How Do Storms Affect Asthma?
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Purpose of Review
There are observations in various geographical areas that thunderstorms occurring during pollen seasons can induce severe asthma attacks in pollinosis patients.
An accredited hypothesis explaining the association between thunderstorms and asthma suggests that storms can concentrate pollen grains at ground level, which may then release allergenic particles of respirable size in the atmosphere after their imbibition of water and rupture by osmotic shock. During the first 20–30 min of a thunderstorm, patients affected by pollen allergy may inhale a high quantity of the allergenic material that is dispersed into the atmosphere as a bioaerosol of allergenic particles, which can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack. A key message is that all subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe asthma exacerbations. In light of these observations, it is useful to predict thunderstorms and thus minimize thunderstorm-related events. Patients with respiratory allergy induced by pollens and molds need to be informed about a correct therapeutic approach of bronchial asthma by inhalation, including the use of bronchodilators and inhaled corticosteroids.
The purpose of this review is to focalize epidemiological, etiopathogenetic, and clinical aspects of thunderstorm-related asthma.
KeywordsClimate change and allergy Thunderstorm asthma Global warming and allergy Storms and respiratory allergy in pollen seasons Pollinosis Allergenic pollens and asthma attacks Aeroallergens Acute asthma exacerbations
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Conflict of Interest
The authors declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.• D’Amato G, Annesi Maesano I, Molino A, Vitale C, D’Amato M. Thunderstorm-related asthma attacks. J Allergy Clin Immunol. 2017;139(6):1786–7. https://doi.org/10.1016/j.jaci.2017.03.003. Among the thunderstorm-related events in the world the worst was recorded on 21 November 2016 in Melbourne, where nine subjects died and more than 8500 were hospitalized . It caused many people, including those who had no history of asthma or respiratory issues, to experience mild to severe breathing difficulties and near fatal asthma. CrossRefPubMedGoogle Scholar
- 2.• D’Amato G, Vitale C, D’Amato M, Cecchi L, Liccardi G, Molino A, et al. Thunderstorm-related asthma: What happens and why. Clin Exp Allergy. 2016;46(3):390–6. https://doi.org/10.1111/cea.12709. All patients affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe exacerbations of asthma and other allergic respiratory diseases. In the light of these observations, it is useful to predict thunderstorms and thus minimize thunderstorm-related events. CrossRefPubMedGoogle Scholar
- 6.• D’Amato G, Holgate ST, Pawankar R, Ledford DK, Cecchi L, Al-Ahmad M, et al. Meteorological conditions, climate change, new emerging factors and asthma and related allergic disorders. A statement of the world allergy Organitation. World Allergy Organ J. 2015;8(1):25–52. https://doi.org/10.1186/s40413-015-0073-0. This is a statement of the World Allergy Organization (WAO) raising the importance of this health hazard and highlights the facts on climate-related health impacts, including: deaths and acute morbidity due to heat waves and extreme meteorological events; increased frequency of acute cardio-respiratory events due to higher concentrations of air pollution and in particular ground level of O3; changes in the frequency of respiratory diseases due to trans-boundary particle pollution; altered spatial and temporal distribution of allergens (outdoors such as pollens and molds, and indoors such mites); and some infectious disease vectors. PubMedGoogle Scholar
- 21.Knox RB. Grass pollen, thunderstorms and asthma. Clin Exp Allergy. 1993;23:354–6. https://doi.org/10.1111/j.1365-2222.1993.tb00339.x.CrossRefPubMedGoogle Scholar
- 26.D’Amato G, Rottem M, Dahl R, Blaiss M, Ridolo E, Cecchi L, et al. Annesi-Maesano and the WAO special committee on climate change and allergy. Climate change, migration and allergic respiratory diseases: An update for the allergist. World Allergy Organ J. 2011;4:120–5. https://doi.org/10.1097/WOX.0b013e3182260a57.PubMedPubMedCentralGoogle Scholar
- 33.D’Amato G, Ruffilli A, Ortolani C. Allergenic significance of Parietaria (pellitory-of-the-wall) pollen. In: D’Amato G, Spieksma F, Bonini S, editors. Allergenic pollen and pollinosis in Europe. Oxford: Blackwell Scientific Publications; 1991. p. 113–8.Google Scholar
- 34.Levy ML. Thunderstorm Asthma BC. Brit J Prim Care Nurs. 2007;1:69–71.Google Scholar
- 35.D’Amato M, Cecchi L, Annesi-Maesano I, D’Amato G. News on climate change, air pollution and allergic trigger factors of asthma. J Investig Allergol Clin Immunol. 2018;17 https://doi.org/10.18176/jiaci.0228.