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      Climate change, air pollution, and allergic respiratory diseases: a call to action for health professionals

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          Abstract

          Rising emissions of greenhouse gases in the atmosphere have warmed the planet substantially and are also accompanied by poor air quality. The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes. Climate change and air pollution pose adverse impacts on respiratory allergies, and that the mechanisms are complex and interactive. Adverse weather conditions, such as extreme temperatures, can act directly on the respiratory tract to induce allergic respiratory illnesses. Thunderstorms and floods can alter the production and distribution of aeroallergens while wildfires and dust storms increase air pollution, and therefore indirectly enhance health risks. Concentrations of particulate matter and ozone in the air have been projected to increase with climate warming and air stagnation, and the rising temperatures and CO 2 increase pollen, molds, and spores, which escalate the risk of allergic respiratory diseases. The synergistic effects of extreme heat and aeroallergens intensify the toxic effect of air pollutants, which in turn augment the allergenicity of aeroallergens. With the Earth's climate change, migration of humans and plants shift the living environments and allergens of susceptible people. Urban residents are exposed to multiple factors while children are sensitive to environmental exposure. Since climate change may pose many unexpected and persistent effects on allergic respiratory diseases, health professionals should advocate for effective mitigation and adaptation strategies to minimize its respiratory health effects.

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          Most cited references77

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          Prevalence, risk factors, and management of asthma in China: a national cross-sectional study

          Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population.
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            Adapt to more wildfire in western North American forests as climate changes.

            Wildfires across western North America have increased in number and size over the past three decades, and this trend will continue in response to further warming. As a consequence, the wildland-urban interface is projected to experience substantially higher risk of climate-driven fires in the coming decades. Although many plants, animals, and ecosystem services benefit from fire, it is unknown how ecosystems will respond to increased burning and warming. Policy and management have focused primarily on specified resilience approaches aimed at resistance to wildfire and restoration of areas burned by wildfire through fire suppression and fuels management. These strategies are inadequate to address a new era of western wildfires. In contrast, policies that promote adaptive resilience to wildfire, by which people and ecosystems adjust and reorganize in response to changing fire regimes to reduce future vulnerability, are needed. Key aspects of an adaptive resilience approach are (i) recognizing that fuels reduction cannot alter regional wildfire trends; (ii) targeting fuels reduction to increase adaptation by some ecosystems and residential communities to more frequent fire; (iii) actively managing more wild and prescribed fires with a range of severities; and (iv) incentivizing and planning residential development to withstand inevitable wildfire. These strategies represent a shift in policy and management from restoring ecosystems based on historical baselines to adapting to changing fire regimes and from unsustainable defense of the wildland-urban interface to developing fire-adapted communities. We propose an approach that accepts wildfire as an inevitable catalyst of change and that promotes adaptive responses by ecosystems and residential communities to more warming and wildfire.
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              Meta-analyses of the associations of respiratory health effects with dampness and mold in homes.

              The Institute of Medicine (IOM) of the National Academy of Sciences recently completed a critical review of the scientific literature pertaining to the association of indoor dampness and mold contamination with adverse health effects. In this paper, we report the results of quantitative meta-analyses of the studies reviewed in the IOM report plus other related studies. We developed point estimates and confidence intervals (CIs) of odds ratios (ORs) that summarize the association of several respiratory and asthma-related health outcomes with the presence of dampness and mold in homes. The ORs and CIs from the original studies were transformed to the log scale and random effect models were applied to the log ORs and their variance. Models accounted for the correlation between multiple results within the studies analyzed. Central estimates of ORs for the health outcomes ranged from 1.34 to 1.75. CIs (95%) excluded unity in nine of 10 instances, and in most cases the lower bound of the CI exceeded 1.2. Based on the results of the meta-analyses, building dampness and mold are associated with approximately 30-50% increases in a variety of respiratory and asthma-related health outcomes. The results of these meta-analyses reinforce the IOM's recommendation that actions be taken to prevent and reduce building dampness problems, and also allow estimation of the magnitude of adverse public health impacts associated with failure to do so.
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                Author and article information

                Journal
                Chin Med J (Engl)
                Chin. Med. J
                CM9
                Chinese Medical Journal
                Wolters Kluwer Health
                0366-6999
                2542-5641
                5 July 2020
                24 June 2020
                : 133
                : 13
                : 1552-1560
                Affiliations
                [1 ]School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
                [2 ]Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China
                [3 ]School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
                [4 ]ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
                [5 ]IMIM (Hospital del Mar Research Institute), Barcelona, Spain
                [6 ]CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
                [7 ]Universitat Pompeu Fabra (UPF), Barcelona, Spain
                [8 ]Departments of Emergency Medicine, Environmental and Occupational Health Sciences, and Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA
                [9 ]School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, China
                [10 ]Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, China.
                Author notes
                Correspondence to: Prof. Cun-Rui Huang, School of Public Health, Sun Yat-sen University, Zhongshan Road #2, Guangzhou, Guangdong 510080, ChinaE-Mail: huangcr@ 123456mail.sysu.edu.cn
                Article
                CMJ-2020-235 00007
                10.1097/CM9.0000000000000861
                7386356
                32590458
                9086b3b2-2ffc-455f-8d31-8f5ab5e8f523
                Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 02 February 2020
                Categories
                Review Articles
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                respiratory allergy,climate change,air pollution,extreme weather events,aeroallergen

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