International Journal of Biometeorology

, Volume 62, Issue 3, pp 471–481 | Cite as

The association between ambient temperature and childhood asthma: a systematic review

  • Zhiwei XuEmail author
  • James Lewis Crooks
  • Janet Mary Davies
  • Al Fazal Khan
  • Wenbiao Hu
  • Shilu Tong
Review Paper


The objectives of this study are to review available information on the association between ambient temperature and childhood asthma, and to elucidate the possible underlying mechanisms of this relationship. A systematic review was conducted based on the papers retrieved from four databases, including PubMed, ProQuest, ScienceDirect, and Scopus. Papers examining the association of absolute temperature or temperature variation with childhood asthma published from 1 January 2000 to 31 December 2016 were included. Thirteen papers have quantified the effect of absolute temperature on childhood asthma, and six papers have examined the effect of intra- or inter-day temperature variation on childhood asthma. All studies were conducted in urban areas. Aeroallergen sensitizations were only considered in the analyses of one study. Discrepancy existed in the significance of the relationship between absolute temperature and childhood asthma, and also in the shape of this relationship (i.e. linear or non-linear) and whether temperature effects were lagged. Increasing evidence is suggesting non-linear relationship between absolute temperature and childhood asthma. Future research should investigate the burden of childhood asthma specifically attributable to extreme temperatures and temperature variation using advanced statistical approach, particularly in rural areas, after properly considering aeroallergens and air pollution. Projecting future burden of childhood asthma under climate change scenarios is also warranted.


