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Rodríguez-Fernández A, Aloisi I, Blanco-Alegre C, Vega-Maray AM, Valencia-Barrera RM, Suanno C, Calvo AI, Fraile R, Fernández-González D. Identifying key environmental factors to model Alt a 1 airborne allergen presence and variation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 917:170597. [PMID: 38307265 DOI: 10.1016/j.scitotenv.2024.170597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
Fungal spores, commonly found in the atmosphere, can trigger important respiratory disorders. The glycoprotein Alt a 1 is the major allergen present in conidia of the genus Alternaria and has a high clinical relevance for people sensitized to fungi. Exposure to this allergen has been traditionally assessed by aerobiological spore counts, although this does not always offer an accurate estimate of airborne allergen load. This study aims to pinpoint the key factors that explain the presence and variation of Alt a 1 concentration in the atmosphere in order to establish exposure risk periods and improve forecasting models. Alternaria spores were sampled using a Hirst-type volumetric sampler over a five-year period. The allergenic fraction from the bioaerosol was collected using a low-volume cyclone sampler and Alt a 1 quantified by Enzyme-Linked ImmunoSorbent Assay. A cluster analysis was executed in order to group days with similar environmental features and then analyze days with the presence of the allergen in each of them. Subsequently, a quadratic discriminant analysis was performed to evaluate if the selected variables can predict days with high Alt a 1 load. The results indicate that higher temperatures and absolute humidity favor the presence of Alt a 1 in the atmosphere, while time of precipitation is related to days without allergen. Moreover, using the selected parameters, the quadratic discriminant analysis to predict days with allergen showed an accuracy rate between 67 % and 85 %. The mismatch between daily airborne concentration of Alternaria spores and allergen load can be explained by the greater contribution of medium-to-long distance transport of the allergen from the major emission sources as compared with spores. Results highlight the importance of conducting aeroallergen quantification studies together with spore counts to improve the forecasting models of allergy risk, especially for fungal spores.
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Affiliation(s)
| | - Iris Aloisi
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy
| | | | - Ana María Vega-Maray
- Department of Biodiversity and Environmental Management (Botany), University of León, León, Spain
| | | | - Chiara Suanno
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy
| | | | | | - Delia Fernández-González
- Department of Biodiversity and Environmental Management (Botany), University of León, León, Spain; Institute of Atmospheric Sciences and Climate-CNR, Bologna, Italy
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2
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Luedders J, Poole JA, Rorie AC. Extreme Weather Events and Asthma. Immunol Allergy Clin North Am 2024; 44:35-44. [PMID: 37973258 DOI: 10.1016/j.iac.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The objective of this article is to review recent literature on the implications of extreme weather events such as thunderstorms, wildfires, tropical cyclones, freshwater flooding, and temperature extremes in relationship to asthma symptoms. Several studies have shown worsening of asthma symptoms with thunderstorms, wildfires, tropical cyclones, freshwater flooding, and temperature extremes. In particular, thunderstorm asthma can be exacerbated by certain factors such as temperature, precipitation, and allergen sensitization. Therefore, it is imperative that the allergy and immunology community be aware of the health effects associated with these extreme weather events in order to educate patients and engage in mitigation strategies.
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Affiliation(s)
- Jennilee Luedders
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, 985990 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Jill A Poole
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, 985990 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Andrew C Rorie
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, 985990 Nebraska Medical Center, Omaha, NE 68198, USA
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3
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Grewling Ł, Ribeiro H, Antunes C, Apangu GP, Çelenk S, Costa A, Eguiluz-Gracia I, Galveias A, Gonzalez Roldan N, Lika M, Magyar D, Martinez-Bracero M, Ørby P, O'Connor D, Penha AM, Pereira S, Pérez-Badia R, Rodinkova V, Xhetani M, Šauliene I, Skjøth CA. Outdoor airborne allergens: Characterization, behavior and monitoring in Europe. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167042. [PMID: 37709071 DOI: 10.1016/j.scitotenv.2023.167042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
Aeroallergens or inhalant allergens, are proteins dispersed through the air and have the potential to induce allergic conditions such as rhinitis, conjunctivitis, and asthma. Outdoor aeroallergens are found predominantly in pollen grains and fungal spores, which are allergen carriers. Aeroallergens from pollen and fungi have seasonal emission patterns that correlate with plant pollination and fungal sporulation and are strongly associated with atmospheric weather conditions. They are released when allergen carriers come in contact with the respiratory system, e.g. the nasal mucosa. In addition, due to the rupture of allergen carriers, airborne allergen molecules may be released directly into the air in the form of micronic and submicronic particles (cytoplasmic debris, cell wall fragments, droplets etc.) or adhered onto other airborne particulate matter. Therefore, aeroallergen detection strategies must consider, in addition to the allergen carriers, the allergen molecules themselves. This review article aims to present the current knowledge on inhalant allergens in the outdoor environment, their structure, localization, and factors affecting their production, transformation, release or degradation. In addition, methods for collecting and quantifying aeroallergens are listed and thoroughly discussed. Finally, the knowledge gaps, challenges and implications associated with aeroallergen analysis are described.
