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1.
Sci Total Environ ; 801: 149806, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34467930

RESUMO

BACKGROUND: The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS: Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS: Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS: High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.

2.
Environ Pollut ; 291: 118072, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34592695

RESUMO

Long-term exposure to air pollutants, especially particulates, in adulthood is related to cardiovascular diseases and vascular markers of atherosclerosis. However, whether vascular changes in children is related to exposure to air pollutants remains unknown. This study examined whether childhood exposure to air pollutants was related to a marker of cardiovascular risk, carotid intima-media thickness (CIMT) in children aged 11-12 years old. Longitudinal Study of Australian Children (LSAC) recruited parents and their children born in 2003-4. Among the participants, CheckPoint examination was conducted when the children were 11-12 years old. Ultrasound of the right carotid artery was performed using standardized protocols. Average and maximum far-wall CIMT, carotid artery distensibility, and elasticity were quantified using semiautomated software. Annual and life-time exposure to air pollutants was estimated using satellite-based land-use regression by residential postcodes. A total of 1063 children (50.4% girls) with CIMT data, serum cholesterol, and modeled estimates of NO2 and PM2.5 exposure for the period 2003 to 2015 were included. The average and maximum CIMT, carotid distensibility, and elasticity were 497 µm (standard deviation, SD 58), 580 µm (SD 44), 17.4% (SD 3.2), and 0.48%/mmHg (SD 0.09), respectively. The life-time average concentrations of PM2.5 and NO2 were 6.4 µg/m3 (SD 1.4) and 6.4 ppb (SD 2.4), respectively. Both average and maximum CIMT were significantly associated with average ambient PM2.5 concentration (average CIMT: +5.5 µm per µg/m3, 95% confidence interval, CI 2.4 to 8.5, and maximum CIMT: +4.9 µm per µg/m3, CI 2.3 to 7.6), estimated using linear regression, adjusting for potential confounders. CIMT was not significantly related to NO2 exposure. Carotid artery diameter, distensibility, and elasticity were not significantly associated with air pollutants. We conclude that life-time exposure to low levels of PM2.5 in children might have measurable adverse impacts on vascular structure by age 11-12 years.

3.
Med J Aust ; 215(6): 269-272, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34341997

RESUMO

OBJECTIVES: To estimate the annual burden of mortality and the associated health costs attributable to air pollution from wood heaters in Armidale. DESIGN: Health impact assessment (excess annual mortality and financial costs) based upon atmospheric PM2.5 measurements. SETTING: Armidale, a regional Australian city (population, 24 504) with high levels of air pollution in winter caused by domestic wood heaters, 1 May 2018 - 30 April 2019. MAIN OUTCOME MEASURES: Estimated population exposure to PM2.5 from wood heaters; estimated numbers of premature deaths and years of life lost. RESULTS: Fourteen premature deaths (95% CI, 12-17 deaths) per year, corresponding to 210 (95% CI, 172-249) years of life lost, are attributable to long term exposure to wood heater PM2.5 pollution in Armidale. The estimated financial cost is $32.8 million (95% CI, $27.0-38.5 million), or $10 930 (95% CI, $9004-12 822) per wood heater per year. CONCLUSIONS: The substantial mortality and financial cost attributable to wood heating in Armidale indicates that effective policies are needed to reduce wood heater pollution, including public education about the effects of wood smoke on health, subsidies that encourage residents to switch to less polluting home heating (perhaps as part of an economic recovery package), assistance for those affected by wood smoke from other people, and regulations that reduce wood heater use (eg, by not permitting new wood heaters and requiring existing units to be removed when houses are sold).

