CO2 overload in blood suggests toxic atmosphere within 50 years

Abstract
Anthropogenic activities are increasing the amount of carbon dioxide (CO
2
) in the atmosphere. There is mounting experimental evidence that lifetime exposure to these increasing atmospheric CO
2
levels can negatively impact the normal physiology of organisms. However, directly assessing this in humans is very difficult. We analysed serum bicarbonate (HCO
3
−
), calcium (Ca) and phosphorus (P) levels from the U.S. National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020 as indirect proxies for atmospheric CO
2
exposure. Over this period, average bicarbonate levels in this population show an increasing trend which parallels rising atmospheric CO
2
concentrations. Both Ca and P have decreased steadily over the same period. If these trends continue, blood bicarbonate values could be at the limit of the accepted healthy range in half a century, and Ca and P will be at the limit of their healthy ranges by the end of this century. Studies indicate that, after this time, elevated atmospheric carbon dioxide, leading to CO
2
accumulation in the body, has the potential to cause a range of adverse health effects. These findings highlight the urgent need for significant reductions in anthropogenic CO
2
emissions to safeguard public health.
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Bone Calcium Homeostasis
Calcium and phosphate metabolic disorders
Calcium
Carbon cycle
Environmental Health
Phosphorus metabolism disorders
Introduction
In aerobic organisms, including humans, CO
2
is produced as a by-product of cellular respiration and needs to be removed from the body as a waste product via expiration (Raven et al.,
2007
). CO
2
crosses the cell plasma membrane, enters the blood and almost all of it (90–95%) diffuses into the red blood cells, where it is rapidly hydrated to hydrogen (H
+
) and bicarbonate (HCO
3
−
) by the enzyme carbonic anhydrase (CA) (Arlot-Bonnemains et al.,
1985
; Lan et al.,
2025
). HCO
3
−
in blood is the most important means of transport for CO
2
throughout the body (Sherwood,
2013
) and when that blood reaches the lungs, the reaction is reversed. HCO
3
−
in the lungs combines with H
+
produced by the oxygenation of deoxyhemoglobin to produce water and CO
2
, which is exhaled as a waste product (Lan et al.,
2025
). Carbonic anhydrase thus allows a large pool of otherwise slowly reacting plasma HCO
3
−
to be utilized in CO
2
excretion (Arlot-Bonnemains et al.,
1985
). A quantitative relationship exists between plasma HCO
3
−
and levels of CO
2
, in the blood whereby when CO
2
increases, so does HCO
3
−
and vice versa. This is evident in multiple clinical situations (Martinu et al.,
2003
; Ueda et al.,
2009
). Importantly, abnormal CO
2
retention, or impaired CO
2
elimination, which is seen in diseases (Mendez et al.,
2019
; Palmer & Clegg,
2023
), impaired ventilation, or excessive CO
2
inhalation (Robertson,
2006
), can result in reduced blood pH. The body then attempts to buffer this ‘acidosis’ by various mechanisms, including increased ventilation (if possible), increased renal excretion of acid and conservation of filtered HCO
3
−
(Sherwood,
2013
), retention of calcium, phosphates and other substances (Gray et al.,
1973
) and nervous system stimulation to counteract the direct effects of pH changes on heart contractility and vasodilation (Burton,
1978
; Eckenhoff & Longnecker,
1995
). Calcium and phosphate (PO₄³⁻) play important supporting roles in maintaining blood acid-base balance, working alongside the HCO
3
−
buffer system. Phosphate can accept or donate hydrogen ions to help stabilize pH, and when blood becomes acidic, calcium and phosphate can be released from bone to help neutralize excess acid (Salcedo-Betancourt & Moe,
2024
).
This leads to the question as to whether increases in atmospheric CO
2
pose a threat to human health. There are now many studies that review health effects in the range 600–5,000 ppm CO
2
(Azuma et al.,
2018
; Bierwirth,
2025
; Carr et al.,
2025
; Jacobson et al.,
2019
) although there is still a paucity of studies investigating the effects of long-term exposure at relevant levels of CO
2
. As such, the U.S. National Health and Nutrition Examination Survey (NHANES) study, which recorded blood chemistry parameters, such as HCO
3
−
, calcium (Ca), and phosphorus (P), from about 7,000 people every two years between 1999 and 2020, provides a unique opportunity to assess potential secular trends in human blood biochemistry that may be a result of a changing air composition.
Atmospheric carbon dioxide throughout human evolution
The ancestor of modern humans is thought to have evolved between 5 and 8 million years ago, with the first
Homo sapiens
appearing in the fossil record around 150,000 years ago (Wood,
1996
). Although not precise, it appears that throughout most, if not all, of the ensuing period of human evolution, levels of CO
2
in the atmosphere remained relatively stable around 300 parts per million (ppm). These data were derived from a combination of studies of relict features including air trapped in ice cores (Barnola et al.,
1987
), the composition of fossil plankton (Zachos et al.,
2001
) and Carbon-13 (
13
C) content in fossil plant material (Cui et al.,
2020
). However, since the advent of widespread industrialisation, atmospheric CO
2
levels have exponentially increased (Fig.
1
). In just the last ~ 50 years it has risen from  420 ppm in 2025 (Lan et al.,
2025
). Atmospheric CO
2
is currently increasing at more than 2 ppm each year, largely due to humanity’s activities, such as the burning of fossil fuels (Eggleton,
2012
).
