‘Breathing Fire’: Impact of Prolonged Bushfire Smoke Exposure in People with Severe Asthma

Tesfalidet Beyene, Erin S. Harvey, Joseph Van Buskirk, Vanessa M. McDonald, Megan E. Jensen, Jay C. Horvat, Geoffrey G. Morgan, Graeme R. Zosky, Edward Jegasothy, Ivan Hanigan, Vanessa E. Murphy, Elizabeth G. Holliday, Anne E. Vertigan, Matthew Peters, Claude S. Farah, Christine R. Jenkins, Constance H. Katelaris, John Harrington, David Langton, Philip Bardin, Gregory P. Katsoulotos, John W. Upham, Jimmy Chien, Jeffrey J. Bowden, Janet Rimmer, Rose Bell and Peter G. Gibson
Additional contact information
Tesfalidet Beyene: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Erin S. Harvey: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Joseph Van Buskirk: Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Vanessa M. McDonald: Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
Megan E. Jensen: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Jay C. Horvat: School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia
Geoffrey G. Morgan: Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Graeme R. Zosky: Tasmanian School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia
Edward Jegasothy: Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Ivan Hanigan: Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Vanessa E. Murphy: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Elizabeth G. Holliday: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Anne E. Vertigan: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
Matthew Peters: Department of Thoracic Medicine, Concord Hospital, Concord, NSW 2139, Australia
Claude S. Farah: Concord Clinical School, University of Sydney, Concord, NSW 2006, Australia
Christine R. Jenkins: Department of Thoracic Medicine, Concord Hospital, Concord, NSW 2139, Australia
Constance H. Katelaris: School of Medicine, Western Sydney University, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
John Harrington: Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
David Langton: Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
Philip Bardin: Lung and Sleep Medicine, Monash University and Medical Centre, Clayton, VIC 3168, Australia
Gregory P. Katsoulotos: St George Specialist Centre, Kogarah, NSW 2217, Australia
John W. Upham: Department of Respiratory Medicine, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
Jimmy Chien: Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW 2145, Australia
Jeffrey J. Bowden: Respiratory and Sleep Services, Flinders Medical Centre, Flinders University, Bedford Park, SA 5042, Australia
Janet Rimmer: Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia
Rose Bell: Asthma Australia, Melbourne, VIC 3003, Australia
Peter G. Gibson: School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia

IJERPH, 2022, vol. 19, issue 12, 1-15

Abstract: Wildfires are increasing and cause health effects. The immediate and ongoing health impacts of prolonged wildfire smoke exposure in severe asthma are unknown. This longitudinal study examined the experiences and health impacts of prolonged wildfire (bushfire) smoke exposure in adults with severe asthma during the 2019/2020 Australian bushfire period. Participants from Eastern/Southern Australia who had previously enrolled in an asthma registry completed a questionnaire survey regarding symptoms, asthma attacks, quality of life and smoke exposure mitigation during the bushfires and in the months following exposure. Daily individualized exposure to bushfire particulate matter (PM 2.5 ) was estimated by geolocation and validated modelling. Respondents ( n = 240) had a median age of 63 years, 60% were female and 92% had severe asthma. They experienced prolonged intense PM 2.5 exposure (mean PM 2.5 32.5 μg/m 3 on 55 bushfire days). Most (83%) of the participants experienced symptoms during the bushfire period, including: breathlessness (57%); wheeze/whistling chest (53%); and cough (50%). A total of 44% required oral corticosteroid treatment for an asthma attack and 65% reported reduced capacity to participate in usual activities. About half of the participants received information/advice regarding asthma management (45%) and smoke exposure minimization strategies (52%). Most of the participants stayed indoors (88%) and kept the windows/doors shut when inside (93%), but this did not clearly mitigate the symptoms. Following the bushfire period, 65% of the participants reported persistent asthma symptoms. Monoclonal antibody use for asthma was associated with a reduced risk of persistent symptoms. Intense and prolonged PM 2.5 exposure during the 2019/2020 bushfires was associated with acute and persistent symptoms among people with severe asthma. There are opportunities to improve the exposure mitigation strategies and communicate these to people with severe asthma.

Keywords: severe asthma; particulate matter; wildfire smoke; bushfire smoke (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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