4.
Artigo em Inglês | MEDLINE | ID: mdl-34299914

RESUMO

Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Incêndios , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Epigênese Genética , Feminino , Humanos , Gravidez , Fumaça/efeitos adversos , Fumaça/análise
5.
Asia Pac J Public Health ; : 10105395211031735, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243677

RESUMO

Smoke from forest fires can reach hazardous levels for extended periods of time. We aimed to determine if there is an association between particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5) and living in a forest fire-prone province and cognitive function. We used data from the Indonesian Family and Life Survey. Cognitive function was assessed by the Ravens Colored Progressive Matrices (RCPM). We used regression models to estimate associations between PM2.5 and living in a forest fire-prone province and cognitive function. In multivariable models, we found very small positive relationships between PM2.5 levels and RCPM scores (PM2.5 level at year of survey: ß = 0.1%; 95% confidence interval [CI] = 0.01% to 0.19%). There were no differences in RCPM scores for children living in forest fire-prone provinces compared with children living in non-forest fire-prone provinces (mean difference = -1.16%, 95% CI = -2.53% to 0.21%). RCPM scores were lower for children who had lived in a forest fire-prone province all their lives compared with children who lived in a non-forest fire-prone province all their life (ß = -1.50%; 95% CI = -2.94% to -0.07%). Living in a forest fire-prone province for a prolonged period of time negatively affected cognitive scores after adjusting for individual factors.

6.
Environ Pollut ; 287: 117211, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34052602

RESUMO

Particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5) concentrations vary between countries with similar carbon dioxide (CO2) emissions, which can be partially explained by differences in air pollution control efficacy. However, no indicator of air pollution control efficacy has yet been developed. We aimed to develop such an indicator, and to evaluate its global and temporal distribution and its association with country-level health metrics. A novel indicator, ambient population-weighted average PM2.5 concentration per unit per capita CO2 emission (PM2.5/CO2), was developed to assess country-specific air pollution control efficacy (abbreviated as APCI). We estimated and mapped the global average distribution of APCI and its changes during 2000-2016 across 196 countries. Pearson correlation coefficients and Generalized Additive Mixed Model (GAMM) were used to evaluate the relationship between APCI and health metrics. APCI varied by country with an inverse association with economic development. APCI showed an almost stable trend globally from 2000 to 2016, with the low-income groups increased and several countries (China, India, Bangladesh) decreased. The Pearson correlation coefficients between APCI and life expectancy at birth (LE), infant-mortality rate (IMR), under-five year of age mortality rate (U5MR) and logarithm of per capita GDP (LPGDP) were -0.57, 0.65, 0.66, -0.59 respectively (all P values < 0.001). APCI could explain international variation of LE, IMR and U5MR. The associations between APCI and LE, IMR, U5MR were independent of per capita GDP and climatic factors. We consider APCI to be a good indicator for air pollution control efficacy given its relation to important population health indicators. Our findings provide a new metric to interpret health inequity across the globe from the point of climate change and air pollution control efficacy.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Mudança Climática , Exposição Ambiental/análise , Humanos , Lactente , Recém-Nascido , Expectativa de Vida , Material Particulado/análise
7.
Environ Int ; 153: 106533, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33799230

RESUMO

BACKGROUND: Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE: To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS: A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS: The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as "mean temperature ≥90th percentile for ≥3 days" (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was "mean temperature ≥95th percentile for ≥3 days", with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS: Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.


Assuntos
Mudança Climática , Temperatura Alta , Humanos , Morbidade , Avaliação de Resultados em Cuidados de Saúde , Temperatura
8.
Artigo em Inglês | MEDLINE | ID: mdl-33809857

RESUMO

There is an established association between air pollution and cardiovascular disease (CVD), which is likely to be mediated by systemic inflammation. The present study evaluated links between long-term exposure to ambient air pollution and high-sensitivity C reactive protein (hs-CRP) in an older Chinese adult cohort (n = 7915) enrolled in the World Health Organization (WHO) study on global aging and adult health (SAGE) China Wave 1 in 2008-2010. Multilevel linear and logistic regression models were used to assess the associations of particulate matter (PM) and nitrogen dioxide (NO2) on log-transformed hs-CRP levels and odds ratios of CVD risk derived from CRP levels adjusted for confounders. A satellite-based spatial statistical model was applied to estimate the average community exposure to outdoor air pollutants (PM with an aerodynamic diameter of 10 µm or less (PM10), 2.5 µm or less (PM2.5), and 1 µm or less (PM1) and NO2) for each participant of the study. hs-CRP levels were drawn from dried blood spots of each participant. Each 10 µg/m3 increment in PM10, PM2.5, PM1, and NO2 was associated with 12.8% (95% confidence interval; (CI): 9.1, 16.6), 15.7% (95% CI: 10.9, 20.8), 10.2% (95% CI: 7.3, 13.2), and 11.8% (95% CI: 7.9, 15.8) higher serum levels of hs-CRP, respectively. Our findings suggest that air pollution may be an important factor in increasing systemic inflammation in older Chinese adults.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Idoso , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Proteína C-Reativa , China/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Inflamação/induzido quimicamente , Inflamação/epidemiologia , Pessoa de Meia-Idade , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/toxicidade , Material Particulado/análise , Material Particulado/toxicidade
9.
Artigo em Inglês | MEDLINE | ID: mdl-33805472

