How global warming turns the climate against the lungs

Even though the term “global warming” has been in use since at least the 1970s, recent years have shifted the previously abstract concept to perceivable reality. Chairwoman Ane Johannessen from the University of Bergen, Norway, made clear during the session’s introduction: ‘climate change is not something in the future anymore – it is right here and right now.’ 

The impact is particularly noticeable in urban areas, as Prof. Zorana Andersen pointed out. Cities –already home to more than half of the world’s population, with a projected increase to 70% by 2050 – are ‘major centres for air pollution’, said the Professor in Environmental Epidemiology at the Department of Public Health of the University of Copenhagen, Denmark. Traffic, energy production, and HVAC for both industrial and residential buildings drive emissions – so much so that, according to the WHO, 99% of the world's population breathes air defined as “unhealthy”, with concentrations of PM_2.5 particles above 5 µg per cubic metre.¹ Even across Europe, more than 400,000 deaths per year are attributed to air pollution. 

Exposure begins even before birth, paving the way for a lifetime of adverse health effects, explained Andersen – raising the risk of lower birth weight, asthma and respiratory infections in children, and COPD in adults. Covid-19 has been linked to air pollution, as has lung cancer. ‘Beyond the lung, air pollution is also a well-established risk factor for cardiovascular disease, stroke, type 2 diabetes, other cancers, neurological disease, as adverse pregnancy outcomes.’ This, she summarised, makes air pollution a major risk factor for nearly all chronic and non-communicable diseases. 

When things are heating up

Heat compounds the problem – and again, cities are affected the most. Due to heat absorption from asphalt and heat generation from A/C and cars, cities can be up to 10°C hotter than surrounding areas, breaking temperature records every year, Andersen said.² ‘Europe is heating twice as fast as the rest of the world. And this is posing new challenges.’ 

Extreme heat puts stress on every organ, including the lung: overheating and dehydration increase inflammation and impede airway function, putting people with existing lung conditions, children and the elderly at particular risk.³ ‘About 60,000 to 70,000 people die every year in Europe alone due to heat waves⁴, and these effects will become stronger – projections with very low heat mitigation indicate a 10- to 20-fold increase in deaths by the end of the century.’ Heat and air pollution also generate synergistic effects, for instance through smoke from increasingly common wildfires.⁵ ‘This is a really potent cocktail,’ Andersen warned. 

Toxic winds from the desert

Even though it may hardly seem connected to European healthcare, desert dust has also emerged as an increasing contributor to lung conditions, noted Prof. Francesco Forastiere. A considerable amount makes its way here, primarily from the Sahara⁶, said the respiratory expert from the Italian National Research Council in Palermo and Imperial College London, UK. The concentration of desert dust is increasing in Europe,⁷ driven by increasing desertification in North Africa and a shift in the atmospheric circulation – both a consequence of climate change. 

The health effects are considerable, since it’s not “just dust”, Forastiere stressed: Travelling across refinery plants in North Africa, the dust ‘can carry anthropogenic pollutants⁸ and even microorganisms’.⁹ It has been linked to oxidative stress, airway damage and inflammation,¹⁰ driving up hospital admissions for cardiovascular and respiratory conditions, and mortality in both adults and children.¹¹ 

Out of the frying pan – into the flood

In the wake of global warming, even water is becoming a threat, illustrated Dr Erol Gaillard from the University of Leicester, UK. Warmer air can hold more water, leading to more and heavier rain, and a higher risk of rivers overflowing their banks, while warming oceans, rising sea levels, and fewer but heavier storms, drive coastal flooding.¹² ‘Severe flooding is becoming more common and more severe, and climate change is absolutely contributing to this. By 2050, 25% of the world's population is going to be at risk of flooding.’ 

Recent catastrophic events – the Ahr Valley flooding in 2021, storm “Boris” in Central Europe, and the 2024 Valencia flash floods – hint at what is to come, the expert continued. ‘Europe is now the fastest-warming continent. And this is definitely going to make Europe's flood problems worse.’¹³ 

Beyond drowning deaths and destroyed livelihoods, flooding endangers patients reliant on ventilators and nebulisers through power outages. It disrupts supply chains for vital medication, and raises the risk of infectious disease outbreaks in emergency shelters. 

After the water recedes, the health problems remain: mould, which can develop in flooded homes within 48 hours, is not only hard to remove, but also causally linked to asthma development and severity, particularly in children.¹⁴ ‘The longer the exposure and the more serious the problem, the worse the health impact,’ Gaillard said. 

Solutions in policies and research

While stopping or even reversing climate change will be a monumental task, measures to mitigate its adverse health effects have already begun. Andersen pointed to London’s Ultra Low Emission Zone (ULEZ), which charges polluting vehicles and, since its introduction in 2019, has measurably improved children’s lung health.¹⁵ Greening cities to counter heat is another vital pillar, the expert added.¹⁶ ‘One successful policy can really inspire other cities to do this,’ she concluded. ‘Studies showing how these policies have a direct impact on health are really important and show the way forward.’ 

To better understand the impact of desert dust, more long-term research is urgently needed, said Forastiere.¹⁷ In the UK, measures to protect vulnerable groups from mould exposure have already progressed further, Gaillard reported: The death of Awaab Ishak, a two-year-old who died in Manchester in 2020 because of mould infestation in his council home, has served as a catalyst. The tragic story led to the introduction of “Awaab’s Law” in 2025 – a legal framework forcing social housing landlords to quickly fix damp and mould issues reported by tenants – in urgent cases, within 24 hours.^18,19 In a world increasingly feeling the pressure of climate change, measures like this are desperately needed to protect public health, he concluded. 

