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Impact of Climate Change-Related Environmental Factors on Allergen Production and the Epidemiology and Severity of Allergic Diseases

Montoro J1,2, Antolín-Amérigo D3,4, Artés M5, Izquierdo-Domínguez A6, Zapata JJ7, Mur P8, Carrillo T9, Antépara I10, Feo F11, Moral A12, Valero A13,14,15

1Sección de Alergia, Unidad Especializada de Asma Grave, Hospital de Arnau de Vilanova - Líria, Valencia, Spain
2Facultad de Medicina, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
3Servicio de Alergia, Hospital Universitario Ramón y Cajal, Madrid, Spain
4Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
5Adelphi Targis, Barcelona, Spain
6Servicio de Alergología, Consorcio Sanitario de Terrassa, Terrassa, Barcelona, Spain
7Clínica de Alergia Dr. Zapata, Almería, Spain
8Servicio de Alergia, Hospital de Puertollano, Puertollano, Ciudad Real, Spain
9Servicio de Alergia, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
10Servicio de Alergia, Hospital Universitario de Basurto, Bilbao, Spain
11Servicio de Alergia, Hospital General de Ciudad Real, Ciudad Real, Spain
12Hospital Virgen del Valle, Toledo, Spain
13Servicio de Alergología, Hospital Clínic de Barcelona, Barcelona, Spain
14Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
15CIBER de Enfermedades Respiratorias (CIBERES), Spain

J Investig Allergol Clin Immunol 2024; Vol 34(6) : 358-366
doi: 10.18176/jiaci.0988

Background: Allergic disease affects up to 40% of the adult population worldwide. This percentage is increasing as a result of environmental changes related to global warming.
Methods: We undertook a systematic review of the literature to identify and evaluate current evidence on the impact of climate change-related environmental factors on allergen production and the epidemiology and severity of allergic diseases. We applied the Population, Exposure, Comparison, Outcome (PECO) criteria to guide our literature searches of the PubMed and Cochrane databases (January 1, 2016 to December 31, 2021). Study outcomes were categorized and grouped to facilitate data synthesis. Outcomes were classified as significant (P<.05), nonsignificant (P>.05), or undetermined (P value not reported). Study quality was assessed using the Mixed Methods Appraisal Tool.
Results: Of 195 studies, 40 were considered relevant, and 9 provided data that could be included in the quantitative data synthesis. Environmental factors, including the presence of pollutants, temperature, and drought influenced the type, volume, and timing of exposure to local aeroallergens. The most relevant environmental factor was the presence of environmental pollutants, of which tropospheric ozone was the most frequently associated with changes in allergen production and prevalence and severity of allergic disease. Several publications also demonstrated the impact of environmental factors on health care burden.
Conclusions: Climate change-related environmental factors worsened allergic disease in terms of prevalence, severity, and health care burden owing to alterations in allergen exposure (volume and type), with the presence of pollutants such as ozone being the most common drivers of this increase.

Key words: Allergen, Environment, Allergy, Pollutant, Epidemiology, Climate change