RESUMO
BACKGROUND: In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire. METHODS: Using Victorian hospital (Jan 2009-Jun 2022) and ambulance (Jan 2013-Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM2.5. Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury). RESULTS: There were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased. CONCLUSIONS: Our findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services.
RESUMO
In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM2.5). We investigated whether the long-term effects of PM2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events.
Assuntos
Dieta , Material Particulado , Humanos , Material Particulado/análise , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Vitória/epidemiologia , Idoso , Adulto , Incêndios , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Exposição Ambiental/efeitos adversos , Minas de Carvão , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/induzido quimicamenteRESUMO
BACKGROUND: In 2014, the Hazelwood coalmine fire shrouded the regional Australian town of Morwell in smoke and ash for 6 weeks. One of the fire's by-products, PM2.5 , is associated with an increased risk of COVID-19 and severe disease. However, it is unclear whether the effect persisted for years after exposure. In this study, we surveyed a cohort established prior to the pandemic to determine whether PM2.5 from the coalmine fire increased long-term vulnerability to COVID-19 and severe disease. METHODS: From August to December 2022, 612 members of the Hazelwood Health Study's adult cohort, established in 2016/17, participated in a follow-up survey that included standardized items to capture COVID-19 cases, as well as questions about hospitalization and vaccinations. Associations were evaluated in crude and adjusted logistic regression models. RESULTS: A total of 268 (44%) participants self-reported or met symptom criteria for having had COVID-19 at least once. All models found a positive association, with odds of COVID-19 increasing by between 4% and 30% for a 10 µg/m3 increase in coalmine fire-related PM2.5 exposure. However, the association was significant in only 2 of the 18 models. There were insufficient hospitalizations to examine severity (n = 7; 1%). CONCLUSION: The findings are inconclusive on the effect of coalmine fire-related PM2.5 exposure on long-term vulnerability to COVID-19. Given the positive association that was robust to modelling variations as well as evidence for a causal mechanism, it would be prudent to treat PM2.5 from fire events as a long-term risk factor until more evidence accumulates.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Adulto , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , Poluentes Atmosféricos/efeitos adversos , Estudos de Coortes , Austrália/epidemiologia , COVID-19/epidemiologia , Fumaça/efeitos adversos , Exposição Ambiental/efeitos adversos , Poluição do Ar/efeitos adversosRESUMO
BACKGROUND: In 2014, wildfires ignited a coal mine in Australia, burning for 6 weeks, releasing large amounts of fine particulate matter ≤2.5 µm in diameter (PM2.5). We investigated the association between individual PM2.5 exposure and emergency department presentations (EDPs) within 5 years post-fire. METHODS: Survey and exposure data for 2725 residents from an exposed and unexposed town were linked with ED administrative data from 2009 to 2019. The association between individual PM2.5 and EDPs was assessed using recurrent survival analysis. RESULTS: A 10 µg/m3 increase in PM2.5 was associated with a 10% increase in respiratory EDPs (HR = 1.10; 95%CI:1.00-1.22) over 5 years post-fire. Increased risks of EDPs for ischaemic heart disease (HR = 1.39; 95%CI:1.12-1.73), atherothrombotic disease (HR = 1.27; 95%CI:1.08-1.50), and cardiovascular disease (HR = 1.10, 95%CI:0.99-1.22) were evident within 2.5 years. CONCLUSION: PM2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory conditions. An increased risk of CVD within 2.5 years post-fire subsided after this time.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doenças Cardiovasculares , Humanos , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Material Particulado/análise , Austrália/epidemiologia , Doenças Cardiovasculares/induzido quimicamente , Serviço Hospitalar de Emergência , Carvão Mineral , Exposição Ambiental/análise , Poluição do Ar/análise , Fumaça/análiseRESUMO
BACKGROUND: Wildfires cause significant physical and mental ill-health. How physical and mental symptoms interact following wildfire smoke exposure is unclear, particularly in the context of repeated exposures. In this cross-sectional study we investigated how posttraumatic stress and general psychological distress associated with somatic symptoms in a community exposed to multiple smoke events. METHODS: A random weighted sample of 709 adults exposed to smoke during the 2014 Hazelwood coal mine fire in south-eastern Australia completed a survey in 2020. The survey coincided with the Black Summer wildfires that caused a similar period of smoke haze in the region. Participants self-reported somatic symptoms (PHQ-15) and mine fire-related posttraumatic stress (IES-R) experienced over the previous week, general psychological distress (K10) experienced over the previous four weeks, lifetime health diagnoses and demographic information. Associations between posttraumatic stress, general psychological distress, and each PHQ-15 somatic symptom were analysed using ordinal logistic regression models. RESULTS: Overall, 36.2% of participants reported moderate- or high-level somatic symptomology. The most frequent somatic symptoms were fatigue, limb pain, trouble sleeping, back pain, headaches, and shortness of breath. After controlling for confounding factors, general psychological distress and posttraumatic stress were independently associated with all somatic symptoms (except menstrual problems in females for posttraumatic stress). CONCLUSIONS: Results highlight the high prevalence of somatic symptoms and their association with general psychological distress and posttraumatic stress within a community in the midst of a second large-scale smoke event. It is essential that healthcare providers and public health authorities consider the interconnections of these conditions when supporting communities affected by climate-related disasters.
