The association of coal mine fire smoke with hospital emergency presentations and admissions: Time series analysis of Hazelwood Health Study.

ABSTRACT

OBJECTIVES: We aimed to examine the change in rates of hospital emergency presentations or hospital admissions during the coal mine fire, and their associations with the coal mine fire-related fine particles (PM2.5). METHODS: Daily data on hospital emergency presentations and admissions were collected from the Department of Health and Human Services for the period January 01, 2009 to June 30, 2015, at Statistical Area Level 2 (SA2). The coal mine fire-related PM2.5 concentrations were modelled by the Chemical Transport Model coupled with the Cubic Conformal Atmospheric Model. A generalised additive mixed model was used to estimate the change in rates of hospital emergency presentations and hospital admissions during the coal mine fire period, and to examine their associations with PM2.5 concentrations for smoke impacted areas, after controlling for potential confounders. RESULTS: Compared with non-fire periods, we found increased risks of all-causes, respiratory diseases, and asthma related emergency presentations and hospital admissions as well as chronic obstructive pulmonary disease (COPD) related emergency presentations during the fire period. Associations between daily concentrations of coal mine fire-related PM2.5 and emergency presentations for all-causes and respiratory diseases, including COPD and asthma, appeared after two days' exposure. Associations with hospital admissions for cerebrovascular and respiratory diseases appeared on the same day of exposure. CONCLUSIONS: Coal mine fire smoke created a substantial health burden. People with respiratory diseases should receive targeted messages, follow self-management plans and take preventive medication during future coal mine fires.