Excess emergency department visits for cardiovascular and respiratory diseases during the 2019–20 bushfire period in Australia: A two-stage interrupted time-series analysis

The health effects of the unprecedented bushfires in Australia in 2019–20 have not been fully examined. We aimed to examine the excess emergency department (ED) visits related to the 2019–20 bushfires in New South Wales (NSW). We obtained weekly data of ED visits for cardiovascular and respiratory diseases in all the 28 Statistical Area Level 4 (SA4) regions in NSW during the bushfire seasons from 2017 to 2020. A two-stage interrupted time-series analysis was applied to quantify the excess risk for ED visits in 2019–20. The total number of excess ED visits, excess percentages, and their empirical confidence intervals (eCIs) were calculated to estimate the impacts of the bushfire season. A total of 416,057 records of cardiorespiratory ED visits were included in our analysis. The bushfire season in 2019–20 was significantly associated with a 6.0% increase (95% eCI: 1.9, 10.3) in ED visits for respiratory diseases and a 10.0% increase (95% eCI: 5.0, 15.2) for cardiovascular diseases, corresponding to 6177 (95% eCI: 1989, 10,166) and 3120 (95% eCI: 1628, 4544) excess ED visits, respectively. The percentage of excess ED visits was higher in regions with lower SES and high fire density. In the context of climate change, more targeted strategies should be developed to prevent adverse bushfire effects and recover from such extreme environmental events.