South Africa: How Climate Change is Quietly Reshaping Lung Health in South Africa

Johannesburg — On any given day, breathing is automatic, an invisible rhythm sustaining life. But for millions of South Africans, every breath carries risk.

Scientists and journalists gathered for a webinar to examine a growing but underreported crisis: the link between climate change and lung health. Hosted under the climate health story project by Bhekisisa and supported by the Wellcome Trust, the session was titled Hotter Days, Sicker Lungs: Can We Fix It?

The conversation, led by allergy specialist Professor Johnny Peter from the University of Cape Town and atmospheric scientist Professor Rebecca Garland from the University of Pretoria, revealed a complex and unsettling truth - climate change is not a distant environmental issue.

It is already inside our lungs.

A hidden burden

South Africa faces a heavy respiratory disease burden. While infectious diseases such as tuberculosis (TB) and HIV-related lung infections remain dominant, chronic respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) are rising steadily.

Asthma alone affects roughly one in ten South Africans, with particularly high rates among children and adolescents. Despite this, the country ranks among the highest globally for asthma-related deaths.

“Asthma is an incredibly treatable disease,” Peter said. “But the outcomes we see are shaped not just by treatment, but by environment, access to care, and social conditions.”

Climate change does not act alone

One of the key messages from the webinar was that climate change does not directly cause lung disease. Instead, it intensifies existing risks.

“It’s not a single pathway,” said Garland. “Climate change influences the systems around us, air quality, weather patterns, pollen, and those, in turn, affect our health.”

These impacts are often grouped into three categories:

Direct effects: Heatwaves and extreme weather can worsen respiratory symptoms and increase hospital visits.

Indirect effects: Shifts in pollen seasons, air pollution, and infectious disease patterns.

Vulnerability factors: Children, the elderly, and people living in informal settlements face disproportionate risks.

In South Africa, where inequality shapes exposure, these risks are unevenly distributed.

When weather becomes a trigger

Asthma is particularly sensitive to environmental changes. The disease is driven by inflammation and narrowing of the airways, often triggered by what people breathe in.

And what we breathe is changing.

Extreme temperatures, both heat and cold, are linked to increased asthma attacks, hospital admissions, and even deaths. Humidity levels, wind, and rainfall patterns also play a role.

One of the most dramatic examples is “thunderstorm asthma”, first documented in Australia in 2016, where over 3,000 people sought emergency care within 30 hours.

The cause? A perfect storm of grass pollen, humidity, and atmospheric conditions that caused pollen grains to rupture into tiny, highly allergenic particles.

South Africa, with its frequent thunderstorms, may face similar risks, but lacks the data to confirm it.

“That’s one of the gaps,” Peter noted. “We need local data to understand our own risk patterns.”

The pollution we cannot see

While weather events are visible, air pollution often is not.

“We tend to notice pollution when we can smell it,” said Garland. “But most harmful pollutants are invisible.”

Fine particulate matter, especially PM2.5, produced by traffic, burning fuels, and industrial activity, is one of the most dangerous. These tiny particles penetrate deep into the lungs, triggering inflammation and worsening asthma.

Ozone, another pollutant linked to climate change, is also rising and associated with increased respiratory problems.

Even small increases in exposure can raise health risks, but when combined with other factors like heat and pollen, the effects can multiply.

A country in bloom and in risk

South Africa’s rich biodiversity adds another layer of complexity.

The country’s diverse ecosystems produce a wide range of pollen, some of which is highly allergenic. Climate change is expected to increase pollen production and extend pollen seasons.

More concerning, studies show that rising carbon dioxide levels can make pollen more potent, increasing the amount of allergenic proteins in each grain.

“We’re not just seeing more pollen,” Professor Peter said. “We’re seeing stronger pollen.”

At the same time, changing climate conditions may shift where certain plants grow, exposing populations to new allergens.

Not all doom and gloom

Despite the risks, the scientists were clear, this is not a story of inevitability.

Asthma, unlike many other chronic diseases, is highly manageable. Effective treatments exist and are available in South Africa’s public health system.

Innovations such as combination inhalers allow patients to adjust their treatment based on symptoms, reducing hospital visits and severe attacks.

At a broader level, better environmental monitoring, tracking pollution, pollen, and weather patterns, can help create early warning systems, enabling people to take preventive action.

“There is real opportunity here,” said Professor Peter. “If we connect environmental data with health systems, we can reduce the burden significantly.”

A story journalists must tell

For journalists, the challenge and opportunity is clear.

Climate change stories often focus on melting ice caps or extreme weather. But the impact on human health, particularly lung health, remains underreported.

“This is not just an environmental story,” said the webinar moderator, Ida Jooste. “It’s a public health story. It’s a human story.”

And crucially, it is a story where action is possible.

From improving air quality to strengthening health systems and raising public awareness, the solutions exist. But they require attention.

Because the most urgent changes are not always the most visible.

Sometimes, they are carried quietly in the air we breathe.

This article originally appeared on AllAfrica