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March 07, 2023; 100 (10) Review

Impacts of Climate Change and Air Pollution on Neurologic Health, Disease, and Practice

A Scoping Review

View ORCID ProfileShreya Louis, View ORCID ProfileAlise K. Carlson, Abhilash Suresh, Joshua Rim, View ORCID ProfileMaryAnn Mays, View ORCID ProfileDaniel Ontaneda, View ORCID ProfileAndrew Dhawan
First published November 16, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201630
Shreya Louis
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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  • ORCID record for Shreya Louis
Alise K. Carlson
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Abhilash Suresh
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Joshua Rim
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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MaryAnn Mays
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Daniel Ontaneda
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Andrew Dhawan
From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Citation
Impacts of Climate Change and Air Pollution on Neurologic Health, Disease, and Practice
A Scoping Review
Shreya Louis, Alise K. Carlson, Abhilash Suresh, Joshua Rim, MaryAnn Mays, Daniel Ontaneda, Andrew Dhawan
Neurology Mar 2023, 100 (10) 474-483; DOI: 10.1212/WNL.0000000000201630

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Abstract

Background and Objectives Although the international community collectively seeks to reduce global temperature rise to less than 1.5°C before 2100, irreversible environmental changes have already occurred, and as the planet warms, these changes will continue to occur. As we witness the effects of a warming planet on human health, it is imperative that neurologists anticipate how the epidemiology and incidence of neurologic disease may change. In this review, we organized our analysis around 3 key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuroinfectious diseases, and pollutant impacts. Across each of these themes, we appraised and reviewed recent literature relevant to neurologic disease and practice.

Methods Studies were identified using search terms relating to climate change, pollutants, and neurologic disease in PubMed, OVID MEDLINE, EMBASE, PsycInfo, and gray literature. Studies published between 1990 and 2022 were included if they pertained to human incidence or prevalence of disease, were in English, and were relevant to neurologic disease.

Results We identified a total of 364 articles, grouped into the 3 key themes of our study: extreme weather events and temperature fluctuations (38 studies), emerging neuroinfectious diseases (37 studies), and pollutant impacts (289 studies). The included studies highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity.

Discussion Temperature extremes and variability both associated with stroke incidence and severity, migraine headaches, hospitalization in patients with dementia, and multiple sclerosis exacerbations. Exposure to airborne pollutants, especially PM2.5 and nitrates, associated with stroke incidence and severity, headaches, dementia risk, Parkinson disease, and MS exacerbation. Climate change has demonstrably expanded favorable conditions for zoonotic diseases beyond traditional borders and poses the risk of disease in new, susceptible populations. Articles were biased toward resource-rich regions, suggesting a discordance between where research occurs and where changes are most acute. As such, 3 key priorities emerged for further study: neuroinfectious disease risk mitigation, understanding the pathophysiology of airborne pollutants on the nervous system, and methods to improve delivery of neurologic care in the face of climate-related disruptions.

Glossary

ALS=
amyotrophic lateral sclerosis;
ED=
emergency department;
ICH=
intracerebral hemorrhage;
JEV=
Japanese encephalitis virus;
MS=
multiple sclerosis;
PD=
Parkinson disease;
TBE=
tick-borne encephalitis;
WHO=
World Health Organization

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Preprint DOI: MedRxivdoi: doi.org/10.1101/2021.11.24.21266840

  • Submitted and externally peer reviewed. The handling editor was Rebecca Burch, MD.

  • Editorial, page 454

  • Received July 1, 2022.
  • Accepted in final form October 18, 2022.
  • © 2023 American Academy of Neurology
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