From:  An expert position paper on environment, occupation and climate change effects on allergic respiratory diseases in Italy

 Effects of climate change on respiratory health.

StudyPopulation/AreaExposureOutcomesEffect estimation
EXHAUSTION Zafeiratou et al., 2023 [72]Norway, Germany, England and Wales, all agesWarm: average temperature increases between the 75th and 99th percentiles of the summer temperature distributionRespiratory mortality (total)RR 1.27 (95% CI 1.19–1.34). Greater risk for the elderly and women
MultiCityMultiCountry Scovronick et al., 2024 [73]532 cities in 33 countries (Americas, Europe, Asia, Africa) (including 16 Italian cities)Extreme heat (99th percentile temperature vs. minimum mortality temperature)Respiratory mortality (total)Greater effect in the elderly
BIGEPI (Stafoggia et al., 2023; Di Blasi et al., 2023) [80, 81]Italy (national)Warm—average temperature increments between the 75th and 99th percentiles of the summer temperature distributionRespiratory mortality (total)+ 37% (95% CI 33–42) on hot days compared to milder summer days
Med-Particles (Stafoggia et al., 2016) [90]13 cities in the Mediterranean basin (includes 8 Italian cities)Desert dust (10 μg/m3 increase in PM10-desert component)Respiratory mortalityIncrease of 0.55% (95% CI 0.24–0.87)
Zauli Sajani et al., 2011 [91]6 cities in Emilia RomagnaDesert dust (10 μg/m3 increase in PM10-desert component)Respiratory mortalityIncrease of 22.0% (95% CI 4.0–43.1)
Systematic reviews
Cheng et al., 2019 [78]27 studies on adults from 20 countries (Australia, America, Europe, Asia)Heat waves (different definitions incl. extreme temperatures)Respiratory mortality (total and COPD)RR 1.18 (95% CI 1.09–1.28) on wave days compared to non-wave days. Greater effect on mortality from COPD and in the elderly
Cheng et al., 2019 [78]20 studies on adults from 20 countries (Australia, America, Europe, Asia)Heat waves (different definitions incl. extreme temperatures)Respiratory morbidity (hospital admissions, ED visits, ambulance calls)RR 1.043 (95% CI 0.995–1.093) on wave days compared to non-wave days. Significant effects only on admissions and admissions to the ED
Tobías et al., 2025 [89]71 studies on all continentsDesert dust transport (days with desert dust advections vs. days without)Respiratory mortality RR 1.0001 (95% CI 0.9773–1.0277)
Tobías et al., 2025 [89]71 studies on all continentsDesert dust transport (days with desert dust advections vs. days without)Respiratory morbidity RR 1.0693 (95% CI 1.0188–1.1224)

CI: confidence interval; COPD: chronic obstructive pulmonary disease; ED: emergency department; PM10: atmospheric particulate matter with a diameter ≤ 10 μm; RR: relative risk.