RESUMO

The 2019-2020 summer wildfire event on the east coast of Australia was a series of major wildfires occurring from November 2019 to end of January 2020 across the states of Queensland, New South Wales (NSW), Victoria and South Australia. The wildfires were unprecedent in scope and the extensive character of the wildfires caused smoke pollutants to be transported not only to New Zealand, but also across the Pacific Ocean to South America. At the peak of the wildfires, smoke plumes were injected into the stratosphere at a height of up to 25 km and hence transported across the globe. The meteorological and air quality Weather Research and Forecasting with Chemistry (WRF-Chem) model is used together with the air quality monitoring data collected during the bushfire period and remote sensing data from the Moderate Resolution Imaging Spectroradiometer (MODIS) and Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellites to determine the extent of the wildfires, the pollutant transport and their impacts on air quality and health of the exposed population in NSW. The results showed that the WRF-Chem model using Fire Emission Inventory (FINN) from National Center for Atmospheric Research (NCAR) to simulate the dispersion and transport of pollutants from wildfires predicted the daily concentration of PM2.5 having the correlation (R2) and index of agreement (IOA) from 0.6 to 0.75 and 0.61 to 0.86, respectively, when compared with the ground-based data. The impact on health endpoints such as mortality and respiratory and cardiovascular diseases hospitalizations across the modelling domain was then estimated. The estimated health impact on each of the Australian Bureau of Statistics (ABS) census districts (SA4) of New South Wales was calculated based on epidemiological assumptions of the impact function and incidence rate data from the 2016 ABS and NSW Department of Health statistical health records. Summing up all SA4 census district results over NSW, we estimated that there were 247 (CI: 89, 409) premature deaths, 437 (CI: 81, 984) cardiovascular diseases hospitalizations and 1535 (CI: 493, 2087) respiratory diseases hospitalizations in NSW over the period from 1 November 2019 to 8 January 2020. The results are comparable with a previous study based only on observation data, but the results in this study provide much more spatially and temporally detailed data with regard to the health impact from the summer 2019-2020 wildfires.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Incêndios Florestais , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Humanos , New South Wales/epidemiologia , Nova Zelândia , Oceano Pacífico , Material Particulado/análise , Queensland , Fumaça/análise , América do Sul , Austrália do Sul , Vitória
10.
Artigo em Inglês | MEDLINE | ID: mdl-33924413