Absolute temperature Aeroallergen Air pollution Childhood asthma Temperature variation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. Abe T, Tokuda Y, Ohde S, Ishimatsu S, Nakamura T, Birrer RB (2009) The relationship of short-term air pollution and weather to ED visits for asthma in Japan. Am J Emerg Med 27(2):153–159. CrossRefGoogle Scholar
  2. Ahluwalia SK, Matsui EC (2011) The indoor environment and its effects on childhood asthma. Curr Opin Allergy Clin Immunol 11(2):137–143. CrossRefGoogle Scholar
  3. Asher I, Pearce N (2014) Global burden of asthma among children. Int J Tuberc Lung Dis 18(11):1269–1278CrossRefGoogle Scholar
  4. Beasley R, Semprini A, Mitchell EA (2015) Risk factors for asthma: is prevention possible? Lancet 386(9998):1075–1085. CrossRefGoogle Scholar
  5. Beggs P, Bambrick H (2005) Is the global rise of asthma an early impact of anthropogenic climate change? Environ Health Perspect 113(8):915–919CrossRefGoogle Scholar
  6. Bull G (1980) The weather and deaths from pneumonia. Lancet 315:1405–1408CrossRefGoogle Scholar
  7. Cakmak S, Dales RE, Coates F (2012) Does air pollution increase the effect of aeroallergens on hospitalization for asthma? J Allergy Clin Immunol 129(1):228–231. CrossRefGoogle Scholar
  8. D’Amato G, Cecchi L, D’Amato M, Annesi-Maesano I (2014) Climate change and respiratory diseases. Eur Respir Rev 23(132):161–169. CrossRefGoogle Scholar
  9. D'Amato G, Cecchi L (2008) Effects of climate change on environmental factors in respiratory allergic diseases. Clin Exp Allergy 38(8):1264–1274. CrossRefGoogle Scholar
  10. D'Amato G, Pawankar R, Vitale C, Lanza M, Molino A, Stanziola A, Sanduzzi A, Vatrella A, D'Amato M (2016) Climate change and air pollution: effects on respiratory allergy. Allergy Asthma Immunol Res 8(5):391–395CrossRefGoogle Scholar
  11. Ding L, Abebe T, Beyene J, Wilke RA, Goldberg A, Woo JG, Martin LJ, Rothenberg ME, Rao M, Hershey GKK, Chakraborty R, Mersha TB (2013) Rank-based genome-wide analysis reveals the association of Ryanodine receptor-2 gene variants with childhood asthma among human populations. Hum Genomics 7(1):16. CrossRefGoogle Scholar
  12. Don Hayes J, Collins PB, Khosravi M, Lin R-L, Lee L-Y (2012) Bronchoconstriction triggered by breathing hot humid air in patients with asthma. Am J Respir Crit Care Med 185(11):1190–1196. CrossRefGoogle Scholar
  13. Donaldson G, Seemungal T, Jeffries D, Wedzicha J (1999) Effect of temperature on lung function and symptoms in chronic obstructive pulmonary disease. Eur Respir J 13(4):844–849CrossRefGoogle Scholar
  14. Ebi K, McGregor G (2008) Climate change, tropospheric ozone and particulate matter, and health impacts. Environ Health Perspect 116(11):1449–1455CrossRefGoogle Scholar
  15. Erbas B, Shrestha SK, Dharmage SC, Katelaris C, Davies J, Abramson MJ (2016) The effects of air pollution on asthma hospital admissions in Adelaide, South Australia, 2003–2013: time series and case-crossover analysis. Clin Exp Allergy 46(12):1623–1624. CrossRefGoogle Scholar
  16. Forno E, Sordillo J, Brehm J, Chen W, Benos T, Yan Q, Avila L, Soto-Quirós M, Cloutier MM, Colón-Semidey A, Alvarez M, Acosta-Pérez E, Weiss ST, Litonjua AA, Canino G, Celedón JC (2017) Genome-wide interaction study of dust mite allergen on lung function in children with asthma. J Allergy Clin Immunol S0091-6749(17):30154–30159. Google Scholar
  17. Gasparrini A, Leone M (2014) Attributable risk from distributed lag models. BMC Med Res Methodol 14(1):55. CrossRefGoogle Scholar
  18. Gern JE (2010) The urban environment and childhood asthma study. J Allergy Clin Immunol 125(3):545–549. CrossRefGoogle Scholar
  19. Graudenz GS, Landgraf RG, Jancar S, Tribess A, Fonseca SG, Faé KC, Kalil J (2006) The role of allergic rhinitis in nasal responses to sudden temperature changes. J Allergy Clin Immunol 118(5):1126–1132. CrossRefGoogle Scholar
  20. Gref MA, Merid MSK, Gruzieva DO et al (2017) Genome-wide interaction analysis of air pollution exposure and childhood asthma with functional follow-up. Am J Respir Crit Care Med.