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Affiliation(s)
- Łukasz Grewling
- Laboratory of Aerobiology, Department of Systematic and Environmental Botany, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland.
| | - Helena Ribeiro
- Department of Geosciences, Environment and Spatial Plannings of the Faculty of Sciences, University of Porto and Earth Sciences Institute (ICT), Portugal
| | - Celia Antunes
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | | | - Sevcan Çelenk
- Department of Biology, Faculty of Arts and Sciences, Bursa Uludag University, Bursa, Turkey
| | - Ana Costa
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga 29010, Spain
| | - Ana Galveias
- Department of Medical and Health Sciences, School of Health and Human Development & ICT-Institute of Earth Sciences, IIFA, University of Évora, 7000-671 Évora, Portugal
| | - Nestor Gonzalez Roldan
- Group of Biofunctional Metabolites and Structures, Priority Research Area Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Borstel, Germany; Pollen Laboratory, Department of Biological and Environmental Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Mirela Lika
- Department of Biology, Faculty of Natural Sciences, University of Tirana, Tirana, Albania
| | - Donát Magyar
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | | | - Pia Ørby
- Department of Environmental Science, Danish Big Data Centre for Environment and Health (BERTHA) Aarhus University, Aarhus, Denmark
| | - David O'Connor
- School of Chemical Sciences, Dublin City University, Dublin D09 E432, Ireland
| | - Alexandra Marchã Penha
- Water Laboratory, School of Sciences and Technology, ICT-Institute of Earth Sciences, IIFA, University of Évora. 7000-671 Évora, Portugal
| | - Sónia Pereira
- Department of Geosciences, Environment and Spatial Plannings of the Faculty of Sciences, University of Porto and Earth Sciences Institute (ICT), Portugal
| | - Rosa Pérez-Badia
- Institute of Environmental Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | | | - Merita Xhetani
- Department of Biology, Faculty of Natural Sciences, University of Tirana, Tirana, Albania
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Terry D, Peck B, Kloot K. Paediatric Emergency Asthma Presentations: Temporal Trends and Representations in Rural Australia. Healthcare (Basel) 2023; 11:3113. [PMID: 38132002 PMCID: PMC10742987 DOI: 10.3390/healthcare11243113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Asthma is a key illness driving children to present to emergency departments, and although paediatric emergency asthma presentations have been examined, the temporal trends remain somewhat elusive. The aim is to highlight, describe, and model the temporal trends of emergency paediatric asthma presentations, using comprehensive hospital emergency presentation data. A retrospective cross-sectional study examined de-identified paediatric (0 to 14 years) emergency asthma presentation data over a three-year period. Data were obtained from nine healthcare facilities in Victoria, Australia. Episode-level data were collected through RAHDaR, a comprehensive emergency data register which includes missing data (35.0%) among rural health facilities not currently captured elsewhere. Monthly presentation rates demonstrate a significant difference in presentations between fall/autumn and spring, and males had higher presentation rates in February and June-August. Emergency presentations were more likely to occur Sunday-Tuesday, peaking in the time periods of 8-9 a.m., 11 a.m.-12 p.m., and 8-9 p.m. Significant differences were noted between all age groups. Examining previously unavailable rural data has highlighted patterns among emergency asthma presentations for children 0-14 years of age. Knowledge of these by season, month, and day of the week, in combination with time of day, offers scope for more focused workforce education and planning, and nuanced referral pathways, particularly in resource-limited settings.
