Abstract
Abstract. We report on the first recorded case of thunderstorm asthma in Israel, which occurred during an exceptionally strong eastern Mediterranean multicell thunderstorm on 25 October 2015. The storms were accompanied by intensive lightning activity, severe hail, downbursts and strong winds followed by intense rain. It was the strongest lightning-producing storm ever recorded by the Israeli Lightning Detection Network (ILDN) since it began operations in 1997. After the passage of the gust front and the ensuing increase in particle concentrations, documented by air-quality sensors, the hospital emergency room (ER) presentation records from three hospitals – two in the direct route of the storm (Meir Medical Center in Kfar Saba and Ha'Emek in Afula) and the other just west of its ground track (Rambam Medical Center in Haifa) – showed that the amount of presentation of patients with respiratory problems in the hours immediately following the storm increased compared with the average numbers in the days before. This pattern is in line with that reported by Thien et al. (2018) for the massive thunderstorm asthma epidemic in Melbourne, Australia. The increase in patient presentations to the emergency rooms persisted for an additional 48–72 h before going back to normal values, indicating that it was likely related to the multi-cell outflow. We discuss how the likelihood of incidence of such public health events associated with thunderstorms will be affected by global trends in lightning occurrence.
Highlights
Thunderstorms and lightning are natural hazards, lethal and destructive with important implications for human societies
In most reported cases of thunderstorm asthma in Europe, Canada, USA and Australia, the initiating agents were spring or summer convective storms, and their occurrence coincided with the flowering season of many plant species whose pollen is known to be highly allergenic
Vective events in Israel occur during fall and spring months, when the Red Sea Trough (RST) pressure system transports mid-level moisture into the eastern Mediterranean and the atmosphere is unstable, enabling deep convection and intense lightning activity
Summary
Thunderstorms and lightning are natural hazards, lethal and destructive with important implications for human societies. D’Amato et al (2015) characterized the main aspects of thunderstormassociated asthma epidemics (based on their Table 2) as follows: (a) the epidemics are limited to seasons when there are high concentrations of airborne allergenic and/or fungal spores; (b) there is a close temporal association between the start of the thunderstorm and the onset of the epidemics; (c) there are not high levels of pollution-related gases and particles during the thunderstorm asthma outbreak; (d) people who stay indoors with their windows closed are not affected; and (e) there is a major risk for subjects who are. A thorough review published by the World Allergy Organization (D’Amato et al, 2015) surveyed the expected changes in the occurrence of thunderstorm asthma and concluded that people with hypersensitivity to pollen allergy should be advised to stay indoors when there are clear indications that thunderstorm activity is expected Such early warning capabilities for lightning are becoming operational in some countries. We present the meteorological and electrical circumstances leading to a notable increase in ER presentations of patients with respiratory problems immediately after the passage of the storm
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