Long-term impact of coal mine fire smoke on lung mechanics in exposed adults

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 (PM_2.5). 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 PM_2.5 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 PM_2.5 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 PM_2.5 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 PM_2.5 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 PM_2.5 exposure to coal mine fire smoke. These results should inform public health policies and planning for future events.