It may almost be forgotten that in the 1980s a smog alarm was occasionally declared in Germany. The air is so thick and full of pollutants that schools have been closed, road traffic stopped and production in factories throttled. “Measured by this, the air quality in Germany has improved significantly,” said Tamara Schikowski, epidemiologist at the Leibniz Institute for Environmental Medicine Research in Düsseldorf, at a health forum Süddeutsche Zeitung. Compared to countries like China, India or even Italy, Germany now has a relatively low level of pollution. Nevertheless, according to the expert: “Even very, very low fine dust pollution can still promote chronic diseases.”
Added to this are the increasing effects of climate change, which can lead to unfavorable interactions with pollution. Pollutants from traffic, heating and industry are driving climate change. At the same time, global warming can increase pollution: ozone increases under the influence of UV radiation, which is a problem especially for people with respiratory diseases. Whether other air pollutants will change as a result of new climatic influences or interact with one another in an unusual way cannot yet be foreseen.
What is certain, however, is that health can suffer from the combination of environmental pollution and global warming. A health forum Süddeutsche Zeitung has therefore devoted itself to selected examples of these developments.
These include allergies and asthma. Pollen allergies, once a seasonal occurrence, have now become a year-round affliction. Bianca Schaub, allergist at Dr. von Hauner Children’s Hospital at the Ludwig-Maximilians-University (LMU) Munich, reported: “There are studies that have shown that we now only have five allergen-free days a year. This is largely due to global warming.”
Higher temperatures prolong the flowering times of allergy-causing plants. “The birch blossom, for example, which we used to usually see from around April, now begins in December or January,” said the doctor. Pollen also floats higher in warmer air, so it stays in the air longer and can become more aggressive in combination with air pollutants. Heavy storms can also carry pollen over longer distances, allowing even exotic specimens to reach us.
Today, even two-year-olds get hay fever
The stress also begins earlier in life. “When I started as a pediatrician 25 years ago, hay fever in children only started at school age, usually around the age of ten. Today we see it in children who are two, three or four years old,” said Bianca Schaub . This could be due, among other things, to the higher allergen load. Other risk factors could be air pollutants such as nitrogen oxides and ozone, but also a changed endogenous microbiome.
Katrin Milger-Kneidinger, allergy and asthma specialist at the LMU, also observes increased stress in adult patients – especially in asthmatics. “What used to be seasonal asthma is now actually seen year-round because we have allergens year-round.” Important triggers for asthma attacks are air pollution and infections, which in turn are favored by air pollutants. “Mucous membranes that are damaged by pollutants, for example from traffic, are more susceptible to pathogens,” says the doctor.
Another trigger for asthma attacks are certain weather conditions, which are likely to increase with climate change. Strong heat means that people have to breathe more, patients with asthma or the lung disease COPD do not do this as well as healthy people, so that their shortness of breath increases. The phenomenon of thunderstorm asthma has also been observed occasionally in southern Germany, even if it is not yet a major problem in this country, says Milger-Kneidinger. It happens more often in Australia: pollen collects near the ground and is torn into small fragments in thunderstorms, which penetrate deep into the lungs – and can trigger severe attacks in patients with allergic asthma.
Climate change also increases the risk of skin cancer, said Mark Berneburg, director of dermatology at Regensburg University Hospital. Due to global warming, less cloud cover and thus more hours of sunshine tend to be observed. People also spend more time outdoors on warm days and are therefore more exposed to the damaging rays of the sun.
Only recently did data from the Federal Statistical Office show that the number of deaths from skin cancer in Germany has risen by 55 percent within 20 years – to 4,100 in 2021. “Even though the therapies have improved,” said Berneburg. “Projections assume that the trend towards more illnesses and deaths will continue.”
Neurological diseases such as dementia or strokes could also increase due to environmental pollution – probably because fine dust particles with a diameter of less than 2.5 micrometers can penetrate into the brain and cause inflammation there, said Tamara Schikowski.
The ideal city is green – but not full of birch trees
So what does an environment that reduces all of these stresses look like? It is above all an area with little traffic, the experts agreed. “A lot would be achieved if cars drove more slowly in the cities and the densely built-up inner cities were free of cars,” said Tamara Schikowski. Even car-free Sundays, like those experienced in Germany during the oil crisis, could reduce particulate matter pollution: “I think we can all do without the car on Sundays.” Many green spaces are also helpful; they buffer pollutants and heat, trees provide shade.
However, Bianca Schaub would like to pay very close attention to which plants are planted in the municipal facilities. “It would be helpful for allergy sufferers if fewer birches were planted and instead more plane trees, for example.”
In order to mitigate UV exposure, Berneburg spoke out in favor of awnings over playgrounds and cafés. Daytime activities in public facilities should be adapted to the sun’s rays – for example, summer festivals or physical education classes should not be scheduled for lunchtime. It is also important to adapt behavior to the UV index, which indicates how much harmful radiation is to be expected. Experts have long been calling for the index to be displayed in public places such as outdoor pools or parks.
As long as this is not implemented, residents should inform themselves (see here) and protect themselves accordingly. Above all, this means avoiding the sun at midday, wearing long, light clothing and a sun hat, and using sunscreen several times a day, says Berneburg.
Allergy sufferers can undergo hyposensitization. Otherwise, they should avoid the triggers as much as possible, says Katrin Milger-Kneidinger. Otherwise, depending on the situation, you can wear a mask, it not only protects against pathogens, but also very well against pollen. If you live on a busy street, you can consider buying an air filter to catch fine dust particles, said Tamara Schikowski.
The experts:
Prof. Dr. Mark BernburgDirector of the Clinic and Polyclinic for Dermatology at the University Hospital Regensburg
PD Dr. Katrin Milger-Kneidingerhead of the outpatient clinic for pulmonary hypertension and asthma at the Medical Clinic and Polyclinic V of the LMU Munich
Prof. Dr. Bianca Schaub, Head of Allergology – Pneumology at the Dr. from the Hauner Children’s Hospital of the LMU Munich
Dr. Tamara Schikowskihead of the working group Environmental Epidemiology of Lung, Brain and Skin Aging at the Leibniz Institute for Research in Environmental Medicine in Düsseldorf
Moderation:
Prof. Dr. Thomas Ruzicka, former director of the Clinic for Dermatology and Allergology at the LMU Munich.
Berit Uhlmann, SZ science editor