Skip to main content

Thunderstorm asthma


Thunderstorms have often been linked to epidemics of asthma, especially during the grass flowering season; however, the precise mechanisms explaining this phenomenon are unknown. Evidence of high respirable allergen loadings in the air associated with specific meteorologic events combined with an analysis of pollen physiology suggests that rupture of airborne pollen can occur. Strong downdrafts and dry, cold outflows distinguish thunderstorm rain from frontal rain. The weather system of a mature thunderstorm likely entrains grass pollen into the cloud base, where pollen rupture would be enhanced, then transports the respirablesized fragments of pollen debris to ground level where outflows distribute them ahead of the rain. The conditions occurring at the onset of a thunderstorm might expose susceptible people to a rapid increase in concentrations of pollen allergens in the air that can readily deposit in the lower airways and initiate asthmatic reactions.

This is a preview of subscription content, access via your institution.

References and Recommended Reading

  1. 1.

    Packe GE, Ayres JG: Asthma outbreaks during a thunderstorm. Lancet 1985, 27:199–204.

    Article  Google Scholar 

  2. 2.

    Celenza A, Fothergill J, Kupek E, Shaw RJ: Thunderstorm associated asthma: a detailed analysis of environmental factors. BMJ 1996, 312:604–607.

    PubMed  CAS  Google Scholar 

  3. 3.

    Davidson AC, Emberlin J, Cook AD, Venables KM: A major outbreak of asthma associated with a thunderstorm: experience of accident and emergency departments and patients’ characteristics. Thames Regions Accident and Emergency Trainees Association. BMJ 1996, 312:601–604.

    PubMed  CAS  Google Scholar 

  4. 4.

    Girgis ST, Marks GB, Downs SH, et al.: Thunderstorm associated asthma in an inland town in southeastern Australia. Who is at risk? Eur Respir J 2000, 16:3–8.

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Hajat S, Goubet SA, Haines A: Thunderstorm-associated asthma: the effect on GP consultations. Br J Gen Pract 1997, 47:639–641.

    PubMed  CAS  Google Scholar 

  6. 6.

    Knox RB: Grass pollen, thunderstorms and asthma. Clin Exp Allergy 1993, 23:354–359.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Lewis SA, Corden JM, Forster GE, Newlands M: Combined effects of aerobiological pollutants, chemical pollutants and meteorological conditions on asthma admissions and A & E attendances in Derbyshire UK, 1993–1996. Clin Exp Allergy 2000, 30:1724–1732.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Newson R, Strachan DP, Archibald E, et al.: Effect of thunderstorms and airborne grass pollen on the incidence of acute asthma in England, 1990–1994. Thorax 1997, 52:680–685.

    PubMed  CAS  Article  Google Scholar 

  9. 9.

    Newson R, Strachan DP, Archibald E, et al.: Acute asthma epidemics, weather and pollen. Eur Resp J 1998, 11:694–701.

    CAS  Google Scholar 

  10. 10.

    Venables KM, Allitt U, Collier CG, et al.: Thunderstorm-related asthma: the epidemic of 24/25 June 1994. Clin Exp Allergy 1997, 27:725–736.

    PubMed  CAS  Google Scholar 

  11. 11.

    Wark PAB, Simpson J, Hensley MJ, Gibson PG: Airway inflammation in thunderstorm asthma. Clin Exp Allergy 2002, 323:1750–1756.

    Article  Google Scholar 

  12. 12.

    Wardman AE, Stefani D, MacDonald JC: Thunderstormassociated asthma or shortness of breath epidemic: a Canadian case report. Can Respir J 2002, 9:267–270.

    PubMed  Google Scholar 

  13. 13.

    Rosas I, McCartney HA, Payne RW, et al.: Analysis of the relationship between environmental factors (aeroallergens, air pollution and weather) and asthma emergency admissions to a hospital in Mexico City. Allergy 1998, 53:394–401.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Fanta CH: Fatal asthma and the environment. Immunol Allergy Clin North Am 2002, 22:911–924.

    Article  Google Scholar 

  15. 15.

    Frei T: Pollenasthma in der Schweiz von 1993 bis 1997. Allergologie 1999, 22:382–387.

    Google Scholar 

  16. 16.

    Bellomo R, Gigliotti P, Treloar A, et al.: Two consecutive thunderstorm-associated epidemics of asthma in the city of Melbourne: the possible role of rye grass pollen. Med J Aust 1992, 156:834–837.

    PubMed  CAS  Google Scholar 

  17. 17.

    Packe GE, Ayres JG: Aeroallergen skin sensitivity in patients with severe asthma during a thunderstorm. Lancet 1986, 12:850–851.

    Article  Google Scholar 

  18. 18.

    Chan TL, Lippmann M: Experimental measurements and empirical modelling of the regional deposition of inhaled particles in humans. Am Ind Hyg Assoc J 1980, 41:399–405.

    PubMed  CAS  Google Scholar 

  19. 19.

    Suphioglu C, Singh MB, Taylor PE, et al.: Mechanism of grass-pollen-induced asthma. Lancet 1992, 399:569–572.

