with the increase of the average daily WS. Local residents are advised to pay attention to climate change so as to take appropriate preventive measures, especially women and middle and old age group should pay close attention to climate change and add more clothes in time, minimise travelling in hazy weather and windy and sandy weather, maintain good nutrition, adequate sleep and moderate exercise in daily life to enhance their immunity, wash hands frequently and ventilate the air, and try to avoid staying in humid and confined spaces in order to reduce the risk of latent TB patients developing the disease.

Impact of Global Climate Change on Pulmonary Health: Susceptible and Vulnerable Populations

As fossil fuel combustion continues to power the global economy, the rate of climate change is accelerating, causing severe respiratory health impacts and large disparities in the degree of human suffering. Hotter and drier climates lead to longer and more severe wildland fire seasons, impairing air quality around the globe. Hotter temperatures lead to higher amounts of ozone and particles, causing the exacerbation of chronic respiratory diseases and premature mortality. Longer pollen seasons and higher pollen concentrations provoke allergic airway diseases. In arid regions, accelerated land degradation and desertification are promoting dust pollution and impairing food production and nutritional content that are essential to respiratory health. Extreme weather events and flooding impede healthcare delivery and can lead to poor indoor air quality due to mold overgrowth. Climate and human activities that harm the environment and ecosystem may also affect the emergence and spread of viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and associated morbidity and mortality exacerbated by air pollution. Children and elderly individuals are more susceptible to the adverse health effects of climate change. Geographical and socioeconomic circumstances, together with a decreased capacity to adapt, collectively increase vulnerability to the adverse effects of climate change. Successful mitigation of anthropogenic climate change is dependent on the commitment of energy-intensive nations to manage greenhouse gas emissions, as well as societal support and response to aggravating factors. In this review, we focus on the respiratory health impacts of global climate change, with an emphasis on susceptible and vulnerable populations and low- and middle-income countries.

Seasonal Dynamics of the Upper Respiratory Tract Microbiome in Chronic Obstructive Pulmonary Disease

Introduction

Increasing evidence suggests that seasonal changes can trigger the alternation of airway microbiome. However, the dynamics of the upper airway bacterial ecology of chronic obstructive pulmonary disease (COPD) patients across different seasons remains unclear.

Methods

In this study, we present a 16S ribosomal RNA survey of the airway microbiome on 72 swab samples collected in different months (March, May, July, September, and November) in 2019 from 18 COPD patients and from six resampled patients in November in 2020.

Results

Our study uncovered a dynamic airway microbiota where changes appeared to be associated with seasonal alternation in COPD patients. Twelve clusters of temporal patterns were displayed by differential and clustering analysis along the time course, systematically revealing distinct microbial taxa that prefer to grow in cool and warm seasons, respectively. Moreover, the upper airway microbiome composition was relatively stable in the same season in different years.

Discussion

Given the tight association between airway microbiome and COPD disease progression, this study can provide useful information for clinically understanding the seasonal trend of disease phenotypes in COPD patients.

Hospital admission tendencies caused by day-to-day temperature changes during summer: a case study for the city of Novi Sad (Serbia)

Increased temperature risk in cities threatens the health and well-being of urban population and is fueled by climate change and intensive urbanization. Consequently, further steps must be taken for assessing temperature conditions in cities and their association with public health, in order to improve public health prevention at local or regional level. This study contributes to solving the problems by analyzing the connection between extreme temperatures and the tendencies of all-cause hospital admissions. The analyses used (a) 1-h air temperature data, and (b) daily data of all-cause hospital admissions. The datasets include the summer period (June, July, August) for the years 2016 and 2017. We tested the effects of two temperature indices, day-to-day change in maximum temperature - T_max,c and daily temperature range - T_r, with all-cause hospital admission subgroups, such as all-cause cases - H_a, hospital admissions in the population below 65 - H_a<65, and hospital admissions in the population aged 65 and over - H_a≥65. The results show the highest values of H_a when T_max,c is between 6 and 10 °C. Therefore, more intensive hospital admissions can be expected when T_max increases from day-to-day (positive values of T_max,c), and it is more visible for H_a and H_a<65 (1 °C = 1% increase in hospital admissions). Also, T_r values between 10 °C and 14 °C cause an increase in the number of hospital admissions, and it is more noticeable for H_a≥65.

Agreement in extreme precipitation exposure assessment is modified by race and social vulnerability

Epidemiologic investigations of extreme precipitation events (EPEs) often rely on observations from the nearest weather station to represent individuals' exposures, and due to structural factors that determine the siting of weather stations, levels of measurement error and misclassification bias may differ by race, class, and other measures of social vulnerability. Gridded climate datasets provide higher spatial resolution that may improve measurement error and misclassification bias. However, similarities in the ability to identify EPEs among these types of datasets have not been explored. In this study, we characterize the overall and temporal patterns of agreement among three commonly used meteorological data sources in their identification of EPEs in all census tracts and counties in the conterminous United States over the 1991-2020 U.S. Climate Normals period and evaluate the association between sociodemographic characteristics with agreement in EPE identification. Daily precipitation measurements from weather stations in the Global Historical Climatology Network (GHCN) and gridded precipitation estimates from the Parameter-elevation Relationships on Independent Slopes Model (PRISM) and the North American Land Data Assimilation System (NLDAS) were compared in their ability to identify EPEs defined as the top 1% of precipitation events or daily precipitation >1 inch. Agreement among these datasets is fair to moderate from 1991 to 2020. There are spatial and temporal differences in the levels of agreement between ground stations and gridded climate datasets in their detection of EPEs in the United States from 1991 to 2020. Spatial variation in agreement is most strongly related to a location's proximity to the nearest ground station, with areas furthest from a ground station demonstrating the lowest levels of agreement. These areas have lower socioeconomic status, a higher proportion of Native American population, and higher social vulnerability index scores. The addition of ground stations in these areas may increase agreement, and future studies intending to use these or similar data sources should be aware of the limitations, biases, and potential for differential misclassification of exposure to EPEs. Most importantly, vulnerable populations should be engaged to determine their priorities for enhanced surveillance of climate-based threats so that community-identified needs are met by any future improvements in data quality.