Assuntos
Desastres , Incêndios , Sintomas Inexplicáveis , Adulto , Feminino , Humanos , Estudos Transversais , Estações do AnoRESUMO
The 2014 Hazelwood coal mine fire in the Latrobe Valley, Australia, distributed toxic smoke into surrounding communities over 45 days. This study investigated risk and protective factors associated with four trajectories of posttraumatic distress (resilient, recovery, delayed-onset, chronic) among exposed adults. Participants (N = 709) completed surveys in 2016-2017 and 2019-2020 assessing mine fire-related particulate matter (PM2.5 ) exposure; sociodemographic, physical, and mental health variables; and exposure to other traumatic and recent stressful events. Mine fire-related posttraumatic distress was measured using the IES-R; trajectories were determined according to established clinical significance thresholds. Relative risk ratios (RRRs) were generated from multivariate multinomial regressions. The resilient trajectory was most common (77.0%). The chronic trajectory (8.5%) was associated with loneliness, RRR = 2.59, 95% CI [1.30, 5.16], and physical health diagnoses, RRR = 2.31, 95% CI [1.32, 4.02]. The delayed-onset trajectory (9.1%) was associated with multiple recent stressful events, RRR = 2.51, 95% CI [1.37, 4.59]; mental health diagnoses, RRR = 2.30, 95% CI [1.25, 4.24]; loneliness, RRR = 2.05, 95% CI [1.09, 3.88]; and male gender, RRR = 2.01, 95% CI [1.18, 3.44]. Socioeconomic advantage protected against chronic, RRR = 0.68, 95% CI [0.53, 0.86], and delayed-onset trajectory membership, RRR = 0.68, 95% CI [0.50, 0.94]; social support protected against chronic trajectory membership, RRR = 0.67, 95% CI [0.49, 0.92]. PM2.5 exposure did not determine trajectory. These findings enhance understanding of longer-term posttraumatic responses to large-scale smoke events and can inform mental health initiatives within at-risk communities.