Fig. 1
Full size image
Atmospheric carbon dioxide concentrations (in ppm) over the last 800,000 years, based on measurements of air trapped in Antarctic ice (Lüthi et al.,
2008
; Rubino et al.,
2019
), and direct measurements made at the Mauna Loa Observatory (1958 to present) (Keeling et al.,
2005
)
Temporal trend in human serum bicarbonate, calcium and phosphorus levels
As levels of atmospheric CO
2
increase, it is obvious that humans will have no option but to inhale more CO
2
. It is also known that increased blood loading with CO
2
(hypercapnia) is physiologically correlated with HCO
3
−
levels (Malte & Wang,
2024
), due to the hydration of CO₂ to form carbonic acid, which dissociates into H⁺ and HCO₃⁻. To compensate, renal mechanisms increase HCO₃⁻ reabsorption and generation to buffer H⁺ and partially restore pH homeostasis (Alka & Casey,
2014
). This potentially represents a health risk if HCO
3
−
levels increase above the normal healthy range and/or the duration of increased HCO
3
−
is excessive. In healthy adult humans, arterial HCO
3
−
is typically between 22 and 26mEq/L (Larkin & Zimmanck,
2015
), although a recent re-evaluation suggests that 22.1–28.3mEq/L is more appropriate for arterial blood, and up to 30mEq/L is appropriate for venous blood (Kraut & Madias,
2018
).
Although temporal population biochemical data relating to HCO
3
−
are rare, a previous study (Zheutlin et al.,
2014
) examined data from the U.S. National Health and Nutrition Examination Survey (NHANES) from 1999 to 2012 (7 cycles) looking at the population average HCO
3
−
levels in blood samples from a total of 33,546 adults (~ 5,000 per cycle). Between 1999 and 2012, there was an upward trend in serum HCO
3
−
levels in the study population, with it increasing approximately 5%, from ~ 23.8mEq/L in 1999–2000 to ~ 25.0mEq/L in 2011–2012. This increase paralleled atmospheric CO
2
levels which increased by a similar proportion over the same period (from ~ 369ppm to ~ 393ppm) (Lan et al.,
2025
). The authors question whether “the increasing trend in serum bicarbonate found in our study is related to elevated ambient CO
2
and climate change”.
Methods
The overarching NHANES protocol is ethically approved by the Ethics Review Committee of the National Center for Health Statistics, which involved obtaining informed consent from all participants. The NHANES project assesses health and nutrition in a representative sample of adults and children in the United States via interviews, physical examinations and laboratory tests.
In the present study, we extend the 7-cycle trend analysis of Zheutlin et al. (
2014
) to include more recent and comprehensive NHANES data. Our analyses encompass an additional 4-cycles (up to 2019) and include all records from the NHANES database (i.e. from birth to 80 + years of age; ~7,000 records per cycle). From the database, we extracted data on levels of bicarbonate (mEg/L), calcium (mmol/L) and phosphorus (mmol/L) in participant serum. These data were averaged across all participants for each cycle, giving mean values at each time point. Atmospheric carbon dioxide levels at Mauna Loa, Hawaii over the same time period were obtained the Global Monitoring Laboratory dataset (Lan et al.,
2025
).
Results
Our key finding was that the increase identified by Zheutlin et al. (
2014
) has continued (Fig.
2
). The most recent serum HCO
3
−
levels measured in the NHANES population (which uses venous blood) was 25.3mEq/L (in 2019–2020), representing a ~ 7% increase from 1999. Similarly, this has paralleled atmospheric CO
2
over the same period. As stated above, the upper healthy limit for HCO
3
−
in venous blood can be taken as 30mEq/L (Kraut & Madias,
2018
), although this value requires further scrutiny particularly given that the high HCO
3
−
condition would likely be perpetual in the future as atmospheric CO
2
continues to increase. Assuming a linear relationship and a ~ 0.34% increase rate per year, the calculated trendline in Fig.
2
A predicts that the healthy maximum HCO
3
−
level of 30mEq/L will be reached in the year 2076. Due to the large sample sizes, population level variation in serum HCO
3
−
levels is low (SE based on unweighted data < 0.032 for all years).
Fig. 2
Full size image
(
A
) Comparison between temporal trend in population serum bicarbonate (filled circles, left y-axis) in U.S. adults from the NHANES biochemistry database and measured atmospheric concentration CO
2
(open boxes, dotted line, right y-axis) at Mauna Loa, Hawaii (Lan et al.,
2025
). The black line is the trendline for HCO
3
−
with the formula y = 0.081x-138.15. (
B
) Temporal trends in population serum calcium (filled triangles, solid line left y-axis) and phosphorus (open diamonds, dotted line, right y-axis) in U.S. adults from the NHANES biochemistry database over the same period of time
Similarly, Fig.
2
B illustrates changes in serum calcium (Ca) and phosphorus (P) levels in the same population between 1999 and 2020. Mean serum Ca levels have decreased ~ 2% over this period, while P levels have decreased by ~ 7% (if the potentially spurious measurement in NHANES 1999–2000 is excluded). Total serum Ca levels for healthy adults are generally accepted to be between 2.1 and 2.6 mmol/L, with levels below this termed hypocalcemia (Bazydlo et al.,
2014
). For P the healthy range is 0.81 to 1.45 mmol/L (Bazydlo et al.,
2014
), below which hypophosphatemia occurs. Like serum HCO
3
−
, due to the large sample sizes, population level variation in both Ca and P are low (SE based on unweighted data < 0.0012 for Ca and < 0.0027 for P for all years). If we also assume linear relationships for these parameters, the calculated trendlines in Fig.
2
B predict that the lower limits for Ca and P would be reached in the years 2099 and 2085 respectively. These are clearly estimations given the variability in the data. As with bicarbonate, these thresholds could be reached earlier as atmospheric CO
2
levels continue to increase.
Discussion
The trends evident in NHANES data indicate that human physiology has progressively and consistently altered over the last ~ 25 years. These changes are consistent with effects that might occur due to breathing increasing levels of atmospheric CO
2
. Under normal circumstances CO
2
is excreted from the body via breathing with the ventilation rate determined by chemoreceptors measuring blood pH (Eckenhoff & Longnecker,
1995
). This is likely a system that has been tuned to the usually stable level of atmospheric CO
2
at around 280 ppm throughout our evolution (Fig.
1
).
