Thunderstorm Asthma: Current Perspectives and Emerging Trends

Isolated episodes and epidemic outbreaks of thunderstorm asthma have now been documented for over 40 years, with global geographical reach across Europe, North America, Middle East, Asia, Oceania, and Africa. This phenomenon encompasses specific environmental and meteorological factors, interacting with aeroallergen propagation and exposure in susceptible allergen-sensitized individuals and populations. There is a likely contribution from climate change with prolonged allergenic pollen seasons combined with increased pollen allergenicity, as well as heightened likelihood of extreme weather events. Differential population susceptibility to thunderstorm asthma presentations, hospitalizations, and deaths with increased vulnerability of certain ethnic groups suggests a gene-environment interaction. This clinical commentary reviews the characteristics and updates the epidemiology of thunderstorm asthma; examines the role of aerobiology and climate change; discusses risk factors for emergency presentations, hospital admissions, and deaths; considers latest research and predictors of thunderstorm asthma; and proposes strategies to manage and mitigate risk.