Assuntos
Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Masculino , Material Particulado/análise , Material Particulado/toxicidade , Carvão Mineral/análise , FumarRESUMO
OBJECTIVE: In 2014, a fire at an open cut coal mine in South-eastern Australia burned for about 6 weeks. Residents of the adjacent town were exposed to high levels of fine particulate matter (PM2.5) during this period. Three and a half years after the event, this study aimed to investigate potential long-term impacts of short-term exposure to coal mine fire smoke on asthma. METHODS: A cross-sectional analysis was undertaken in a group of exposed participants with asthma from Morwell (n = 165) and a group of unexposed participants with asthma from the control town of Sale (n = 64). Exposure was determined by modeled PM2.5 data for the mine fire period. Respiratory symptoms were assessed with a validated respiratory health questionnaire and symptom severity score. Asthma control was assessed with a validated questionnaire. Lung function testing included spirometry, bronchodilator response, and fraction of exhaled nitric oxide. RESULTS: There was no evidence that exposed participants had more severe asthma symptoms, worse lung function, or more eosinophilic airway inflammation than unexposed participants. However, there was some evidence that Morwell participants had more uncontrolled than well-controlled asthma, compared to the participants from Sale (adjusted relative risk ratio 2.71 95% CI: 1.02, 7.21, p = .046). CONCLUSION: Three and a half years after exposure, coal mine fire smoke did not appear to be associated with more severe asthma symptoms or worse lung function but might be associated with poorer asthma control.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/epidemiologia , Asma/etiologia , Carvão Mineral/efeitos adversos , Carvão Mineral/análise , Estudos Transversais , Exposição Ambiental/análise , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , Fumaça/efeitos adversos , NicotianaRESUMO
BACKGROUND: For six weeks from February 9, 2014, smoke and ash from a fire in the Morwell open cut brown coal mine adjacent to the Hazelwood power station covered parts of the Latrobe Valley, in south eastern Australia. AIMS: To evaluate the health impact of the mine fire, daily counts of ambulance attendances from July 2010 to March 2015 were analysed. METHODS: Time series models were used to evaluate the relative risk of ambulance attendances during the mine fire, in comparison with the remainder of the analysis period, and to also assess the risk of ambulance attendances associated with lagged effects of exposure to mine fire-related PM2.5 levels. The models controlled for factors likely to influence ambulance attendances including seasonality, long-term temporal trends, day of the week, daily maximum temperature and public holidays. RESULTS: A 10 µg/m3 increase in fire-related PM2.5 was found to be associated with a 42% (95%CI: 14-76%) increase in ambulance attendances for respiratory conditions and a 7% (0-14%) increase in all ambulance attendances over a 20-day lag period. A smaller effect associated with exposure to fire-related PM2.5 was identified when assuming shorter lag effects. Similar results were identified when assessing whether ambulance attendances increased during the 30-day mine fire period. There was a 15% (8-21%) increased risk of ambulance attendances for all conditions and a 47% (19-81%) increased risk for respiratory conditions during the mine fire period. CONCLUSIONS: Exposure to smoke and ash from a fire in an open cut brown coal mine was associated with increased ambulance attendances, particularly for respiratory conditions. These findings guide the development and implementation of effective and timely strategies and health service planning to respond and mitigate health risks that arise in affected communities during future major air pollution episodes.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Ambulâncias/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Material Particulado/análise , Material Particulado/toxicidade , Austrália do SulRESUMO
