Can thunderstorms cause asthma? Is "thunderstorm asthma" really caused by fear?

This is the 4926th article of Da Yi Xiao Hu

If you are asked what respiratory diseases are most common in spring, you will definitely think of bronchial asthma caused by allergic problems. Some people cough, some have chest tightness, and some are even at risk of suffocation. However, there is also an asthma disease with hidden causes, which often appears suddenly after the first thunderstorm in spring, and can even cause overcrowding in respiratory departments and emergency rooms. Do you know what "thunderstorm asthma" is? Most patients feel that they have coughing, wheezing, chest tightness and shortness of breath for no reason. Some people jokingly say that "thunderstorm asthma" is caused by fear. Is this true? Why do so many similar symptoms occur in a short period of time?

Medical observations show that many of these patients are experiencing the disease for the first time, but they have a history of allergic rhinitis, pharyngitis, or skin allergies. These symptoms are usually significantly improved after using bronchodilators and other drugs commonly used for asthma. Clinical treatment can indeed be solved according to bronchial asthma, that is, to eliminate allergies, dilate the trachea, and improve chronic airway inflammation.

The so-called "thunderstorm asthma" refers to the increase in acute asthma cases observed after a thunderstorm occurs near the local area. It is not asthma caused by fear, but a common allergic disease that requires specific population + specific weather + specific environmental factors to form.

This hidden environmental factor is actually pollen. When a thunderstorm occurs, pollen (and/or spores) are swept into the cloud bottom by warm updrafts. The difference in ion charge generated by the storm causes pollen (and/or spores) to break into finer particles. At the same time, pollen (and/or spores) absorb moisture in a high humidity environment, expand and break, and break into smaller fragments. This is like the PM2.5 PM10 we often hear about. These large amounts of tiny particles are blown to the ground by downdrafts and gusts. They can bypass the first barrier of the human body, the nasopharynx, and are inhaled into the bronchi and bronchioles without filtration, usually inducing acute bronchospasm within just a few seconds to a few minutes.

(Photo from China National Radio)

Statistics show that there have been 26 recorded cases of thunderstorm asthma worldwide so far. The earliest report of thunderstorm asthma came from Birmingham, England in 1983. The most serious thunderstorm asthma occurred in Melbourne in 2016, resulting in more than 8,500 emergency visits or hospitalizations and eight deaths. It can be seen that once thunderstorm asthma occurs, the number of people affected may be very large. In rare cases, thunderstorm asthma may be fatal. Its treatment is the same as that of general acute asthma attacks, and every second counts. Treatment is divided into cause treatment and symptomatic treatment. Cause refers to leaving the sensitizing environment, such as closing windows, wearing masks, and staying away from areas with more pollen; symptomatic treatment includes oral antiallergic drugs, inhaled hormones and airway dilators. If a major asthma attack occurs, you must go to the hospital as soon as possible.

Author: Putuo District Central Hospital

Department of Respiratory Medicine Shi Zhaowen, deputy chief physician