Evaluating the impact of air pollution on the incidence of out-of-hospital cardiac arrest in the Perth Metropolitan Region: 2000–2010

Background: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Several studies have found that an increased level of ambient particulate matter (PM) smaller than 2.5 microns (PM2.5) is associated with an increased risk of OHCA. We investigated the relationship between air pollution levels and the incidence of OHCA in Perth, Western Australia.Methods: We linked St John Ambulance OHCA data of presumed cardiac aetiology with Perth air pollution data from seven monitors which recorded hourly levels of PM smaller than 2.5 and 10 microns (PM2.5/PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3). We used a case-crossover design to estimate the strength of association between ambient air pollution levels and risk of OHCA.Methods: We linked St John Ambulance OHCA data of presumed cardiac aetiology with Perth air pollution data from seven monitors which recorded hourly levels of PM smaller than 2.5 and 10 microns (PM2.5/PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3). We used a case-crossover design to estimate the strength of association between ambient air pollution levels and risk of OHCA.Conclusions: Elevated ambient PM2.5 and CO are associated with an increased risk of OHCA

Is remaining indoors an effective way of reducing exposure to fine particulate matter during biomass burning events?

Bushfires, prescribed burns, and residential wood burning are significant sources of fine particles (aerodynamic diameter 2.5) affecting the health and well-being of many communities. Despite the lack of evidence, a common public health recommendation is to remain indoors, assuming that the home provides a protective barrier against ambient PM2.5. The study aimed to assess to what extent houses provide protection against peak concentrations of outdoor PM2.5 and whether remaining indoors is an effective way of reducing exposure to PM2.5. The effectiveness of this strategy was evaluated by conducting simultaneous week-long indoor and outdoor measurements of PM2.5 at 21 residences in regional areas of Victoria, Australia. During smoke plume events, remaining indoors protected residents from peak outdoor PM2.5 concentrations, but the level of protection was highly variable, ranging from 12% to 76%. Housing stock (e.g., age of the house) and ventilation (e.g., having windows/doors open or closed) played a significant role in the infiltration of outdoor PM2.5 indoors. The results also showed that leaving windows and doors closed once the smoke plume abates trapped PM2.5 indoors and increased indoor exposure to PM2.5. Furthermore, for approximately 50% of households, indoor sources such as cooking activities, smoking, and burning candles or incense contributed significantly to indoor PM2.5. Implications: Smoke from biomass burning sources can significantly impact on communities. Remaining indoors with windows and doors closed is a common recommendation by health authorities to minimize exposures to peak concentrations of fine particles during smoke plume events. Findings from this study have shown that the protection from fine particles in biomass burning smoke is highly variable among houses, with information on housing age and ventilation status providing an approximate assessment on the protection of a house. Leaving windows closed once a smoke plume abates traps particles indoors and increases exposures

Associations between respiratory health outcomes and coal mine fire PM2.5 smoke exposure: a cross- sectional study

In 2014, wildfires ignited a fire in the Morwell open cut coal mine, Australia, which burned for six weeks. This study examined associations between self-reported respiratory outcomes in adults and mine fire-related PM2.5 smoke exposure. Self-reported data were collected as part of the Hazelwood Health Study Adult Survey. Eligible participants were adult residents of Morwell. Mine fire-related PM2.5 concentrations were provided by the Commonwealth Scientific and Industrial Research Organisation Oceans & Atmosphere Flagship. Personalised mean 24-h and peak 12-h mine fire-related PM2.5 exposures were estimated for each participant. Data were analysed by multivariate logistic regression. There was some evidence of an association between respiratory outcomes and mine fire PM2.5 exposure. Chronic cough was associated with an odds ratio (OR) of 1.13 (95% confidence interval 1.03 to 1.23) per 10 μg/m3 increment in mean PM2.5 and 1.07 (1.02 to 1.12) per 100 μg/m3 increment in peak PM2.5. Current wheeze was associated with peak PM2.5, OR = 1.06 (1.02 to 1.11) and chronic phlegm with mean PM2.5 OR = 1.10 (1.00 to 1.20). Coal mine PM2.5 smoke exposure was associated with increased odds of experiencing cough, phlegm and wheeze. Males, participants 18–64 years, and those residing in homes constructed from non-brick/concrete materials or homes with tin/metal roofs had higher estimated ORs. These findings contribute to the formation of public health policy responses

