Heat stroke, burning forests, and breathing…
Not only are our FORESTS at risk during severe weather, but so is our IMMUNE SYSTEM.
Temperature and humidity
High temperature and high humidity can cause our lungs to be unhappy and if you have asthma, your symptoms may worsen.
Bronchoconstriction is a very common symptom of the lungs during weather extremes. Bronchoconstriction is a condition in which the smooth muscles of the bronchus (the pathway that moves air to and from your lungs) contracts or tightens. This muscle contraction causes the bronchus to narrow and restrict the amount of air passing into and out of your lungs making breathing more difficult, especially during physical activity.
Other weather conditions, such as thunderstorms, can also cause asthma exacerbations in some people.
Low temperatures and low humidity can also influence the severity of exercise-induced asthma. While the precise mechanism is not clear, the inhalation of cold and dry air appears to increase bronchoconstriction during or shortly after exercise.
Some experts believe that increased breathing during exercise causes water loss in the airways. This water loss leads to an exchange of molecules in the cells lining the airways, causing inflammation that ultimately leads to bronchoconstriction. A second theory suggests increased breathing during exercise leads to cooling of the airways – many non-medical people also believe this to be the case. This cooling is followed by the rapid flow of blood into airway blood vessels (to bring warmth) and resultant edema or inflammation.
Climate changes
Conditions related to climate change are predicted to increase exposure to asthma triggers. These may include more hot, sunny days that increase ozone-related asthma symptoms, rises in sea level or altered rainfall that may affect the dampness of indoor environments leading to more dust mite and mold growth, and higher ambient carbon dioxide levels that may increase exposure to allergens by lengthening the pollen season.
Risk factors for thunderstorm asthma
"Thunderstorm asthma" refers to asthma episodes that occur in the hours after a thunderstorm, especially storms occurring during pollen seasons. (Like what just happened this week!) The thunder, lightning, and wind cause a shake-up, that ruptures water-logged pollen grains, which then release allergenic debris into the air. The debris is swept up by the storms strong cross currents and then deposited in concentrated form at ground level. There are times when people with asthma or allergies will suffer more; especially when their immune system is highly sensitized, or when their asthma is not well controlled.
Doctors and families should be aware that thunderstorms can trigger asthma, and people with pollen allergies and asthma should avoid the outdoors during and after thunderstorms, especially during pollen seasons.
Potential interventions
Simply being aware of these triggers can help you prepare for different environments and anticipate problems to gain a better sense of control over your asthma.
Masks and scarves that trap heat and moisture when a person breathes out and warm the cold air during inhalation may help persons with asthma who work, exercise, or spend time in cold temperatures.
Use of a short-acting beta-agonist (SABA, such as salbutamol or Ventolin) prior to exercise in cold or dry conditions or at the onset of storms during pollen seasons can help prevent symptom flares.
Patients whose asthma is triggered by pollen or mold allergy should be made aware that the conditions at the beginning of a thunderstorm during pollen season can be particularly troublesome and advised to avoid being outdoors during thunderstorms.
References:
Up to Date - published by Wolters Kluwer. Accessed on July 20, 2022 from: https://www.uptodate.com/contents/trigger-control-to-enhance-asthma-management?sectionName=Thunderstorms&search=Risk%20factors%20for%20thunderstorm%20asthma&topicRef=8363&anchor=H486751745&source=see_link&mkt_tok=NTkxLVdKVy0xMTUAAAGFuv6pb5l_QL_XHrMdR147eyOwWgSyYkNcMpZ057PxUq6Bc02jk5k3fNqjL9tW0jCZp3XrnYk6NKGehmTx_inB7L8_cOyx-f2Q-0heuI6Sd4mQ#H486751745
Douglass JA, Lodge C, Chan S, et al. Thunderstorm asthma in seasonal allergic rhinitis: The TAISAR study. J Allergy Clin Immunol 2022; 149:1607.