RESUMO

During extreme air pollution events, such as bushfires, public health agencies often recommend that vulnerable individuals visit a nearby public building with central air conditioning to reduce their exposure to smoke. However, there is limited evidence that these "cleaner indoor air shelters" reduce exposure or health risks. We quantified the impact of a "cleaner indoor air shelter" in a public library in Port Macquarie, NSW, Australia when concentrations of fine particulate matter (PM2.5) were elevated during a local peat fire and nearby bushfires. Specifically, we evaluated the air quality improvements with central air conditioning only and with the use of portable high efficiency particulate air (HEPA) filter air cleaners. We measured PM2.5 from August 2019 until February 2020 by deploying pairs of low-cost PM2.5 sensors (i) inside the main library, (ii) in a smaller media room inside the library, (iii) outside the library, and (iv) co-located with regulatory monitors located in the town. We operated two HEPA cleaners in the media room from August until October 2019. We quantified the infiltration efficiency of outdoor PM2.5 concentrations, defined as the fraction of the outdoor PM2.5 concentration that penetrates indoors and remains suspended, as well as the additional effect of HEPA cleaners on PM2.5 concentrations. The infiltration efficiency of outdoor PM2.5 into the air-conditioned main library was 30%, meaning that compared to the PM2.5 concentration outdoors, the concentrations of outdoor-generated PM2.5 indoors were reduced by 70%. In the media room, when the HEPA cleaners were operating, PM2.5 concentrations were reduced further with a PM2.5 infiltration efficiency of 17%. A carefully selected air-conditioned public building could be used as a cleaner indoor air shelter during episodes of elevated smoke emissions. Further improvements in indoor air quality within the building can be achieved by operating appropriately sized HEPA cleaners.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Austrália , Monitoramento Ambiental , Humanos , Tamanho da Partícula , Material Particulado/análise , Fumaça/análise
11.
Artigo em Inglês | MEDLINE | ID: mdl-33924462

RESUMO

The choice of a green space metric may affect what relationship is found with health outcomes. In this research, we investigated the relationship between percent green space area, a novel metric developed by us (based on the average contiguous green space area a spatial buffer has contact with), in three different types of buffers and type 2 diabetes (T2D). We obtained information about diagnosed T2D and relevant covariates at the individual level from the large and representative 45 and Up Study. Average contiguous green space and the percentage of green space within 500 m, 1 km, and 2 km of circular buffer, line-based road network (LBRN) buffers, and polygon-based road network (PBRN) buffers around participants' residences were used as proxies for geographic access to green space. Generalized estimating equation regression models were used to determine associations between access to green space and T2D status of individuals. It was found that 30%-40% green space within 500 m LBRN or PBRN buffers, and 2 km PBRN buffers, but not within circular buffers, significantly reduced the risk of T2D. The novel average green space area metric did not appear to be particularly effective at measuring reductions in T2D. This study complements an existing research body on optimal buffers for green space measurement.


Assuntos
Diabetes Mellitus Tipo 2 , Parques Recreativos , Diabetes Mellitus Tipo 2/epidemiologia , Humanos
12.
Aust Health Rev ; 45(1): 4-6, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33563369

RESUMO

A warming climate is increasing the duration of fire seasons and the risk of more extensive and intense bushfires. The Black Summer bushfires that occurred in Australia from September 2019 to early February 2020 were unprecedented in their scale and intensity. The fires led to loss of lives and homes, and widespread destruction of flora, fauna and ecosystems. Dense smoke from these catastrophic fires blanketed major cities and towns for weeks. A Commonwealth Royal Commission and two state inquiries provided recommendations for reducing the risk of future bushfires and for better disaster management processes to support the preparedness, relief, response and recovery to such megafires. While strategies to reduce the risk of bushfires and the damage to our biota and ecosystems are necessary and important, there is also an urgent need for mitigation strategies to reduce or prevent emission of greenhouse gases. If we are to minimise the planetary effects of a warming climate, we need to limit global warming to well below 2°C compared to pre-industrial levels and to reach net zero carbon emissions by 2050. This requires transformative thinking and action by our political leaders that builds on the Australian public and industry's willingness to play their part.


Assuntos
Mudança Climática , Incêndios , Austrália , Ecossistema , Incêndios/prevenção & controle , Humanos
13.
J Expo Sci Environ Epidemiol ; 31(1): 170-176, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32719441

