Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations

Aim: The aim of this paper was to describe the patient characteristics and outcomes from a metropolitan emergency department (ED) during the 2019/2020 ‘Black Summer Bushfires’ disaster in Australia and compare the patient characteristics and outcomes to a matched period from the same ED one year ear...

Full description

Bibliographic Details
Main Authors: Jamie Ranse, Matthew Luther, Attila Hertelendy, Richard Skinner
Format: Article
Language:English
Published: Elsevier 2022-05-01
Series:The Journal of Climate Change and Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667278222000025
_version_ 1811219546314375168
author Jamie Ranse
Matthew Luther
Attila Hertelendy
Richard Skinner
author_facet Jamie Ranse
Matthew Luther
Attila Hertelendy
Richard Skinner
author_sort Jamie Ranse
collection DOAJ
description Aim: The aim of this paper was to describe the patient characteristics and outcomes from a metropolitan emergency department (ED) during the 2019/2020 ‘Black Summer Bushfires’ disaster in Australia and compare the patient characteristics and outcomes to a matched period from the same ED one year earlier. Background: Years of drought, low relative humidity, high temperatures, and high forest fuel loads led to catastrophic fire conditions across Australia during 2019 and 2020. As a result; 33 people died, 3 billion animals and 24 to 40 million hectares were lost, and 3,000 homes were destroyed. The impact of wildfire smoke is emerging in the literature regarding an exacerbation of respiratory, cardiac and cardiovascular disease. However, the impact on Australian EDs is minimally reported in the literature. Method: This retrospective cross-sectional cohort study used routinely collected data from the ED patient information system from one metropolitan Australian ED. Data were obtained for patient presentations during the 2019/2020 Black Summer Bushfire period and a matched period, 2018/2019, one year earlier. Daily mean air quality indicators (PM2.5, PM10) were obtained from the nearest air quality monitoring station. Data analysis included descriptive statistics, correlation coefficient and inferential statistics. Statistical significance was set at p ≤ 0.05. Results: The 2019/2020 study period had a statistically significantly higher airborne particulate matter (PM2.5) when compared to the matched period (p=<0.001), with comparable presentations between the study periods. However, an increase in respiratory related presentations (p<0.001; χ2 = 34.31) was noted in the 2019/2020 period, with a positive correlation between daily increasing mean air quality (PM2.5, PM10) and increasing patient presentations with respiratory related illness (p<0.001). Proportionately, patient demographics; mode of arrival, triage category, length of stay and admissions did not differ between periods. However, there was an increase in the raw number of patients being admitted to hospital with respiratory related illnesses, with a statistically significantly longer stay in the ED when compared to those discharged home (p<0.001). Conclusions: Wildfires produce smoke and subsequently poor air quality. The 2019/2020 Black Summer wildfire disaster in Australia resulted in an increase in respiratory-related patient presentations to the ED. Targeted public warning systems could be implemented in an attempt to limit an individual's exposure to wildfire smoke. Further, health services should monitor air quality as a predictor of patient presentations and subsequent health service demand, in support of ED preparedness.
first_indexed 2024-04-12T07:27:08Z
format Article
id doaj.art-944b3a122d594c88be2dffb3adb9caad
institution Directory Open Access Journal
issn 2667-2782
language English
last_indexed 2024-04-12T07:27:08Z
publishDate 2022-05-01
publisher Elsevier
record_format Article
series The Journal of Climate Change and Health