Climate change and allergic diseases: An overview

Climate change has been regarded as a threat to the human species on the earth. Greenhouse gasses are leading to increased temperatures on Earth besides impacting the humanity. These atmospheric conditions have shown to alter the release pattern of pollens and can change the timing and magnitude of pollen release with flowering plants. As pollen is responsible for respiratory allergies in humans, so climate change can adversely affect human health in susceptible individuals. In this review, we highlight the association between climate change, increased prevalence and severity of asthma, and related allergic diseases. Increased air pollution can alter the production of local and regional pollen. This altered pattern depends on bioclimatic parameters. As simulated with a pollen-release model and future bioclimatic data, warmer temperatures lead to an increased pollen count in some specific locations and for longer periods. Thus, anticipation of a future allergic disease burden can help public health agencies in planning to develop strategies in mitigating the unprecedented health challenges expected in future years.

Open-Source Hardware May Address the Shortage in Medical Devices for Patients with Low-Income and Chronic Respiratory Diseases in Low-Resource Countries

Respiratory diseases pose an increasing socio-economic burden worldwide given their high prevalence and their elevated morbidity and mortality. Medical devices play an important role in managing acute and chronic respiratory failure, including diagnosis, monitoring, and providing artificial ventilation. Current commercially available respiratory devices are very effective but, given their cost, are unaffordable for most patients in low- and middle-income countries (LMICs). Herein, we focus on a relatively new design option—the open-source hardware approach—that, if implemented, will contribute to providing low-cost respiratory medical devices for many patients in LMICs, particularly those without full medical insurance coverage. Open source reflects a set of approaches to conceive and distribute the comprehensive technical information required for building devices. The open-source approach enables free and unrestricted use of the know-how to replicate and manufacture the device or modify its design for improvements or adaptation to different clinical settings or personalized treatments. We describe recent examples of open-source devices for diagnosis/monitoring (measuring inspiratory/expiratory pressures or flow and volume in mechanical ventilators) and for therapy (non-invasive ventilators for adults and continuous positive airway pressure support for infants) that enable building simple, low-cost (hence, affordable), and high-performance solutions for patients in LMICs. Finally, we argue that the common practice of approving clinical trials by the local hospital ethics board can be expanded to ensure patient safety by reviewing, inspecting, and approving open hardware for medical application to maximize the innovation and deployment rate of medical technologies.

Prediction of airborne pollen concentrations by artificial neural network and their relationship with meteorological parameters and air pollutants

After the early rainfall in the autumn of 2013, respiratory syndromes spread in the Khuzestan province of Iran with the most severity in Ahvaz. There have been recurring outbreaks in recent years. Considering that pollen-derived airborne allergens are regarded as key aeroallergens and the main cause of allergic rhinitis and asthma, this work aimed to forecast total pollen concentration in Ahvaz through an artificial neural network (ANN), followed by evaluating the pollen spatial distribution across the city and the association between pollen concentrations and environmental parameters. The utilized ANN in this work included an input layer with 13 parameters, a hidden layer of five neurons, and an output layer. Data were classified into training, validation, and testing sets. The ANN was implemented with 70% and 80% of data for training. The value of the correlation coefficient for the data validation of these two networks was 0.89 and 0.92, respectively. The results also indicated that despite the difference in the mean concentration of the pollens in various areas of Ahvaz, this difference was not statistically significant (P > 0.05). Furthermore, there was a negative correlation between the concentration of total pollen and relative humidity, precipitation, and air pressure. However, it had a positive correlation with temperature. Consequently, considering the logistical challenges of monitoring bioaerosols in the air, the ANN approach could predict total pollen concentrations. Therefore, in addition to measurements, the ANN technique can be a good tool to enable authorities to mitigate the impact of airborne pollen on people.

Climate advocacy among Italian pediatric pulmonologists: A national survey on the effects of climate change on respiratory allergies

Climate change (CC) is expected to negatively impact respiratory health due to air pollution and increased aeroallergen exposure. Children are among the most vulnerable populations due to high ventilation rates, small peripheral airways, and developing respiratory and immunological systems. To assess the current knowledge among Italian pediatric pulmonologists on the potential effects of CC on pediatric respiratory allergic diseases, a national survey was launched online from February 2020 to February 2021. The members of the Italian Pediatric Respiratory Society (SIMRI) were contacted by email and 117 questionnaires were returned (response rate 16.4%). 72.6% of respondents were females, 53.8% were academic pediatricians, 42.7% had been working >10 years. Most of the participants were aware of the potential health effects of CC and stated that they had noticed an increase in the incidence (90.6%) and severity (67.5%) of allergic respiratory diseases among their patients. About 61% and 41% of participants respectively felt that there had been an increase in the number of children sensitized to pollen and molds. When applying latent class analysis to identify the features characterizing participants with greater awareness and knowledge of CC-related health effects, two classes were identified: almost 60% of the participants were labeled as "poor knowledge" and those with greater awareness were older, had longer work experience, and were those using the Internet to gather information about CC. There is urgent need to increase pediatricians' awareness of the detrimental effects of CC on children's respiratory health and integrate them in the educational programs of healthcare professionals.

The Effect of Outdoor Aeroallergens on Asthma Hospitalizations in Children in North-Western Tuscany, Italy

Few data are currently available on the effects of aeroallergens in triggering respiratory symptoms in children. To evaluate the potential effects of daily outdoor aeroallergens loads on childhood admissions, in this case-crossover study, we analyzed data from 85 children hospitalized at the University Hospital of Pisa, Italy, for asthma or asthma-like symptoms without respiratory infection, between 2010 and 2019. Data were linked to outdoor allergens, temperature, nitrogen dioxide, and relative humidity observed during the same period. A 10-grains/m³ increase in the total aeroallergen concentration was associated with an increased risk of admission at lag 0 (OR = 1.054, 95% CI: 1.011–1.098), with a smaller effect at lag 1 (OR = 1.037, 95% CI: 1.008–1.067) and lag 2 (OR = 1.021, 95% CI: 1.003–1.039). Trends to larger effects were observed in children with sensitization to one or more aeroallergens (OR = 1.085, 95% CI: 1.004–1.173 at lag 0), in males (OR = 1.069, 95% CI: 1.009–1.132 at lag 0) and in older children (OR = 1.065, 95% CI: 1.007–1.127 at lag 0). Our study shows an association between increased outdoor allergens loads and asthma or asthma-like symptoms in children up to at least two days prior to hospitalization, suggesting that tracking aeroallergen counts may be useful to improve the management of respiratory allergic diseases.