In situations of excess CO
2
, the bones provide an early compensation mechanism by storing CO
2
as bicarbonate and carbonate (Schaefer et al.,
1979a
; Stumm,
2023
). Additionally bone resorption may occur (Holy et al.,
2012
), whereby minerals such as Ca and phosphate (PO₄³⁻) are released from the bones into the blood, thereby temporarily increasing blood pH (Arnett,
2010
). Studies of long-term exposure to 5,000 ppm CO
2
in guinea pigs show that blood levels of Ca and P are cyclic after CO
2
exposure (Schaefer et al.,
1979a
). When bone (and kidney) Ca increase, blood Ca decreases. Ca and P levels are mirrored. In chronic acidosis, however, the ability of the kidneys to handle Ca is impaired, such that there may be an increase in Ca excretion and a net loss of Ca from the body in urine (hypercalciuria) over time (Bushinsky et al.,
2003
). Schaefer (
1982
) determined that after CO
2
exposure, an initial decline in blood calcium corresponds to a decline in blood pH and marks a period of deposition of CO
2
in bones at 1.5% CO
2
(Schaefer,
1982
). At 7,000 ppm CO
2
, human blood levels of Ca and P were seen to rise after 20 days (Holy et al.,
2012
) with loss of these elements from the bones. At 1.5% CO
2
, plasma calcium, mirroring the changes in pH, showed a decrease during the first 23 days of exposure and a return to initial levels during the latter part of exposure (Schaefer et al.,
1963
). The significant decrease in plasma calcium during this period of CO
2
retention suggests that Ca was deposited in the skeleton together with CO
2
(Schaefer et al.
1963
). Thus, the effects of breathing elevated CO
2
for extended periods on serum levels of calcium and phosphorus/phosphates is complex. This is further complicated by most studies being conducted at higher CO
2
levels than the current atmosphere and involving acidic (low pH) conditions. However, a recent study provides some insight by demonstrating that, at near neutral pH, excess HCO
3
−
ions can become incorporated in precipitating amorphous calcium carbonate (Huang et al.,
2021
). It appears that increasing HCO
3
−
in the blood, as shown by the NHANES data, is involved in the exchange of H
+
with Ca and P and the subsequent storage in the bones of CO
2
via calcium carbonate and phosphates. This is a potential reason for declining calcium and phosphate levels in the blood.
Whatever the exact mechanisms, the changes seen in human blood chemistry over the last quarter of a century, as illustrated by the NHANES data, are greatly concerning from a human health perspective. They show we may have already entered a period where there is permanent and developing physiological compensation for CO
2
in our bodies.
Health effects of long-term increases in bicarbonate and carbon dioxide
As already stated, HCO
3
−
is a critical physiological anion that plays crucial roles in the transport of CO
2
throughout the body and in buffering pH (Sherwood,
2013
). The fact that its level in the blood is increasing (at a population scale) in parallel with increasing atmospheric CO
2
is concerning. The question remains, however, whether this is really a problem, or whether human physiology will not be negatively impacted. Indeed, some authors have elegantly argued that blood acid-base compensatory mechanisms will easily be able to handle further increases in atmospheric CO
2
(Malte & Wang,
2024
; Saunders & Habgood,
2023
). Unfortunately, these arguments ignore the mounting evidence that even small, short-term increases in atmospheric CO
2
do indeed impact physiology in many species ranging from gastropods (Mardones et al.,
2022
; Navarro et al.,
2022
), to rodents (Kiray et al.,
2014
; Larcombe et al.,
2021
; Martrette et al.,
2017
; Wyrwoll et al.,
2022
) and humans (Allen et al.,
2016
; Lu et al.,
2015
; Satish et al.,
2012
; Seppänen et al.,
1999
). Additionally, they do not consider the impact of longer-term (i.e. life-course) exposure, or exposure during critical windows of development and the potential for such exposures to alter our physiological compensation mechanisms. To the best of our knowledge, currently there are no studies of long-term (approximating lifetime) health effects of exposure to atmospheric CO
2
in the range that is vitally important for the near future (500–800 ppm) (IPCC,
2022
). However, two recent publications from our research group explore the effects of “life-time” (
in utero
to early adulthood) exposure to levels just above this (890 ppm) using a mouse model (Larcombe et al.,
2021
; Wyrwoll et al.,
2022
). We measured effects on lung structure and function, behaviour and neural expression of genes in CO
2
exposed groups.
The possible effects of increased HCO
3
−
and CO
2
can also potentially be observed from other studies of short-term exposure to slightly higher CO
2
levels, such as those commonly experienced in indoor environments (e.g. 1,000 to 3,000 ppm CO
2
) (reviewed in (Azuma et al.,
2017
)). For example, an older study (Eliseeva,
1964
) reported marked changes in human respiration, circulation, and cerebral electrical activity at 1,000 ppm CO
2
, while more recent studies of humans and animals have shown harmful effects of CO
2
exposure at these levels, such as changes in heart rate, kidney calcification, oxidative stress, neural damage and inflammation (Kiray et al.,
2014
; MacNaughton et al.,
2016
; Schaefer,
1982
; Thom et al.,
2017
; Vehviläinen et al.,
2016
), reviewed in (Jacobson et al.,
2019
). This is important due to many human populations spending a significant proportion of their time indoors, where CO
2
levels are typically higher. For example, The National Human Activity Pattern Survey (NHAPS) found that Americans spent an average of 87% of their time in enclosed buildings and ~ 6% of their time in enclosed vehicles in 1992–1994 (Klepeis et al.,
2001
). This has potentially increased since the COVID-19 pandemic (Young et al.,
2024
), with many people working-from-home in environments with poor mechanical air-ventilation (Nazaroff,
2021
). The proportion of time spent in indoor, CO
2
enriched environments could also contribute to the changes in blood chemistry noted in the NHANES data and is an important consideration in interpreting changes over time, and forecasts for the future.