RESUMO

BACKGROUND: Wildland fire (wildfire; bushfire) pollution contributes to poor air quality, a risk factor for premature death. The frequency and intensity of wildfires are expected to increase; improved tools for estimating exposure to fire smoke are vital. New-generation satellite-based sensors produce high-resolution spectral images, providing real-time information of surface features during wildfire episodes. Because of the vast size of such data, new automated methods for processing information are required. OBJECTIVE: We present a deep fully convolutional neural network (FCN) for predicting fire smoke in satellite imagery in near-real time (NRT). METHODS: The FCN identifies fire smoke using output from operational smoke identification methods as training data, leveraging validated smoke products in a framework that can be operationalized in NRT. We demonstrate this for a fire episode in Australia; the algorithm is applicable to any geographic region. RESULTS: The algorithm has high classification accuracy (99.5% of pixels correctly classified on average) and precision (average intersection over union = 57.6%). SIGNIFICANCE: The FCN algorithm has high potential as an exposure-assessment tool, capable of providing critical information to fire managers, health and environmental agencies, and the general public to prevent the health risks associated with exposure to hazardous smoke from wildland fires in NRT.


Assuntos
Poluentes Atmosféricos , Aprendizado Profundo , Incêndios , Poluentes Atmosféricos/análise , Austrália , Comunicação , Humanos , Imagens de Satélites , Fumaça/análise
14.
Med J Aust ; 213(11): 490-492.e10, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33264812

RESUMO

The MJA-Lancet Countdown on health and climate change was established in 2017, and produced its first Australian national assessment in 2018 and its first annual update in 2019. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In the wake of the unprecedented and catastrophic 2019-20 Australian bushfire season, in this special report we present the 2020 update, with a focus on the relationship between health, climate change and bushfires, highlighting indicators that explore these linkages. In an environment of continuing increases in summer maximum temperatures and heatwave intensity, substantial increases in both fire risk and population exposure to bushfires are having an impact on Australia's health and economy. As a result of the "Black Summer" bushfires, the monthly airborne particulate matter less than 2.5 µm in diameter (PM2.5 ) concentrations in New South Wales and the Australian Capital Territory in December 2019 were the highest of any month in any state or territory over the period 2000-2019 at 26.0 µg/m3 and 71.6 µg/m3 respectively, and insured economic losses were $2.2 billion. We also found growing awareness of and engagement with the links between health and climate change, with a 50% increase in scientific publications and a doubling of newspaper articles on the topic in Australia in 2019 compared with 2018. However, despite clear and present need, Australia still lacks a nationwide adaptation plan for health. As Australia recovers from the compounded effects of the bushfires and the coronavirus disease 2019 (COVID-19) pandemic, the health profession has a pivotal role to play. It is uniquely suited to integrate the response to these short term threats with the longer term public health implications of climate change, and to argue for the economic recovery from COVID-19 to align with and strengthen Australia's commitments under the Paris Agreement.


Assuntos
COVID-19 , Mudança Climática , Exposição Ambiental , Saúde Pública , Incêndios Florestais , Austrália , Humanos , Pandemias , Material Particulado , SARS-CoV-2
15.
BMJ Open Respir Res ; 7(1)2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33334858

RESUMO

BACKGROUND: Long-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult populations is inconsistent. OBJECTIVE: To address this knowledge gap, we investigated the associations between particulate matter (PM), nitrogen dioxide (NO2) exposure and lung function, as well as COPD prevalence, in older Chinese adults. METHODS: We used data from the WHO Study on global AGEing and adult health (SAGE) China Wave 1, which includes 111 693 participants from 64 townships in China. A cross-sectional analysis explored the association between satellite-based air pollution exposure estimates (PM with an aerodynamic diameter of ≤10 µm [PM10], ≤2.5 µm [PM2.5] and NO2) and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (defined as post-bronchodilator FEV1/FVC <70%). Data on lung function changes were further stratified by COPD status. RESULTS: Higher exposure to each pollutant was associated with lower lung function. An IQR (26.1 µg/m3) increase in PM2.5 was associated with lower FEV1 (-71.88 mL, 95% CI -92.13 to -51.64) and FEV1/FVC (-2.81 mL, 95% CI -3.37 to -2.25). For NO2, an IQR increment of 26.8 µg/m3 was associated with decreases in FEV1 (-60.12 mL, 95% CI -84.00 to -36.23) and FVC (-32.33 mL, 95% CI -56.35 to -8.32). A 31.2 µg/m3 IQR increase in PM10 was linked to reduced FEV1 (-8.86 mL, 95% CI -5.40 to 23.11) and FEV1/FVC (-1.85 mL, 95% CI -2.24 to -1.46). These associations were stronger for participants with COPD. Also, COPD prevalence was linked to higher levels of PM2.5 (POR 1.35, 95% CI 1.26 to 1.43), PM10 (POR 1.24, 95% CI 1.18 to 1.29) and NO2 (POR 1.04, 95% CI 0.98 to 1.11). CONCLUSION: Ambient air pollution was associated with lower lung function, especially in individuals with COPD, and increased COPD prevalence in older Chinese adults.