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Affiliation(s)
- Daniel Terry
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich, QLD 4305, Australia;
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC 3350, Australia;
| | - Blake Peck
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC 3350, Australia;
| | - Kate Kloot
- School of Medicine, Deakin University, Warrnambool, VIC 3280, Australia
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5
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Simunovic M, Boyle J, Erbas B, Baker P, Davies JM. Airborne grass pollen and thunderstorms influence emergency department asthma presentations in a subtropical climate. ENVIRONMENTAL RESEARCH 2023; 236:116754. [PMID: 37500047 DOI: 10.1016/j.envres.2023.116754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Grass pollen is considered a major outdoor aeroallergen source worldwide. It is proposed as a mechanism for thunderstorm asthma that lightning during thunderstorms promotes electrical rupture of pollen grains that leads to allergic airway inflammation. However, most evidence of associations between grass pollen and asthma comes from temperate regions. The objective of this study was to investigate short-term associations between airborne grass pollen exposure and asthma emergency department presentations in a subtropical population. METHODS Episode level public hospital presentations for asthma (2016-2020) were extracted for greater Brisbane, Australia, from Queensland Health's Emergency Data Collection. Concentrations of airborne pollen were determined prospectively using a continuous flow volumetric impaction sampler. Daily time series analysis using a generalised additive mixed model were applied to determine associations between airborne grass pollen concentrations, and lightning count data, with asthma presentations. RESULTS Airborne grass pollen showed an association with asthma presentations in Brisbane; a significant association was detected from same day exposure to three days lag. Grass pollen exposure increased daily asthma presentations up to 48.5% (95% CI: 12%, 85.9%) in female children. Lightning did not modify the effect of grass pollen on asthma presentations, however a positive association was detected between cloud-to-cloud lightning strikes and asthma presentations (P = 0.048). CONCLUSION Airborne grass pollen exposure may exacerbate symptoms of asthma requiring urgent medical care of children and adults in a subtropical climate. This knowledge indicates an opportunity for targeted management of respiratory allergic disease to reduce patient and health system burden. For the first time, an influence of lightning on asthma was detected in this context. The outcomes support a need for continued pollen monitoring and surveillance of thunderstorm asthma risk in subtropical regions.
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Affiliation(s)
- Marko Simunovic
- School of Biomedical Sciences, Centre for Immunity and Infection Control, Centre for Environment, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Justin Boyle
- Australian E-Health Research Centre, The Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
| | - Philip Baker
- School of Public Health and Social Work, Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Janet M Davies
- School of Biomedical Sciences, Centre for Immunity and Infection Control, Centre for Environment, Queensland University of Technology, Brisbane, Queensland, Australia; Office of Research, Metro North Hospital and Health Services, Herston, Queensland, Australia.
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Nickovic S, Petković S, Ilić L, Pejanović G, Mijić Z, Huete A, Marks G. Prediction of airborne pollen and sub-pollen particles for thunderstorm asthma outbreaks assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:160879. [PMID: 36521601 DOI: 10.1016/j.scitotenv.2022.160879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
When exposed to convective thunderstorm conditions, pollen grains can rupture and release large numbers of allergenic sub-pollen particles (SPPs). These sub-pollen particles easily enter deep into human lungs, causing an asthmatic response named thunderstorm asthma (TA). Up to now, efforts to numerically predict the airborne SPP process and to forecast the occurrence of TAs are unsatisfactory. To overcome this problem, we have developed a physically-based pollen model (DREAM-POLL) with parameterized formation of airborne SPPs caused by convective atmospheric conditions. We ran the model over the Southern Australian grass fields for 2010 and 2016 pollen seasons when four largest decadal TA epidemics happened in Melbourne. One of these TA events (in November 2016) was the worldwide most extreme one which resulted to nine deaths and hundreds of hospital patient presentations. By executing the model on a day-by-day basis in a hindcast real-time mode we predicted SPP peaks exclusively only when the four major TA outbreaks happened, thus achieving a high forecasting success rate. The proposed modelling system can be easily implemented for other geographical domains and for different pollen types.
