| Hill's criteria | Application to the thunderstorm-related asthma |
| Temporal relationship | Thunderstorms always precede asthma attacks |
| Exposure always precedes the outcome | |
| Strength | Increased risk of asthma attacks in relation to thunderstorms |
| The stronger the association, the more likely it is that the relationship of the factor to the health outcome is causal | |
| Dose–response relationship | |
| An increasing amount of exposure increases the probability of the health outcome Of note, the absence of a dose–response relationship does not rule out a causal relationship | Increased amount of pollen and mould spores at the beginning of the thunderstorm associated with increased probability of asthma attacks in pollen patients and other allergic patients |
| Consistency | |
| The association is consistent when results in different studies and among different populations | Association between thunderstorm and asthma found in different studies and different populations |
| Plausibility | |
| The association agrees with currently accepted understanding of pathological processes | Evidence of biological plausibility at the basis of thunderstorm-related asthma through pollen exposure (allergens and starch granules in the cytoplasm or other paucimicronic cytoplasmic-components carrying allergens) Evidence to be established in the case of mould spores |
| Consideration of alternate explanations | Alternate hypothesis involving chemical air pollution less explanatory than thunderstorm-related asthma |
| It is necessary to consider multiple hypotheses before making conclusions about the causal relationship between any two items under investigation | |
| Experimental | Evidence indicating that prevention is possible by avoiding exposure to thunderstorm (at its beginning) in pollen patients |
| The condition can be altered (prevented or ameliorated) by an appropriate experimental regimen | |
| Specificity | Poorly shown by experimental data (also sparse and heterogeneous) |
| This is established when a single putative cause produces a specific effect | |
| Coherence | Existing theory and knowledge support the existence of thunderstorm-related asthma |
| The association should be compatible with existing theory and knowledge |