16.
Artigo em Inglês | MEDLINE | ID: mdl-32824314

RESUMO

Many studies document the relationship between housing quality and health status. Poor housing in Aboriginal communities continues to be linked to the compromised health status of Aboriginal Australians. The New South Wales (NSW) Housing for Health (HfH) program has been assessing and repairing Aboriginal community housing across the state for 20 years using a standardised intervention methodology that aims to improve the health of Aboriginal people in NSW by improving their living environments. Items are tested and repairs are prioritised to maximise safety and health benefits and measured against 11 Critical Healthy Living Priorities (e.g., safety, facilities for washing people and clothes, removing waste and preparing food). Descriptive analysis of data collected pre- and post-intervention from 3670 houses was conducted to determine the effectiveness of the program. Analysis demonstrated statistically significant improvements in the ability of the houses to support safe and healthy living for all critical healthy living priorities post-interventions. Trend analysis demonstrated the magnitude of these improvements increased over 20 years. In 24 communities (n = 802 houses) where projects were repeated (5-17 years later), results indicate sustainability of improvements for 9 of 11 priorities. However, the overall condition of health-related hardware in Aboriginal community housing across NSW pre-intervention has not significantly changed during the program's 20 years. Results suggest a systematic lack of routine maintenance and quality control continues to be the overwhelming cause for this lack of improvement pre-intervention. Our evaluation of the HfH program demonstrated that fidelity to a standardised housing testing and repair methodology to improve residents' safety and health can have sustainable effects on housing infrastructure and associated health benefits, such as a 40% reduction in infectious disease hospital separations. Housing and health agencies should collaborate more closely on social housing programs and ensure programs are adequately resourced to address safety and health issues.


Assuntos
Nível de Saúde , Habitação , Grupo com Ancestrais Oceânicos , Austrália , Humanos , Controle de Infecções , New South Wales , Segurança
17.
Artigo em Inglês | MEDLINE | ID: mdl-32615056

RESUMO

Over the past decades, air pollution has become one of the critical environmental health issues in China. The present study aimed to evaluate links between ambient air pollution and the prevalence of type 2 diabetes mellitus (T2DM) and the levels of glycosylated hemoglobin (HbA1c). A multilevel linear and logistic regression was used to assess these associations among 7,770 participants aged ≥50 years from the WHO Study on global AGEing and adult health (SAGE) in China in 2007-2010. The average exposure to each of pollutants (particulate matter with an aerodynamic diameter of ≤10 µm/≤2.5 µm/≤1 µm [PM10/PM2.5/PM1] and nitrogen dioxide [NO2]) was estimated using a satellite-based spatial statistical model. In logistic models, a 10 µg/m3 increase in PM10 and PM2.5 was associated with increased T2DM prevalence (Prevalence Odds Ratio, POR: 1.27; 95% CI: 1.11, 1.45 and POR: 1.23; 95% CI: 1.03, 1.46). Similar increments in PM10, PM2.5, PM1 and NO2 were associated with increase in HbA1c levels of 1.8% (95% CI: 1.3, 2.3), 1.3% (95% CI: 1.1, 1.5), 0.7% (95% CI: 0.1, 1.3), and 0.8% (95% CI: 0.4, 1.2), respectively. In a large cohort of older Chinese adults, air pollution was liked to both higher T2DM prevalence and elevated HbA1c levels.