Allergen Management in Children with Type 2-High Asthma

Children exposed to various indoor and outdoor allergens are placed at an increased risk of developing asthma in later life, with sensitization in these individuals being a strong predictor of disease morbidity. In addition, aeroallergen exposure influences asthma outcomes through an interplay with adverse determinants of health. The goal of this review is to provide an introductory overview of factors related to aeroallergen exposure in type 2-high childhood asthma. These include the relevance of exposure in asthma exacerbations and severity, and the evidence-base for avoidance and treatment for sensitization to these allergens. This review will focus on both indoor aeroallergens (house dust mite, pet, cockroach, mold, and rodent) and outdoor aeroallergens (pollens and molds). Treatment of aeroallergen sensitization in children with asthma includes avoidance and removal measures, although there is limited evidence of clinical benefit especially with single-strategy approaches. We will also address the interplay of aeroallergens and climate change, adverse social determinants, and the current COVID-19 pandemic, when we have seen a dramatic reduction in asthma exacerbations and emergency department visits among children. While there are many factors that are hypothesized to contribute to this reduction, among them is a reduced exposure to outdoor seasonal aeroallergens.

Study on the Collection Efficiency of Bioaerosol Nanoparticles by Andersen-Type Impactors

Airborne transmission is much more common than previously thought. Based on our knowledge about SARS-COV-2 (COVID-19) infection, the aerosol transmission routes for all respiratory infections must be reassessed. Thus far, the COVID-19 outbreak has caused catastrophic public health and economic crises, posing a serious threat to the lives and health of people around the world and directing public attention toward the airborne transmission of pathogens. The novel coronavirus transmission in the form of nanoaerosols in a wider range hinders prevention and early warning efforts. As a classical bioaerosol sampler, the Andersen six-stage sampler is widely used in the collection and research of aerosol particles. In this study, the physical and biological collection efficiency of the six-stage sampler was explored by qPCR and colony counting method. Results showed that the physical collection efficiency reached more than 50% when the particle size was larger than 0.75 μm. However, the overall biological collection efficiency was only 0.25%. In addition, fluorescence microscopy and flow cytometry were used to detect the microbial state after sampling, and the results showed that the proportion of the collected live bacteria was less than 15% of the total. This result is of great significance not only for the application of the Andersen six-stage sampler in collecting nanosized bioaerosols, but also provides reference for the selection of subsequent detection technologies for effective collection.

Extreme Precipitation Events and Infectious Disease Risk: A Scoping Review and Framework for Infectious Respiratory Viruses

Extreme precipitation events (EPE) change the natural and built environments and alter human behavior in ways that facilitate infectious disease transmission. EPEs are expected with high confidence to increase in frequency and are thus of great public health importance. This scoping review seeks to summarize the mechanisms and severity of impacts of EPEs on infectious diseases, to provide a conceptual framework for the influence of EPEs on infectious respiratory diseases, and to define areas of future study currently lacking in this field. The effects of EPEs are well-studied with respect to enteric, vector-borne, and allergic illness where they are shown to moderately increase risk of illness, but not well-understood in relation to infectious respiratory illness. We propose a framework for a similar influence of EPEs on infectious respiratory viruses through several plausible pathways: decreased UV radiation, increased ambient relative humidity, and changes to human behavior (increased time indoors and use of heating and cooling systems). However, limited work has evaluated meteorologic risk factors for infectious respiratory diseases. Future research is needed to evaluate the effects of EPEs on infectious respiratory diseases using individual-level case surveillance, fine spatial scales, and lag periods suited to the incubation periods of the disease under study, as well as a full characterization of susceptible, vulnerable, and sensitive population characteristics.

Outdoor Temperature as an Independent Risk Factor for Acute Pharyngitis Incidence: A Preliminary Study

Objective: Acute pharyngitis is common worldwide. Meteorological changes contribute to respiratory infections. This study aims to explore the correlation between acute pharyngitis and meteorological parameters. Methods: We collected the monthly acute pharyngitis cases in our hospital and the meteorological data, including temperature, relative humidity, and air quality index (AQI) of Shanghai, China, from January, 2015, to December, 2017. Pearson correlation and multivariable regression analysis were used to explore the association between meteorological parameters and the monthly hospital visits. Results: A total of 8287 patients were included in this study, and the monthly number of hospital visits was 230.2 ± 39.0. The best air quality index was 46.4 and the worst was 113.2. Temperature ranged from 5.2°C to 32.0°C, and relative humidity ranged from 59.4% to 83.1%. The monthly hospital visits of acute pharyngitis were negatively correlated with temperature (r = -.558, 95% CI -.746, -.274) and relative humidity (r = -.480, 95% CI -.695, -.137). A decrease of 1°C could cause an increase in hospital visits by 1.9. No significant correlation was found were found between acute pharyngitis cases and AQI (P = .051, 95% CI -.005, .590). Multivariable linear regression analysis showed the temperature was the independent risk factor of acute pharyngitis (coefficient = -1.906, P = .022). Conclusion: Low temperature might cause an increased incidence of acute pharyngitis.

Spatio-temporal patterns of childhood pneumonia in Bhutan: a Bayesian analysis

Pneumonia is one of the top 10 diseases by morbidity in Bhutan. This study aimed to investigate the spatial and temporal trends and risk factors of childhood pneumonia in Bhutan. A multivariable Zero-inflated Poisson regression model using a Bayesian Markov chain Monte Carlo simulation was undertaken to quantify associations of age, sex, altitude, rainfall, maximum temperature and relative humidity with monthly pneumonia incidence and to identify the underlying spatial structure of the data. Overall childhood pneumonia incidence was 143.57 and 10.01 per 1000 persons over 108 months of observation in children aged < 5 years and 5–14 years, respectively. Children < 5 years or male sex were more likely to develop pneumonia than those 5–14 years and females. Each 1 °C increase in maximum temperature was associated with a 1.3% (95% (credible interval [CrI] 1.27%, 1.4%) increase in pneumonia cases. Each 10% increase in relative humidity was associated with a 1.2% (95% CrI 1.1%, 1.4%) reduction in the incidence of pneumonia. Pneumonia decreased by 0.3% (CrI 0.26%, 0.34%) every month. There was no statistical spatial clustering after accounting for the covariates. Seasonality and spatial heterogeneity can partly be explained by the association of pneumonia risk to climatic factors including maximum temperature and relative humidity.

