Interstitial lung diseases in a changing climate: emerging risks and opportunities to improve care

Although climate change represents one of the greatest public health challenges of our time, its impacts on patients with interstitial lung disease (ILD) remain unclear. This Personal View synthesises the evidence surrounding established, emerging, and postulated climate change health effects on patients with ILD, who are especially vulnerable to disease due to older age, reduced lung function, and sensitivity to inhaled exposures. Established risk factors for ILD such as air pollution might worsen with climate change, whereas other exposures such as extreme heat, viral illnesses, residential water intrusion, pollen, natural disasters, and desertification could pose novel threats to this population. Knowledge gaps exist across multiple domains, including wildfire smoke effects, the effects of climate on occupational ILD, and disaster preparedness. The incorporation of multiple research modalities, including patient-centred approaches, is crucial to address these gaps. Clinicians, scientists, and professional societies can lead climate-health research, the adoption of mitigation and adaptation strategies, and drive global policy actions to address this growing challenge.