In animals, CO
2
exposure has been found to play a role in oxidative stress caused by reactive oxygen species (ROS) (Ezraty et al.,
2011
; Kiray et al.,
2014
). For example. Ezraty et al. (
2011
) demonstrated that current, and slightly elevated, atmospheric CO
2
levels play a role in exacerbating oxidative stress in a bacterial model (Ezraty et al.,
2011
). Kiray et al. (
2014
) concluded that 1,000 ppm CO
2
is associated with oxidative stress and oxidative damage to brain tissue in mice (Kiray et al.,
2014
). ROS are produced by aerobic metabolism of molecular oxygen and play a major role in various clinical conditions including malignant diseases, diabetes, atherosclerosis, chronic inflammation and neurological disorders such as Parkinson’s and Alzheimer’s diseases (Waris & Ahsan,
2006
). In particular, oxidative damage to cellular DNA can lead to mutations resulting in the initiation and progression of cancer.
As discussed above, increased exposure to CO
2
leads to increased blood acidity, and as part of the body’s compensation mechanisms, the kidneys retain bicarbonate helping to normalise blood pH (Schaefer et al.,
1979b
). This clearly means that bicarbonate levels are normally intimately tied to processes that rely on acid-base balance. However, with long-term high levels of CO
2
in the blood, compensation mechanisms are no longer sufficient, metabolic acidosis occurs and the kidneys do not respond in producing bicarbonate. Under these conditions it appears that Ca
2+
ions are mobilized to replace H
+
ions, producing calcification (CaCO
3
) of the kidneys and other body tissues such as arteries (Schaefer,
1982
). Tissue calcification has been observed in the kidneys of guinea pigs and rats exposed to 1,500 ppm CO
2
for ~ 6 to ~ 15 weeks (Schaefer et al.,
1979b
). The effect may be driven by the over-expression of the carbonic anhydrase (CA) enzyme caused by having more CO
2
to catalyse (Phelan et al.,
2021
) since high CA activity is associated with calcification (Adeva-Andany et al.,
2014
). This is a protein malfunction that appears possible at projected future CO
2
levels given lifetime exposure. CA malfunction due to elevated CO
2
and HCO
3
−
can also have indirect effects on the development and progression of diseases such as cancer and diabetes (Aspatwar et al.,
2021
). Similarly, a recent report suggests that exposure to increasing atmospheric CO
2
“is likely to lead to proteome malfunction” – due to “protein misfolding, aggregation, charge distribution, and altered interaction with other molecules” (Duarte et al.,
2020
). The authors suggest that these changes could help explain the increasing prevalence of certain syndromes including diabetes and neurological disorders. In a similar vein, Kryvenko and Vadász (
2021
) describe how acute and chronic hypercapnia can impair endoplasmic reticulum (ER) function. The ER is a cellular organelle that serves many roles including protein synthesis and calcium storage (Voeltz et al.,
2002
). Elevated HCO
3
−
and CO
2
levels are thought to cause ER stress, which alters ER protein-folding homeostasis potentially leading to tissue and organ malfunction (Kryvenko & Vadász,
2021
). More research is required to understand the potential for slightly elevated atmospheric CO
2
levels to lead to these changes.
Another physiological effect of exposure to slightly elevated atmospheric CO
2
is its potential to detrimentally impact learning, cognitive abilities and mental health in humans (Allen et al.,
2019
; Allen et al.,
2016
; Satish et al.,
2012
; Scully et al.,
2019
). There is now a considerable body of published data showing impacts at levels < 1,000ppm CO
2
, although the effects of exposure remain controversial. For example, one study found no impact of exposure to levels up to 15,000 ppm (Rodeheffer et al.,
2018
), however the study population was a group of highly trained US Navy submariners. Conversely, studies in young adults (Satish et al.,
2012
), office workers (Allen et al.,
2016
) and university staff/students (Snow et al.,
2019
) showed negative effects at CO
2
levels as low as 950 ppm. Of potential importance, the study by Snow et al. (
2019
), found that there were no clear physiological drivers underlying the measured impacts on cognitive performance. Such studies are supported by assessment of CO
2
-induced changes in human brainwaves, measured by electroencephalography (EEG) combined with cognitive tests (reviewed in (Zhang et al.,
2024
)). Such studies show that exposure to CO
2
between 1,000 and 2,500 ppm results in heightened brain activity. Although the mechanisms underlying these impacts are not clear, Stumm (
2023
) postulates that CO
2
induced increase in extracellular calcium ions may restrict the movement of sodium ions thereby reducing neuron excitability (Stumm,
2023
). Another explanation may be that CO
2
signalling activates the autonomic nervous system causing stress which affects cognitive performance (Azuma et al.,
2018
). Brain activity holds paramount importance for human functioning, acting as the central regulator that coordinates various bodily functions and cognitive processes (Zhang et al.,
2024
). Given that CO
2
exposure at moderate levels appears to prove detrimental to brain activity, additional research is urgently required to assess whether life-time exposure to CO
2
levels predicted by climate change modelling will have significant impacts on human cognitive function.
Carbon dioxide is also known to cause anxiety and panic attacks in humans (Battaglia,
2017
). CO
2
sensitivity is one of the most basic and general alarm/avoidance systems within the realm of biology. While panic and anxiety attacks generally occur at high levels of CO
2
, the distribution of liability to CO
2
sensitivity is continuous and normally distributed in humans and animals. This means that there are potentially small anxiety increases even at the current and near-future elevated levels of atmospheric CO
2
. To this effect, increased hormones associated with anxiety have been observed in mammals at levels of CO
2
in the range 700–1000 ppm (Kiray et al.,
2014
; Martrette et al.,
2017
; Wyrwoll et al.,
2022
). Even a small permanent increase in global human anxiety could have a dangerous impact on societies being associated with greater fear, mental disturbance, conflicts, etc.
Health effects of long-term decreases in calcium and phosphorus
Both calcium and phosphorus are essential for human health, with insufficient levels (hypocalcemia and hypophosphatemia) being associated with a range of adverse health impacts (Gaasbeek & Meinders,
2005
; Pepe et al.,
2020
).
