Association Between Changes in Timing of Spring Onset and Asthma Hospitalization in Maryland
The proposed association between climate change and increased burden of allergic diseases are based on three different thematic observational studies that have linked (i) increased CO 2 concentration with higher pollen production, (ii) warmer air/surface temperatures with early spring onset and longer pollen season, and (iii) higher pollen exposure with increased risk of asthma hospitalizations. Yet empirical evidence collectively linking climate change with pollen season and asthma exacerbation is still lacking. Using satellite observations, in situ pollen monitoring data, and hospitalization records (2001-2012), here we show that changes in the timing of spring onset resulting from ongoing climate variability and change is directly related to a longer tree pollen season and increased risk of asthma hospitalization. More specifically, we observed that very early start of season (SOS) to be associated with 10% increase in risk of asthma hospitalization (Incident Rate Ratio (IRR): 1.10, 95% Confidence Interval (CI): 1.02- 1.20) while late onset of SOS to be associated with 3% increase in risk of asthma hospitalization in Maryland (IRR: 1.03, 95% CI: 0.97-1.11), however the risk in the latter case was not statistically significant. Our results serve as a wake-up call to public health and medical communities regarding the need to anticipate and adapt to the ongoing changes in the timing and severity of the spring allergy season.