What Can Noses Tell Us About Climate Change?

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“Noses are the first line of defense against pathogens, against pollution,” says Stella Lee, MD, a fellowship-trained rhinologist and director of the Brigham Sinus Center. “They’re like a HEPA filter for our lungs.”

So, when she started to see unexpectedly high rates of chronic rhinosinusitis (CRS) and allergic rhinitis in her patients at her Pittsburgh clinic, she began to ask why.

While asking her patients about exposures, she became aware of a possible link between higher exposure to PM2.5, black carbon, and related pollutants and higher rates of CRS and non-allergic rhinitis, which led her to research the impact of air quality on upper respiratory conditions. After joining the faculty at Brigham and Women’s Hospital, she began exploring the question in larger datasets and recently completed a study on the association between air quality and head and neck cancers. Her research aligns with work done by her colleagues, including Center for Surgery and Public Health (CSPH) faculty Regan Bergmark, MD, MPH, on the impact of climate change on otolaryngologic surgery.

Lee’s research reflects her guiding principle that doctors have a unique opportunity and responsibility to address the determinants of the health of their patients. “We see the patients, we understand the disease in a more relevant and profound way because we interface with the actual quality of life impact and disease impact face-to-face,” she says. Lee is inspired by her patients to look upstream and find ways to improve the environment they live and work in. As pollution and climate change continue to impact the health of patients, our understanding of these pathways and our willingness to act will be critical.

Lee’s arrival at the Brigham and CSPH has allowed her to build multidisciplinary collaborations with biostatisticians, experts at the Harvard T.H. Chan School of Public Health, the Massachusetts Institute of Technology (MIT), and other institutions. She is currently studying the impact of wildfires on respiratory health, the disparities of environmental exposures, and the role of volatile organic compounds, such as those emitted by gas stoves, in upper airway health.

“It behooves us, I think, to really ask those important research questions and work together as teams because where we are deficient, where we really need the help, is in how to build better ways of measuring the quality of and improving the air we breathe,” she says.

By listening to patients, observing the data, and imagining innovative solutions, Lee and her team are carving a path to cleaner air and healthier noses and sinuses.