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Affiliation(s)
- Slobodan Nickovic
- Institute of Physics Belgrade, University of Belgrade, Pregrevica 118, 11080 Belgrade, Serbia; Republic Hydrometeorological Service of Serbia, 11000 Belgrade, Serbia.
| | - Slavko Petković
- Republic Hydrometeorological Service of Serbia, 11000 Belgrade, Serbia
| | - Luka Ilić
- Institute of Physics Belgrade, University of Belgrade, Pregrevica 118, 11080 Belgrade, Serbia
| | - Goran Pejanović
- Republic Hydrometeorological Service of Serbia, 11000 Belgrade, Serbia
| | - Zoran Mijić
- Institute of Physics Belgrade, University of Belgrade, Pregrevica 118, 11080 Belgrade, Serbia
| | - Alfredo Huete
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Guy Marks
- University of New South Wales, Sydney, Australia
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7
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Price D, Hughes KM, Dona DW, Taylor PE, Morton DAV, Stevanovic S, Thien F, Choi J, Torre P, Suphioglu C. The perfect storm: temporal analysis of air during the world's most deadly epidemic thunderstorm asthma (ETSA) event in Melbourne. Ther Adv Respir Dis 2023; 17:17534666231186726. [PMID: 37646293 PMCID: PMC10469229 DOI: 10.1177/17534666231186726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND There have been 26 epidemic thunderstorm asthma (ETSA) events worldwide, with Melbourne at the epicentre of ETSA with 7 recorded events, and in 2016 experienced the deadliest ETSA event ever recorded. Health services and emergency departments were overwhelmed with thousands requiring medical care for acute asthma and 10 people died. OBJECTIVES This multidisciplinary study was conducted across various health and science departments with the aim of improving our collective understanding of the mechanism behind ETSA. DESIGN This study involved time-resolved analysis of atmospheric sampling of the air for pollen and fungal spores, and intact and ruptured pollen compared with different weather parameters, pollution levels and clinical asthma presentations. METHODS Time-resolved pollen and fungal spore data collected by Deakin AirWATCH Burwood, underwent 3-h analysis, to better reflect the 'before', 'during' and 'after' ETSA time points, on the days leading up to and following the Melbourne 2016 event. Linear correlations were conducted with atmospheric pollution data provided by the Environment Protection Authority (EPA) of Victoria, weather data sourced from Bureau of Meteorology (BOM) and clinical asthma presentation data from the Victorian Agency for Health Information (VAHI) of Department of Health. RESULTS Counts of ruptured grass pollen grains increased 250% when the thunderstorm outflow reached Burwood. Increased PM10, high relative humidity, decreased temperature and low ozone concentrations observed in the storm outflow were correlated with increased levels of ruptured grass pollen. In particular, high ozone levels observed 6 h prior to this ETSA event may be a critical early indicator of impending ETSA event, since high ozone levels have been linked to increasing pollen allergen content and reducing pollen integrity, which may in turn contribute to enhanced pollen rupture. CONCLUSION The findings presented in this article highlight the importance of including ruptured pollen and time-resolved analysis to forecast ETSA events and thus save lives.
