A Scoping Review of Risk Factors for Thunderstorm Asthma in Pediatric Patients.

Thunderstorm weather conditions are known to trigger asthma-like symptoms in susceptible patients, causing spikes in the use of paramedical, primary care, and hospital services. While risk factors for thunderstorm asthma (TSA) in adults have been studied in both original research and systematic reviews, there has been less focus on the risk profile of pediatric patients. With epidemic TSA (ETSA) events predicted to increase in frequency and severity as climate change progresses, it is more crucial than ever to identify those children most at risk so that appropriate public health education, parent and family education, and conservative management can be initiated. This scoping review followed the PRISMA-ScR checklist. We searched Embase, Ovid MEDLINE, and Scopus for primary research that assessed risk factors or strong predictive associations for TSA in patient cohorts that included children. A total of 39 studies met our inclusion criteria; of these, just five focused exclusively on pediatric populations. We found that ETSA events may trigger a first-time asthma presentation in a large proportion of pediatric patients, especially those with atopic conditions such as allergic rhinitis or eczema. In some studies that included both children and adults, younger age groups were among those most affected by TSA; however, analysis was not routinely age-stratified. These findings highlight a critical gap in the literature, limiting the ability to define a pediatric-specific risk profile. Further research is needed to inform targeted prevention strategies, clinical management, and public health preparedness.