Assuntos
Envelhecimento/sangue , Poluentes Atmosféricos/análise , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Exposição por Inalação/análise , Material Particulado/análise , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Organização Mundial da Saúde
18.
Artigo em Inglês | MEDLINE | ID: mdl-32380747

RESUMO

BACKGROUND: Health effects of air pollution on anaemia have been scarcely studied worldwide. We aimed to explore the associations of long-term exposure to ambient air pollutants with anaemia prevalence and haemoglobin levels in Chinese older adults. METHODS: We used two-level linear regression models and modified Poisson regression with robust error variance to examine the associations of particulate matter (PM) and nitrogen dioxide (NO2) on haemoglobin concentrations and the prevalence of anaemia, respectively, among 10,611 older Chinese adults enrolled in World Health Organization (WHO) Study on global AGEing and adult health (SAGE) China. The average community exposure to ambient air pollutants (PM with an aerodynamic diameter of 10 µm or less (PM10), 2.5 µm or less (PM2.5), 1 µm or less (PM1) and nitrogen dioxide (NO2)) for each participant was estimated using a satellite-based spatial statistical model. Haemoglobin levels were measured for participants from dried blood spots. The models were controlled for confounders. RESULTS: All the studied pollutants were significantly associated with increased anaemia prevalence in single pollutant model (e.g., the prevalence ratios associated with an increase in inter quartile range in three years moving average PM10 (1.05; 95% CI: 1.02-1.09), PM2.5 (1.11; 95% CI: 1.06-1.16), PM1 (1.13; 95% CI: 1.06-1.20) and NO2 (1.42; 95% CI: 1.34-1.49), respectively. These air pollutants were also associated with lower concentrations of haemoglobin: PM10 (-0.53; 95% CI: -0.67, -0.38); PM2.5 (-0.52; 95% CI: -0.71, -0.33); PM1 (-0.55; 95% CI: -0.69, -0.41); NO2 (-1.71; 95% CI: -1.85, -1.57) respectively. CONCLUSIONS: Air pollution exposure was significantly associated with increased prevalence of anaemia and decreased haemoglobin levels in a cohort of older Chinese adults.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Anemia , Idoso , Poluentes Atmosféricos/toxicidade , Anemia/epidemiologia , China/epidemiologia , Exposição Ambiental , Feminino , Hemoglobinas , Humanos , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio , Material Particulado , Prevalência
19.
Ann Acad Med Singap ; 49(2): 78-87, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32246709

RESUMO

INTRODUCTION: Air pollution is associated with adverse health outcomes. However, its impact on emergency health services is less well understood. We investigated the impact of air pollution on nation-wide emergency department (ED) visits and hospital admissions to public hospitals in Singapore. MATERIALS AND METHODS: Anonymised administrative and clinical data of all ED visits to public hospitals in Singapore from January 2010 to December 2015 were retrieved and analysed. Primary and secondary outcomes were defined as ED visits and hospital admissions, respectively. Conditional Poisson regression was used to model the effect of Pollutant Standards Index (PSI) on each outcome. Both outcomes were stratified according to subgroups defined a priori based on age, diagnosis, gender, patient acuity and time of day. RESULTS: There were 5,791,945 ED visits, of which 1,552,187 resulted in hospital admissions. No significant association between PSI and total ED visits (Relative risk [RR], 1.002; 99.2% confidence interval [CI], 0.995-1.008; P = 0.509) or hospital admissions (RR, 1.005; 99.2% CI, 0.996-1.014; P = 0.112) was found. However, for every 30-unit increase in PSI, significant increases in ED visits (RR, 1.023; 99.2% CI, 1.011-1.036; P = 1.24 × 10-6 ) and hospital admissions (RR, 1.027; 99.2% CI, 1.010-1.043; P = 2.02 × 10-5 ) for respiratory conditions were found. CONCLUSION: Increased PSI was not associated with increase in total ED visits and hospital admissions, but was associated with increased ED visits and hospital admissions for respiratory conditions in Singapore.


Assuntos
Poluição do Ar/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Criança , Utilização de Instalações e Serviços , Feminino , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Respiratórias/complicações , Doenças Respiratórias/terapia , Estudos Retrospectivos , Singapura , Adulto Jovem
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