Every year in Japan, forecasts of heavy rain bring concerns about flooding and landslides, with such storms leading to hundreds of deaths and destroying thousands of homes in recent years. But what if this weather had severe implications for respiratory health as well?

Scientists are now making that exact link, drawing a strong association between the kind of extreme rainfall that is being made more frequent and intense by climate change and increases in mortality from respiratory diseases. While more work needs to be done to clarify the connection — increases in pollen following storms and drops in atmospheric pressure are among the proposed reasons — this has implications for people with asthma and other similar ailments.

In a paper published in Nature Sustainability in February, researchers examining the link between respiratory mortality and extreme rain in 30 cities across East Asia, including in Japan, found that rain of an intensity that would be expected every five and 10 years was “significantly associated” with an increased risk of death from respiratory diseases compared with days without extreme rainfall. The link was strongest for asthma, followed by chronic obstructive pulmonary disease, a lung disease that restricts airflow. However, there was no significant association for pneumonia.