A scoping review on climate change and tuberculosis

Climate change is a global public health challenge. The changes in climatic factors affect the pattern and burden of tuberculosis, which is a worldwide public health problem affecting low and middle-income countries. However, the evidence related to the impact of climate change on tuberculosis is few and far between. This study is a scoping review following a five-stage version of Arksey and O'Malley's method. We searched the literature using the keywords and their combination in Google scholar, and PubMed. Climate change affects tuberculosis through diverse pathways: changes in climatic factors like temperature, humidity, and precipitation influence host response through alterations in vitamin D distribution, ultraviolet radiation, malnutrition, and other risk factors. The rise in extreme climatic events induces population displacement resulting in a greater number of vulnerable and risk populations of tuberculosis. It creates a conducive environment of tuberculosis transmission and development of active tuberculosis and disrupts tuberculosis diagnosis and treatment services. Therefore, it stands to reasons that climate change affects tuberculosis, particularly in highly vulnerable countries and areas. However, further studies and novel methodologies are required to address such a complex relationship and better understand the occurrence of tuberculosis attributable to climate change.

Determination of vulnerable regions of SARS-CoV-2 in Malaysia using meteorology and air quality data

This study aims to explore the state-wise assessment of SARS-CoV-2 (COVID-19) pandemic spread in Malaysia with focus on influence of meteorological parameters and air quality. In this study, state-wise COVID-19 data, meteorological parameters and air quality index (AQI) were collected from March 13 to April 30, 2020, which encompass three movement control order (MCO) periods in the country. Overall, total infected cases were observed to be higher in MCO phase 1 and 2 and significantly reduced in MCO phase 3. Due to the variation in the spatial interval of population density and individual immunity, the relationship of these parameters to pandemic spread could not be achieved. The study infers that temperature (T) between 23 and 25 °C and relative humidity (RH) (70-80%) triggered the pandemic spread by increase in the infected cases in northern and central Peninsular Malaysia. Selangor, WP Kuala Lumpur and WP Putrajaya show significantly high infected cases and a definite trend was not observed with respect to a particular meteorological factor. It is identified that high precipitation (PPT), RH and good air quality have reduced the spread in East Malaysia. A negative correlation of T and AQI and positive correlation of RH with total infected cases were found during MCO phase 3. Principal component analysis (PCA) indicated that T, RH, PPT, dew point (DP) and AQI are the main controlling factors for the spread across the country apart from social distancing. Vulnerability zones were identified based on the spatial analysis of T, RH, PPT and AQI with reference to total infected cases. Based on time series analysis, it was determined that higher RH and T in Peninsular Malaysia and high amount of PPT, RH and good air quality in East Malaysia have controlled the spreading during MCO phase 3. The predominance of D614 mutant was observed prior to March and decreases at the end of March, coinciding with the fluctuation of meteorological factors and air quality. The outcome of this study gives a general awareness to the public on COVID-19 and the influence of meteorological factors. It will also help the policymakers to enhance the management plans against the pandemic spreading apart from social distancing in the next wave of COVID-19.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10668-021-01719-z.

Particulate matter exposure is highly correlated to pediatric asthma exacerbation

Asthma is a heterogeneous disease in which environmental factors play an important role, and the effect of particulate matter (PM) on the occurrence and severity of asthma is drawing more attention. This study aims to identify the correlation between PM and pediatric asthma exacerbation and explore the potential mechanisms. The asthma visits data (N = 16,779,739) in a university-based tertiary children’s hospital from January 2013 to December 2017 were collected, and the relationship between asthma visits and local PM concentration was analyzed. For further study, we established a house dust mite (HDM)-induced allergic airway inflammation model with PM intervention. We detected a correlation between PM concentration and pediatric asthma visits, especially in children under 6 years old. The in vivo data showed that PM aggravated HDM-induced airway inflammation, and IL-33 neutralizing antibody exerted a protective role. Our study suggests that PM is a risk factor in promoting pediatric asthma exacerbation, in which IL-33 might be a promising target.

Increased sensitization rates to tree pollens in allergic children and adolescents and a change in the pollen season in the metropolitan area of Seoul, Korea

INTRODUCTION

Children with allergies are at greater risk of becoming sensitized to allergenic pollens in response to environmental changes. This study investigated the relationship between changes in pollination associated with meteorologic changes and the sensitization rates of children to tree pollen allergens in the metropolitan area of Seoul, Korea.

METHODS

The study population consisted of 8,295 children who visited the pediatric allergy clinics at Hanyang University Seoul and Guri Hospital for allergy symptoms between January 1, 1998, and December 31, 2019. Pollen was collected at the two hospitals during the study using a Burkard 7-day sampler. Meteorologic data were obtained from the National Weather Service.

RESULTS

Among the major tree pollens, the largest increase in allergic sensitization was to oak, hazel, and alder pollens (0.28% annually). The pollen-sensitization rates increased annually within younger age groups. The duration of the pollen season was 98 days in 1998 and 140 days in 2019. Positive correlations were determined between the duration of the pollen season and the rates of sensitization to tree pollens, as well as between the pollen-sensitization rates and increasing temperature.

CONCLUSIONS

This study demonstrated the correlation between weather changes and the resulting changes in the pollen season with sensitization rates to allergenic pollens in children living in the Seoul metropolitan area. An annual increase in sensitization rates in younger children was determined. This pattern is expected to continue due to continuing climate change.