BACKGROUND AND OBJECTIVE: In 2014, a 6-week-long fire at the Hazelwood coal mine exposed residents in the adjacent town of Morwell to high concentrations of fine particulate matter with an aerodynamic diameter < 2.5 µm (PM2.5 ). The long-term health consequences are being evaluated as part of the Hazelwood Health Study. METHODS: Approximately 3.5-4 years after the mine fire, adults from Morwell (n = 346) and the comparison town Sale (n = 173) participated in the longitudinal Respiratory Stream of the Study. Individual PM2.5 exposure was retrospectively modelled. Lung mechanics were assessed using the forced oscillation technique (FOT), utilizing pressure waves to measure respiratory system resistance (Rrs) and reactance (Xrs). Multivariate linear regression was used to evaluate associations between PM2.5 and transformed Rrs at 5 Hz, area under the reactance curve (AX5) and Xrs at 5 Hz controlling for key confounders. RESULTS: There were clear dose-response relationships between increasing mine fire PM2.5 and worsening lung mechanics, including a reduction in post-bronchodilator (BD) Xrs5 and an increase in AX5. A 10 µg/m3 increase in mine fire-related PM2.5 was associated with a 0.015 (95% CI: 0.004, 0.027) reduction in exponential (Xrs5) post-BD, which was comparable to 4.7 years of ageing. Similarly, the effect of exposure was associated with a 0.072 (0.005, 0.138) increase in natural log (lnAX5) post-BD, equivalent to 3.9 years of ageing. CONCLUSION: This is the first study using FOT in adults evaluating long-term respiratory outcomes after medium-term ambient PM2.5 exposure to coal mine fire smoke. These results should inform public health policies and planning for future events.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Poluentes Atmosféricos/análise , Carvão Mineral , Exposição Ambiental/efeitos adversos , Humanos , Pulmão/química , Material Particulado/efeitos adversos , Material Particulado/análise , Estudos Retrospectivos , Fumaça/efeitos adversosRESUMO
OBJECTIVES: Hypertension is a leading risk factor for death and disability. We aimed to estimate the prevalence of hypertension in an older rural Australian cohort and identify predictors of hypertension management. DESIGN: Analysis of cross-sectional data collected from participants in a prospective cohort study. SETTING: The Victorian rural towns of Morwell and Sale in 2018-2019. PARTICIPANTS: A weighted random sample of 1119 eligible participants from Morwell or Sale, aged ≥55-90 years for men and ≥60-90 years for women, was drawn from the Hazelwood Health Study's Adult Survey cohort. MAIN OUTCOME MEASURES: Blood pressure, body mass index, left ventricular hypertrophy by electrocardiogram, estimated glomerular filtration rate and glycosylated haemoglobin (HbA1c ) were measured. Participants with hypertension were categorised as managed, undermanaged or unmanaged. RESULTS: Testing undertaken of 498 participants estimated the weighted prevalence of hypertension (defined as blood pressure ≥ 140/90 mm Hg, a self-reported doctor diagnosis of hypertension or taking antihypertensive medication) to be 79.9% (95% confidence interval: 75.7-83.4). Of those, 54.5% (49.4-60.0) had managed hypertension (<140/90 mm Hg), 37.1% (32.3-42.1) undermanaged hypertension and 8.4% (5.9-11.9) a new finding of hypertension (unmanaged hypertension). Current employment (relative risk 1.47, 95% confidence interval: 1.06-2.02) and single marital status (relative risk 1.45, 1.4-1.84) were associated with under- or unmanaged hypertension. Compared with no hypertension, the hypertensive groups were more likely to demonstrate markers of end-organ damage such as left ventricular hypertrophy and impaired renal function. CONCLUSION: Hypertension is a highly prevalent condition among older rural Australians which is suboptimally identified and managed.
Assuntos
Nível de Saúde , Hipertensão/diagnóstico , Hipertensão/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Austrália , Pressão Sanguínea/fisiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Estilo de Vida , Masculino , Obesidade/epidemiologia , Prevalência , Estudos ProspectivosRESUMO
BACKGROUND: Following the 1990-1991 Gulf War, Gulf War veterans (veterans) reported health symptoms more commonly than non-deployed groups. This article examines symptom persistence, incidence and prevalence 20 years on. METHODS: In 2000-2003 and 2011-2012, a 63-item symptom checklist was administered to 697 veterans and 659 comparison group. Symptomatology was compared using log-binomial regression. RESULTS: Both veterans and comparison group reported significantly increased prevalence (3-52%) over time in more than half the symptoms, with a similar overall rate of increase. Half the symptoms had higher incidence (risk-ratios ranged 1.43-1.50) and a quarter were more persistent (risk-ratios ranged 1.12-1.20) in veterans than the comparison group. CONCLUSIONS: Symptomatology increased in both groups over time, but persisted to a similar extent and had higher incidence among veterans than the comparison group. The gap in symptom prevalence between the two groups remained unchanged. These findings suggest enduring health consequences of Gulf War service.
