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Impact of climate change-related environmental factors on the allergens production and the epidemiology and severity of allergic pathologies

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)
doi: 10.18176/jiaci.0988

Background: Allergic disease affects up to 40% of the global adult population, a proportion that is increasing with environmental changes related to global warming.
Methods: We undertook a systematic review of the literature to identify and evaluate the current evidence of the impact of climate change-related environmental factors on the allergen production and the epidemiology and severity of allergic pathologies. PECO criteria were established and guided the literature searches of the PubMed and Cochrane databases (Jan 1, 2016 to Dec 31, 2021). Study outcomes were categorized and grouped to facilitate data synthesis. Outcomes were classified as significant (statistical significance <0.05), non-significant (p>0.05) or undetermined (p value not reported). Study quality was assessed using MMAT analysis.
Results: Of 195 studies, 40 were considered relevant and 9 of them provided data to be included in the data quantitative 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 to changes in allergen production, prevalence, and severity of allergic disease. Also, several publications demonstrated the impact of environmental factors on the healthcare burden.
Conclusions: Climate-change related environmental factors increased allergic disease in terms of prevalence, severity, and healthcare burden due to alterations in allergen exposure (volume and type) with the presence of pollutants such as ozone being the most commonly reported driver of such increase. 

Key words: Allergen, environment, allergy, pollutant, epidemiology, climate change