Calcium is essential to maintaining total body health, with low levels potentially impacting virtually any organ or system (Pepe et al.,
2020
). For example, calcium is essential in muscle contraction, oocyte activation, building strong bones and teeth, blood clotting, nerve impulse, transmission, regulating heart-beat and fluid balance within cells (Pravina et al.,
2013
). The requirements are greatest during periods of growth such as childhood. Low blood calcium (hypocalcemia) produces symptoms including muscle cramps, lethargy, numbness and tingling in the fingers, and problems with heart rhythm. Systemic Ca
2+
is regarded as a hormone itself, as it can modulate the function of the parathyroid gland, the thyroid gland, the kidney, and other organs and cells via the calcium-sensing receptor (Proudfoot,
2019
).
Similarly, phosphorus plays many critical roles in the body (Gaasbeek & Meinders,
2005
). These include metabolic processes within the cell such as energy metabolism and protein phosphorylation which are key mechanisms that control many cellular functions, including metabolism, growth, and muscle contraction (Shaker & Deftos,
2023
). It is a vital component of adenosine triphosphate (ATP), the body’s primary energy carrying molecule (Bonora et al.,
2012
), and 2,3-diphosphoglycerate (2,3-DPG), which is found in erythrocytes and is crucial in oxygen transport (Macdonald,
1977
). Accordingly, abnormally low levels of phosphate can lead to tissue hypoxia and cellular function disruption (Gaasbeek & Meinders,
2005
). Phosphorus also plays a role in nucleotide metabolism which is used to build DNA, RNA and it influences phospholipid metabolism that forms a vital part of cell growth and function (Shaker & Deftos,
2023
).
Conclusions
The analysis of average blood HCO
3
−
levels in a large human population shows an increase between the years 2000 and 2020, while both calcium and phosphorus show a decrease over the same period. The increase in average blood HCO
3
−
(~ 0.34% per year) is comparable to the increase in atmospheric CO
2
levels (~ 0.5% per year). This trend suggests there may be a causal link between ambient CO
2
and systemic bicarbonate levels, a finding that warrants additional attention. Trend analysis suggests that HCO
3
−
levels will be at the currently accepted limit of the healthy range within 50 years, with calcium and phosphorus reaching the currently accepted minimum levels shortly after. Clearly these are estimations, as there are uncertainties due to factors such as variations in the numbers of participants, their environment leading up to blood sampling and differences in measurement procedures during each collection. Also, the relationships may not be linear. However, on the face of it, this raw analysis of biochemical data suggests the distinct possibility that, within a half century from now, HCO
3
−
levels in human blood will reach unhealthy levels. What effects this may have on physiology remain to be elucidated, but urgently need to be considered.
Given that the entire evolution period for humans has seen a stable and relatively low atmospheric CO
2
level (< 300 ppm), it’s possible that our physiology is finely tuned for a range of CO
2
that will not be much greater than this level. As the atmospheric CO
2
levels rise, already at 420 pm, the increasing levels of bicarbonate, and decreasing levels of calcium and phosphorus in our blood represent permanent and growing changes in human blood chemistry. These changes can be explained by CO
2
retention and overload in the body. The extra CO
2
being inhaled isn’t expelled via increased ventilation, as ventilation rate is controlled by pH which has likely remained stable due to acid-base regulation. CO
2
storage in the body then becomes a major issue presenting a risk to population health and an existential threat for many species especially given that the rise in atmospheric CO
2
may be a phenomenon that has significant momentum. Realistically, to mitigate this approaching threat, the alarm needs to be raised immediately. Unfortunately, currently there is little awareness or inclination for action on this issue.
Data availability
Data are available from the US National Health and Nutrition Examination Survey (NHANES).
References
Adeva-Andany MM, Carneiro-Freire N, Donapetry-García C, Rañal-Muíño E, López-Pereiro Y (2014) The importance of the ionic product for water to understand the physiology of the acid-base balance in humans. BioMed Res Int 2014(1):695281
Google Scholar
Alka K, Casey JR (2014) Bicarbonate transport in health and disease. IUBMB Life 66(9):596–615.
https://doi.org/10.1002/iub.1315
Article
CAS
Google Scholar
Allen JG, MacNaughton P, Cedeno-Laurent JG, Cao X, Flanigan S, Vallarino J, Rueda F, Donnelly-McLay D, Spengler JD (2019) Airplane pilot flight performance on 21 maneuvers in a flight simulator under varying carbon dioxide concentrations. J Expo Sci Environ Epidemiol 29(4):457–468
Article
CAS
Google Scholar
Allen JG, MacNaughton P, Satish U, Santanam S, Vallarino J, Spengler JD (2016) Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: a controlled exposure study of green and conventional office environments. Environ Health Perspect 124(6):805–812
Article
CAS
Google Scholar
Arlot-Bonnemains Y, Fouchereau-Peron M, Moukhtar MS, Benson AA, Milhaud G (1985) Calcium-regulating hormones modulate carbonic anhydrase II in the human erythrocyte. Proc Natl Acad Sci U S A 82(24):8832–8834
Article
CAS
Google Scholar
Arnett TR (2010) Acidosis, hypoxia and bone. Arch Biochem Biophys 503(1):103–109.
https://doi.org/10.1016/j.abb.2010.07.021
Article
CAS
Google Scholar
Aspatwar, A., Peltola, J., & Parkkila, S. (2021). Targeting carbonic anhydrase isozymes in the treatment of neurological disorders.
The Carbonic Anhydrases: Current and Emerging Therapeutic Targets
, 103–120.
Azuma K, Kagi N, Yanagi U, Osawa H (2018) Effects of low-level inhalation exposure to carbon dioxide in indoor environments: a short review on human health and psychomotor performance. Environ Int 121:51–56
Article
CAS
Google Scholar
Azuma, K., Yanagi, U., Kagi, N., & Osawa, H. (2017). A review of the effects of exposure to carbon dioxide on human health in indoor environment.
Healthy Buildings 2017 Europe July 2–5, 2017, Lublin, Poland.
