title: An expert assessment on climate change and health - with a European focus on lungs and allergies.
abstract: BACKGROUND
  For almost 20 years, the Intergovernmental Panel on Climate Change has been assessing the potential health risks associated with climate change; with increasingly convincing evidence that climate change presents existing impacts on human health. In industrialized countries climate change may further affect public health and in particular respiratory health, through existing health stressors, including, anticipated increased number of deaths and acute morbidity due to heat waves; increased frequency of cardiopulmonary events due to higher concentrations of air pollutants; and altered spatial and temporal distribution of allergens and some infectious disease vectors. Additionally exposure to moulds and contaminants from water damaged buildings may increase.
  
  
  METHODS
  We undertook an expert elicitation amongst European researchers engaged in environmental medicine or respiratory health. All experts were actively publishing researchers on lung disease and air pollution, climate and health or a closely related research. We conducted an online questionnaire on proposed causal diagrams and determined levels of confidence that climate change will have an impact on a series of stressors. In a workshop following the online questionnaire, half of the experts further discussed the results and reasons for differences in assessments of the state of knowledge on exposures and health effects.
  
  
  RESULTS
  Out of 16 experts, 100% expressed high to very high confidence that climate change would increase the frequency of heat waves. At least half expressed high or very high confidence that climate change would increase levels of pollen (50%), particulate matter (PM2.5) (55%), and ozone (70%). While clarity is needed around the impacts of increased exposures to health impacts of some stressors, including ozone and particulate matter levels, it was noted that definitive knowledge is not a prerequisite for policy action. Information to the public, preventive measures, monitoring and warning systems were among the most commonly mentioned preventative actions.
  
  
  CONCLUSIONS
  This group of experts identifies clear health risks associated with climate change, and express opinions about these risks even while they do not necessarily regard themselves as covering all areas of expertise. Since some changes in exposure have already been observed, the consensus is that there is already a scientific basis for preventative action, and that the associated adaptation and mitigation policies should also be evidence based.
authors: Occupational and Environmental Medicine, Umea University, Sweden. bertil.forsberg@envmed.umu.se
authors: Bertil
authors: B
authors: Forsberg
authors: Lennart
authors: L
authors: Bråbäck
authors: Hans
authors: H
authors: Keune
authors: Mike
authors: M
authors: Kobernus
authors: Martin
authors: M
authors: Krayer von Krauss
authors: Aileen
authors: A
authors: Yang
authors: Alena
authors: A
authors: Bartonova
mesh_terms: D000393:Air Pollutants / Q000633:toxicity; D000485:Allergens / Q000633:toxicity; D057231:Climate Change; D004782:Environmental Health; D005060:Europe; D005104:Expert Testimony; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000209:etiology*; D011795:Surveys and Questionnaires
chemical_list: D000393:Air Pollutants; D000485:Allergens