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Urban Air Pollution and Climate Change as Environmental Risk Factors of Respiratory Allergy: An Update


G D’Amato,1 L Cecchi,2,3 M D’Amato,4 G Liccardi1

1Division of Pneumology and Allergology, Department of Respiratory Diseases, High Specialty Hospital “A. Cardarelli,” Naples, Italy
2Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy
3Allergy Clinic, Azienda Sanitaria 10, Florence, Italy
4Division of PheumoTisiology, Department of Respiratory Diseases, High Specialty Hospital “V. Monaldi,” Naples, Italy

J Investig Allergol Clin Immunol 2010; Vol. 20(2): 95-102



The incidence of allergic respiratory diseases and bronchial asthma appears to be increasing worldwide, and people living in urban areas more frequently experience these conditions than those living in rural areas. One of the several causes of the rise in morbidity associated with allergic respiratory diseases is the increased presence of outdoor air pollutants resulting from more intense energy consumption and
exhaust emissions from cars and other vehicles. Urban air pollution is now a serious public health hazard.
Laboratory studies confirm epidemiologic evidence that air pollution adversely affects lung function in asthmatics. Damage to airway mucous membranes and impaired mucociliary clearance caused by air pollution may facilitate access of inhaled allergens to the cells of the immune system, thus promoting sensitization of the airway. Consequently, a more severe immunoglobulin (Ig) E–mediated response to
aeroallergens and airway inflammation could account for increasing prevalence of allergic respiratory diseases in polluted urban areas.
The most abundant components of urban air pollution in urban areas with high levels of vehicle traffic are airborne particulate matter, nitrogen dioxide, and ozone. In addition, the earth’s temperature is increasing, mainly as a result of anthropogenic factors (eg, fossil fuel combustion and greenhouse gas emissions from energy supply, transport, industry, and agriculture), and climate change alters the concentration and distribution of air pollutants and interferes with the seasonal presence of allergenic pollens in the atmosphere by prolonging these periods.

Key words: Air pollution. Allergy. Allergic asthma. Bronchial asthma. Climate change. Environmental diseases. Airway hyperreactivity. Pollen allergy. Respiratory allergy. Urban air pollution. Hypersensitivity.