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Affiliation(s)
- Dwan Price
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Victorian Department of Health, Melbourne, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Kira M Hughes
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Dulashi Withanage Dona
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australia
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Philip E Taylor
- Pharmacy and Biomedical Science, School of Molecular Sciences, La Trobe University, Bendigo, VIC, Australia
| | - David A V Morton
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
| | - Svetlana Stevanovic
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
| | - Francis Thien
- Respiratory Medicine, Eastern Health, Box Hill Hospital and Monash University, Box Hill, VIC, Australia
| | - Jason Choi
- Environment Protection Authority, Centre for Applied Sciences, Macleod, VIC, Australia
| | - Paul Torre
- Environment Protection Authority, Centre for Applied Sciences, Macleod, VIC, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds Campus, 75 Pidgons Road, Geelong, VIC 3216, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AirWATCH Pollen and Spore Counting and Forecasting Facility, Deakin University, VIC, Australi
- Centre for Sustainable Bioproducts (CSB), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
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Rodríguez-Arias RM, Rojo J, Fernández-González F, Pérez-Badia R. Desert dust intrusions and their incidence on airborne biological content. Review and case study in the Iberian Peninsula. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120464. [PMID: 36273688 DOI: 10.1016/j.envpol.2022.120464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/27/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Desert dust intrusions cause the transport of airborne particulate matter from natural sources, with important consequences for climate regulation, biodiversity, ecosystem functioning and dynamics, human health, and socio-economic activities. Some effects of desert intrusions are reinforced or aggravated by the bioaerosol content of the air during these episodes. The influence of desert intrusions on airborne bioaerosol content has been very little studied from a scientific point of view. In this study, a systematic review of scientific literature during 1970-2021 was carried out following the standard protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After this literature review, only 6% of the articles on airborne transport from desert areas published in the last 50 years are in some way associated with airborne pollen, and of these, only a small proportion focus on the study of pollen-related parameters. The Iberian Peninsula is affected by Saharan intrusions due to its proximity to the African continent and is seeing an increasing trend the number of intrusion events. There is a close relationship among the conditions favouring the occurrence of intrusion episodes, the transport of particulate matter, and the transport of bioaerosols such as pollen grains, spores, or bacteria. The lack of linearity in this relationship and the different seasonal patterns in the occurrence of intrusion events and the pollen season of most plants hinders the study of the correspondence between both phenomena. It is therefore important to analyse the proportion of pollen that comes from regional sources and the proportion that travels over long distances, and the atmospheric conditions that cause greater pollen emission during dust episodes. Current advances in aerobiological techniques make it possible to identify bioaerosols such as pollen and spores that serve as indicators of long-distance transport from remote areas belonging to other bioclimatic and biogeographical units. A greater incidence of desert intrusion episodes may pose a challenge for both traditional systems and for the calibration and correct validation of automatic aerobiological monitoring methods.
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Affiliation(s)
- R M Rodríguez-Arias
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - J Rojo
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - F Fernández-González
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - R Pérez-Badia
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain.
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9
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Maya-Manzano JM, Oteros J, Rojo J, Traidl-Hoffmann C, Schmidt-Weber C, Buters J. Drivers of the release of the allergens Bet v 1 and Phl p 5 from birch and grass pollen. ENVIRONMENTAL RESEARCH 2022; 214:113987. [PMID: 35961547 DOI: 10.1016/j.envres.2022.113987] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/12/2022] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
The drivers affecting the Pollen Allergen Potency (PAP, amount of allergen released per pollen) are sparsely known. Betula and Poaceae airborne pollen are the two main allergenic pollen in the World. Airborne pollen and their allergens Bet v 1 and Phl p 5 were simultaneously measured from 2010 to 2015 in Davos (Switzerland) and Munich (Germany) by using volumetric traps and ChemVol cascade impactors. Daily variations in PAP were analysed in PM>10 and PM2.5-10 air fractions and generalized additive models were created to explain which factors determine PAP, including meteorological parameters and inorganic pollutants. 87.1 ± 13.9% of Bet v 1 and 88.8 ± 15.5% of Phl p 5 was detected in the fraction PM>10 where most pollen grains were collected. Significantly higher PAP for grasses (3.5 ± 1.9 pg Phl p 5/pollen grain) were observed in Munich than in Davos (2.4 ± 1.5 pg/pollen grain, p < 0.001), but not for Betula (2.5 ± 1.6 pg Bet v 1/pollen grain in Munich and 2.3 ± 1.7 in Davos, N.S.). PAP varied between days, years and location, and increased along the pollen season for Poaceae, but remaining constant for Betula. Free allergens (allergens observed in the fraction with limited pollen, PM2.5- 10) were recorded mostly at the beginning or at the end of the pollen season, being linked to higher humidity and rainy days. Also, PAP was higher when the airborne pollen concentrations increased rapidly after one day of low/moderate levels. Our findings show that pollen exposure explains allergen exposure only to a limited extend, and that day in the season, geographic location and some weather conditions need to be considered also to explain symptoms of allergic individuals.