Inverse-designed semiconductor nanocatalysts for targeted CO2 reduction in water

The most commonly used photocatalyst for CO₂ reduction is TiO₂. However, this semiconductor material is far from being ideally suited for this purpose, owing to its inefficient energy harvesting (it absorbs in the UV), low reduction rates (it exhibits short carrier lifetimes), and lack of selectivity with respect to competing reactions (such as the nearly isoenergetic and kinetically more favourable water reduction). In this work we compile a wish-list of properties for the ideal photocatalyst (including high reaction selectivity, availability of multiple redox equivalents at one time, large contact area for CO₂ adsorption with independently tunable band gap, and availability of electrons and holes at different locations on the surface for the two redox reactions to take place), and, using the principles of inverse design, we engineer a semiconductor nanostructure that not only meets all the necessary fundamental criteria to act as a catalyst for CO₂ reduction, but also exhibits all the wish-list properties, as confirmed by our state-of-the-art atomistic semi-empirical pseudopotential modelling. The result is a potentially game-changing material.

The Consequences of Our Changing Environment on Life Threatening and Debilitating Fungal Diseases in Humans

Human activities have significantly impacted the environment and are changing our climate in ways that will have major consequences for ourselves, and endanger animal, plant and microbial life on Earth. Rising global temperatures and pollution have been highlighted as potential drivers for increases in infectious diseases. Although infrequently highlighted, fungi are amongst the leading causes of infectious disease mortality, resulting in more than 1.5 million deaths every year. In this review we evaluate the evidence linking anthropomorphic impacts with changing epidemiology of fungal disease. We highlight how the geographic footprint of endemic mycosis has expanded, how populations susceptible to fungal infection and fungal allergy may increase and how climate change may select for pathogenic traits and indirectly contribute to the emergence of drug resistance.

Impact of environmental factors on pulmonary tuberculosis in multi-levels industrial upgrading area of China

In the present paper, an association between the growth rate of PTB and the environmental impacting elements in the pearl river delta region and the closed industry related cities in China is studied. We summarized the characteristics of different industry characteristics in this region by three echelons of urban agglomerations conducted by K-means clustering model on the time series of their monthly AQI data. To determine the impact of environmental factors on the increase of PTB, the SMLR in GLM has been applied. We then measured the seasonal effect and suggest the spring to be the leading season which keep the highest possibility of the incidence of PTB. Besides giving the analysis by fixed meteorological factors, we presented a sensitive analysis with a variation of precipitation. The Genetic algorithms (GAs) is used to determine the "tolerant" interval and as the results, the width of "tolerant" almost keep a declining trend as the precipitation increasing except when the precipitation comes the interval [68,74]. In addition, with the precipitation increasing higher than 64 mm, the "tolerant" for the AQI values from the first and the second echelon both trend to decline, and a lenient environmental policy currently may easily cause a rapid development of PTB growth rate.

From Livable Communities to Livable Metropolis: Challenges for Urban Mobility in Lisbon Metropolitan Area (Portugal)

Urban mobility plays an important role in addressing urban livability. The complexification and dispersion of travel due to the improvement of transport and the multiplication of our daily living places underline the relevance of multilevel territorial planning, recognizing that the knowledge of local differences is essential for more effective urban policies. This paper aims (1) to comprehend conceptually how urban mobility contributes to the urban livability from the local to metropolitan level and (2) to assess the previous relation toward a livable metropolis based on the readily available statistics for the Lisbon Metropolitan Area. Hence, a triangulation between conceptual, political/operative, and quantitative/monitoring approaches is required. The methodology follows four steps: (1) literature review focusing on the quantification of urban mobility within the urban livability approach; (2) data collection from the Portuguese statistics system; (3) data analysis and results, using principal component analysis (PCA) followed by cluster analysis (CA); (4) discussion and conclusions. In Portugal, although it is implicit, consistency is evident between the premises of recent urban mobility policies and respective planning instruments, such as the Sustainable Urban Mobility Plans (SUMP), and the premises of urban livability as an urban movement. Focusing on the national statistics system, the available indicators that meet our quality criteria are scarce and represent a reduced number of domains. Even so, they allow identifying intra-metropolitan differences in the Lisbon Metropolitan Area (LMA) that could support multilevel planning instruments. The results identified five principal components related to commuting at the local and intermunicipal level, including car use as well as social and environmental externalities, and they reorganized the 18 LMA municipalities into eight groups, clearly isolating Lisbon, the capital, from the others. The identification of sensitive territories and respective problems based on urban livability principles is fundamental for an effective urban planning from livable communities to livable metropolis.

Climate Change and Pollen Allergy in India and South Asia

Increased levels of CO₂ and various greenhouse gases cause global warming and, in combination with pollutants from fossil fuel combustion and vehicular and industrial emissions, have been driving increases in noncommunicable diseases across the globe, resulting a higher mortality and morbidity. Respiratory diseases and associated allergenic manifestations have increased worldwide, with rates higher in developing countries. Pollen allergy serves as a model for studying the relationship between air pollution and respiratory disorders. Climate changes affect the quality and amount of airborne allergenic pollens, and pollutants alter their allergenicity, resulting in greater health impacts, especially in sensitized individuals.

Effects of educational efforts in tribal homes and schools to reduce asthma triggers, symptoms and missed school days

Native American asthma prevalence has been estimated higher than for the U.S. population average, and uncontrolled asthma results in absence from schools. This study analyzed effects of targeted education campaigns in both homes and schools on reducing asthma triggers and symptoms among 119 children with asthma, who were recruited from Cherokee and Nez Perce communities. The education campaigns were developed in collaboration with the researchers and the tribes, tailoring strategies to reduce asthma triggers adapted to tribal lifestyles. There was a special emphasis in identification of Traditional Ecological Knowledge (TEK) aspects, which were woven into the study plan and implementation. Some 62 study homes were investigated and the parents received targeted education at the beginning of the study, whereas the remaining control homes received the same education at the end of the study. In Cherokee homes, allergen levels were significantly increased in both control and study groups throughout the study. In Nez Perce homes, dog and cockroach allergen levels decreased significantly in the study homes. The parents reported asthma control test (ACT) scores of the children were significantly improved in both study and control groups, whereas respiratory illness days were reduced in the study group. In schools, allergen levels, particularly cat, dog and cockroach allergens, increased throughout the year in both study and control schools. However, high contact surface cleaning effectiveness based on adenosine tri phosphate (ATP) readings was improved in the study schools. It was also found that high contact surface cleaning effectiveness may have effects on students' absence rates tracked by schools. In conclusion, the results indicate partial improvements in parent reported health symptoms, although the improvements could not be definitively attributed to reduction of any specific exposure in the home environment. In the school environment, effective cleaning throughout the flu season could result in decreased absence rates.