Barnola J-M, Raynaud D, Korotkevich YS, Lorius C (1987) Vostok ice core provides 160,000-year record of atmospheric CO2. Nature 329(6138):408–414
Article
CAS
Google Scholar
Battaglia M (2017) Sensitivity to carbon dioxide and translational studies of anxiety disorders. Neuroscience 346:434–436
Article
CAS
Google Scholar
Bazydlo LAL, Needham M, Harris NS (2014) Calcium, Magnesium, and Phosphate. Lab Med 45(1):e44–e50.
https://doi.org/10.1309/LMGLMZ8CIYMFNOGX
Article
Google Scholar
Bierwirth, P. (2025).
Long-term carbon dioxide toxicity and climate change: a critical unapprehended risk for human health
.
https://www.researchgate.net/publication/311844520_Long-term_carbon_dioxide_toxicity_and_climate_change_a_critical_unapprehended_risk_for_human_health
Bonora M, Patergnani S, Rimessi A, De Marchi E, Suski JM, Bononi A, Giorgi C, Marchi S, Missiroli S, Poletti F (2012) ATP synthesis and storage. Purinergic Signal 8:343–357
Article
CAS
Google Scholar
Burton RF (1978) Intracellular buffering. Respir Physiol 33(1):51–58
Article
CAS
Google Scholar
Bushinsky DA, Smith SB, Gavrilov KL, Gavrilov LF, Li J, Levi-Setti R (2003) Chronic acidosis-induced alteration in bone bicarbonate and phosphate. Am J Physiol Renal Physiol 285(3):F532–F539.
https://doi.org/10.1152/ajprenal.00128.2003
Article
Google Scholar
Carr, J. M. J. R., Ainslie, P. N., & Day, T. (2025). Confined spaces in space: Cerebral implications of chronic elevations of inspired carbon dioxide and implications for long-duration space travel.
Exp Physiol
.
https://doi.org/10.1113/EP091659
[doi]
Cui Y, Schubert BA, Jahren AH (2020) A 23 my record of low atmospheric CO2. Geology 48(9):888–892
Article
CAS
Google Scholar
Duarte CM, Jaremko Ł, Jaremko M (2020) Hypothesis: potentially systemic impacts of elevated CO2 on the human proteome and health. Front Public Health 8:543322
Article
Google Scholar
Eckenhoff, R., & Longnecker, D. (1995). The therapeutic gases. Effects of carbon dioxide.
Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 9th Ed (Hardman JG, ed). McGraw Hill
, 355–356.
Eggleton T (2012) A short introduction to climate change. Cambridge University Press
Book
Google Scholar
Eliseeva, O. V. (1964). Data to substantiate the maximum permissible concentration of carbon dioxide in the air of apartments and public buildings.
Gig Sanit
, 10–15.
Ezraty B, Chabalier M, Ducret A, Maisonneuve E, Dukan S (2011) CO2 exacerbates oxygen toxicity. EMBO Rep 12(4):321–326
Article
CAS
Google Scholar
Gaasbeek A, Meinders AE (2005) Hypophosphatemia: an update on its etiology and treatment. Am J Med 118(10):1094–1101
Article
CAS
Google Scholar
Gray SP, Morris JEW, Brooks CJ (1973) Renal handling of calcium, magnesium, inorganic phosphate and hydrogen ions during prolonged exposure to elevated carbon dioxide concentrations. Clinical Science and Molecular Medicine 45(6):751–764
CAS
Google Scholar
Holy X, Collombet J-M, Labarthe F, Granger-Veyron N, Bégot L (2012) Effects of seasonal vitamin D deficiency and respiratory acidosis on bone metabolism markers in submarine crewmembers during prolonged patrols. J Appl Physiol 112(4):587–596
Article
CAS
Google Scholar
Huang YC, Rao A, Huang SJ, Chang CY, Drechsler M, Knaus J, Chan JCC, Raiteri P, Gale JD, Gebauer D (2021) Uncovering the role of bicarbonate in calcium carbonate formation at near-neutral pH. Angew Chem Int Ed Engl 60(30):16707–16713
Article
CAS
Google Scholar
IPCC (2022) AR6 Synthesis Report: Climate Change 2022. C. U. Press
Google Scholar
Jacobson TA, Kler JS, Hernke MT, Braun RK, Meyer KC, Funk WE (2019) Direct human health risks of increased atmospheric carbon dioxide. Nat Sustain 2(8):691–701
Article
Google Scholar
Keeling CD, Piper SC, Bacastow RB, Wahlen M, Whorf TP, Heimann M, Meijer HA (2005) Atmospheric CO2 and 13CO2 exchange with the terrestrial biosphere and oceans from 1978 to 2000: observations and carbon cycle implications. A history of atmospheric CO2 and its effects on plants, animals, and ecosystems. Springer, pp 83–113
Google Scholar
Kiray M, Sisman A, Camsari U, Evren M, Dayi A, Baykara B, Aksu I, Ates M, Uysal N (2014) Effects of carbon dioxide exposure on early brain development in rats. Biotech Histochem 89(5):371–383
Article
CAS
Google Scholar
Klepeis NE, Nelson WC, Ott WR, Robinson JP, Tsang AM, Switzer P, Behar JV, Hern SC, Engelmann WH (2001) The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol 11(3):231–252.
https://doi.org/10.1038/sj.jea.7500165
Article
CAS
Google Scholar
Kraut, J. A., & Madias, N. E. (2018). Re-Evaluation of the Normal Range of Serum Total CO2 Concentration.
Clinical Journal of the American Society of Nephrology
,
13
(2). https://journals.lww.com/cjasn/fulltext/2018/02000/re_evaluation_of_the_normal_range_of_serum_total.27.aspx
Kryvenko V, Vadász I (2021) Mechanisms of hypercapnia-induced endoplasmic reticulum dysfunction. Front Physiol 12:735580
Article
Google Scholar
Lan, X., Tans, P., & Thoning, K. W. (2025).