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Affiliation(s)
- José M Maya-Manzano
- Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University and Helmholtz Center Munich, Munich, Germany
| | - Jose Oteros
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain.
| | - Jesús Rojo
- Department of Pharmacology, Pharmacognosy and Botany, Complutense University, Madrid, Spain
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Institute of Environmental Medicine, Helmholtz Center Munich - German Research Center for Environmental Health, Augsburg, Germany; Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Carsten Schmidt-Weber
- Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University and Helmholtz Center Munich, Munich, Germany
| | - Jeroen Buters
- Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University and Helmholtz Center Munich, Munich, Germany
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10
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Climate Change Factors and the Aerobiology Effect. Immunol Allergy Clin North Am 2022; 42:771-786. [DOI: 10.1016/j.iac.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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11
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Idrose NS, Lodge CJ, Erbas B, Douglass JA, Bui DS, Dharmage SC. A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127541. [PMID: 35742795 PMCID: PMC9224249 DOI: 10.3390/ijerph19127541] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 02/04/2023]
Abstract
Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies.
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Affiliation(s)
- Nur Sabrina Idrose
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.S.I.); (C.J.L.); (D.S.B.)
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.S.I.); (C.J.L.); (D.S.B.)
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia;
| | - Jo A. Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, VIC 3050, Australia;
- Department of Medicine, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Dinh S. Bui
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.S.I.); (C.J.L.); (D.S.B.)
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.S.I.); (C.J.L.); (D.S.B.)
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Correspondence: ; Tel.: +61-383-440-737
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Combined Exposure to Birch Pollen and Thunderstorms Affects Respiratory Health in Stockholm, Sweden-A Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105852. [PMID: 35627390 PMCID: PMC9141405 DOI: 10.3390/ijerph19105852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/03/2022] [Accepted: 05/07/2022] [Indexed: 01/27/2023]
Abstract
Background: Thunderstorm asthma is a term used to describe surges in acute respiratory illnesses following a thunderstorm and is often attributed to an intense exposure to aeroallergens. Several episodes of thunderstorm asthma have been observed worldwide; however, no such cases have been described in Sweden. In Sweden, the most prominent exposure to air-borne pollen occurs during the blooming of the birch. We aimed to explore the associations between respiratory health and the combined exposure to thunderstorms and birch pollen. Methods: We investigated the association between the daily numbers of outpatient visits due to respiratory cases and the combined exposure to thunderstorms and birch pollen during the period of 1 May–31 September in 2001–2017, in Stockholm County, Sweden, by using time series analysis with log linear models. Results: We detected noticeable increases in the number of outpatient visits on both the same day (max 26%; 95% CI 1.16–1.37) and the day after (max 50%; 95% CI 1.32–1.70) the occurrence of a thunderstorm, when the concentrations of birch pollen and the number of lightning discharges were within the highest categories. Conclusions: It is possible that co-exposure to heavy thunderstorms and high concentrations of birch pollen affects the respiratory health of the Stockholm population. To the best of our knowledge, this is the first study addressing the thunderstorm-related respiratory illnesses in Sweden and the effects of birch pollen. Our study may be important for future public health advice related to thunderstorm asthma.
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Spike in Asthma Healthcare Presentations in Eastern England during June 2021: A Retrospective Observational Study Using Syndromic Surveillance Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312353. [PMID: 34886084 PMCID: PMC8657080 DOI: 10.3390/ijerph182312353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 12/02/2022]
Abstract
Thunderstorm asthma is often characterised by a sudden surge in patients presenting with exacerbated symptoms of asthma linked to thunderstorm activity. Here, we describe a large spike in asthma and difficulty breathing symptoms observed across parts of England on 17 June 2021. The number of healthcare presentations during the asthma event was compared to expected levels for the overall population and across specific regions. Across affected geographical areas, emergency department attendances for asthma increased by 560% on 17 June compared to the average number of weekday daily attendances during the previous 4 weeks. General practitioner out of hours contacts increased by 349%, National Health Service (NHS) 111 calls 193%, NHS 111 online assessments 581% and ambulance call outs 54%. Increases were particularly noted in patient age groups 5–14 and 15–44 years. In non-affected regions, increases were small (<10%) or decreased, except for NHS 111 online assessments where there was an increase of 39%. A review of the meteorological conditions showed several localised, weak, or moderate thunderstorms specifically across parts of Southeast England on the night of June 16. In this unprecedented episode of asthma, the links to meteorologically defined thunderstorm activity were not as clear as previous episodes, with less evidence of ‘severe’ thunderstorm activity in those areas affected, prompting further discussion about the causes of these events and implications for public health management of the risk.
