Spanish spotlight selected publications

The Spanish EATRIS node started its Spotlight Programme in May 2024 with the topic of “The Impact of Climate Change on Health”. One of the main aims of the Programme is to highlight national research infrastructures, institutions, and researchers. To that end, Spanish node has selected publications co-authored by researchers from EATRIS Spanish member institutes to showcase the research that is conducted on the topic of climate change and health exploring it through various subtopics. The first of five topics is Allergies and Respiratory Diseases, which you can explore below. This will be followed by Severity of Chronic Diseases in Vulnerable Populations, Infectious Diseases and Vector Redistribution, Data Management and Analysis soon.

Allergies and Respiratory Diseases

Climate change has a significant and multifaceted impact on allergies and respiratory diseases, posing a growing threat to public health worldwide. Indeed, change is a major driver of the increasing burden of allergies and respiratory diseases globally. The key aspects of this impact include:

  • Increased Pollen Production and Allergen Exposure: Rising temperatures and carbon dioxide levels are stimulating plant growth and leading to longer pollen seasons. This results in increased allergen exposure, triggering and exacerbating allergic rhinitis (hay fever) and asthma in susceptible individuals.
  • Air Pollution Exacerbation: Climate change worsens air quality through various mechanisms. Warmer temperatures promote the formation of ground-level ozone, a potent respiratory irritant. Additionally, wildfires, which are increasing in frequency and intensity due to climate change, release vast amounts of smoke and particulate matter into the air, further compromising respiratory health.
  • Changes in Mold and Fungi: Warmer and more humid conditions favor the growth of mold and fungi, both indoors and outdoors. Exposure to mold spores can trigger allergic reactions and respiratory problems, particularly in people with asthma or pre-existing lung conditions.
  • Extreme Weather Events: Climate change is associated with an increase in the frequency and severity of extreme weather events, such as heat waves, droughts, and floods. These events can directly impact respiratory health, particularly for vulnerable populations like children, the elderly, and those with chronic respiratory diseases.
  • Geographic Shifts in Allergens: Climate change is altering the distribution of plants and animals, including those that produce allergens. As a result, people may encounter new allergens to which they have not previously been exposed, potentially leading to allergic reactions and respiratory problems.

Spanish Health Research Institutes are studying all these impacts, in collaboration with other European Institutions, leading to relevant publications on the field. We highlighted some of them below. Click on the title to read the abstract and more.

Both air pollution and climate change are major threats to human health, especially when it comes to respiratory problems like allergies and asthma. Our modern lifestyles, where we spend a lot of time indoors in well-insulated homes, expose us to indoor allergens like dust mites and mold. At the same time, outdoor air pollution from things like traffic not only directly harms our health but also makes some plants more likely to cause allergies and contributes to global warming. Climate change itself alters where and when allergens from plants and fungi appear and leads to more extreme weather events. This article looks at how all these factors – indoor and outdoor air pollution, and the resulting climate change – affect asthma and allergies in both children and adults and offers suggestions for policy changes and lifestyle adjustments to lessen these harmful effects.

IBIMA and Córdoba University as participants.

Ibon Eguiluz-Gracia , Alexander G Mathioudakis, Sabine Bartel,Susanne J H Vijverberg, Elaine Fuertes, Pasquale Comberiati, Yutong Samuel Cai, Peter Valentin Tomazic, Zuzana Diamant , Jørgen Vestbo , Carmen Galan , Barbara Hoffmann. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma. Allergy (IF:13.15, Q1). .2020 Sep;75(9):2170-2184. doi: 10.1111/all.14177. Epub 2020 Jan 30.

The One Health approach is a collaborative strategy that recognizes the interconnectedness of human, animal, and environmental health. It can be a powerful tool for managing complex conditions like allergies and asthma, which are influenced by a variety of factors in our surroundings. According to the One Health perspective, allergic diseases and asthma are triggered by exposure to allergens, infections, and irritants both indoors and outdoors. The quality of our environment – air, water, and soil – along with animal health significantly impacts these conditions. These environmental and animal health factors are, in turn, heavily influenced by broader issues like climate change, land use, and population shifts.

Therefore, addressing the root causes of allergies and asthma requires a coordinated response that focuses on the environment, human health, and animal health simultaneously. This demands collaboration across various fields, including public health, veterinary medicine, and environmental science, with active participation from the community.

