Breathing through climate change

2026: ERS Barcelona

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For Europeans, the impact of climate change is increasingly tangible, with multiple heatwaves and wildfires in the past summer. In fact, Europe is the fastest-warming continent according to the Copernicus Climate change service, with temperatures increasing at more than twice the global average rate. With increased urbanisation, wildfires and extreme weather events, this will also bring additional challenges for respiratory health.

Cities are hotspots for air pollution and heat

Economic development is driving urbanization, but more industry and bigger cities increase the demand for transportation, energy production, more buildings and cooling air – all contributing to air pollution and to the urban heat island effect. The temperature in a city can be 5-10 degrees hotter than outside the city, as buildings, dark roofs and roads absorb more heat. More than half of the world population lives in cities, and this is estimated to increase to nearly 70% by 2050, mainly in Africa and Southeast Asia.¹ These regions currently experience the world’s highest levels of air pollution, and the highest temperatures.

Only high blood pressure is deadlier than air pollution

Air pollution has just passed tobacco smoking in the global ranking of risk factor for all cause mortality, estimated to cause 1 in 8 deaths worldwide.² This has to do with the near complete exposure to air pollution – 99% of the world’s population breathes air that exceeds WHO’s air quality limits.³ The corresponding number for Europe is only slightly better, 94%,⁴ associated with about 400 000 deaths annually.⁵

Air pollution drives lung disease

The impact of air pollution starts already prenatally and is accumulated throughout the life time. It is well established that air pollution contributes to childhood asthma, development of COPD, lower respiratory infections in adults and lung cancer.² Air pollution also causes cardiometabolic, metabolic and neurological morbidity.^2,6

Climate change heating up cities faster

Extreme heat poses a stress for all organs, including the lungs, disrupts body balance and triggers asthma and COPD exacerbations. Children and elderly persons have poorer temperature regulation and are especially vulnerable to extreme heat. Outdoor workers are also at risk as they spend longer time in the heat.

High temperatures are associated with increased risk of mortality, but the mortality is further increased in days with elevated levels of ambient pollution.⁷ With the hot and dry weather, more wildfires occur, further accelerating air pollution.

Despite public opposition, the mayor of London introduced traffic restriction in the city, called Ultra Low Emission Zones (ULEZ). It has now been demonstrated in the CHILL study that these zones have led to improved lung function in children, confirming that traffic regulations can be effective in improving health.⁸

Greening

By introducing more green space in the cities, heat exposure can be reduced by replacing the heat-absorbing asphalt surface with trees and providing shade. In addition, plants absorb carbon dioxide and can trap harmful pollutants. Urban planning has an important role in mitigating the health impact of climate change on the urban population.

Flooding

Global warming also leads to heavy precipitation and flooding. This creates optimal conditions for growth of mould in houses. In a recent Finnish study, 19% of inspected homes had damp and mould problems.⁹ As mould exposure causes development of asthma, occupational asthma and more asthma attacks, this is a major health issue needing attention.¹⁰ Socioeconomically weak groups are disproportionately impacted. Following the death of the two-year-old boy Awaab in Manchester, caused by toxic mould in his home, legislation (Awaab’s Law) has been put in place in UK to force landlords to promptly address damp and mould.

Panel discussion: What can we do?

For vulnerable populations, access to air condition mitigates risks following extreme temperatures but not everyone can afford them. They also contribute to the warming of the city. As individuals, we can make a difference to limit our own emissions, but having the right policies in place is paramount for preparing urban life to manage heat and mitigating air pollution.

24250-10.09.2026