    Article  Google Scholar 

  20. 20.

    Dales RE, Cakmak S, Judek S, et al.: The role of fungal spores in thunderstorm asthma. Chest 2003, 123:745–750.

    PubMed  Article  Google Scholar 

  21. 21.

    Editorial: Asthma and the weather. Lancet 1985, 8437:1079-1080.

  22. 22.

    Taylor PE, Flagan R, Valenta R, Glovsky MM: Release of allergens in respirable aerosols: a link between grass pollen and asthma. J Allergy Clin Immunol 2002, 109:51–56. Observed grass flowers to be a site of pollen rupture, and used controlled emission experiments to generate and characterize aerosols of allergenic pollen debris from flowers.

    PubMed  Article  Google Scholar 

  23. 23.

    Glovsky MM, Taylor PE, Esch R, et al.: Respirable allergenic aerosols produced from pollen and molds. In Asthma: From Genes to Clinical Management. Edited by Sepiashvili R. Bologna, Italy: Monduzzi Editore; 2003:155–160.

    Google Scholar 

  24. 24.

    Gorny RL, Reponen T, Willieke K, et al.: Fungal fragments as indoor air biocontaminants. App Environ Micro 2002, 68:3522–3531. Detected respirable-sized fragments emitted from a fungal colony housed within a controlled-emission chamber.

    Article  CAS  Google Scholar 

  25. 25.

    Higham JH: Asthma trends: thunderstorm peak in Luton. BMJ 1994, 309:604.

    PubMed  CAS  Google Scholar 

  26. 26.

    Marks GB, Colquhoun JR, Girgis ST, et al.: Thunderstorm outflows preceding epidemics of asthma during spring and summer. Thorax 2001, 56:468–471. Correlated the incidence of thunderstorm outflows with an increase in grass pollen abundance and epidemics of asthma affecting grass pollen sensitive patients.

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Blackley CH: Experimental Researches on the Causes and Nature of Catarrhus Aestivus (Hay Fever or Asthma). London: Balliere, Tindall and Cox; 1873.

    Google Scholar 

  28. 28.

    Pehkonen E, Rantio-Lehtimaki A: Variations in airborne pollen antigenic particles caused by meteorologic factors. Allergy 1994, 49:472–477.

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Schäppi G, Taylor PE, Pain MCF, et al.: Concentrations of major grass group 5 allergens in pollen grains and atmospheric respirable particles: implications for hayfever and allergic asthma sufferers sensitised to grass pollen allergens. Clin Exp Allergy 1999, 29:633–641. Collected respirable-sized particles on outdoor air filters and performed immuno-analysis in an attempt to quantify the presence of grass group 1 allergens.

    PubMed  Article  Google Scholar 

  30. 30.

    Spieksma FTM, Kramps JA, Van der Linden AC: Evidence of grass pollen allergenic activity in the smaller micronic atmospheric aerosol fraction. Clin Exp Allergy 1990, 20:273–280.

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Spieksma FTM, Nikkels BH, Dijkman JH: Seasonal appearance of grass pollen allergen in natural pauci-micronic aerosol of various size fractions: relationship with airborne grass pollen concentration. Clin Exp Allergy 1995, 25:234–239.

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Staff IA, Schaeppi G, Taylor PE: Localisation of allergens in rye-grass pollen and in airborne micronic particles. Protoplasma 1999, 208:47–57.

    Article  CAS  Google Scholar 

  33. 33.

    McDonald JE: Collection and washout of airborne pollens and spores by raindrops. Science 1962, 135:435–436.

    Article  PubMed  Google Scholar 

  34. 34.

    Byers HR, Braham RR: The Thunderstorm: Report of The Thunderstorm Project. Washington, DC: US Dept of Commerce; 1949.

    Google Scholar 

  35. 35.

    Krehbiel PR: The electrical structure of thunderstorms. In The Earth’s Electrical Environment. Washington, DC: National Academy Press: 1986:90–113.

    Google Scholar 

  36. 36.

    Higham J, Venables K, Kupek E, et al.: Asthma and thunderstorms: description of an epidemic in general practice in Britain using data from a doctors’ deputising service in the UK. J Epidemiol Comm Health 1997, 51:233–238.

    CAS  Article  Google Scholar 

  37. 37.

    Bibi H, Nutman A, Shoseyov D, et al.: Prediction of emergency department visits for respiratory symptoms using an artificial neural network. Chest 2002, 122:1627–1632.

    PubMed  Article  Google Scholar 

  38. 38.

    Hashimoto M, Fukuda T, Shimizu T, et al.: Influence of climatic factors on emergency visits for childhood asthma attack. Pediatr Int 2004, 46:48–52.

    PubMed  Article  Google Scholar 

Download references

Author information



Rights and permissions

Reprints and Permissions

About this article

Cite this article

Taylor, P.E., Jonsson, H. Thunderstorm asthma. Curr Allergy Asthma Rep 4, 409–413 (2004).

Download citation


  • Asthma
  • Grass Pollen
  • Airborne Pollen
  • Pollen Allergen
  • Cloud Base