Are convergence lines associated with high asthma presentation days? A case-control study in Melbourne, Australia

Bannister, Tony; Csutoros, Danny; Arnold, Anna-Lena; Black, Jim; Feren, Geoffrey; Russell, Richard; Watson, Andrew I.; Williams, Scott M.; Silver, Jeremy D.; Hughes, Nicole

doi:10.1016/j.scitotenv.2020.140263

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Grass pollen plays a crucial role in thunderstorm asthma (TA), as evidenced by our systematic review [ 34 ]. TA is defined by acute bronchospasm that is triggered within minutes or hours following a thunderstorm or convergence line weather event (defined as a band of rain and cloud, formed when winds from opposite directions collide) with or without the presence of lightning [ 35 , 36 ]. TA can perpetuate an early asthmatic response that is severe enough to seek emergency treatment and, in some instances, death [ 35 , 37 ].…”

Section: Short-term Impact Of Pollen On Adverse Respiratory Outcomesmentioning

confidence: 99%

“…During a thunderstorm, whole pollen grains (

m) are disseminated up and horizontally into the air. The convergence line weather events, plus a sudden drop in temperature and air pressure, high humidity, electrical ions, lightning strikes and heavy rainfall, facilitate the rupturing of whole pollen grains into Lol p 5-enriched sub-pollen particles (

2.5

m) [ 36 , 44 , 45 , 46 ]. The gusty wind then transports the sub-pollen particles over long distances, while the cold downdraft and outflows re-deposit the ruptured pollen grains onto or near to the ground [ 46 , 47 ].…”

Section: Short-term Impact Of Pollen On Adverse Respiratory Outcomesmentioning

confidence: 99%

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A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

Idrose

Lodge

Erbas

et al. 2022

IJERPH

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Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies.

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Section: Short-term Impact Of Pollen On Adverse Respiratory Outcomesmentioning

confidence: 99%

“…During a thunderstorm, whole pollen grains (

2.5

Section: Short-term Impact Of Pollen On Adverse Respiratory Outcomesmentioning

confidence: 99%

A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

Idrose

Lodge

Erbas

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Furthermore, convergence line weather events have been associated with a significant proportion of increased asthma presentations which may not always be thunderstorm related, including in Australia and Iran. 21,22 The largest ETSA event prior to 2016 was in the UK in 1994, attributed to grass pollen (GP) allergen, with 640 hospital attendances, five intensive care unit (ICU) admissions, and the first ETSA-related death. 6 To date, there have been cumulative reports of over 7,000 hospital presentations with 18 reported deaths due to ETSA.…”

Section: Overview Of Historical Episodesmentioning

confidence: 99%

Managing Exacerbations in Thunderstorm Asthma: Current Insights

Chatelier

Chan

Tan

et al. 2021

JIR

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Epidemic thunderstorm asthma (ETSA) occurs following a thunderstorm due to the interaction of environmental and immunologic factors. Whilst first reported in the 1980s, the world's largest event in Melbourne, Australia, on November 21, 2016 has led to a wealth of clinical literature seeking to identify its mechanisms, susceptibility risk factors, and management approaches. Thunderstorm asthma (TA) typically presents during an aeroallergen season in individuals sensitized to perennial rye grass pollen (RGP) in Australia, or fungus in the United Kingdom, in combination with meteorological factors such as thunderstorms and lightning activity. It is now well recognized that large pollen grains, which usually lodge in the upper airway causing seasonal allergic rhinitis (SAR), are ruptured during these events, leading to sub-pollen particles respirable to the lower respiratory tract causing acute asthma. The identified risk factors of aeroallergen sensitization, specifically to RGP in Australians with a history of SAR, and individuals born in Australia of South-East Asian descent as a risk factor for TA has been key in selecting appropriate patients for preventative management. Moreover, severity-determining risk factors for ETSA-related asthma admission or mortality, including pre-existing asthma or prior hospitalization, poor inhaled corticosteroid adherence, and outdoor location at the time of the storm are important in identifying those who may require more aggressive treatment approaches. Basic treatments include optimizing asthma control and adherence to inhaled corticosteroid therapy, treatment of SAR, and education regarding TA to increase recognition of at-risk days. Precision treatment approaches may be more beneficial in select individuals, including the use of allergen immunotherapy and even biologic treatment to mitigate asthma severity. Finally, we discuss the importance of environmental health literacy in the context of concerns surrounding the increased frequency of ETSA due to climate change and its implications for the frequency and severity of future events.

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“…Indeed, a recent case-control study of convergence lines identified on radar imagery and asthma presentation data at Melbourne hospitals provides strong evidence for this hypothesis (Bannister et al 2020). Also, a higher concentration of airborne grass pollen would…”

Section: Foundation For An Epidemic Thunderstorm Asthma Risk Matrixmentioning

confidence: 97%

A Pilot Forecasting System for Epidemic Thunderstorm Asthma in Southeastern Australia

Bannister

Ebert

Williams

et al. 2021

Bulletin of the American Meteorological Society

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Are convergence lines associated with high asthma presentation days? A case-control study in Melbourne, Australia

Cited by 12 publications

References 20 publications

A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

Managing Exacerbations in Thunderstorm Asthma: Current Insights

A Pilot Forecasting System for Epidemic Thunderstorm Asthma in Southeastern Australia

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