Assuntos
Guerra do Golfo , Síndrome do Golfo Pérsico/epidemiologia , Veteranos/estatística & dados numéricos , Adulto , Lista de Checagem , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Síndrome do Golfo Pérsico/etiologia , Prevalência , Análise de Regressão , Avaliação de Sintomas/métodos , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Environmental disasters such as wildfires, floods and droughts can introduce significant interruptions and trauma to impacted communities. Children and young people can be disproportionately affected with additional educational disruptions. However, evaluating the impact of disasters is challenging due to difficulties in establishing studies and recruitment post-disasters. OBJECTIVES: We aimed to (1) develop a Bayesian model using aggregated school-level data to evaluate the impact of environmental disasters on academic achievement and (2) evaluate the impact of the 2014 Hazelwood mine fire (a six-week fire event in Australia). METHODS: Bayesian hierarchical meta-regression was developed to evaluate the impact of the mine fire using easily accessible aggregated school-level data from the standardised National Assessment Program-Literacy and Numeracy (NAPLAN) test. NAPLAN results and school characteristics (2008-2018) from 69 primary/secondary schools with different levels of mine fire-related smoke exposure were used to estimate the impact of the event. Using an interrupted time series design, the model estimated immediate effects and post-interruption trend differences with full Bayesian statistical inference. RESULTS: Major academic interruptions across NAPLAN domains were evident in high exposure schools in the year post-mine fire (greatest interruption in Writing: 11.09 [95%CI: 3.16-18.93], lowest interruption in Reading: 8.34 [95%CI: 1.07-15.51]). The interruption was comparable to a four to a five-month delay in educational attainment and had not fully recovered after several years. CONCLUSION: Considerable academic delays were found as a result of a mine fire, highlighting the need to provide educational and community-based supports in response to future events. Importantly, this work provides a statistical method using readily available aggregated data to assess the educational impacts in response to other environmental disasters.
Assuntos
Incêndios , Criança , Humanos , Adolescente , Teorema de Bayes , Análise de Séries Temporais Interrompida , Escolaridade , EstudantesRESUMO
Background and Aims: Mega-wild fires are exposing large communities to weeks or months of high concentration smoke-related fine particulate air pollution (PM). However, little research has examined the long-term vascular responses from exposure to PM of this concentration and duration. We investigated whether level of exposure to 6 weeks of PM from the 2014 Hazelwood coal mine fire was associated with abnormal vascular responses approximately four years later. Methods: A cross-sectional analysis was undertaken of 387 participants (225 exposed, 162 unexposed) aged 55-89 years, 3.5-4 years after the mine fire. The primary outcome was flow-mediated dilatation (FMD), with time to reach peak diameter as the secondary outcome. Other secondary markers included high-sensitivity C-reactive protein (hsCRP) and ischaemic Electrocardiogram (ECG) changes. Results: There was no evidence of a difference in FMD between participants with high, medium, low or no mine-fire related PM2.5 exposure (4.09% vs 4.06% vs 4.02% vs 3.98%, respectively, p=0.99). Likewise, there was no difference in hsCRP or ischaemic ECG changes. In contrast, there was evidence of a difference in time to peak diameter (p=0.002) with more unexposed participants reaching peak diameter within 30 seconds (36%) compared to those who had high, medium, or low exposure (23%, 22%, 13%, respectively). Multivariate ordinal logistic regression analysis suggested that township, Morwell (exposed) vs Sale (unexposed), but not level of PM2.5 exposure, was associated with delayed time to peak diameter (OR 2.71; 95% CI 1.56, 4.69). Smokers also had delayed time to peak diameter. Conclusion: There was no association between level of exposure to PM2.5 from the 6-week Hazelwood coal mine fire smoke event and reduced FMD, elevated hsCRP or ischaemic ECG four years later. Evidence of delayed time to peak diameter observed in adults from the exposed town, compared to an unexposed town, requires further investigation.