Asia Pacific Association of Allergy Asthma and Clinical Immunology White Paper 2020 on climate change, air pollution, and biodiversity in Asia-Pacific and impact on allergic diseases

Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on a variety of chronic noncommunicable diseases in particular respiratory and cardiovascular diseases. The extent of air pollution both outdoor and indoor air pollution and climate change including global warming is increasing-to alarming proportions particularly in the developing world especially rapidly industrializing countries worldwide. In recent years, Asia has experienced rapid economic growth and a deteriorating environment and increase in allergic diseases to epidemic proportions. Air pollutant levels in many Asian countries especially in China and India are substantially higher than are those in developed countries. Moreover, industrial, traffic-related, and household biomass combustion, indoor pollutants from chemicals and tobacco are major sources of air pollutants, with increasing burden on respiratory allergies. Here we highlight the major components of outdoor and indoor air pollutants and their impacts on respiratory allergies associated with asthma and allergic rhinitis in the Asia-Pacific region. With Asia-Pacific comprising more than half of the world's population there is an urgent need to increase public awareness, highlight targets for interventions, public advocacy and a call to action to policy makers to implement policy changes towards reducing air pollution with interventions at a population-based level.

1. Epidemiological studies show that indoor and outdoor pollutions affect respiratory health, including an increased prevalence of asthma and allergic diseases. Global warming will increase the effects of outdoor air pollution on health.

2. The Asia-Pacific is the most populated region in the world, with a huge burden of both outdoor and indoor pollutants, including PM_2.5, PM₁₀, SPM, CO, O₃, NO₂, SO₂, NO and household pollutants including biomass and tobacco.

3. The risk factors for the epidemic rise of allergic diseases in the Asia-Pacific are due to the increasing urbanization, environmental factors of air pollution and climate changes in recent decades than in the other parts of the world.

4. In light of the different environmental exposures in different countries of the Asia-Pacific region, strategies to combat allergic disease in this region should be focused on active government policies to fight air pollution based on the local conditions.

5. Substantial efforts need to be implemented with a concerted strategy at legislative, administrative, and community levels to improve air quality.

6. Abatement of the main risk factors for respiratory diseases, in particular, environmental tobacco smoke, indoor biomass fuels, and outdoor air pollution, as well as better control of asthma and rhinitis will achieve huge health benefits.

Respiratory

Lung disease rivals the position for the top cause of death worldwide. Causes and pathology of the myriad lung diseases are varied, yet nutrition can either affect the outcome or support treatment in the majority of cases. This chapter explores the modifiable risk factors, from lifestyle changes to dietary intake to specific nutrients, anti-nutrients, and toxins helpful for the nutritionist or dietitian working with lung disease patients. General lung health is discussed, and three major disease states are explored in detail, including alpha-1 antitrypsin deficiency, asthma, and idiopathic pulmonary fibrosis. Although all lung diseases have diverse causes, many integrative and functional medical nutrition therapies are available and are not being utilized in practice today. This chapter begins the path toward better nutrition education for the integrative and functional medicine professional.

Impact of heatwaves on daily outpatient visits of respiratory disease: A time-stratified case-crossover study

OBJECTIVES

This study aims to estimate the impact of heatwaves from July 2010 to October 2012 on daily outpatient visits for respiratory disease (RD) in Cangnan, China and identify vulnerable populations.

METHODS

The definition of heatwave was a period at least 3 consecutive days with maximum temperature exceeding 35 °C in this study. A time-stratified case-crossover design was conducted to examine the relationship between heatwaves and outpatient visits for RD. Patient data for the period from 2010 to 2012 were collected from the Third People's Hospital of Cangnan and daily meteorological data for the same period were collected from the China Meteorological Data Service Center. Data regarding the air pollution index (API), a composite indicator of air pollution, were collected from the Data Center of the Chinese Ministry of Environmental Protection. RD were identified based on the 10th revision International Classification of Diseases (ICD-10) codes (J00-J99). A conditional Poisson regression model was applied to examine the heatwave-RD association using the Relative Risk (RR) while adjusting for meteorological and air pollution factors including temperature, rainfall, wind speed, pressure, humidity, sunshine hours and API.

RESULTS

During the study period, 4 heatwaves occurred and a total of 1732 outpatient visits for RD were reported. Heatwaves increased the frequency of RD outpatient visits and the highest RR of total RD was 1.155% and 95% Confidence Intervals (95% CI) was 1.084-1.232 at Lag 0. For subcategories, heatwaves increased the risk of infectious RD (Lag 0: RR =1.182, 95% CI: 1.106-1.263) and decreased the risk of non-infectious RD ((Lag 6: RR =0.750, 95% CI: 0.568-0.990). Moreover, heatwaves showed adverse effects on acute upper respiratory infection (Lag 0: RR =1.306, 95% CI: 1.177-1.450). The RR of outpatient visits for RD was statistically significant in females (Lag 0: RR =1.161, 95% CI: 1.046-1.298), males (Lag 4: RR =1.161, 95% CI: 1.096-1.261), young people aged 4-17 years (Lag 0: RR =1.741, 95% CI: 1.524-1.990) and elders aged 65 years or older (Lag 5: RR =1.412, 95% CI: 1.111-1.794) during heatwaves.

CONCLUSIONS

Heatwaves had a significant harmful impact on daily outpatient visits for RD in Cangnan, especially for vulnerable population identified. These results can be used not only to strengthen the health education and protection of these vulnerable populations, but also to assist relevant organizations with developing intervention programmes and improving disease prevention and community care.