  21. Guo Y, Jiang F, Peng L, Zhang J, Geng F, Xu J, Zhen C, Shen X, Tong S (2012) The association between cold spells and pediatric outpatient visits for asthma in Shanghai, China. PLoS One 7(7):e42232. CrossRefGoogle Scholar
  22. Hashimoto M, Fukuda T, Shimizu T, Watanabe S, Watanuki S, Eto Y, Urashima M (2004) Influence of climate factors on emergency visits for childhood asthma attack. Pediatr Int 46(1):48–52. CrossRefGoogle Scholar
  23. Hervás D, Utrera JF, Hervás-Masip J, Hervás JA, García-Marcos L (2015) Can meteorological factors forecast asthma exacerbation in a paediatric population? Allergol Immunopathol (Madr) 43(1):32–36. CrossRefGoogle Scholar
  24. IPCC (2013) Climate change 2013: the physical science basis. Contribution of working group I to the fifth assessment report of the intergovernmental panel on climate change. Cambridge University Press, CambridgeGoogle Scholar
  25. Johnston SL, Pattemore PK, Sanderson G et al (1996) The relationship between upper respiratory infections and hospital admissions for asthma: a time-trend analysis. Am J Respir Crit Care Med 154(3):654–660. CrossRefGoogle Scholar
  26. Kaminsky D, Bates J, Irvin C (2000) Effects of cool, dry air stimulation on peripheral lung mechanics in asthma. Am J Respir Crit Care Med 162(1):179–186CrossRefGoogle Scholar
  27. Kassebaum NJ, Arora M, Barber RM et al (2016) Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388(10053):1603–1658. CrossRefGoogle Scholar
  28. Khreis H, Kelly C, Tate J, Parslow R, Lucas K, Nieuwenhuijsen M (2017) Exposure to traffic-related air pollution and risk of development of childhood asthma: a systematic review and meta-analysis. Environ Int 100:1–31. CrossRefGoogle Scholar
  29. Koskela H, Tukiainen H, Kononoff A, Pekkarinen H (1994) Effect of whole-body exposure to cold and wind on lung function in asthmatic patients. Chest 105(6):1728–1731. CrossRefGoogle Scholar
  30. Lam HC-Y, Li AM, Chan EY-Y, Goggins WB (2016) The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax 71(12):1097–1109. CrossRefGoogle Scholar
  31. LaVoy ECP, McFarlin BK, Simpson RJ (2011) Immune responses to exercising in a cold environment. Wilderness Environ Med 22(4):343–351. CrossRefGoogle Scholar
  32. Li M, Li Q, Yang G, Kolosov VP, Perelman JM, Zhou XD (2011) Cold temperature induces mucin hypersecretion from normal human bronchial epithelial cells in vitro through a transient receptor potential melastatin 8 (TRPM8)-mediated mechanism. J Allergy Clin Immunol 128(3):626–634.e625. CrossRefGoogle Scholar
  33. Li S, Baker PJ, Jalaludin BB, Guo Y, Marks GB, Denison LS, Williams GM (2014a) Are children’s asthmatic symptoms related to ambient temperature? A panel study in Australia. Environ Res 133:239–245. CrossRefGoogle Scholar
  34. Li S, Baker PJ, Jalaludin BB, Guo Y, Marks GB, Denison LS, Williams GM (2014b) An Australian national panel study of diurnal temperature range and children’s respiratory health. Ann Allergy Asthma Immunol 112(4):348–353.e348. CrossRefGoogle Scholar
  35. Li K, Ni H, Yang Z, Wang Y, Ding S, Wen L, Yang H, Cheng J, Su H (2016) Effects of temperature variation between neighbouring days on daily hospital visits for childhood asthma: a time-series analysis. Public Health 136:133–140. CrossRefGoogle Scholar
  36. Lowen AC, Mubareka S, Steel J, Palese P (2007) Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog 3(10):e151. CrossRefGoogle Scholar
  37. Meehl GA, Tebaldi C (2004) More intense, more frequent, and longer lasting heat waves in the 21st century. Science 305(5686):994–997. CrossRefGoogle Scholar
  38. Michelozzi P, Accetta G, Sario MD et al (2009) High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European cities. Am J Respir Crit Care Med 179(5):383–389. CrossRefGoogle Scholar
  39. Mirabelli M, Vaidyanathan A, Flanders W, Qin X, Garbe P (2016) Outdoor PM2.5, ambient air temperature, and asthma symptoms in the past 14 days among adults with active asthma. Environ Health Perspect 124(12):1882–1890CrossRefGoogle Scholar
  40. Mireku N, Wang Y, Ager J, Reddy RC, Baptist AP (2009) Changes in weather and the effects on pediatric asthma exacerbations. Ann Allergy Asthma Immunol 103. doi:
