Chronic airway diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are highly sensitive to environmental factors, with growing evidence showing that extreme weather events and air pollution can exacerbate symptoms and worsen quality-of-life for patients living with these conditions.

In this interview, we spoke with Dr Tugce Karamustafalioglu (Mersin University, Mersin, Turkey) about her award-winning abstract exploring how extreme weather events and air pollution affect asthma and COPD. Dr Karamustafalioglu also emphasizes the importance of extra precautions for patients with chronic airway diseases during hot or polluted days, and highlights what receiving the ELF Best Abstract grant means for her research and its wider impact on the field.

The abstract ‘The Impact of Extreme Heat Waves and Air Pollution on the Prognosis of Chronic Airway Diseases‘ won the ELF Best Abstract Grant for Healthy Lungs for Life at ERS 2025, 27 September–1 October, Amsterdam, The Netherlands.

touchRESPIRATORY coverage from ERS 2025:  

Could you describe the rationale, objectives and design of your study?

Our study was conducted in Mersin, the city where I live, located on the southern coast of Türkiye. Summers there are extremely hot and humid, which makes it an important setting to explore how heat affects patients with asthma and COPD, who represent the largest group in our clinic.

In the existing literature, the effects of temperature on these patients have mostly been evaluated retrospectively, focusing on systemic outcomes, such as mortality or hospital admissions. However, no prospective study has comprehensively assessed patients in this context from clinical, functional, and inflammatory perspectives. We aimed to evaluate the impact of these conditions from multiple perspectives in a comparative way.

Patients were assessed twice: once during periods of normal seasonal temperatures and again during documented extreme heatwaves. At each visit, we measured airway inflammation with fractional exhaled nitric oxide (FeNO), lung function with spirometry, and we also evaluated quality-of-life and clinical scores. Throughout the study, patients were monitored for exacerbations. In addition, on every study day, we recorded environmental data including temperature, humidity, wind, and air quality parameters.

How do extreme heat waves and air pollution affect people with chronic airway diseases like asthma and COPD?

This was actually the key question that led us to initiate our study. We found that extreme heat waves, together with the accompanying rise in ozone levels, significantly worsened patient outcomes in both asthma and COPD groups. These periods were associated with increased symptoms, reduced quality-of-life, poorer clinical scores, heightened airway inflammation, and more frequent exacerbations.

What were the main changes in symptoms or quality-of-life observed during these extreme weather events?

During extreme heatwaves, our asthma patients often experienced more allergic symptoms, such as watery eyes, a runny nose, and wheezing. They felt more limited in their daily activities and needed their short-acting inhalers more often. Their quality-of-life, especially in relation to environmental exposure, clearly declined.

For COPD patients, we saw more shortness of breath, cough, and sputum. Many of them preferred to stay indoors, feeling that the heat and poor air-quality made it harder to go outside.

Were there differences in how asthma versus COPD patients responded to heat and pollution?

We did not specifically aim to compare asthma and COPD patients with each other. However, when we looked at the comparison, both groups appeared to be affected at similar rates.

What practical advice or protective measures would you recommend for patients with chronic lung conditions on hot or polluted days?

There are only a few precautionary measures that patients can take. On days with extreme heat waves, patients should try to stay indoors as much as possible. If available, using air conditioning or air purifiers can also be helpful. In addition, telemedicine systems could be further developed to reduce the need for hospital visits during these periods. However, we believe that broader public health and healthcare policies should also adapt to these changing environmental conditions, as climate-related health risks will likely become more frequent and severe in the future.

Congratulations on winning the ELF Best Abstract Grant for Healthy Lungs for Life, what does this recognition mean for your research and its impact?

Receiving this award is truly meaningful. It is actually the very first award I have received in my career, and being recognized at such an early stage for a study I truly enjoyed working on has motivated me for my future research as well. I would like to sincerely thank ERS and ELF once again for this recognition. Thanks to this foundation, I was also able to attend my first international congress, where I had the chance to meet colleagues from many different countries and to see the diversity of research being carried out.