Climate change is affecting the health of Americans 1 . As the climate continues to change, the risks to human health will grow, exacerbating existing health threats and creating new public health challenges. This assessment significantly advances what we know about the impacts of climate change on public health, and the confidence with which we know it. While all Americans will be affected by climate change, the report recognizes populations of concern, such as children, the elderly, outdoor workers, and those living in disadvantaged communities, who are disproportionately vulnerable.
Whether airway hyperresponsiveness is a symptom of airway inflammation or airway remodeling, or whether it is the cause of long-term loss of lung function, remains controversial. Some investigators have hypothesized that aggressive treatment with anti-inflammatory therapies improves the long-term course of asthma beyond their salutary effects on parameters of asthma control and rates of exacerbation over time. 13 This contention has been supported by an observational study 14 that found long-term exposure to ICS was associated with an attenuation of the accelerated decline in lung function previously reported in asthmatics; more studies are required to substantiate these findings.