Assuntos
Poluentes Atmosféricos , Carvão Mineral , Adulto , Poluentes Atmosféricos/análise , Proteína C-Reativa/análise , Carvão Mineral/análise , Estudos Transversais , Exposição Ambiental/análise , Humanos , Material Particulado/análiseRESUMO
BACKGROUND: Little is known about the long-term health impacts of exposures to landscape fire smoke. We aimed to evaluate the association between exposure to coal mine fire-related particulate matter 2.5 µm or less in diameter (PM2.5) and hospitalisation in the 5 years following the 6-week Hazelwood coal mine fire in Australia in 2014. METHODS: We surveyed 2725 residents (mean age: 58.3 years; 54.3% female) from an exposed and a comparison town. Individual PM2.5 exposures during the event were estimated using modelled PM2.5 concentrations related to the coal mine fire and self-reported location data. The individual exposure and survey data were linked with hospitalisation records between January 2009 and February 2019. Recurrent event survival analysis was used to evaluate relationships between PM2.5 exposure and hospitalisation following mine fire, adjusting for important covariates. RESULTS: Each 10-µg/m3 increase in mine fire-related PM2.5 was associated with a 9% increased hazard [hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01, 1.17] of respiratory hospitalisation over the next 5 years, with stronger associations observed for females (HR = 1.16; 95% CI: 1.06, 1.27) than males (HR = 0.99; 95% CI: 0.89, 1.11). In particular, increased hazards were observed for hospitalisations for asthma (HR = 1.43; 95% CI: 1.19, 1.73) and chronic obstructive pulmonary disease (HR = 1.14; 95% CI: 1.02, 1.28). No such association was found for hospitalisations for cardiovascular diseases, mental illness, injuries, type 2 diabetes, renal diseases or neoplasms. CONCLUSIONS: A 6-week exposure to coal mine fire-related PM2.5 was associated with increased hazard of respiratory hospitalisations over the following 5 years, particularly for females.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Carvão Mineral , Material Particulado , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Diabetes Mellitus Tipo 2 , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , Material Particulado/toxicidadeRESUMO
BACKGROUND: Little is known about the long-term health effects of coalmine fire smoke exposure. The 2014 Hazelwood coalmine fire event in southeast Australia released smoke into surrounding areas for 6 weeks. OBJECTIVES: We aimed to investigate whether individual-level exposure to coalmine fire-related PM2.5 was associated with a long-term increase in ambulance attendances following a coalmine fire event. METHODS: A total of 2223 residents from the most exposed town of Morwell were assessed for ambulance attendances after the Hazelwood event from April 1, 2014 to December 31, 2017. PM2.5 exposure was estimated for each individual using participant self-reported location diary data during the event and modelled PM2.5 concentrations. Recurrent event survival analysis was used to evaluate the relationship between PM2.5 exposure and ambulance attendances. RESULTS: For each 10 µg/m3 increase in mean coalmine fire-related PM2.5 exposure, there was a 10% (adjusted hazard ratio [HR]:1.10, 95%CI:1.03-1.17) increase in the overall risk of ambulance attendances within 3.5 years after the coalmine fire. Exposure to PM2.5 was also associated with increased risk of respiratory (HR: 1.21, 95%CI: 1.02-1.44) and cardiovascular (HR: 1.13, 95%CI: 1.01-1.28) related ambulance attendances. CONCLUSION: These results demonstrate that exposure to coalmine fire smoke during the Hazelwood event was associated with a long-term health risk post the fire event, specifically for respiratory and cardiovascular conditions. These findings are important for effective implementation of health care services following future extended coalmine fire PM2.5 events.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Incêndios , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Ambulâncias , Cidades , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade , Fumaça/efeitos adversos , Fumaça/análiseRESUMO
Rationale: In 2014, the Hazelwood open-cut coal mine in southeastern Australia burned for 6 weeks, exposing nearby residents to high concentrations of fine particulate matter (PM2.5). The long-term health consequences are unknown and are being evaluated as part of the Hazelwood Health Study. Objectives: To explore the association between PM2.5 exposure and chronic obstructive pulmonary disease (COPD). Methods: A sample of 346 exposed and 173 unexposed adults participated in the longitudinal Respiratory Stream of the Hazelwood Health Study. Participants underwent spirometry and gas transfer measurements and answered validated respiratory questionnaires 3.5-4 years after the fire. Individual-level mine fire-related PM2.5 exposure was modeled. Multivariate linear regression and logistic models were fitted to analyze associations between mean and peak PM2.5 exposure and clinical outcomes, stratified by smoking status. Results: A 10 µg/m3 increase in mean PM2.5 exposure was associated with a 69% (95% confidence interval [CI], 11-158%) increase in odds of spirometry consistent with COPD among nonsmokers and increased odds of chest tightness (odds ratio [OR], 1.30; 95% CI, 1.03-1.64) and chronic cough (OR, 1.24; 95% CI, 1.02-1.51) in the previous 12 months in all participants. For current smokers, increments in mean PM2.5 exposure were associated with higher odds of chronic cough in the preceding 12 months (OR, 2.13; 95% CI, 1.24-3.65). Conclusions: Almost 4 years after a 6-week period of coal fire PM2.5 exposure, we identified a dose-response association between exposure and COPD in nonsmokers. With climate change a likely contributor to increased risk of landscape fires, the findings will inform policy decisions during future sustained smoke events.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Carvão Mineral/toxicidade , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/etiologiaRESUMO