Trends in globally-averaged CO2 determined from NOAA Global Monitoring Laboratory measurements. Version Friday, 07-Feb-2025 13:14:06 MST
https://doi.org/10.15138/9N0H-ZH07.
Larcombe AN, Papini MG, Chivers EK, Berry LJ, Lucas RM, Wyrwoll CS (2021) Mouse lung structure and function after long-term exposure to an atmospheric carbon dioxide level predicted by climate change modeling. Environ Health Perspect 129(1):017001
Article
CAS
Google Scholar
Larkin BG, Zimmanck RJ (2015) Interpreting arterial blood gases successfully. AORN J 102(4):343–357
Article
Google Scholar
Lüthi D, Le Floch M, Bereiter B, Blunier T, Barnola J-M, Siegenthaler U, Raynaud D, Jouzel J, Fischer H, Kawamura K (2008) High-resolution carbon dioxide concentration record 650,000–800,000 years before present. Nature 453(7193):379–382
Article
Google Scholar
Lu C-Y, Lin J-M, Chen Y-Y, Chen Y-C (2015) Building-related symptoms among office employees associated with indoor carbon dioxide and total volatile organic compounds. Int J Environ Res Public Health 12(6):5833–5845
Article
CAS
Google Scholar
Macdonald R (1977) Red cell 2, 3-diphosphoglycerate and oxygen affinity. Anaesthesia 32(6):544–553
Article
CAS
Google Scholar
MacNaughton P, Spengler J, Vallarino J, Santanam S, Satish U, Allen J (2016) Environmental perceptions and health before and after relocation to a green building. Build Environ 104:138–144
Article
Google Scholar
Malte, H., & Wang, T. (2024). Climate change: The rise in atmospheric CO 2 poses no risk for acid–base balance in humans.
Acta Physiologica
,
240
(1).
Mardones ML, Thatje S, Fenberg PB, Hauton C (2022) The short and long-term implications of warming and increased sea water pCO 2 on the physiological response of a temperate neogastropod species. Mar Biol 169:1–9
Article
Google Scholar
Martinu T, Menzies D, Dial S (2003) Re-evaluation of acid‐base prediction rules in patients with chronic respiratory acidosis. Can Respir J 10(6):311–315
Google Scholar
Martrette J-M, Egloff C, Clément C, Yasukawa K, Thornton SN, Trabalon M (2017) Effects of prolonged exposure to CO2 on behaviour, hormone secretion and respiratory muscles in young female rats. Physiol Behav 177:257–262
Article
CAS
Google Scholar
Mendez Y, Ochoa-Martinez FE, Ambrosii T (2019) Chronic obstructive pulmonary disease and respiratory acidosis in the intensive care unit. Curr Respir Med Rev 15(2):79–89
Article
Google Scholar
Navarro J, Andrade-Villagrán P, Manríquez P, Duarte C, Chaparro O (2022) Long-term effects of contrasting pCO2 levels on the scope for growth in the carnivorous gastropod
Concholepas concholepas
. Mar Environ Res 175:105586
Article
CAS
Google Scholar
Nazaroff WW (2021) Residential air-change rates: a critical review. Indoor Air 31(2):282–313
Article
Google Scholar
Palmer BF, Clegg DJ (2023) Respiratory acidosis and respiratory alkalosis: core curriculum 2023. Am J Kidney Dis 82(3):347–359.
https://doi.org/10.1053/j.ajkd.2023.02.004
Article
CAS
Google Scholar
Pepe J, Colangelo L, Biamonte F, Sonato C, Danese VC, Cecchetti V, Occhiuto M, Piazzolla V, De Martino V, Ferrone F (2020) Diagnosis and management of hypocalcemia. Endocrine 69:485–495
Article
CAS
Google Scholar
Phelan DE, Mota C, Lai C, Kierans SJ, Cummins EP (2021) Carbon dioxide-dependent signal transduction in mammalian systems. Interface Focus 11(2):20200033
Article
CAS
Google Scholar
Pravina P, Sayaji D, Avinash M (2013) Calcium and its role in human body. Int J Res Pharm Biomed Sci 4(2):659–668
CAS
Google Scholar
Proudfoot D (2019) Calcium signaling and tissue calcification. Cold Spring Harb Perspect Biol 11(10):a035303
Article
CAS
Google Scholar
Raven P, Johnson G, Mason K, Losos J, Singer S (2007) Biology. McGraw-Hill Companies,Incorporated
Google Scholar
Robertson, D. S. (2006). Health effects of increase in concentration of carbon dioxide in the atmosphere.
Current science
, 1607–1609.
Rodeheffer CD, Chabal S, Clarke JM, Fothergill DM (2018) Acute exposure to low-to-moderate carbon dioxide levels and submariner decision making. Aerosp Med Hum Perform 89(6):520–525
Article
Google Scholar
Rubino, M., Etheridge, D., Thornton, D., Allison, C., Francey, R., Langenfelds, R., Steele, P., Trudinger, C., Spencer, D., Curran, M., Van Ommon, T., & Smith, A. (2019). Rubino, Mauro; Etheridge, David; Thornton, David; Allison, Colin; Francey, Roger; Langenfelds, Ray; Steele, Paul; Trudinger, Cathy; Spencer, Darren; Curran, Mark; Van Ommen, Tas; & Smith, Andrew (2019): Law Dome Ice Core 2000-Year CO2, CH4, N2O and d13C-CO2. v3. CSIRO. Data Collection.
https://doi.org/10.25919/5bfe29ff807fb.