Key activities to move this approach forward include: (1) Monitoring and analyzing environmental and health data. (2) Targeted interventions to reduce exposure to allergens and irritants. (3) Research to understand the mechanisms behind the development of allergic diseases and asthma.

In this consensus document developed by the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Allergy, Asthma, and Immunology (AAAAI), we provide insights into the One Health approach, aiming to establish a framework for tackling the complex nature of allergic diseases and asthma.

IBIMA as participant.

Marek Jutel , Giselle S Mosnaim , Jonathan A Bernstein , Stefano Del Giacco , David A Khan, Kari C Nadeau , Isabella Pali-Schöll, Maria J Torres , Magdalena Zemelka-Wiacek , Ioana Agache The One Health approach for allergic diseases and asthma. Allergy (IF:13.15, Q1) .2023 Jul;78(7):1777-1793. doi: 10.1111/all.15755.Epub 2023 May 9.

Pressurized metered-dose inhalers (pMDIs), while effective for delivering medication, contribute to CO2 emissions. Alternative inhaler devices with lower environmental impacts are available, but the choice of device should prioritize patient needs and suitability. The primary aim was to assess the impact of pMDIs used in Spain on annual CO2 emissions. The secondary aim was to evaluate the potential impact of switching patients with asthma from pMDIs to dry-powder inhalers (DPIs).A systematic review of evidence published between 2010 and 2021 was conducted. Average annual CO2 emissions from DPIs and pMDIs were calculated in two scenarios: the current situation and a hypothetical switch from all pMDIs to DPIs. The impact of this switch on clinical outcomes was also assessed. DPIs and pMDIs currently account for 0.0056% and 0.0909%, respectively, of Spain’s total CO2 emissions. If all pMDIs (except those used for rescue medication) were switched to DPIs, these percentages would become 0.0076% and 0.0579%. The evaluation of efficacy, handling, satisfaction, safety, and healthcare resource use was inconclusive. In conclusion, while pMDIs contribute a relatively small percentage of Spain’s overall CO2 footprint, there is a need for research into more sustainable inhaler devices. When prescribing an inhaler, patient factors such as age and inspiratory flow should be prioritized alongside suitability.

IDIBAPs and IRYCIS as participants.

Impact of Asthma Inhalers on Global Climate: A Systematic Review of Their Carbon Footprint and Clinical Outcomes in Spain.Montoro J, Antolín-Amérigo D, Izquierdo-Domínguez A, Zapata JJ, González G, Valero A. J Investig Allergol Clin Immunol. 2023 Jul 27;33(4):250-262. doi: 10.18176/jiaci.0887. Epub 2023 Jan 4. PMID: 36648318 Review.

Allergic diseases are on the rise globally, potentially linked to environmental changes caused by global warming.We conducted a systematic review of research published between 2016 and 2021 to assess the impact of climate change-related environmental factors on allergen production, and the frequency and severity of allergic conditions. Out of 195 studies, 40 were relevant, with 9 providing enough data for detailed analysis. We found that environmental factors, including pollutants, temperature, and drought, affect the type, amount, and timing of exposure to airborne allergens. Air pollution, particularly tropospheric ozone, was most strongly linked to changes in allergen levels, disease prevalence, and severity. Several studies also demonstrated the impact of environmental factors on the overall burden on healthcare systems. In conclusion, climate change-related environmental factors are contributing to an increase in the prevalence and severity of allergic diseases, mainly through changes in allergen exposure. Air pollutants like ozone play a key role in driving this increase, leading to a greater burden on healthcare resources.

IDIBAPs and IRYCIS as participants.

Impact of climate change-related environmental factors on the allergens production and the epidemiology and severity of allergic pathologies. Montoro J, Antolín-Amérigo D, Artés M, Izquierdo-Domínguez A, Zapata JJ, Mur P, Carrillo T, Antépara I, Feo F, Moral A, Valero A. J Investig Allergol Clin Immunol. 2024 Jan 11:0. doi: 10.18176/jiaci.0988. Online ahead of print. PMID: 38221868 Review.

Coming soon

Selected publications on topics such as Severity of Chronic Diseases in Vulnerable Populations, Infectious Diseases and Vector Redistribution, Data Management and Analysis.