Over 25 million people in the United States (US) have asthma and it’s only becoming more prevalent, as climate change contributes to the climbing allergic asthma rates. But, there are concrete steps the US health care system can take to improve the lives of those impacted.
Half of adults and almost 90% of children with asthma have allergic asthma. Triggered by inhaling allergens such as pollen, dust mites, or pet dander, allergic asthma commonly produces respiratory symptoms like shortness of breath and chest tightness, as well as hives and nose irritation.
The impact of asthma on a person’s quality of life is significant. Asthma is actually one of the top reasons children miss school. In 2013, kids missed almost 14 million days because of asthma alone. (A more recent statistic is not available.) And a fifth of adults with asthma report that workplace exposures make their symptoms worse and negatively affect their productivity. These losses, coupled with related medical costs, make asthma one of the most expensive diseases in the US.
While many asthma cases aren’t preventable, the noted increase in allergic asthma rates is likely due in part to climate change.
First, global warming – due to an increase in greenhouse gases in the atmosphere caused by human activities – impacts the duration and intensity of allergy season.
Warmer temperatures confuse trees into releasing more pollen, and releasing it earlier than they normally do. Think January instead of March. In North America, there is currently almost 20% more pollen than there was in 1990. Historically cooler environments like Norway and Canada are feeling it, too, now that warmer temperatures can support more pollen-producing plants.
Second, global warming causes more frequent, extreme weather events, worsening air quality. For example, wildfires and floods often trigger asthma attacks because the former releases pollutants into the air and the latter promotes indoor mold growth. Even thunderstorms have an effect: Heavy rain and strong winds break up pollen grains into smaller pieces that can travel longer distances.
What’s worse, historically marginalized individuals are hit the hardest by climate change. The data show these populations are 52% more likely to live in areas with higher predicted asthma-related emergency room visits. Higher rates of asthma are also common in low-income households, and Black children are more than seven times as likely to die from asthma than their non-Hispanic White peers.
While daunting, there are ways to reduce the impact of climate change on allergic asthma.
For starters, providers could consider switching the inhalers they prescribe, choosing dry powder inhalers, instead of metered-dose inhalers. Metered-dose inhalers account for almost 90% of the US asthma medication market, prescribed to 144 million patients per year. Yet with every use, they release a greenhouse gas more powerful than carbon dioxide (the most significant contributor to the greenhouse effect) and produce the same amount of emissions as all of the homes in Milwaukee, Wisconsin.
Hospitals could also make environmentally friendly changes. After all, they are major greenhouse gas emitters. The health care system in the US is responsible for 8.5% of all of the country’s carbon emissions, regardless of industry, and 25% of the world’s health care-related emissions. One fix could be to improve energy efficiency in buildings and to substitute fuel powered emergency vehicles with electric ones. Some also recommend reducing single use plastics by switching to reusable isolation gowns, surgical supplies, linens, and other products.
But other sectors have a large role to play, too, and broader scale climate change reform from the federal government could have trickle-down effects.
For example, federal policies could limit how much Americans use fossil fuels. Policymakers could require that large corporations reduce their emissions and enforce a goal of carbon neutrality by 2050 (the year when the damage from climate change will be irreversible). More work can be done on the state and local levels, too, to create and prioritize renewable energy sources like solar, wind, and hydropower.
Asthma won’t ever be gone completely, but rates of allergic asthma could be reduced if global warming is. The health care system and policymakers must work together to protect respiratory health while it’s still possible.
