There is an urgent need for a national health strategy to protect the population from exposure to bushfire smoke, say researchers
While bushfires have always been a feature of the natural environment in Australia, the risk has increased over time, say public health and medical researchers Sotiris Vardoulakis, Bin Jalaludin, Geoffrey Morgan, Ivan Hanigan and Fay Johnston from across the universities of NSW, Sydney, Canberra, Tasmania and Australian National University.
Fire seasons are starting earlier, finishing later, and extreme fire weather is becoming more severe with climate change they write in the Medical Journal of Australia this week.
Here are 8 things to know about the health effects of bushfire smoke from their piece:
1. Bushfire smoke, as well as smoke from prescribed burns, contains a complex mixture of particles and gases that are chemically transformed in the atmosphere and transported by the wind over long distances.
2. A major public health concern is population exposure to atmospheric particulate matter (PM) with a diameter < 2.5 μm (PM5), which can penetrate deep into the respiratory system, inducing oxidative stress and inflammation, and even translocate into the bloodstream.
3. Mortality rates have been found to increase in Sydney on days with high bushfire smoke pollution. Hospital admissions, emergency department attendances, ambulance call outs and general practitioner consultations, particularly for respiratory conditions, all increase during periods of severe PM5 levels from bushfires.
4. Certain population groups are at higher risk from exposure to smoke, either because they typically breathe in more air per bodyweight and their organs are still developing (young children), spend more time outdoors (outdoor workers, homeless people), or are more vulnerable to smoke due to old age or a pre‐existing health condition (asthma, chronic obstructive pulmonary disease or other respiratory condition, cardiovascular illness, or diabetes).
5. There is evidence that exposure to bushfire smoke during pregnancy is associated with reduced birthweight in babies and a higher risk of gestational diabetes in mothers.
6. People in lower socio‐economic groups are potentially at higher risk, as they may have poorer housing, and lower health literacy and ability to take preventive measures.
7. Current health protection advice related to bushfire smoke mainly focuses on short term measures aimed at reducing personal exposure to pollution. This includes advice to stay indoors with windows and doors closed, and reduce strenuous physical exercise outdoors, particularly if individuals experience health symptoms or have pre‐existing respiratory or cardiovascular conditions.
However advice to stay indoors may be ineffective over longer periods. The priority for those affected should be to create a clean air space within their home, by sealing doors and windows and using air conditioning and filtration if possible, where they can spend most of their time during prolonged periods of bushfire smoke.
8. Access to regular medication, including asthma preventers and relievers, statins or aspirin, is important for people with pre‐existing lung and heart conditions, and should be arranged in consultation with their GPs, say the researchers.
However NSW Pharmacy Guild president David Heffernan has said that pharmacists should be able to provide these medications without prescription to increase access during bushfires and related smoke haze.
While he congratulated the NSW government on its move to allow emergency supply of asthma prescription medications for a 90 day period in declared emergency areas, “it does little for those who are in places which have been affected by smoke,” he said.
The researchers strongly recommend that all Australian jurisdictions present actual hourly PM2.5 data rather than an index.
“Real time, hourly averaged PM2.5 concentrations are the most appropriate metric to guide personal behaviour that minimises exposure to bushfire smoke,” they say in the MJA.
“More government investment is needed in air quality monitoring, forecasting and research on public health messaging, and exposure reduction measures to protect Australians from bushfire smoke.”
They also call for an independent national expert committee on air pollution and health protection to be established to support environmental health decision making in Australia.
“Managing the health impacts of fire smoke should be integral to landscape fire planning and bushfire emergency response,” they conclude.
See the full article in the MJA here (open access)