Climate change and climatic variation Impact on chronic oedemas: A systematic review

Susan Witt, Bec Watt, Sue Gordon, Neil Piller

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Chronic oedema is a significant problem worldwide and results in substantial burden to the health services, as well as major impact on individuals’ quality of life. It is primarily managed through ongoing use of compression garments, bandaging and manual lymphatic drainage. Higher temperatures and increased humidity result in additional discomfort through physiological changes related to oedema and increased difficulty with compression garment use. This may result in reduced compliance with core treatment recommendations, increased swelling and poorly managed symptoms. Rising temperature due to climate change is well documented with scientists predicting a 1.5–2.5% increase in average temperature across the globe by 2050. It is anticipated this will present significant challenges for the ongoing management of chronic oedema and an increased risk of infection. Aims of study: The objective of this study was to systematically review the literature for evidence of the impact of climatic conditions on chronic oedema. Methods: The PRISMA protocol was followed; a search of MEDLINE (via Ovid), Scopus, CINAHL, Informit Health Database Collection, Cochrane reviews, Web of Science, Emcare (via Ovid), Green File and Google Scholar was conducted using the search terms climat* OR weather OR tropic* AND chronic oedema OR lymphoedema OR edema. Studies were included that examined the general population (adult and/or children) who have chronic limb oedema as a result of primary or secondary lymphoedema, lipoedema, elephantiasis, vascular insufficiency or trauma or any other condition resulting in chronic oedema. Literature that were not a primary study and studies published before 2000 were excluded. Results: A total of 3,536 studies were identified and screened. Five articles met the inclusion criteria. Articles fell into three broad categories of compression garment difficulties, physiological changes and seasonal filarial attacks. Despite the broad search terms relating to chronic oedema, all included articles related to lymphoedema. Populations included breast cancer-related lymphoedema (n= 3), lymphatic filariasis lymhoedema (n=1) and lower-limb lymphoedema (n=1). Research was conducted in temperate climate (Sydney, Australia and Japan), tropical climate (Townsville, Australia, and Ghana) and continental climate (Alberta, Canada). Conclusions: Studies showed a clear connection with warmer temperatures and symptoms of lymphoedema, however, there were very few studies in this area and none relating to other types of chronic oedema. While qualitative indications showed a clear correlation with warmer weather, their physiological measures did not clearly reflect the same. There is a distinct lack of both quantitative and qualitative evidence. Further research in this area is strongly recommended.

Original languageEnglish
Pages (from-to)24-32
Number of pages9
JournalJournal of Lymphoedema
Issue number1
Publication statusPublished - 8 Sept 2021


  • Chronic oedema
  • Climate change
  • Climatic variation impact
  • International perspectives
  • Literature review
  • Lymphoedema
  • Symptom variation and linkage
  • Systematic review


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