We investigated the association between respiratory symptoms and psychological distress in the context of a prolonged smoke event, and evaluated whether smoke exposure, or pre-existing respiratory and mental health conditions, influenced the association. Three thousand ninety-six residents of a rural town heavily exposed to smoke from the 6-week Hazelwood coal mine fire, and 960 residents of a nearby unexposed town, completed Kessler's psychological distress questionnaire (K10) and a modified European Community Respiratory Health Survey. Logistic regression models evaluated associations between distress and respiratory symptoms, with interactions fitted to evaluate effect modification. Smoke exposed participants reported higher levels of distress than those unexposed, and participants reporting respiratory symptoms recorded higher levels of distress than participants without respiratory symptoms, irrespective of exposure. 5-unit increments in K10 scores were associated with 21%-48% increases in the odds of reporting respiratory symptoms. There were significant interactions with pre-existing asthma, chronic obstructive pulmonary disease and mental health conditions, but not with smoke exposure. Although participants with pre-existing conditions were more likely to report respiratory symptoms, increasing distress was most strongly associated with respiratory symptoms among those without pre-existing conditions. Communities exposed to landscape fire smoke could benefit from interventions to reduce both psychological and respiratory distress.
Assuntos
Incêndios , Angústia Psicológica , Humanos , Material Particulado/análise , Autorrelato , Inquéritos e QuestionáriosRESUMO
Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM2.5) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM2.5 exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM2.5 from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Incêndios , Angústia Psicológica , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Carvão Mineral/análise , Exposição Ambiental/análise , Humanos , Material Particulado/análise , Fumar , VitóriaRESUMO
BACKGROUND: In 2014, the Morwell brown coal mine, located in the Latrobe Valley of South eastern Australia, caught fire covering nearby areas in plumes of smoke over a 6-week period. AIMS: To investigate the association between exposure to mine fire related air pollution and the risk of mortality. METHODS: Time series models were used to evaluate the risk of mortality during the first 30 days of the mine fire, when the smoke was most intense, and in the following six months. Associations were also investigated between mine fire related PM2.5 and mortality. RESULTS: During the 30-day mine fire period, there was an increased risk of death from injury in the most exposed town of Morwell, however no increased risk was observed for all-cause, cardiovascular or respiratory mortality. In the broader Latrobe Valley, males and residents aged 80 and above were at greatest risk of death from injury during the mine fire. In Morwell, during the six months after the mine fire there was an increased risk of all-cause mortality and death from Ischaemic Heart Disease (IHD). Males and residents aged 80 and above in the broader Latrobe Valley, were at increased risk of death from IHD six months after the fire. CONCLUSIONS: Coal mine fire exposure was associated with an increase in injury deaths during the mine fire and cardiovascular deaths in the six months after the fire. These findings assist in identifying at risk groups, and improving targeted health advice for future air pollution exposures in the community.
Assuntos
Exposição Ambiental , Incêndios , Mortalidade , Material Particulado , Idoso de 80 Anos ou mais , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Carvão Mineral , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Masculino , Mortalidade/tendências , Material Particulado/efeitos adversosRESUMO
No studies have investigated the cancer outcomes from high level medium duration coal mine fire fine particulate matter ⩽2.5 µm in diameter (PM2.5) exposure. We included 2208 Morwell residents (exposed) and 646 Sale residents (unexposed) who participated in the Hazelwood Health Study Adult Survey. Competing risk regression models were used to evaluate relationships between coal mine fire exposure and cancer incidence, adjusting for known confounders. There were 137 cancers in the exposed and 27 in the unexposed over 14 849 person-years of follow-up. A higher risk of cancer incidence was observed for Morwell participants (HR = 1.67 [95% CI 1.05-2.67]), but no evidence to suggest associations between PM2.5 exposure and incidence of all cancers (HR = 1.02 [95% CI 0.91-1.13]), or site-specific cancers. There is no strong evidence that exposure to high concentrations of mine fire-related PM2.5 over a prolonged period could explain the higher risk in exposed population in this study.