TY - JOUR
T1 - Vascular Responses Among Adults Four Years Post Exposure to 6 Weeks of Smoke from the Hazelwood Coal Mine Fire
AU - Mundisugih, Juan
AU - Gao, Caroline X.
AU - Ikin, Jillian F.
AU - Abramson Sinjini Biswas, Michael J.
AU - Brown, David
AU - Biswas, Sinjini
AU - Dewar, Elizabeth M.
AU - Liew, Danny
AU - Stub, Dion
N1 - Funding Information:
A Victorian State Government appointed Board of Inquiry into the fire led to the establishment of the Hazelwood Health Study (HHS; www.hazelwoodhealthstudy.org.au), a collaborative program of research funded by the Victorian Department of Health (DH). The ongoing HHS aims to determine the potential long-term health consequences of the mine fire for the local population. Using daily counts of dispensed prescription medication from the Pharmaceutical Benefit Scheme (PBS) database, the Hazelinks Stream of the HHS observed an association between 10 mg/m3 unit increases in hourly PM2.5 concentrations and a 10% increase in dispensed cardiovascular medications over a lag range of 3–7 days exposure.13 Medical service utilisation data showed increases in general practitioner (GP) consultations, but there was no observed increase in cardiovascular-specific services.14 Hazelinks also utilised mortality data from the Australian Institute of Health and Welfare and estimated a 62% increase in risk of death from cardiovascular conditions in Morwell (95% CI 25%-110%) during the six months after the mine fire, including an 88% increase in deaths from ischaemic heart disease (IHD).15 In total there were 26 cardiovascular-related deaths in Morwell attributed to this six month, post mine fire period, including 17 with IHD. These 26 cardiovascular deaths represented 38% of all cardiovascular deaths in Morwell during this period.15
Funding Information:
Michael J Abramson holds investigator-initiated grants for unrelated research from Pfizer, Boehringer-Ingelheim, Sanofi and GSK. He has also undertaken an unrelated consultancy for Sanofi and received a speaker’s fee from GSK. Danny Liew has undertaken unrelated consultancies for AbbVie, Astellas, AstraZeneca, Bristol-Myers Squibb, CSL-Behring, Novartis, Pfizer and Sanofi. Dion Stub undertakes unrelated research supported by a National Heart Foundation fellowship. The remaining authors report no relationships that could be construed as a conflict of interest in this work.
Publisher Copyright:
© 2022 Mundisugih et al. This work is published and licensed by Dove Medical Press Limited.
PY - 2022/4/13
Y1 - 2022/4/13
N2 - 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.
AB - 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.
KW - air pollution
KW - epidemiology
KW - flow mediated dilatation
KW - particulate matter
KW - time to peak diameter
KW - vascular responses
UR - http://www.scopus.com/inward/record.url?scp=85128796957&partnerID=8YFLogxK
U2 - 10.2147/VHRM.S339439
DO - 10.2147/VHRM.S339439
M3 - Article
C2 - 35444423
AN - SCOPUS:85128796957
SN - 1176-6344
VL - 18
SP - 253
EP - 265
JO - Vascular Health and Risk Management
JF - Vascular Health and Risk Management
ER -
