Extreme Heat and Pollution Heighten Respiratory Risks for Israelis with Chronic Lung Diseases
Israel has been experiencing increasingly extreme and frequent heat waves, with temperatures soaring above 35 degrees Celsius. These heat waves are often accompanied by dust, humidity, and air pollution, creating hazardous conditions especially for hundreds of thousands of Israelis living with asthma or chronic obstructive pulmonary disease (COPD). Professor David Shitrit, head of the Pulmonary Department at Clalit Health Services, explains that hot, dry air combined with dust and pollution can irritate the airways, causing constriction, shortness of breath, coughing, wheezing, and increased mucus production. While some patients experience temporary discomfort, others may face severe exacerbations.
The risk of respiratory flare-ups rises during Israel's summer heat waves, particularly on days with air pollution alerts. Patients are advised to avoid physical activity during peak heat, monitor air quality warnings, stay in air-conditioned environments while avoiding abrupt temperature changes, and maintain their regular treatment even when feeling well. Discontinuing treatment independently during summer can increase the risk of exacerbations when the respiratory system is already stressed.
Exacerbations in COPD patients can cause lasting lung function decline, increase the likelihood of future flare-ups, lead to repeated hospitalizations, and raise mortality risk. Preventing exacerbations is now a primary treatment goal. Recent advances include biological therapies for COPD patients with eosinophilic phenotypes who continue to suffer exacerbations despite optimal inhaler use. Studies show these treatments can reduce exacerbations by about 43%, decrease hospital admissions and emergency visits, and lower healthcare costs.
Smoking cessation remains the most impactful intervention, as no current treatment can reverse the cumulative damage caused by smoking. Quitting smoking slows disease progression, reduces exacerbation and hospitalization risks, improves quality of life, and lowers mortality risk. It is essential alongside tailored exercise, pulmonary rehabilitation, and adherence to medication.
Significant progress has also been made in severe asthma treatment, shifting goals from merely reducing attacks and steroid use to achieving remission, deep, sustained disease control with minimal symptoms and steroid dependence. Biological therapies targeting specific inflammatory mechanisms now enable some patients to reach this previously unattainable goal. Recent research suggests these treatments may also modify airway structural changes, potentially slowing disease progression.
While heat, dust, and pollution are uncontrollable summer factors, managing chronic respiratory diseases effectively can prevent exacerbations. Patients should avoid extreme heat exposure, maintain adapted physical activity, continue regular inhaler use, quit smoking, and consider advanced treatments like biologics if needed. The key message is that chronic respiratory diseases need not dominate patients' lives; modern medical advances aim not only to manage but to prevent exacerbations, maintain disease stability, and enable active, quality lives.
