[LUM#23] “In Paris, who lives next to the ring road?”

[LUM Magazine] - Published on June 30, 2026 in Science and Society

In 2025, the American Thoracic Society published an article calling for greater equity in respiratory health. What’s at stake? Greater exposure of vulnerable populations to pollution caused or exacerbated by climate change. Among the authors is Isabella Annesi-Maesano, a researcher at the IHU Immun4Cure in Montpellier. Interview.

This article (“Climate Change and Respiratory Health: Opportunities to Contribute to Environmental Justice: Report from an Official Workshop of the American Thoracic Society, 2025”) is the result of work conducted by the American Thoracic Society, of which you are a member. What is it about?
They are pulmonologists, nurses, nutritionists, physical therapists—
, or “caregivers,” as they’re called in English—respiratory health professionals. It’s a large organization, but not as large as the European Respiratory Society, of which I’m also a member.

What are the most common respiratory diseases?
There is asthma, of course—or rather, various forms of asthma, since there are several types that affect 340 million people worldwide. But the most common is COPD, or chronic obstructive pulmonary disease, which is the third leading cause of death worldwide and affects 400 million people. It’s a disease that’s often diagnosed late because it’s characterized by a gradual decline in breathing capacity, which is frequently attributed to aging. Then there’s lung cancer, pulmonary fibrosis, and so on. Respiratory conditions are often incurable, but their progression can be halted or slowed.

What role does the environment play in the development of these diseases?
It’s a direct one. For cancer, the primary cause is, of course, tobacco, but pollution is also a factor. In all cases, these are multifactorial diseases, but epidemiological studies clearly demonstrate the significant role of pollution, and that makes sense: as their names suggest, these are respiratory diseases, so what we inhale plays a crucial role.

I learned from your article that global warming increases exposure to natural pollution. What are these forms of pollution?
These are forms of air pollution caused by natural disasters:
such as the massive wildfires we’ve seen in Canada and Australia (Cold forests are burning! Siberia is burning, Canada is burning! 2021). There are also volcanic eruptions, earthquakes, and sandstorms. This affects Europe less, of course, even though sand sometimes reaches Paris. Furthermore, inhaled biocontaminants—pollen, mold, and infectious agents—are also influenced by climate change.

You claim that one of the primary factors contributing to environmental injustice is linked to urbanization—don’t we all breathe the same air?
Indeed, urbanization, with all that it entails—traffic, air conditioning,
housing, industry—is a major source of pollution (AtUM Science, Living with Industrial Pollution, 2023). By 2050, 70% of the world’s population will live in cities, yet we do not all live in the same cities. Our countries have been deindustrialized, but this is not the case in Eastern Europe, let alone Asia.

You mention that rising temperatures due to global warming will exacerbate these respiratory risks—why is that?
Yes, air temperature increases the risk of inflammation and also raises levels of certain pollutants that cause respiratory problems, such as nitrogen dioxide, fine particulate matter from vehicle traffic, and ozone—a secondary pollutant that increases the risk of cardiopulmonary diseases. Rising temperatures also lead to an increase in certain types of pollen.

Which groups are most at risk?
Obviously, it’s first and foremost those who are most economically vulnerable. In Paris, who lives near the ring road? Disadvantaged social classes and ethnic minorities are more exposed to both outdoor and indoor pollution. Homes with poor insulation increase the risk of exposure to excessive heat during heat waves, as well as—when the weather is humid—to biological contaminants, particularly mold. Mold is bad for the lungs—it’s actually very unhealthy. But it’s not just the air; water and soil pollution also play a role.

In respiratory diseases?
Yes, nutrition, for example, which depends on contamination of water, soil, etc.
is a risk factor. We know that lower socioeconomic groups are forced to buy low-quality products that are often contaminated. Every day, we see that there are horrible things in what we eat.

Is exposure the only factor contributing to inequality?
It is the primary factor, but not the only one; there are also inequalities in access to healthcare. The poorer you are, the less access you have to healthcare and screenings, which means that the disease is diagnosed later, at more advanced stages. There is also inequality in access to rights.

In what way?
Disadvantaged communities often have less political clout and fewer resources to challenge certain projects, such as the construction of a polluting factory, a landfill, etc.

In the article you co-authored, there is a call to rethink environmental and healthcare systems.
Yes, and this can be done on four levels. The individual level: if we are informed, we can avoid exposing ourselves to certain risk factors. The family level, in terms of diet or exposure to certain pollutants such as cigarette smoke. Then there’s the community level. When it comes to climate change, Paris doesn’t follow the same policies as other cities… Finally, the last level is societal. Pollution is the result of collective choices (urban planning, transportation, energy, housing). Obviously, the smaller the scale, the easier it is to take action.

How can the medical community contribute to greater equity in respiratory health?
There is a lack of knowledge about the links between the environment and health, including inequalities in exposure and access to care. Medical societies must get the message across by emphasizing the need for prevention, but let’s be honest: if you organize a session on the latest COPD treatment, the room will be packed—people will even spill out into the hallway. That won’t be the case if you organize a session on climate change. Doctors’ primary concern is, above all, providing care.

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