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Chatelier J, Chan S, Tan JA, Stewart AG, Douglass JA. Managing Exacerbations in Thunderstorm Asthma: Current Insights. J Inflamm Res 2021; 14:4537-4550. [PMID: 34526800 PMCID: PMC8436255 DOI: 10.2147/jir.s324282] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022] Open
Abstract
Epidemic thunderstorm asthma (ETSA) occurs following a thunderstorm due to the interaction of environmental and immunologic factors. Whilst first reported in the 1980s, the world's largest event in Melbourne, Australia, on November 21, 2016 has led to a wealth of clinical literature seeking to identify its mechanisms, susceptibility risk factors, and management approaches. Thunderstorm asthma (TA) typically presents during an aeroallergen season in individuals sensitized to perennial rye grass pollen (RGP) in Australia, or fungus in the United Kingdom, in combination with meteorological factors such as thunderstorms and lightning activity. It is now well recognized that large pollen grains, which usually lodge in the upper airway causing seasonal allergic rhinitis (SAR), are ruptured during these events, leading to sub-pollen particles respirable to the lower respiratory tract causing acute asthma. The identified risk factors of aeroallergen sensitization, specifically to RGP in Australians with a history of SAR, and individuals born in Australia of South-East Asian descent as a risk factor for TA has been key in selecting appropriate patients for preventative management. Moreover, severity-determining risk factors for ETSA-related asthma admission or mortality, including pre-existing asthma or prior hospitalization, poor inhaled corticosteroid adherence, and outdoor location at the time of the storm are important in identifying those who may require more aggressive treatment approaches. Basic treatments include optimizing asthma control and adherence to inhaled corticosteroid therapy, treatment of SAR, and education regarding TA to increase recognition of at-risk days. Precision treatment approaches may be more beneficial in select individuals, including the use of allergen immunotherapy and even biologic treatment to mitigate asthma severity. Finally, we discuss the importance of environmental health literacy in the context of concerns surrounding the increased frequency of ETSA due to climate change and its implications for the frequency and severity of future events.
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Affiliation(s)
- Josh Chatelier
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Chan
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Immunology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Ju Ann Tan
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Alastair G Stewart
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, University of Melbourne, Melbourne, Victoria, Australia
- ARC Centre for Personalised Therapeutics Technologies, University of Melbourne, Melbourne, Victoria, Australia
| | - Jo Anne Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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Paudel B, Chu T, Chen M, Sampath V, Prunicki M, Nadeau KC. Increased duration of pollen and mold exposure are linked to climate change. Sci Rep 2021; 11:12816. [PMID: 34140579 PMCID: PMC8211740 DOI: 10.1038/s41598-021-92178-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/07/2021] [Indexed: 11/12/2022] Open
Abstract
Pollen and molds are environmental allergens that are affected by climate change. As pollen and molds exhibit geographical variations, we sought to understand the impact of climate change (temperature, carbon dioxide (CO2), precipitation, smoke exposure) on common pollen and molds in the San Francisco Bay Area, one of the largest urban areas in the United States. When using time-series regression models between 2002 and 2019, the annual average number of weeks with pollen concentrations higher than zero increased over time. For tree pollens, the average increase in this duration was 0.47 weeks and 0.51 weeks for mold spores. Associations between mold, pollen and meteorological data (e.g., precipitation, temperature, atmospheric CO2, and area covered by wildfire smoke) were analyzed using the autoregressive integrated moving average model. We found that peak concentrations of weed and tree pollens were positively associated with temperature (p < 0.05 at lag 0–1, 0–4, and 0–12 weeks) and precipitation (p < 0.05 at lag 0–4, 0–12, and 0–24 weeks) changes, respectively. We did not find clear associations between pollen concentrations and CO2 levels or wildfire smoke exposure. This study’s findings suggest that spore and pollen activities are related to changes in observed climate change variables.
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Affiliation(s)
- Bibek Paudel
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Theodore Chu
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Meng Chen
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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