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Synergistic Effects of Air Pollutants and Extreme Temperature on Asthma: A Narrative Review of Mechanisms and Evidence
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This review pulls together existing research showing that air pollution, extreme heat or cold, and even microplastics don't just each harm your lungs on their own—they team up to make asthma worse than any single factor would alone, likely by triggering inflammation and stress in airway cells. This matters because as climate change intensifies both pollution and temperature extremes, the real-world risk to asthma sufferers may be higher than studies looking at just one factor suggest, meaning future health guidelines may need to address these combined exposures together rather than one at a time.
Global climate change and air pollution jointly threaten respiratory health. Asthma, a prevalent chronic inflammatory airway disease, is exacerbated by both traditional air pollutants such as particulate matter (PM2.5), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and emerging contaminants like microplastics (MPs) and per- and polyfluoroalkyl substances (PFAS), with effects amplified under extreme temperature conditions. In reality, individuals face complex combined exposures, yet the synergistic effects of these factors on asthma pathogenesis remain poorly understood. This narrative review synthesizes epidemiological and toxicological evidence. It aims to elucidate both the individual and the notably synergistic effects of these factors on asthma pathogenesis. The central mechanistic pathway is initiated by oxidative stress, which activates key inflammatory signaling pathways, thereby driving immune imbalance and airway inflammation. Our review underscores that the combined exposure to traditional pollutants, emerging pollutants, and extreme temperatures may pose a greater threat than individual factors. These findings underscore the critical need for an integrated perspective in asthma research and public health policy. Moving beyond single-pollutant approaches, we advocate for combinatorial risk assessment and synergistic intervention strategies to effectively mitigate the growing burden of asthma in a changing climate.
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Respiratory Health Impacts from Natural Disasters and Other Extreme Weather Events: The Role of Environmental Stressors on Asthma and Allergies
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This review looked at how natural disasters and extreme weather events, including wildfires, floods, and heat waves, are worsening respiratory conditions like asthma and allergies. Researchers found that these events release environmental stressors including microplastics and PFAS chemicals that can trigger lung inflammation and immune disruption. The study suggests that as extreme weather becomes more frequent, understanding these exposure pathways is increasingly important for protecting respiratory health.
Co-exposure of environmental contaminants with unfavorable temperature or humidity/moisture: Joint hazards and underlying mechanisms
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This review examines how extreme temperatures and changes in humidity or soil moisture interact with environmental pollutants to create combined harmful effects on living organisms. Researchers found that both high heat and low moisture conditions can amplify the toxicity of contaminants including microplastics, heavy metals, and pesticides. The study suggests that as climate change increases the frequency of extreme weather, organisms will face escalating risks from these pollutant-climate interactions.
Synergistic effects of microplastics and bioaerosols: emerging trends in urban air pollution complexification and public health implications
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This review examines the emerging synergistic health risks of airborne microplastics and bioaerosols in urban environments. Researchers found that microplastics can serve as carriers for bacteria, fungi, and viruses, potentially prolonging pathogen survival and increasing human exposure through inhalation. The combined exposure may amplify respiratory inflammation and oxidative stress beyond what either pollutant causes individually, highlighting a growing concern for urban public health.
Allergy and immunotoxicology in preventive and clinical medicine from theory to practice: Environmental factors in bronchial asthma
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This review applies an exposome framework to bronchial asthma, identifying living-environment pollutants including microplastics, air pollution, tobacco smoke, climate change, and dietary changes as contributors to asthma pathogenesis and exacerbation.
Microplastics in pediatric asthma: Clinical associations with disease severity
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Researchers found tiny plastic particles (microplastics) in the lung mucus of every single child with asthma they tested, and kids with worse-controlled asthma had higher levels of these particles in their airways. Lab experiments on lung tissue models suggested these plastics may trigger harmful cell stress and inflammation, though more research is needed to confirm this actually causes the asthma symptoms rather than just being linked to them. This study is a reminder that the air we breathe, and the plastic particles in it, may be quietly affecting respiratory health, especially in children.
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