Impact of Meteorological and Environmental Factors on Respiratory Emergency Department Visits in Northern Germany

Introduction : Climate change and increasing environmental pollution are recognized as major public health challenges. Respiratory diseases are particularly sensitive to fluctuations in temperature, air quality, and meteorological extremes. However, systematic data on the relationship between these factors and acute respiratory presentations to emergency departments in Northern Germany are still limited. Methods : We conducted a retrospective analysis of emergency department admissions in Lübeck and southeastern Schleswig-Holstein between 2014 and 2024. Data included demographic information, ZIP code, admission diagnoses (ICD-10/11), and admission dates. These were linked to meteorological parameters obtained from the German Weather Service, fine particulate matter (PM) data from the regional environmental authority, and infectious disease incidence (influenza, COVID-19) from the Robert Koch Institute. Descriptive statistics, cluster analyses, and generalized additive models were applied to assess short- and medium-term associations between environmental exposures and respiratory diagnoses. Results : Preliminary analyses demonstrated geographical clustering of respiratory diagnoses with higher burdens in urbanized ZIP areas. Increasing air pollution levels were associated with a rise in relative risk (RR) of respiratory emergency visits, with a cumulative RR exceeding 1.3 at high exposure levels. Lag-response models indicated immediate increases in risk within the first two days following peaks in pollution, followed by a delayed secondary effect. Specific meteorological conditions, such as extreme cold or heat, were associated with age-dependent vulnerability, particularly among elderly patients. Discussion : Our findings highlight the relevance of environmental exposures as important determinants of respiratory health in emergency settings. Both acute pollution peaks and meteorological extremes contribute to a measurable increase in emergency department utilization. The delayed lag effects underline the importance of anticipatory public health measures and early-warning systems. Future analyses will explore socioeconomic modifiers and long-term temporal trends. Publication History Article published online: 04 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany