Table 2.

Brief responses to the question: “Please describe if you have a relevant anecdote about a patient who has experienced one of these impacts.” (In parenthesis is the location of the physician respondent.)

Air pollution–related increases in severity of chronic disease	Change in the classic characteristic of the seasons makes winters warmer with abrupt change of humidity and temperature which apparently increases the rate of COPD and asthma exacerbations. (Argentina)
	Frequency and severity of bronchial asthma, COPD, and related cardiovascular diseases are increasing and causing increased hospital bed occupancy as well as health-related budget. (Bangladesh)
	Mostly I see severe asthma and COPD exacerbations during periods with very moist and hot weather and during periods of sandstorms. These I see frequently, as I work in Cyprus (Mediterranean Sea). Many patients without pre-existent lung disease see me with breathlessness, cough, and wheeze during sandstorms and periods of hot, moist weather. These are increasing in frequency over the past 10 yr. (Georgia)
	On one of the dusty days due to desert dust storm in Gaziantep, Southeast Turkey, I saw a patient with COPD exacerbation at outpatients’ clinics, and asked what the reason he thought about his symptoms. He said that his symptoms started with dust storm, and he stated that there were more dust storms comparing the old days, when he was young. I asked what he thought about the cause of more dust storms. He said that he believed this was due to global climate change and temperature increase. I hear these kinds of anecdotes more from my patients comparing to old days when I started as a young physician. (Turkey, Mid-East)
Allergic symptom increases	Seasonal allergy to grass pollens and to house dust mites is clearly occurring over a much longer period of time for my patients due to increased humidity arising out of climate change. (Australia)
	Patient with new-onset asthma due to mold in her workplace. The concrete building she works in sits on a mountain top where extreme rain events and other storms seem to be increasing. The building is now leaking. Maybe not only related to climate change, but our built environment faces new stressors due to climate change. (Canada)
Heat-related effects	In our part of Canada (northern), we did not have long summers and therefore most houses (even cars) did not need air conditioning. In the last 2-3 years, however, peak summer temperatures have gone up noticeably and stayed up for longer periods of time. As a result, those people who have not installed air conditioning in their houses find it difficult to fall asleep and stay asleep at night in the summer months. In our practice, we have seen an increase in the frequency and intensity of complaints relating to the lack of sleep and poor sleep quality, not just in the summer months, but lingering through subsequent seasons. (Canada)
	We had about 100 people die from heat stroke this year because of high temperature. I think the land temperature is increasing and it will continue to increase in the coming years and this will have great impact on humans and also patients’ lifestyle as well. (Egypt)
	In the very hot summer of 2015 we treated 3 patients with heat stroke, a disease formerly virtually unknown in our region. (Switzerland)
Vector-borne Infections	We suffered a Chikungunya epidemic in our area. (Ecuador)
	I am from Delhi, India. I am 40 years old. My birthday is in month of October and an important festival 'Diwali' is in November. I remember I used to wear sweaters on my birthday and on Diwali when I was young. Now we wear half sleeve shirts till start of December. In my childhood, there were mosquitoes till about September-early October only. Now we have mosquitoes till December. In recent past my wife, son and daughter have caught Dengue, thankfully a non-shock, non-hemorrhagic severity. (India)
Injuries due to severe weather, storms, floods, droughts, fires	More flooding, more malnutrition and ill-health. (Nigeria)
	Generally: Cities have plans for extreme heat events; more attention than ever is being paid to air quality (thank goodness!); allergies are increasing; smoke from forest fires is affecting the population more than ever. (Canada)

Definition of abbreviation: COPD = chronic obstructive pulmonary disease.