Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb.
Division of Allergy, Asthma and Immunology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Mo.
J Allergy Clin Immunol. 2019 May;143(5):1702-1710. doi: 10.1016/j.jaci.2019.02.018. Epub 2019 Feb 28.
Weather and climate change are constant and ever-changing processes that affect allergy and asthma. The purpose of this report is to provide information since the last climate change review with a focus on asthmatic disease. PubMed and Internet searches for topics included climate and weather change, air pollution, particulates, greenhouse gasses, traffic, insect habitat, and mitigation in addition to references contributed by the individual authors. Changes in patterns of outdoor aeroallergens caused by increasing temperatures and amounts of carbon dioxide in the atmosphere are major factors linked to increased duration of pollen seasons, increased pollen production, and possibly increased allergenicity of pollen. Indoor air pollution threats anticipated from climate changes include microbial and mold growth secondary to flooding, resulting in displacement of persons and need for respiratory protection of exposed workers. Air pollution from indoor burning of mosquito repellants is a potential anticipatory result of an increase in habitat regions. Air pollution from fossil fuel burning and traffic-related emissions can alter respiratory defense mechanisms and work synergistically with specific allergens to enhance immunogenicity to worsen asthma in susceptible subjects. Community efforts can significantly reduce air pollution, thereby reducing greenhouse gas emission and improving air quality. The allergist's approach to weather pattern changes should be integrated and anticipatory to protect at-risk patients.
天气和气候变化是持续不断且不断变化的过程,会影响过敏和哮喘。本报告的目的是提供自上次气候变化审查以来的信息,重点是哮喘疾病。使用 PubMed 和互联网搜索了与气候和天气变化、空气污染、颗粒物、温室气体、交通、昆虫栖息地以及个别作者提供的参考文献相关的主题。由于大气中二氧化碳含量增加导致的室外气传过敏原模式变化是与花粉季节持续时间延长、花粉产量增加以及花粉致敏性增加相关的主要因素。气候变化预期会造成室内空气污染威胁,包括洪水导致的微生物和霉菌生长,从而导致人员流离失所,并需要对暴露于污染物的工人进行呼吸防护。室内燃烧驱蚊剂产生的空气污染可能是栖息地区域增加的预期结果。化石燃料燃烧和交通相关排放造成的空气污染会改变呼吸道防御机制,并与特定过敏原协同作用,增强对易患哮喘的敏感人群的免疫原性,从而使哮喘恶化。社区努力可以显著减少空气污染,从而减少温室气体排放并改善空气质量。过敏症专家应采取综合的、有预见性的方法来应对天气模式变化,以保护高危患者。