Action: The Time to Act is Now

Kari C. Nadeau, MD, PhD

Director of the Sean N. Parker Center for Allergy & Asthma

Research at Stanford University

In my 30 years as a physician and scientist working with allergies and asthma, I have seen the rates and severity of allergies and asthma increase at an astounding rate. Between 1997 and 2011, there was a 50% increase in food allergy and a 69% increase in skin allergy.1 In children in the US, food allergy is now estimated at 8%2, atopic dermatitis at 10.7%3, and asthma at 8.3%.4 By 2025, it is expected that the prevalence of asthma will increase by 25%5 – an alarming rate of increase! Infants and children are the most vulnerable as they are rapidly developing and maturing. In addition to increases in allergy, they are also at a greater risk of cardiovascular, metabolic, respiratory, and neurodegenerative diseases.

During the last few decades, scientists have tried to understand the causes behind these increasing rates of allergy and asthma. It is now abundantly clear that environmental alterations and increases in air and water pollutants caused by human activity are the primary drivers behind these increases. Air pollution from industry-derived emissions and motor vehicles are creating gross changes in the environments where we live. Increased concentrations of greenhouse gases in the atmosphere have already warmed the planet substantially, causing more severe and prolonged heat waves, variability in temperature, increased air pollution, forest fires, droughts, and floods – all of which put the health of the public at risk6. Pollutants found in our water supply also pose a huge concern. In a recent joint study (New Hampshire Birth Cohort Study) by my group and the Children’s Environmental Health and Disease Prevention Research Center at Dartmouth, we found that exposure to relatively low levels of arsenic and cadmium (environmental pollutants in drinking water) may contribute to lowered immune function observed later in infancy/childhood.

Wildfire smoke contains carbon dioxide, water vapor, carbon monoxide, particulate matter, complex hydrocarbons, nitrogen oxides, trace minerals, and several other toxic and carcinogenic compounds. California has seen increasing wildfires. 2017 was the worst fire year on record for California with extreme wildfires in Southern (Ventura and Santa Barbara counties) and Northern California (Santa Rosa), both located at wildland-urban interfaces. There is no safe distance from a wildfire. Smoke from the CA wildfire in Southern California was detected as far at 1000 miles away. In a study investigating health effects of a 2008 California wildfire, risk of asthma exacerbation as determined by increased emergency department visits was found to be associated with wildfire PM2.57 (particulate matter with a diameter of 2.5 μm and smaller).

California cities regularly dominate the American Lung Association’s annual State of the Air report list of metro areas with the worst air quality. to patients, families, and neighbors are suffering. Traffic-related air-pollution is high near roadways and include polycyclic aromatic hydrocarbons, particulate matter, nitrogen-dioxide and ozone. Children who live near highways are susceptible to asthma. This year, the Bay Area ranked sixth most polluted in the country for short-term particle pollution (soot – 24 hour PM2.5), tenth for year-round particle pollution (annual PM2.5) and 13th most polluted for ground-level ozone (smog)8.

There is nothing more dear to me than the health and well-being of our children. As the Director of the Sean N. Parker Center for Allergy and Asthma at Stanford University, I am committed to working towards a healthier environment and protecting the health of 8our children and I ask that each of you do so too. The task ahead is enormous and the stakes are high. It is going to take a huge and dedicated effort from each and every one of us to create the healthy future we envision for our children. California needs to lead the way. There are thousands of ways, big and small, that you can help in our fight for a healthier environment. I ask that all of you who attend the Global Action Summit to educate yourselves on ways that you can make take steps towards sustainable living. This is a call to action. The time to act is now.


Please join us on September 13 when the Sean N. Parker Center for Allergy & Asthma Research at Stanford University and the Center for Innovation in Global Health in the Stanford School of Medicine will join C-CHANGE at the Harvard T.H. Chan School of Public Health to host an event to discuss the many ways children’s health is already impacted by climate change, what we can do about it and where additional research and resources are needed. 



  1. CDC. Trends in Allergic Conditions Among Children: United States, 1997–2011. 2013. Available at: Accessed: Aug 16 2018.
  2. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 2011;128:e9-17.
  3. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017;137:26-30.
  4. CDC. Most Recent Asthma Data. 2018. Available at: Accessed: Aug 16 2018.
  5. Global Alliance against Chronic Respiratory Diseases (GARD). Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. 2007.
  6. Intergovernmental panel on climate change. Climate Change 2013: The Physical Science Basis2013. Available from:
  7. Reid CE, Jerrett M, Tager IB, Petersen ML, Mann JK, Balmes JR. Differential respiratory health effects from the 2008 northern California wildfires: A spatiotemporal approach. Environ Res 2016;150:227-35.
  8. American Lung Association. State of the Air 2018. Available at: Accessed: Aug 16 2018.