Immune-mediated disease caused by climate change-associated environmental hazards: mitigation and adaptation

Abstract

Global warming and climate change have increased the pollen burden and the frequency and intensity of wildfires, sand and dust storms, thunderstorms, and heatwaves—with concomitant increases in air pollution, heat stress, and flooding. These environmental stressors alter the human exposome and trigger complex immune responses. In parallel, pollutants, allergens, and other environmental factors increase the risks of skin and mucosal barrier disruption and microbial dysbiosis, while a loss of biodiversity and reduced exposure to microbial diversity impairs tolerogenic immune development. The resulting immune dysregulation is contributing to an increase in immune-mediated diseases such as asthma and other allergic diseases, autoimmune diseases, and cancer. It is now abundantly clear that multisectoral, multidisciplinary, and transborder efforts based on Planetary Health and One Health approaches (which consider the dependence of human health on the environment and natural ecosystems) are urgently needed to adapt to and mitigate the effects of climate change. Key actions include reducing emissions and improving air quality (through reduced fossil fuel use), providing safe housing (e.g., improving weatherization), improving diets (i.e., quality and diversity) and agricultural practices, and increasing environmental biodiversity and green spaces. There is also a pressing need for collaborative, multidisciplinary research to better understand the pathophysiology of immune diseases in the context of climate change. New data science techniques, biomarkers, and economic models should be used to measure the impact of climate change on immune health and disease, to inform mitigation and adaptation efforts, and to evaluate their effectiveness. Justice, equity, diversity, and inclusion (JEDI) considerations should be integral to these efforts to address disparities in the impact of climate change.

Climate change-associated health impacts: a way forward

“…Given the multitude of climate change drivers, addressing the GHG mitigation challenge will require many technological and policy changes across multiple sectors. Agache et al summarize the implementable and economically sound evidence-and equity-based strategies needed to reduce the impact of climate change on health, and they highlight the need for buy-in and cooperation among governments, industries, communities, individuals, and healthcare providers (2). They emphasize the need to reduce fossil fuel emissions and improve air quality, provide safe housing (e.g., improving weatherization) and green spaces, improve diets, adopt sustainable agricultural practices, and increase environmental biodiversity.…”

“…In their lead article, Agache and colleagues (2) summarize the myriad of impacts of changes on physical healthincluding respiratory and allergic disorders, heat-related deaths, cancer, food-and waterborne infectious diseases, zoonotic diseases, and malnutrition-and mental health. As they point out, one of the strongest links between climate change and health is the direct effect of exposure to fossil fuel combustion products [e.g., particulate matter (PM 2.5 ), nitrogen oxides, and sulfur dioxide].…”

Accelerating the end of the fossil fuel era: a human and planetary health imperative and opportunity

“…Change (IPCC) Global Warming of 1.5°C Special Report-warned that global warming of 2°C cannot considered safe and that all additional warming beyond current levels will lead to greater health harms through increases in extreme heat, air pollution, vectorborne diseases, poverty, and other impacts including food insecurity, sea-level rise and saltwater intrusion, drought, flooding, and involuntary migration (2). In this context, the article by Agache et al (1) can be seen as clarifying that, from a human and planetary health perspective, humanity must expedite the transition from the "beginning of the end" of the fossil fuel era to the "end of the fossil fuel era".…”