Thunderstorms can trigger asthma attacks requiring hospitalization, study finds

The calm before the storm isn’t really that calm, at least not for people with asthma or other severe breathing conditions, new research shows.

In the days leading up to a major thunderstorm, emergency room visits for seniors with asthma and chronic obstructive pulmonary disease (COPD) increased dramatically, according to a research letter published Monday in JAMA Internal Medicine.

Although the study used Medicare data for those 65 and over, the danger is just as real for young people with severe respiratory illnesses, said study author Dr. Anupam Jena, associate professor. of Health Policy at Harvard Medical School.

“It could definitely have an impact on children and young adults with asthma,” Jena said. “We just needed the specific data provided by Medicare so that we could compare hospitalization rates with weather conditions in small areas.”

The study found that emergency room visits peaked the day before the storm, with an average of 1.8 additional visits per million beneficiaries.

“The visits did not take place during the thunderstorm when the rains are falling,” Jena said. “And after the storm was over, we saw the emergency room visit rate drop.”

Stormy asthma

The phenomenon of “stormy asthma” was first recorded in Birmingham, England, 1983 and Melbourne, Australia, 1987, where widespread waves of asthma attacks appeared to be linked to severe thunderstorms. during a high number of pollens.

It happened again in Melbourne in 2016, killing eight people and sending some 8,000 to the emergency room.

No one understood why this could happen since rain usually cleans pollen from the air. In addition, the size of the rye pollen spores in the Melbourne area was too large to be easily inhaled and usually lodged in the sinuses before they could reach the lungs.

So why would a rare storm with this type of pollen cause such an extreme reaction?

Researchers at the University of Georgia studied the Australian event and publishes an article the following year. They found that downdrafts of cold air inside a storm send mold and pollen high into the clouds, where humidity levels and lighting cause spores to burst. Returning to the ground as much smaller fragments, the tiny particles can then pass through the nose and sinuses into the lungs.

“In our study, we found that pollen had not increased in the days leading up to the storm, which makes it strange to then attribute the increase in hospitalizations to pollen, at least exclusively,” Jena said.

Levels of nitrogen dioxide, sulfur dioxide, carbon monoxide and ozone also did not change in the days leading up to a thunderstorm, Jena said. All levels, however, fell after the storms ended.

“Previous studies suggest that rapid increases in temperature can precipitate respiratory problems, and we have observed temperature changes in the days leading up to thunderstorms,” ​​he added.

“The last thing to note is that this was a study of thousands of thunderstorms occurring in the United States, coupled with high frequency data on environmental parameters and hospitalizations, making these findings potentially more generalizable than previous studies on this topic, ”Jena said. .

The day before the storm is more dangerous

The study analyzed health insurance claims for emergency room visits related to acute respiratory distress between January 1999 and December 2012, comparing data to atmospheric and lightning data from the US National Oceanic and Atmospheric Administration for every US county.

“We found that emergency room visits increased in the days leading up to the storm, when the temperature rises and the amount of particles in the air begins to rise,” Jena said.

Particles are a mixture of solids and liquids present in the air. The particles of dust, dirt and smoke are larger, but there are also extremely small inhalable particles that cannot be seen with the naked eye. These are called PM 2.5 because their size is usually 2.5 microns or less.

It’s really tiny – for comparison, the average human hair is 30 times the size of a PM 2.5 particle. Because they are so small, these particles can penetrate deep into the lungs and wreak havoc on our lungs and bodily functions.

Different aspects of weather – such as higher temperatures, rain, wind speed, air turbulence, and the sun – impact levels of ozone and particulate matter, depending on the National Meteorological Service. Chemical reactions in the air speed up as temperatures rise, and air turbulence and wind speed affect how pollutants disperse in an area.

The rain, for its part, washes away the particles.

Using census data, the study estimated that there were 37.7 million Americans aged 65 or older. Using these numbers, the study estimated an additional 52,000 emergency room visits over the 14-year period due to respiratory distress in the three or more days surrounding major storms.

“If you know a thunderstorm is coming, be careful as you would when the pollen count is high and be a little more careful,” Jena advised.

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