Occupational exposures to solvents and metals are associated with fixed airflow obstruction

peer-reviewedOur study is the first to investigate the associations between exposures to solvents and metals using lifetime work history calendars and fixed airflow obstruction (AO). We have shown that increasing cumulative exposure-unit years to chlorinated solvents is associated with fixed AO. We found that women were at increased risk of fixed AO with increasing cumulative exposed-unit-years to chlorinated solvents but not men

Health effects of smoke from planned burns: a study protocol

Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia) involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest). It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors

Avoidable mortality attributable to anthropogenic fine particulate matter (Pm2.5) in Australia

Ambient fine particulate matter 2.5) air pollution increases premature mortalityglobally. Some PM2.5 is natural, but anthropogenic PM2.5 is comparatively avoidable. We determinedthe impact of long-term exposures to the anthropogenic PM component on mortality in Australia.PM2.5-attributable deaths were calculated for all Australian Statistical Area 2 (SA2; n = 2310) regions.All-cause death rates from Australian mortality and population databases were combined withannual anthropogenic PM2.5 exposures for the years 2006–2016. Relative risk estimates were derivedfrom the literature. Population-weighted average PM2.5 concentrations were estimated in eachSA2 using a satellite and land use regression model for Australia. PM2.5-attributable mortality wascalculated using a health-impact assessment methodology with life tables and all-cause death rates.The changes in life expectancy (LE) from birth, years of life lost (YLL), and economic cost of lostlife years were calculated using the 2019 value of a statistical life. Nationally, long-term populationweighted average total and anthropogenic PM2.5 concentrations were 6.5 µg/m3(min 1.2–max 14.2)and 3.2 µg/m3(min 0–max 9.5), respectively. Annually, anthropogenic PM2.5-pollution is associatedwith 2616 (95% confidence intervals 1712, 3455) deaths, corresponding to a 0.2-year (95% CI 0.14, 0.28)reduction in LE for children aged 0–4 years, 38,962 (95%CI 25,391, 51,669) YLL and an average annualeconomic burden of $6.2 billion (95$4.0 billion, $8.1 billion). We conclude that the anthropogenicPM2.5-related costs of mortality in Australia are higher than community standards should allow,and reductions in emissions are recommended to achieve avoidable mortality

Internet of Things for Sustainable Human Health

The sustainable health IoT has the strong potential to bring tremendous improvements in human health and well-being through sensing, and monitoring of health impacts across the whole spectrum of climate change. The sustainable health IoT enables development of a systems approach in the area of human health and ecosystem. It allows integration of broader health sub-areas in a bigger archetype for improving sustainability in health in the realm of social, economic, and environmental sectors. This integration provides a powerful health IoT framework for sustainable health and community goals in the wake of changing climate. In this chapter, a detailed description of climate-related health impacts on human health is provided. The sensing, communications, and monitoring technologies are discussed. The impact of key environmental and human health factors on the development of new IoT technologies also analyzed

Exploring links between greenspace and sudden unexpected death: A spatial analysis

Greenspace has been increasingly recognized as having numerous health benefits. However, its effects are unknown concerning sudden unexpected death (SUD), commonly referred to as sudden cardiac death, which constitutes a large proportion of mortality in the United States. Because greenspace can promote physical activity, reduce stress and buffer air pollutants, it may have beneficial effects for people at risk of SUD, such as those with heart disease, hypertension, and diabetes mellitus. Using several spatial techniques, this study explored the relationship between SUD and greenspace. We adjudicated 396 SUD cases that occurred from March 2013 to February 2015 among reports from emergency medical services (EMS) that attended out-of-hospital deaths in Wake County (central North Carolina, USA). We measured multiple greenspace metrics in each census tract, including the percentages of forest, grassland, average tree canopy, tree canopy diversity, near-road tree canopy and greenway density. The associations between SUD incidence and these greenspace metrics were examined using Poisson regression (non-spatial) and Bayesian spatial models. The results from both models indicated that SUD incidence was inversely associated with both greenway density (adjusted risk ratio [RR] = 0.82, 95% credible/ confidence interval [CI]: 0.69–0.97) and the percentage of forest (adjusted RR = 0.90, 95% CI: 0.81–0.99). These results suggest that increases in greenway density by 1 km/km2 and in forest by 10% were associated with a decrease in SUD risk of 18% and 10%, respectively. The inverse relationship was not observed between SUD incidence and other metrics, including grassland, average tree canopy, near-road tree canopy and tree canopy diversity. This study implies that greenspace, specifically greenways and forest, may have beneficial effects for people at risk of SUD. Further studies are needed to investigate potential causal relationships between greenspace and SUD, and potential mechanisms such as promoting physical activity and reducing stress