Heatwaves killing thousands of Europeans every summer, desert dust settling over cities that have never seen a desert, and floodwaters destroying entire valleys, leaving mouldy homes:
The effects of global warming on lung health are becoming ever more apparent. At the European Respiratory Society’s ERS Congress in Barcelona, experts discussed how extreme heat, dust storms, and flooding impact healthcare. The session’s speakers went on to detail not only the scale of the damage, but also the concrete policy and clinical responses already showing results.
Report: Wolfgang Behrends
Even though the term “global warming” has been in use since at least the 1970s, recent years have shifted the previously abstract concept to perceivable reality. Chairwoman Ane Johannessen from the University of Bergen, Norway, made clear during the session’s introduction: ‘climate change is not something in the future anymore – it is right here and right now.’
The impact is particularly noticeable in urban areas, as Prof. Zorana Andersen pointed out. Cities –already home to more than half of the world’s population, with a projected increase to 70% by 2050 – are ‘major centres for air pollution’, said the Professor in Environmental Epidemiology at the Department of Public Health of the University of Copenhagen, Denmark. Traffic, energy production, and HVAC for both industrial and residential buildings drive emissions – so much so that, according to the WHO, 99% of the world’s population breathes air defined as “unhealthy”, with concentrations of PM2.5 particles above 5 µg per cubic metre.1 Even across Europe, more than 400,000 deaths per year are attributed to air pollution.
Focus on environmental medicine
Harmful substances in the soil, water and air also endanger people’s health. In recent years, environmental medicine has been increasingly concerned with the consequences of climate change.
Exposure begins even before birth, paving the way for a lifetime of adverse health effects, explained Andersen – raising the risk of lower birth weight, asthma and respiratory infections in children, and COPD in adults. Covid-19 has been linked to air pollution, as has lung cancer. ‘Beyond the lung, air pollution is also a well-established risk factor for cardiovascular disease, stroke, type 2 diabetes, other cancers, neurological disease, as adverse pregnancy outcomes.’ This, she summarised, makes air pollution a major risk factor for nearly all chronic and non-communicable diseases.
When things are heating up
Heat compounds the problem – and again, cities are affected the most. Due to heat absorption from asphalt and heat generation from A/C and cars, cities can be up to 10°C hotter than surrounding areas, breaking temperature records every year, Andersen said.2 ‘Europe is heating twice as fast as the rest of the world. And this is posing new challenges.’
Extreme heat puts stress on every organ, including the lung: overheating and dehydration increase inflammation and impede airway function, putting people with existing lung conditions, children and the elderly at particular risk.3 ‘About 60,000 to 70,000 people die every year in Europe alone due to heat waves4, and these effects will become stronger – projections with very low heat mitigation indicate a 10- to 20-fold increase in deaths by the end of the century.’ Heat and air pollution also generate synergistic effects, for instance through smoke from increasingly common wildfires.5 ‘This is a really potent cocktail,’ Andersen warned.
Out of the frying pan – into the flood
In the wake of global warming, even water is becoming a threat, illustrated Dr Erol Gaillard from the University of Leicester, UK. Warmer air can hold more water, leading to more and heavier rain, and a higher risk of rivers overflowing their banks, while warming oceans, rising sea levels, and fewer but heavier storms, drive coastal flooding.12 ‘Severe flooding is becoming more common and more severe, and climate change is absolutely contributing to this. By 2050, 25% of the world’s population is going to be at risk of flooding.’
Recent catastrophic events – the Ahr Valley flooding in 2021, storm “Boris” in Central Europe, and the 2024 Valencia flash floods – hint at what is to come, the expert continued. ‘Europe is now the fastest-warming continent. And this is definitely going to make Europe’s flood problems worse.’13
Beyond drowning deaths and destroyed livelihoods, flooding endangers patients reliant on ventilators and nebulisers through power outages. It disrupts supply chains for vital medication, and raises the risk of infectious disease outbreaks in emergency shelters.
After the water recedes, the health problems remain: mould, which can develop in flooded homes within 48 hours, is not only hard to remove, but also causally linked to asthma development and severity, particularly in children.14 ‘The longer the exposure and the more serious the problem, the worse the health impact,’ Gaillard said. After the water recedes, the health problems remain: mould, which can develop in flooded homes within 48 hours, is not only hard to remove, but also causally linked to asthma development and severity, particularly in children.14 ‘The longer the exposure and the more serious the problem, the worse the health impact,’ Gaillard said.
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