Forest fire smoke exposures and out-of-hospital cardiac arrests in Melbourne, Australia: a case-crossover study

Research output: Contribution to journalArticleResearchpeer-review

35 Citations (Scopus)

Abstract

Background: Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries. Objective: In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke. Methods: We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (= 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site. Results: There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter = 2.5 ?m (PM2.5) (8.05 ; 95 CI: 2.30, 14.13 ; IQR = 6.1 ?g/m3) or = 10 ?m (PM10) (11.1 ; 95 CI: 1.55, 21.48 ; IQR = 13.7 ?g/m3) and carbon monoxide (35.7 ; 95 CI: 8.98, 68.92 ; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventyfour ?fire-hours? (i.e., hours in which Melbourne?s air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95 CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations inPM2.5 during these fire-hours. Conclusions: This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons
Original languageEnglish
Pages (from-to)959 - 964
Number of pages6
JournalEnvironmental Health Perspectives
Volume123
Issue number10
DOIs
Publication statusPublished - 2015

Cite this

@article{9ee6d22c7e6042ca948737131dc4f763,
title = "Forest fire smoke exposures and out-of-hospital cardiac arrests in Melbourne, Australia: a case-crossover study",
abstract = "Background: Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries. Objective: In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke. Methods: We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (= 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site. Results: There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter = 2.5 ?m (PM2.5) (8.05 ; 95 CI: 2.30, 14.13 ; IQR = 6.1 ?g/m3) or = 10 ?m (PM10) (11.1 ; 95 CI: 1.55, 21.48 ; IQR = 13.7 ?g/m3) and carbon monoxide (35.7 ; 95 CI: 8.98, 68.92 ; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventyfour ?fire-hours? (i.e., hours in which Melbourne?s air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95 CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations inPM2.5 during these fire-hours. Conclusions: This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons",
author = "Dennekamp, {Martine Neeltje} and Straney, {Lahn David John} and Bircan Erbas and Abramson, {Michael John} and Keywood, {Melita Doris} and Smith, {Karen Louise} and Sim, {Malcolm Ross} and Glass, {Deborah Catherine} and {Del Monaco}, Anthony and Anjali Haikerwal and Tonkin, {Andrew Maxwell}",
year = "2015",
doi = "10.1289/ehp.1408436",
language = "English",
volume = "123",
pages = "959 -- 964",
journal = "Environmental Health Perspectives",
issn = "0091-6765",
publisher = "National Institute of Environmental Health Sciences",
number = "10",

}

TY - JOUR

T1 - Forest fire smoke exposures and out-of-hospital cardiac arrests in Melbourne, Australia: a case-crossover study

AU - Dennekamp, Martine Neeltje

AU - Straney, Lahn David John

AU - Erbas, Bircan

AU - Abramson, Michael John

AU - Keywood, Melita Doris

AU - Smith, Karen Louise

AU - Sim, Malcolm Ross

AU - Glass, Deborah Catherine

AU - Del Monaco, Anthony

AU - Haikerwal, Anjali

AU - Tonkin, Andrew Maxwell

PY - 2015

Y1 - 2015

N2 - Background: Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries. Objective: In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke. Methods: We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (= 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site. Results: There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter = 2.5 ?m (PM2.5) (8.05 ; 95 CI: 2.30, 14.13 ; IQR = 6.1 ?g/m3) or = 10 ?m (PM10) (11.1 ; 95 CI: 1.55, 21.48 ; IQR = 13.7 ?g/m3) and carbon monoxide (35.7 ; 95 CI: 8.98, 68.92 ; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventyfour ?fire-hours? (i.e., hours in which Melbourne?s air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95 CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations inPM2.5 during these fire-hours. Conclusions: This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons

AB - Background: Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries. Objective: In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke. Methods: We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (= 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site. Results: There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter = 2.5 ?m (PM2.5) (8.05 ; 95 CI: 2.30, 14.13 ; IQR = 6.1 ?g/m3) or = 10 ?m (PM10) (11.1 ; 95 CI: 1.55, 21.48 ; IQR = 13.7 ?g/m3) and carbon monoxide (35.7 ; 95 CI: 8.98, 68.92 ; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventyfour ?fire-hours? (i.e., hours in which Melbourne?s air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95 CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations inPM2.5 during these fire-hours. Conclusions: This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590745/pdf/ehp.1408436.pdf

U2 - 10.1289/ehp.1408436

DO - 10.1289/ehp.1408436

M3 - Article

VL - 123

SP - 959

EP - 964

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 10

ER -