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Background: Globally, pollen allergy is a major public health problem, but a fundamental unknown is the likely impact of climate change. To our knowledge, this is the first study to quantify the consequences of climate change upon pollen allergy in humans.

Objectives: We produced quantitative estimates of the potential impact of climate change upon pollen allergy in humans, focusing upon common ragweed (Ambrosia artemisiifolia) in Europe.

Methods: A process-based model estimated the change in ragweed's range under climate change. A second model simulated current and future ragweed pollen levels. These findings were translated into health burdens using a dose-response curve generated from a systematic review and from current and future population data. Models considered two different suites of regional climate/pollen models, two greenhouse gas emissions scenarios [Representative Concentration Pathways (RCPs) 4.5 and 8.5], and three different plant invasion scenarios.

Results: Our primary estimates indicated that sensitization to ragweed will more than double in Europe, from 33 to 77 million people, by 2041-2060. According to our projections, sensitization will increase in countries with an existing ragweed problem (e.g., Hungary, the Balkans), but the greatest proportional increases will occur where sensitization is uncommon (e.g., Germany, Poland, France). Higher pollen concentrations and a longer pollen season may also increase the severity of symptoms. Our model projections were driven predominantly by changes in climate (66%) but were also influenced by current trends in the spread of this invasive plant species. Assumptions about the rate at which ragweed spreads throughout Europe had a large influence upon the results.

Conclusions: Our quantitative estimates indicate that ragweed pollen allergy will become a common health problem across Europe, expanding into areas where it is currently uncommon. Control of ragweed spread may be an important adaptation strategy in response to climate change.