Profiles: 

Zorana Jovanovic Andersen is a Professor in Environmental Epidemiology at the Department of Public Health, University of Copenhagen, and Chair of the European Respiratory Society Environment and Health Committee. Her main research areas include health effects of air pollution on a range of diseases, including cardiovascular, respiratory disease, cancer, diabetes, dementia, and mental health. Prof. Andersen is a member of the Copenhagen Municipality Air Pollution Expert Group, Danish Council for Disease Prevention, ISEE Policy Committee, International Network on Policy in Epidemiology, and WHO Global Air Pollution and Health Technical Advisory Group. 

Francesco Forastiere, MD, PhD, is with the National Research Council (CNR) in Palermo, Italy and a visiting professor at Imperial College, London. He has served for 37 years as a public health officer in the Department of Epidemiology, Lazio Region Health Service, Rome. With a medical background in respiratory and occupational medicine, Master of Science in Epidemiology (LSHTM) and PhD. in Epidemiology (Linkoping, Sweden), he has conducted studies on the health effects of numerous environmental and occupational exposures. 

Dr Erol Gaillard is a Paediatric Respiratory and Asthma consultant and clinical service lead at University Hospitals of Leicester NHS Trust and an Associate Professor at the University of Leicester. His research interests include investigating the impact of the indoor and outdoor airborne exposome on respiratory health and asthma diagnosis. Dr Gaillard is the current chair of the European Respiratory Society (ERS) paediatric Asthma and Allergy Assembly and co-chair of a recently funded ERS Clinical Research Collaboration (EXPLAIN-IT) to study the role of the exposome on respiratory health. 

References: 

1. WHO global air quality guidelines: particulate matter (‎PM2.5 and PM10)‎, ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide; World Health Organization 2021  
2. 2024 was the warmest year on record, Copernicus data show; European Centre for Medium-Range Weather Forecasts 2025  
3. Scovronick N, Sera F, Vu B, et al. Temperature-mortality associations by age and cause: a multi-country multi-city study. Environ Epidemiol. 2024;8(5):e336. Published 2024 Sep 24. doi:10.1097/EE9.0000000000000336  
4. Janoš T, Quijal-Zamorano M, Shartova N, et al. Author Correction: Heat-related mortality in Europe during 2024 and health emergency forecasting to reduce preventable deaths. Nat Med. 2025;31(12):4311. doi:10.1038/s41591-025-04125-4  
5. EU EXHAUSTION project  
6. Shao, Y., M. Klose, and K.-H. Wyrwoll (2013), Recent global dust trend and connections to climate forcing, J. Geophys. Res. Atmos., 118, 11,107–11,118, doi:10.1002/jgrd.50836.  
7. Vasilakos, P.N., Upadhyay, A., Manousakas, M.I. et al. Rising dust pollution across Europe in a changing climate. Nature 655, 647–654 (2026). https://doi.org/10.1038/s41586-026-10743-w 
8. Rodríguez, S., Alastuey, A., Alonso-Pérez, S., Querol, X., Cuevas, E., Abreu-Afonso, J., Viana, M., Pérez, N., Pandolfi, M., and de la Rosa, J.: Transport of desert dust mixed with North African industrial pollutants in the subtropical Saharan Air Layer, Atmos. Chem. Phys., 11, 6663–6685, https://doi.org/10.5194/acp-11-6663-2011, 2011. 
9. Griffin, D.W., Garrison, V.H., Herman, J.R. et al. African desert dust in the Caribbean atmosphere: Microbiology and public health. Aerobiologia 17, 203–213 (2001). https://doi.org/10.1023/A:1011868218901 
10. Fussell JC, Kelly FJ. Mechanisms underlying the health effects of desert sand dust. Environ Int. 2021;157:106790. doi:10.1016/j.envint.2021.106790  
11. Stafoggia M, Zauli-Sajani S, Pey J, et al. Desert Dust Outbreaks in Southern Europe: Contribution to Daily PM₁₀ Concentrations and Short-Term Associations with Mortality and Hospital Admissions. Environ Health Perspect. 2016;124(4):413-419. doi:10.1289/ehp.1409164  
12. Gaillard E: Climate change impacts: three ways global warming leads to house flooding; Exp Rev Resp Med 2026, in press 
13. Extreme weather: floods, droughts and heatwaves; European Environmental Agency 2026  
14. Caillaud D, Leynaert B, Keirsbulck M, Nadif R; mould ANSES working group. Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies. Eur Respir Rev. 2018;27(148):170137. Published 2018 May 15. doi:10.1183/16000617.0137-2017  
15. Wood H, Hajmohammadi H, Dove R et al.: Impact of the Ultra Low Emission Zone on lung function growth in children in London, UK: a prospective parallel cohort study; The Lancet Public Health, 2026; https://doi.org/10.1016/S2468-2667(26)00163-5 
16. Barboza E, Cirach M, Khomenko S et al.: Green space and mortality in European cities: a health impact assessment study; The Lancet Planetary Health, 5, e718-e730; https://doi.org/10.1016/S2542-5196(21)00229-1 
17. Li T, Cohen AJ, Krzyzanowski M, et al. Sand and dust storms: a growing global health threat calls for international health studies to support policy action. Lancet Planet Health. 2025;9(1):e34-e40. doi:10.1016/S2542-5196(24)00308-5  
18. Understanding and addressing the health risks of damp and mould in the home; UK Ministry of Housing, Communities and Local Government, Department of Health and Social Care and UK Health Security Agency 2023 (updated 2026)  
19. eClinicalMedicine: Awaab Ishak and the politics of mould in the UK; eClinicalMedicine, 54; https://doi.org/10.1016/j.eclinm.2022.101801 

05.10.2026

• environmental medicine (59)
• lung (248)