spelling doaj.art-944b3a122d594c88be2dffb3adb9caad2022-12-22T03:42:09ZengElsevierThe Journal of Climate Change and Health2667-27822022-05-016100113Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentationsJamie Ranse0Matthew Luther1Attila Hertelendy2Richard Skinner3Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia; Corresponding author.Emergency Department, Calvary Public Hospital Bruce, Canberra, Australian Capital Territory, AustraliaDepartment of Information Systems and Business Analytics, College of Business, Florida International University, United States; Fellowship in Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, Boston, Massachusetts, United States; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, United StatesSchool of Pharmacy and Medical Sciences, Griffith Universtiy, Gold Coast, Queensland, AustraliaAim: The aim of this paper was to describe the patient characteristics and outcomes from a metropolitan emergency department (ED) during the 2019/2020 ‘Black Summer Bushfires’ disaster in Australia and compare the patient characteristics and outcomes to a matched period from the same ED one year earlier. Background: Years of drought, low relative humidity, high temperatures, and high forest fuel loads led to catastrophic fire conditions across Australia during 2019 and 2020. As a result; 33 people died, 3 billion animals and 24 to 40 million hectares were lost, and 3,000 homes were destroyed. The impact of wildfire smoke is emerging in the literature regarding an exacerbation of respiratory, cardiac and cardiovascular disease. However, the impact on Australian EDs is minimally reported in the literature. Method: This retrospective cross-sectional cohort study used routinely collected data from the ED patient information system from one metropolitan Australian ED. Data were obtained for patient presentations during the 2019/2020 Black Summer Bushfire period and a matched period, 2018/2019, one year earlier. Daily mean air quality indicators (PM2.5, PM10) were obtained from the nearest air quality monitoring station. Data analysis included descriptive statistics, correlation coefficient and inferential statistics. Statistical significance was set at p ≤ 0.05. Results: The 2019/2020 study period had a statistically significantly higher airborne particulate matter (PM2.5) when compared to the matched period (p=<0.001), with comparable presentations between the study periods. However, an increase in respiratory related presentations (p<0.001; χ2 = 34.31) was noted in the 2019/2020 period, with a positive correlation between daily increasing mean air quality (PM2.5, PM10) and increasing patient presentations with respiratory related illness (p<0.001). Proportionately, patient demographics; mode of arrival, triage category, length of stay and admissions did not differ between periods. However, there was an increase in the raw number of patients being admitted to hospital with respiratory related illnesses, with a statistically significantly longer stay in the ED when compared to those discharged home (p<0.001). Conclusions: Wildfires produce smoke and subsequently poor air quality. The 2019/2020 Black Summer wildfire disaster in Australia resulted in an increase in respiratory-related patient presentations to the ED. Targeted public warning systems could be implemented in an attempt to limit an individual's exposure to wildfire smoke. Further, health services should monitor air quality as a predictor of patient presentations and subsequent health service demand, in support of ED preparedness.http://www.sciencedirect.com/science/article/pii/S2667278222000025WildfiresBushfiresSmokeEmergency departmentRespiratory
spellingShingle Jamie Ranse
Matthew Luther
Attila Hertelendy
Richard Skinner
Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
The Journal of Climate Change and Health
Wildfires
Bushfires
Smoke
Emergency department
Respiratory
title Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
title_full Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
title_fullStr Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
title_full_unstemmed Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
title_short Impact of fine particulate matter (PM2.5) smoke during the 2019 / 2020 Australian bushfire disaster on emergency department patient presentations
title_sort impact of fine particulate matter pm2 5 smoke during the 2019 2020 australian bushfire disaster on emergency department patient presentations
topic Wildfires
Bushfires
Smoke
Emergency department
Respiratory
url http://www.sciencedirect.com/science/article/pii/S2667278222000025
work_keys_str_mv AT jamieranse impactoffineparticulatematterpm25smokeduringthe20192020australianbushfiredisasteronemergencydepartmentpatientpresentations
AT matthewluther impactoffineparticulatematterpm25smokeduringthe20192020australianbushfiredisasteronemergencydepartmentpatientpresentations
AT attilahertelendy impactoffineparticulatematterpm25smokeduringthe20192020australianbushfiredisasteronemergencydepartmentpatientpresentations
AT richardskinner impactoffineparticulatematterpm25smokeduringthe20192020australianbushfiredisasteronemergencydepartmentpatientpresentations