Salcedo-Betancourt JD, Moe OW (2024) The effects of acid on calcium and phosphate metabolism. Int J Mol Sci 25(4):2081
Article
CAS
Google Scholar
Satish U, Mendell MJ, Shekhar K, Hotchi T, Sullivan D, Streufert S, Fisk WJ (2012) Is CO2 an indoor pollutant? Direct effects of low-to-moderate CO2 concentrations on human decision-making performance. Environ Health Perspect 120(12):1671–1677
Article
CAS
Google Scholar
Saunders NR, Habgood MD (2023) Misunderstanding of the contribution of climate change to inspired CO2 and acid–base balance in pregnant women: it is not a hazard to their offspring. J Physiol 601(5):1037–1037.
https://doi.org/10.1113/JP284217
Article
CAS
Google Scholar
Schaefer KE (1982) Effects of increased ambient CO2 levels on human and animal health. Experientia 38(10):1163–1168
Article
CAS
Google Scholar
Schaefer KE, Douglas WHJ, Messier AA, Shea ML, Gohman PA. (1979a) Effect of prolonged exposure to 0.5% CO
2
on kidney calcification and ultrastructure of lungs. Undersea Biomed Res. Suppl 6:S155-S161.
Schaefer KE, Hastings BJ, Carey CR, Nichols G Jr. (1963) Respiratory acclimatization to carbon dioxide. J Appl Physiol 18:1071–1078.
https://doi.org/10.1152/jappl.1963.18.6.1071
Article
CAS
Google Scholar
Schaefer KE, Pasquale SM, Messier AA, Niemoeller H (1979b) CO2-induced kidney calcification. Undersea Biomed Res 6(Suppl):S143–S153
Google Scholar
Scully RR, Basner M, Nasrini J, Lam C-w, Hermosillo E, Gur RC, Moore T, Alexander DJ, Satish U, Ryder VE (2019) Effects of acute exposures to carbon dioxide on decision making and cognition in astronaut-like subjects. NPJ Microgravity 5(1):17
Article
Google Scholar
Seppänen O, Fisk W, Mendell MJ (1999) Association of ventilation rates and CO2 concentrations with health andother responses in commercial and institutional buildings. Indoor Air 9(4):226–252
Article
Google Scholar
Shaker, J. L., & Deftos, L. (2023). Calcium and phosphate homeostasis.
Endotext [Internet]
.
Sherwood, L. (2013).
Human physiology : from cells to systems
. Ninth edition. Belmont, CA : Brooks/Cole, Cengage Learning, [2015] ©2015. https://search.library.wisc.edu/catalog/9910192145402121
Snow S, Boyson AS, Paas KHW, Gough H, King M-F, Barlow J, Noakes CJ (2019) Exploring the physiological, neurophysiological and cognitive performance effects of elevated carbon dioxide concentrations indoors. Build Environ 156:243–252
Article
Google Scholar
Stumm RE (2023) Carbon dioxide’s direct impact on down-regulating the human species. Sci Total Environ 905:167198
Article
CAS
Google Scholar
Thom SR, Bhopale VM, Hu J, Yang M (2017) Inflammatory responses to acute elevations of carbon dioxide in mice. J Appl Physiol 123(2):297–302
Article
CAS
Google Scholar
Ueda Y, Aizawa M, Takahashi A, Fujii M, Isaka Y (2009) Exaggerated compensatory response to acute respiratory alkalosis in panic disorder is induced by increased lactic acid production. Nephrol Dial Transplant 24(3):825–828
Article
CAS
Google Scholar
Vehviläinen T, Lindholm H, Rintamäki H, Pääkkönen R, Hirvonen A, Niemi O, Vinha J (2016) High indoor CO2 concentrations in an office environment increases the transcutaneous CO2 level and sleepiness during cognitive work. J Occup Environ Hyg 13(1):19–29
Article
Google Scholar
Voeltz, G. K., Rolls, M. M., & Rapoport, T. A. (2002). Structural organization of the endoplasmic reticulum.
EMBO reports
.
Waris G, Ahsan H (2006) Reactive oxygen species: role in the development of cancer and various chronic conditions. J Carcinog 5:14
Article
Google Scholar
Wood B (1996) Human evolution. Bioessays 18(12):945–954.
https://doi.org/10.1002/bies.950181204
Article
CAS
Google Scholar
Wyrwoll CS, Papini MG, Chivers EK, Yuan J, Pavlos NJ, Lucas RM, Bierwirth PN, Larcombe AN (2022) Long-term exposure of mice to 890 ppm atmospheric CO2 alters growth trajectories and elicits hyperactive behaviours in young adulthood. J Physiol 600(6):1439–1453.
https://doi.org/10.1113/JP282179
Article
CAS
Google Scholar
Young AS, Parikh S, Dedesko S, Bliss M, Xu J, Zanobetti A, Miller SL, Allen JG (2024) Home indoor air quality and cognitive function over one year for people working remotely during COVID-19. Build Environ 257:111551.
https://doi.org/10.1016/j.buildenv.2024.111551
Article
Google Scholar
Zachos J, Pagani M, Sloan L, Thomas E, Billups K (2001) Trends, rhythms, and aberrations in global climate 65 Ma to present. Science 292(5517):686–693
Article
CAS
Google Scholar
Zhang N, Liu C, Hou C, Wang W, Yuan Q, Gao W (2024) The impact of indoor carbon dioxide exposure on human brain activity: a systematic review and meta-analysis based on studies utilizing electroencephalogram signals. Build Environ 259:111687.
https://doi.org/10.1016/j.buildenv.2024.111687
Article
Google Scholar
Zheutlin AR, Adar SD, Park SK (2014) Carbon dioxide emissions and change in prevalence of obesity and diabetes in the United States: an ecological study. Environ Int 73:111–116.
https://doi.org/10.1016/j.envint.2014.07.012
Article
CAS
Google Scholar
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Alexander N. Larcombe
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Alexander N. Larcombe
School of Human Sciences, University of Western Australia, Perth, Australia
Alexander N. Larcombe
Emeritus Faculty, Australian National University, Canberra, Australia
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Larcombe, A.N., Bierwirth, P.N. Carbon dioxide overload, detected in human blood, suggests a potentially toxic atmosphere within 50 years.
Air Qual Atmos Health
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, 44 (2026). https://doi.org/10.1007/s11869-026-01918-5
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Keywords
Carbon dioxide
Serum bicarbonate
Blood chemistry
Health