Seasonal asthma in Melbourne, Australia, and some observations on the occurrence of thunderstorm asthma and its predictability.

We examine the seasonality of asthma-related hospital admissions in Melbourne, Australia, in particular the contribution and predictability of episodic thunderstorm asthma. Using a time-series ecological approach based on asthma admissions to Melbourne metropolitan hospitals, we identified seasonal peaks in asthma admissions that were centred in late February, June and mid-November. These peaks were most likely due to the return to school, winter viral infections and seasonal allergies, respectively. We performed non-linear statistical regression to predict daily admission rates as functions of the seasonal cycle, weather conditions, reported thunderstorms, pollen counts and air quality. Important predictor variables were the seasonal cycle and mean relative humidity in the preceding two weeks, with higher humidity associated with higher asthma admissions. Although various attempts were made to model asthma admissions, none of the models explained substantially more variation above that associated with the annual cycle. We also identified a list of high asthma admissions days (HAADs). Most HAADs fell in the late-February return-to-school peak and the November allergy peak, with the latter containing the greatest number of daily admissions. Many HAADs in the spring allergy peak may represent episodes of thunderstorm asthma, as they were associated with rainfall, thunderstorms, high ambient grass pollen levels and high humidity, a finding that suggests thunderstorm asthma is a recurrent phenomenon in Melbourne that occurs roughly once per five years. The rarity of thunderstorm asthma events makes prediction challenging, underscoring the importance of maintaining high standards of asthma management, both for patients and health professionals, especially during late spring and early summer.

Heat stress during the Black Saturday event in Melbourne, Australia.

The Black Saturday bushfire event of February 7, 2009, devastated the state of Victoria, Australia, resulting in 173 deaths. On this day, the maximum temperature in Melbourne (state capital of Victoria, population 4 million people) exceeded 46 °C, there were wind gusts of over 80 km h(-1) and the relative humidity dropped below 5 %. We investigated the severe meteorological conditions of Black Saturday and the risk of heat stress and dehydration for the residents of Melbourne. This was through the analysis of weather station data, air pollution data, the apparent temperature (AT) and the COMfort FormulA human energy budget model. A very strong pressure gradient caused hot and dry air to be advected to Melbourne from the desert interior of Australia creating the extreme weather conditions. The AT showed that on Black Saturday, heat stress conditions were present, though underrepresented due to assumptions in the AT formula. Further investigation into the human energy budget revealed that the conditions required a sweating rate of 1.4 kg h(-1) to prevent heat accumulation into the body. If sweating stopped, hyperthermia could occur in 15 min. Sensitivity tests indicated that the dry air and strong winds on Black Saturday helped to release latent heat, but the required sweating rate was virtually unattainable for an average person and would result in intense dehydration. Air particulates were at dangerous concentrations in Melbourne on Black Saturday, further intensifying the stresses to the human body. In the future, we recommend that the AT is not used as a thermal comfort measure as it underestimates the physical stress people experience.

A new 'bio-comfort' perspective for Melbourne based on heat stress, air pollution and pollen.

Humans are at risk from exposure to extremes in their environment, yet there is no consistent way to fully quantify and understand the risk when considering more than just meteorological variables. An outdoor 'bio-comfort' threshold is defined for Melbourne, Australia using a combination of heat stress, air particulate concentration and grass pollen count, where comfortable conditions imply an ideal range of temperature, humidity and wind speed, acceptable levels of air particulates and a low pollen count. This is a new approach to defining the comfort of human populations. While other works have looked into the separate impacts of different variables, this is the first time that a unified bio-comfort threshold is suggested. Composite maps of surface pressure are used to illustrate the genesis and evolution of the atmospheric structures conducive to an uncomfortable day. When there is an uncomfortable day due to heat stress conditions in Melbourne, there is a high pressure anomaly to the east bringing warm air from the northern interior of Australia. This anomaly is part of a slow moving blocking high originating over the Indian Ocean. Uncomfortable days due to high particulate levels have an approaching cold front. However, for air particulate cases during the cold season there are stable atmospheric conditions enhanced by a blocking high emanating from Australia and linking with the Antarctic continent. Finally, when grass pollen levels are high, there are northerly winds carrying the pollen from rural grass lands to Melbourne, due to a stationary trough of low pressure inland. Analysis into days with multiple types of stress revealed that the atmospheric signals associated with each type of discomfort are present regardless of whether the day is uncomfortable due to one or multiple variables. Therefore, these bio-comfort results are significant because they offer a degree of predictability for future uncomfortable days in Melbourne.