|Year : 2014 | Volume
| Issue : 3 | Page : 149-150
Climate change and respiratory health: Time to act!!
Department of Pulmonary Medicine, KLE University's J.N. Medical College, Belgaum, Karnataka, India
|Date of Web Publication||19-Sep-2014|
Department of Pulmonary Medicine, KLE University's J.N. Medical College, Belgaum, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mahishale V. Climate change and respiratory health: Time to act!!. J Sci Soc 2014;41:149-50
It is now proved that the earth's temperature is increasing, as evidenced by warming of the oceans, rising sea levels, glaciers melting, sea ice retreating in the Arctic and diminished snow cover in the Northern Hemisphere. Changes are also occurring in the amount, intensity, frequency and type of rainfall, and there is an increase in extreme weather events, such as heat waves, droughts, floods, and hurricanes. Most of the observed increase in global warming since the mid-20 th century is very likely due to an increase in anthropogenic greenhouse gas (GHG) concentrations. , GHGs such as CO 2 come from a variety of sources, but mostly from the burning of fossil fuels, emissions from energy supply, transport, agriculture, industry, forestry, waste, and commercial and residential buildings. The atmospheric concentration of these gases has increased from 280 parts per million at the start of the Industrial Revolution to roughly 395 parts/million today.
Observational evidence indicates that recent regional changes in climate, particularly temperature increase, have already affected a diverse set of physical and biologic systems in many parts of the world. The Intergovernmental Panel on Climate Change, 2007, reported an increase in the global average air temperature by 1.0°F-0.3°F (0.6°C-0.2°C) since the late 19 th century. They projected a likely increase in the average surface temperature of the Earth by 2°F-11°F (1.1°C-6.4°C) by the end of the 21 st century and estimated that the average rate of warming of inhabited continent is very likely to be at least twice as large as that experienced during the 20 th century.  Increase in Earth's average temperature affects the ground level ozone because warmer temperatures catalyze its production.  Ozone is created when oxides of nitrogen react with volatile organic compounds (both of which are present in the exhaust from motor vehicles and fossil fuel-burning power plants) in the presence of ultraviolet radiation and heat. 
A substantial body of epidemiological research describes how rising atmospheric temperatures associated with climate change are linked to changing distributions of respiratory disease and mortality. Extreme weather events in recent years such as wild fires, heat waves, floods, hurricanes, droughts have highlighted some of the significant health consequences of these events on respiratory health.
Heat and drought conditions across the world have increased the frequency of wildfires. Smoke emissions from these fires can travel hundreds of kilometers, exposing people to a complex mixture of fine particles, ozone precursors, and other health-harming compounds. Respiratory and cardiovascular hospital admissions and emergency room visits increase as a result of wildfire smoke exposures. These health threats could increase in future with climate change that exacerbates wildfire risks in many regions. , Aero-allergenic plant pollen production is also affected by climate change. Laboratory and field studies in Europe, North America, Australia and Asia have shown that allergenic tree, grass, and weed pollen production increases several-fold under the influence of higher carbon dioxide (CO 2 ) concentrations.  The combination of earlier spring onset and warmer summer temperatures extend pollen production seasons and significantly increase the asthma exacerbations and its severity.
Extreme heat increases short-term premature mortality and morbidity from a variety of causes, including those directly heat-related (heat stroke, heat syncope, heat edema, etc.) and a range of cardiovascular, respiratory, kidney and other illnesses. The relationship between heat and all-cause mortality has been well-established, and heat wave deaths predominantly affect the elderly and those with chronic respiratory or cardiovascular diseases. Numerous recent studies have found excess hospital admissions for respiratory diseases and mortality as a result of heat waves in Europe and the United States. For each 1°C increase in mean temperature during the 2006 heat wave in Portugal, all-cause mortality increased by 2.7% and chronic obstructive pulmonary disease (COPD) morbidity increased by 5.4%, with even greater increases, in COPD morbidity for women and people over the age of 75 years.  Ground-level ozone exposures diminish lung function and increase acute premature mortality, asthma-related hospitalizations and emergency department visits. For people with COPD, Cardiovascular diseases and diabetes, chronic ozone exposures also increase mortality risks. Temperatures have been projected to continue to rise through the end of this century. Climate change could potentially increase the incidence of childhood pneumonia. Increased indoor time because of heavier rainfall could increase crowding and exposure to biomass fuel smoke, and decrease exposure to sunlight (i.e., reduced Vitamin D). Population displacement due to drought and food crisis could further increase the rate of transmission of infections including tuberculosis (TB). It is likely that climate change will be associated with more episodes of extreme precipitation, potentially leading to severe flooding, consequent population dislocation, poor living conditions, worsening water quality, poor nutrition and inadequate access to medical care. This will increase respiratory infections like pneumonia and TB in particular and also their outcome.
Climate change represents the greatest environmental challenge of our times. Disproportionate consumption of fossil fuels by rich nations, as well as developing countries, is responsible for our current levels of global warming. Many developed countries have considerably reduced their emissions of GHGs by inflexible regulatory laws and public awareness. Unfortunately, China, India and other rapidly developing nations have significantly increased their production of GHGs and are continuing the increase in pollution globally.
Low-resource countries continue to suffer the greatest impacts because of their increased exposure to the effects of warming and their reduced ability to adapt to the changes. Considering the fact that the change in the climate is significantly affecting the health of patients with chronic lung diseases, much can be gained from actions to reduce GHGS emissions. Burning fewer fossil fuels will yield immediate dividends because the major pollutants known to worsen asthma, COPD, and other respiratory diseases (air particulates, nitrogen oxides, sulfates, and ozone among them) come from fossil fuel combustion. CO 2 stays in the atmosphere for hundreds of years, which means its effects on the climate are long-lived, and therefore reducing emissions today will yield enormous health benefits in the future. The best available science indicates that unless significant action is taken to reduce GHGs, the planet may warm 2°C-3°C above the preindustrial threshold by the end of the century. ,
Many people remain confused about climate science and its impact on health. Physicians and in particular Pulmonologists, whose patients are among those expected to suffer most from climate change, can help change this. They can play a vital role in communicating the health risks of climate change to the public and policymakers, just as they did with tobacco. Together we can secure a path that leads to a healthier and pollution-free future.
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