  41. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4(1):1. CrossRefGoogle Scholar
  42. Mölter A, Simpson A, Berdel D et al (2015) A multicentre study of air pollution exposure and childhood asthma prevalence: the ESCAPE project. Eur Respir J 45(3):610–624. CrossRefGoogle Scholar
  43. Morales-Suárez-Varela M, Llopis-González A, Vergara-Hernández C et al (2017) Asthma in older people hospitalized with influenza in Spain: a case-control study. Allergy Asthma Proc 38(4):277–285. CrossRefGoogle Scholar
  44. Nastos PT, Paliatsos AG, Papadopoulos M, Bakoula C, Priftis KN (2008) The effect of weather variability on pediatric asthma admissions in Athens, Greece. J Asthma 45(1):59–65. CrossRefGoogle Scholar
  45. Qiu H, IT-s Y, Tse LA, Chan EYY, Wong TW, Tian L (2015) Greater temperature variation within a day associated with increased emergency hospital admissions for asthma. Sci Total Environ 505:508–513. CrossRefGoogle Scholar
  46. Ren C, Williams G, Tong S (2006) Does particulate matter modify the association between temperature and cardiorespiratory diseases? Environ Health Perspect 114(11):1690–1696Google Scholar
  47. Sheffield PE, Knowlton K, Carr JL, Kinney PL (2011) Modeling of regional climate change effects on ground-level ozone and childhood asthma. Am J Prev Med 41(3):251–257. CrossRefGoogle Scholar
  48. Son J-Y, Bell ML, Lee J-T (2014) The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea. Int J Biometeorol 58(9):1893–1903. CrossRefGoogle Scholar
  49. Soneja S, Jiang C, Fisher J, Upperman CR, Mitchell C, Sapkota A (2016) Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A. Environ Health 15(1):57. CrossRefGoogle Scholar
  50. Togias AG, Naclerio RM, Proud D, Fish JE, Adkinson NF Jr, Kagey-Sobotka A, Norman PS, Lichtenstein LM (1985) Nasal challenge with cold, dry air results in release of inflammatory mediators. Possible mast cell involvement. J Clin Invest 76(4):1375–1381. CrossRefGoogle Scholar
  51. Ueda K, Nitta H, Odajima H (2010) The effects of weather, air pollutants, and Asian dust on hospitalization for asthma in Fukuoka. Environ Health Prev Med 15(6):350–357. CrossRefGoogle Scholar
  52. Weinmayr G, Romeo E, Sario MD, SKWeiland FF (2010) Short-term effects of PM10 and NO2 on respiratory health among children with asthma or asthma-like symptoms: a systematic review and meta-analysis. Environ Health Perspect 118(4):449–457CrossRefGoogle Scholar
  53. Winquist A, Grundstein A, Chang HH, Hess J, Sarnat SE (2016) Warm season temperatures and emergency department visits in Atlanta, Georgia. Environ Res 147:314–323. CrossRefGoogle Scholar
  54. Xirasagar S, Lin H-C, Liu T-C (2006) Seasonality in pediatric asthma admissions: the role of climate and environmental factors. Eur J Pediatr 165(11):747–752. CrossRefGoogle Scholar
  55. Xu Z, Huang C, Hu W, Turner LR, Su H, Tong S (2013a) Extreme temperatures and emergency department admissions for childhood asthma in Brisbane, Australia. Occup Environ Med 70(10):730–735. CrossRefGoogle Scholar
  56. Xu Z, Huang C, Su H, Turner LR, Qiao Z, Tong S (2013b) Diurnal temperature range and childhood asthma: a time-series study. Environ Health 12(1):12. CrossRefGoogle Scholar
  57. Yamazaki S, Shima M, Yoda Y et al (2013) Association of ambient air pollution and meteorological factors with primary care visits at night due to asthma attack. Environ Health Prev Med 18(5):401–406. CrossRefGoogle Scholar

Copyright information

© ISB 2017

Authors and Affiliations

  1. 1.School of Public Health and Social Work & Institute of Health and Biomedical InnovationQueensland University of TechnologyKelvin GroveAustralia
  2. 2.National Jewish HealthDenverUSA
  3. 3.School of Biomedical Sciences & Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneAustralia
  4. 4.International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
  5. 5.School of Public Health and Institute of Environment and Human HealthAnhui Medical UniversityHefeiChina
  6. 6.Shanghai Children’s Medical CentreShanghai Jiao-Tong UniversityShanghaiChina

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