Сardiovascular mortality during heat waves in temperate climate: an association with bioclimatic indices

The authors studied the relative predictive powers of several bioclimatic indices as predictors of population mortality during heat waves. Daily mean and maximum values of air temperature, Humidex, apparent, and physiological equivalent temperatures (PETs) were examined. The numbers of daily deaths and daily meteorological data in Rostov-on-Don (southern Russia) were used. The study period spanned April-September between 1999 and 2011. The eight selected bioclimatic indices were used to identify heat waves and calculate the expected increases in mortality during such events from Poisson generalized linear model of daily death counts. All of the bioclimatic indices considered were positively and significantly associated with mortality during heat waves. The best predictor was chosen from a set of similar models by maximization of relative mortality risk estimates. Having compared the relative increases and their significance levels in several cause- and age-specific mortality rates, the authors concluded that PET was the most powerful predictor.

Seasonal temperature variability and emergency hospital admissions for respiratory diseases: a population-based cohort study

Background

Climate change increases global mean temperature and changes short-term (eg, diurnal) and long-term (eg, intraseasonal) temperature variability. Numerous studies have shown that mean temperature and short-term temperature variability are both associated with increased respiratory morbidity or mortality. However, data on the impact of long-term temperature variability are sparse.

Objective

We aimed to assess the association of intraseasonal temperature variability with respiratory disease hospitalisations among elders.

Methods

We ascertained the first occurrence of emergency hospital admissions for respiratory diseases in a prospective Chinese elderly cohort of 66 820 older people (≥65 years) with 10–13 years of follow-up. We used an ordinary kriging method based on 22 weather monitoring stations in Hong Kong to spatially interpolate daily ambient temperature for each participant’s residential address. Seasonal temperature variability was defined as the SD of daily mean summer (June–August) or winter (December–February) temperatures. We applied Cox proportional hazards regression with time-varying exposure of seasonal temperature variability to respiratory admissions.

Results

During the follow-up time, we ascertained 12 689 cases of incident respiratory diseases, of which 6672 were pneumonia and 3075 were COPD. The HRs per 1°C increase in wintertime temperature variability were 1.20 (95% CI 1.08 to 1.32), 1.15 (1.01 to 1.31) and 1.41 (1.15 to 1.71) for total respiratory diseases, pneumonia and COPD, respectively. The associations were not statistically significant for summertime temperature variability.

Conclusion

Wintertime temperature variability was associated with higher risk of incident respiratory diseases.

An anaerobic-aerobic sequential batch process with simultaneous methanogenesis and short-cut denitrification for the treatment of marine biofoulings

Although combination of denitritation and methanogenesis for wastewater treatment has been widely investigated, an application of this technology to solid waste treatment has been rarely studied. This study investigated an anaerobic-aerobic batch system with simultaneous denitritation-methanogenesis as an effective treatment for marine biofoulings, which is a major source of intermittently discharged organic solid wastes. Preliminary NO₂^--exposed sludge was inoculated to achieve stable methanogenesis process without NO₂^- inhibition. Both high NH₄⁺-N removal of 99.5% and high NO₂^--N accumulation of 96.4% were achieved on average during the nitritation step. Sufficient CH₄ recovery of 101 L-CH₄ kg-COD^-1 was achieved, indicating that the use of NO₂^--exposed sludge is effective to avoid NO₂^- inhibition on methanogenesis. Methanogenesis was the main COD utilization pathway when the substrate solubilization occurred actively, while denitritation was the main when solubilization was limited because of substrate shortage. The results showed a high COD removal efficiency of 96.0% and a relatively low nitrogen removal efficiency of 64.4%. Fitting equations were developed to optimize the effluent exchange ratio. The estimated results showed that the increase of effluent exchange ratio during the active solubilization period increased the nitrogen removal efficiency but decreased CH₄ content in biogas. An appropriate effluent exchange ratio with high anaerobic effluent quality below approximately 120 mg-N L^-1 as well as sufficient CH₄ gas quality which can be used as fuel for gas engine generator was achieved by daily effluent exchange of 80% during the first week and 5% during the subsequent 8 days.

The impact of heat waves and cold spells on respiratory emergency department visits in Beijing, China

The objectives of this article were (i) to find the association between extreme temperatures and respiratory emergency department (ED) visits and (ii) to explore the added effects of heat waves and cold spells on respiratory ED visits in Beijing from 2009 to 2012. A quasi-Poisson generalised linear model combined with a distributed lag non-linear model was performed to quantify this association. The results indicated that (i) ambient temperature related to respiratory ED visits exhibited a U-shaped association. The minimum-morbidity temperature was 21.5°C. (ii) the peak relative risk (RR) of cold spells on respiratory ED visits was observed in relatively mild cold spells with a threshold below the 3rd percentile for 4days (RR=1.885, 95% CI: 1.300-2.734), and there was a reduction in risk during extremely chilly cold spells (RR=1.811, 95% CI: 1.229-2.667). However, the risk of heat waves increased with the thresholds, and the greatest risk was found for extremely hot heat waves (RR=1.932, 95% CI: 1.461-2.554). (iii) the added effect of heat waves was small, and we observed that the added heat wave effect only introduced additional risk in females (RR=1.166, 95% CI: 1.007-1.349). No added effect of cold spells was identified. In conclusion, the main effects of heat waves and cold spells on respiratory ED visits showed different change trends. In addition, the added effects of extreme temperatures on respiratory ED visits were small and negligible.

The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka

BACKGROUND

Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing.

OBJECTIVES

To determine the correlations between daily counts of patients nebulized at the Outpatient Department (OPD) of Teaching Hospital - Kandy (THK) and local meteorological variables, and to explore the utility of that information.

DESIGN

We considered daily counts of patients nebulized at the OPD of THK as an indicator of exacerbations of wheezing in the population catered to by this hospital. We determined the correlations between daily counts of patients nebulized at OPD and the following meteorological variables for four years: daily rainfall, minimum temperature, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours, daytime humidity, nighttime humidity, barometric pressure and visibility. We utilized wavelet time series method for data analysis.

RESULTS

All nine meteorological parameters studied were correlated with the daily counts of patients nebulized with average lag periods ranging from 5 to 15 days. Peaks of daily rainfall, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours and daytime humidity were followed by peaks of counts of patients nebulized (positive correlations). Troughs of minimum temperature, nighttime humidity, barometric pressure and visibility were followed by peaks of patients nebulized (negative correlations).

