Respiratory Health Impacts from Natural Disasters and Other Extreme Weather Events: The Role of Environmental Stressors on Asthma and Allergies.

Purpose of review: The frequency of natural disasters, other extreme weather events, and downstream emissions of emerging contaminants is increasing. One category of health outcome that is now experiencing increased prevalence due to these environmental threats is respiratory disease, specifically asthma and allergies; though a review summarizing current knowledge and research gaps has not been synthesized on this topic in recent years despite growing evidence.

Recent findings: We identified recent literature that connects allergy/asthma with environmental events that are increasing in prevalence alongside natural disasters and other extreme weather events, including algal blooms, floods, heat stress, wildfires, and thunderstorms. Coinciding emissions of per-and polyfluoroalkyl substances (PFAS) and microplastics (MPs) are also discussed as downstream outcomes of these environmental events. Available evidence ranged according to environmental event/stressor type, with over 50 papers identified as relevant to this research scope in the last five years. Narrative synthesis of these papers highlighted exposure-disease linkages for stressors related to natural disasters, other extreme weather events, and downstream emissions of emerging contaminants with pulmonary asthma and allergy outcomes. Underlying biological mechanisms are beginning to be elucidated and include widespread inflammation in the lungs and changes in immune cell signaling and function across the pulmonary system. Take home points in this review pave the way for future investigations to better understand the impacts of these environmental events amongst the complex milieu of threats becoming increasingly prevalent worldwide.