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Meta-Analysis
. 2023 Jun 7;32(168):230019.
doi: 10.1183/16000617.0019-2023. Print 2023 Jun 30.

Extreme weather and asthma: a systematic review and meta-analysis

Firdian Makrufardi  1   2 , Amja Manullang  1 , Desy Rusmawatiningtyas  2 , Kian Fan Chung  3 , Sheng-Chieh Lin  4   5 , Hsiao-Chi Chuang  6   7   8   9
Affiliations
Meta-Analysis

Extreme weather and asthma: a systematic review and meta-analysis

Firdian Makrufardi et al. Eur Respir Rev. .

Abstract

Background: Climate change's influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes.

Methods: A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes.

Results: We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13-1.24), 1.10-fold for asthma symptoms (95% CI 1.03-1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00-1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14-1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04-1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06-1.34) and of asthma mortality of 2.10-fold (95% CI 1.35-3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08-1.32 and 95% CI 0.98-1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13-1.36).

Conclusions: Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.

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Conflict of interest statement

Conflict of interest: All authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart of the study.
FIGURE 2
FIGURE 2
Forest plot of extreme weather events with general asthma outcomes: a) asthma events; b) asthma symptoms; c) asthma diagnosis. IV: inverse variance; SE: standard error.
FIGURE 3
FIGURE 3
Forest plot for extreme weather events with acute exacerbations of asthma. a) Emergency department visits related to asthma. b) Hospital admissions related to asthma. c) Outpatient visits related to asthma. d) Asthma mortality. IV: inverse variance; SE: standard error.
FIGURE 4
FIGURE 4
Subgroup analyses of extreme weather events with general asthma outcomes. a) Asthma events. b) Asthma symptoms.
FIGURE 5
FIGURE 5
Subgroup analyses of extreme weather events with acute exacerbations of asthma. a) Asthma emergency department visits. b) Asthma hospital admissions.
See this image and copyright information in PMC

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