CONCLUSIONS

The THK shall expect more patients with acute wheezing after extremes of weather. Minimum temperature has been consistently correlated with the exacerbation of respiratory symptoms in the past studies in other countries as well. Hence, prescribing the inhalation of more drugs on unusually cold days (prophylactically) may help prevent acute exacerbation of wheezing in patients on treatment for asthma and COPD.

The relationship of climate variables in the prevalence of acute respiratory infection in children under two years old in Rondonópolis-MT, Brazil

It is estimated that approximately 30% of childhood diseases can be attributed to environmental factors and 40% involve children under the age of five years old, representing about 10% of world population. This study aimed to analyze the relationship of climate variables in the prevalence of acute respiratory infection (ARI) in children under two years old, in Rondonopolis-MT, from 1999 to 2014. It was used a cross-sectional study with a quantitative and a descriptive approach with meteorological teaching and research data from the database from the health information system. For statistical analysis, it adjusted the negative binomial model belonging to the class of generalized linear models, adopting a significance level of 5%, based on the statistical platform R. The average number of cases of ARI decreases at approximately by 7.9% per degree centigrade increase above the average air temperature and decrease about 1.65% per 1% increase over the average air relative humidity. Already, the rainfall not associated with these cases. It is the interdisciplinary team refocus practical actions to assist in the control and reduction of ARI significant numbers in primary health care, related climate issues in children.

Potential impact of climate change on emerging vector-borne and other infections in the UK

Climate is one of several causes of disease emergence. Although half or more of infectious diseases are affected by climate it appears to be a relatively infrequent cause of human disease emergence. Climate mostly affects diseases caused by pathogens that spend part of their lifecycle outside of the host, exposed to the environment. The most important routes of transmission of climate sensitive diseases are by arthropod (insect and tick) vectors, in water and in food. Given the sensitivity of many diseases to climate, it is very likely that at least some will respond to future climate change. In the case of vector-borne diseases this response will include spread to new areas. Several vector-borne diseases have emerged in Europe in recent years; these include vivax malaria, West Nile fever, dengue fever, Chikungunya fever, leishmaniasis, Lyme disease and tick-borne encephalitis. The vectors of these diseases are mosquitoes, sand flies and ticks. The UK has endemic mosquito species capable of transmitting malaria and probably other pathogens, and ticks that transmit Lyme disease. The UK is also threatened by invasive mosquito species known to be able to transmit West Nile, dengue, chikungunya and Zika, and sand flies that spread leishmaniasis. Warmer temperatures in the future will increase the suitability of the UK's climate for these invasive species, and increase the risk that they may spread disease. While much attention is on invasive species, it is important to recognize the threat presented by native species too. Proposed actions to reduce the future impact of emerging vector-borne diseases in the UK include insect control activity at points of entry of vehicles and certain goods, wider surveillance for mosquitoes and sand flies, research into the threat posed by native species, increased awareness of the medical profession of the threat posed by specific diseases, regular risk assessments, and increased preparedness for the occurrence of a disease emergency.

Climate change, air pollution, and allergic respiratory diseases: an update

PURPOSE OF REVIEW

The rising trend in prevalence of allergic respiratory disease and bronchial asthma, observed over the last decades, can be explained by changes occurring in the environment, with increasing presence of biologic, such as allergens, and chemical atmospheric trigger factors able to stimulate the sensitization and symptoms of these diseases.

RECENT FINDINGS

Many studies have shown changes in production, dispersion, and allergen content of pollen and spores because of climate change with an increasing effect of aeroallergens on allergic patients.

SUMMARY

Over the last 50 years, global earth's temperature has markedly risen likely because of growing emission of anthropogenic greenhouse gas concentrations. Major changes involving the atmosphere and the climate, including global warming induced by human activity, have a major impact on the biosphere and human environment.Urbanization and high levels of vehicle emissions are correlated to an increase in the frequency of pollen-induced respiratory allergy prevalent in people who live in urban areas compared with those who live in rural areas. Measures of mitigation need to be applied for reducing future impacts of climate change on our planet, but until global emissions continue to rise, adaptation to the impacts of future climate variability will also be required.

Evaluation of the environmental epidemiologic data and methodology for the air quality standard in Beijing

To evaluate the relationship between exposure to air pollutants and respiratory emergency room visits, a generalized additive model (GAM) was used to analyze the exposure-effect relationship between air pollutants and respiratory emergency room visits. The results showed that NO₂, SO₂, and PM₁₀ have positive relationships with respiratory disease. Concentration increases of 10 μg/m³ in NO₂, SO₂, and PM₁₀ corresponded to 3.90% (95%CI 3.56-4.25), 0.81% (95%CI -0.09-1.72), and 0.64% (95%CI 0.55-0.74) increases in respiratory emergency room visits. In addition, there is a strong synergic effect of PM₁₀ and NO₂ on respiratory diseases. The threshold values of the national standard grade II limits used in Beijing should be adjusted. An appropriate standard could effectively promote a significant decline in respiratory room visits and would eventually be beneficial to air quality management in residential areas.

Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II

We studied dampness and mold in homes in relation to climate, building characteristics and socio-economic status (SES) across Europe, for 7127 homes in 22 centers. A subsample of 3118 homes was inspected. Multilevel analysis was applied, including age, gender, center, SES, climate, and building factors. Self-reported water damage (10%), damp spots (21%), and mold (16%) in past year were similar as observed data (19% dampness and 14% mold). Ambient temperature was associated with self-reported water damage (OR=1.63 per 10°C; 95% CI 1.02-2.63), damp spots (OR=2.95; 95% CI 1.98-4.39), and mold (OR=2.28; 95% CI 1.04-4.67). Precipitation was associated with water damage (OR=1.12 per 100 mm; 95% CI 1.02-1.23) and damp spots (OR=1.11; 95% CI 1.02-1.20). Ambient relative air humidity was not associated with indoor dampness and mold. Older buildings had more dampness and mold (P<.001). Manual workers reported less water damage (OR=0.69; 95% CI 0.53-0.89) but more mold (OR=1.27; 95% CI 1.03-1.55) as compared to managerial/professional workers. There were correlations between reported and observed data at center level (Spearman rho 0.61 for dampness and 0.73 for mold). In conclusion, high ambient temperature and precipitation and high building age can be risk factors for dampness and mold in homes in Europe.