Impacts of Climate Change and Air Pollution on Neurologic Health, Disease, and Practice

Abstract

Background and objectives:Although the international community collectively seeks to reduce global temperature rise to under 1.5ºC before 2100, irreversible environmental changes have already occurred, and as the planet warms these changes will continue to occur. As we witness the effects of a warming planet on human health, it is imperative that neurologists anticipate how the epidemiology and incidence of neurologic disease may change. In this review, we organized our analysis around three key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuro-infectious diseases, and pollutant impacts. Across each of these themes, we appraised and reviewed recent literature relevant to neurological disease and practice.Methods:Studies were identified using search terms relating to climate change, pollutants, and neurologic disease in PubMed, OVID MEDLINE, Embase, PsycInfo, and grey literature. Studies published between 1990 and 2022 were included if they pertained to human incidence or prevalence of disease, were in English, and were relevant to neurologic disease.Results:We identified a total of 364 articles, grouped into the three key themes of our study; extreme weather events and temperature fluctuations (38 studies), emerging neuro-infectious diseases (37 studies), and pollutant impacts (289 studies). The included studies highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity.Discussion:Temperature extremes and variability both associated with stroke incidence and severity, migraine headaches, hospitalization in dementia patients, and multiple sclerosis exacerbations. Exposure to airborne pollutants, especially PM2.5 and nitrates, associated with stroke incidence and severity, headaches, dementia risk, Parkinson’s disease, and MS exacerbation. Climate change has demonstrably expanded favorable conditions for zoonotic diseases beyond traditional borders, and poses the risk of disease in new, susceptible populations. Articles were biased towards resource-rich regions, suggesting a discordance between where research occurs and where changes are most acute. As such, three key priorities emerged for further study; neuro-infectious disease risk mitigation, understanding the pathophysiology of airborne pollutants on the nervous system, and methods to improve delivery of neurologic care in the face of climate-related disruptions.

Migraine and air pollution: A systematic review

“…Two recent publications have briefly reviewed associations between air pollution and headache and/or migraine 13,55 . The overall conclusions of these papers are in agreement with our results.…”

“…The overall conclusions of these papers are in agreement with our results. A scoping review that included a summary of air pollution and headache 55 reported point estimates above the null value for associations between migraine outcomes and carbon monoxide, nitrogen dioxide, ozone, PM 2.5 , and PM 10 . A recent narrative review of air pollution and headache disorders 56 cited 10 studies in total in relation to headache.…”

Climate Change and Air Pollution

“…We thank Louis et al 7 for advancing in our knowledge of this topic. The information they provide may help in our efforts to protect and improve the neurologic health of our communities and our world!…”

“…5 Modeling studies indicate that the economic value of health cobenefits from improved air quality may exceed the entire cost of the measures needed to mitigate climate change. 6 In this issue of Neurology, Louis et al 7 have advanced our educational mission with their scoping review of articles dealing with the association of climate change and human neurologic disorders. They grouped the articles into consequences of extreme weather, neuroinfectious diseases, and pollution impacts.…”

“…In this issue of Neurology , Louis et al 7 have advanced our educational mission with their scoping review of articles dealing with the association of climate change and human neurologic disorders. They grouped the articles into consequences of extreme weather, neuroinfectious diseases, and pollution impacts.…”