Dennekamp Martine, Straney Lahn D, Erbas Bircan, Abramson Michael J, Keywood Melita, Smith Karen, Sim Malcolm R, Glass Deborah C, Del Monaco Anthony, Haikerwal Anjali, Tonkin Andrew M
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Environ Health Perspect. 2015 Oct;123(10):959-64. doi: 10.1289/ehp.1408436. Epub 2015 Mar 20.
Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries.
In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke.
We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (≥ 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site.
There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter ≤ 2.5 μm (PM2.5) (8.05%; 95% CI: 2.30, 14.13%; IQR = 6.1 μg/m(3)) or ≤ 10 μm (PM10) (11.1%; 95% CI: 1.55, 21.48%; IQR = 13.7 μg/m(3)) and carbon monoxide (35.7%; 95% CI: 8.98, 68.92%; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventy-four "fire-hours" (i.e., hours in which Melbourne's air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95% CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations in PM2.5 during these fire-hours.
This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons.
数以百万计的人可能会接触到森林火灾产生的烟雾，这在许多国家成为一个重要的公共卫生问题。
在本研究中，我们旨在测量在一个大城市严重森林火灾季节期间院外心脏骤停（OHCA）与森林火灾烟雾暴露之间的关联，并估计因火灾烟雾导致的OHCA额外发生数量。
我们在澳大利亚墨尔本对成年人（≥35岁）进行了一项病例交叉研究，调查了颗粒物（PM）和其他空气污染物与OHCA之间的关联。使用条件逻辑回归模型来估计与暴露增加一个四分位间距（IQR）相关的OHCA发生率的百分比变化。从2006年7月到2007年6月，从维多利亚州救护车心脏骤停登记处收集OHCA数据。每小时空气污染浓度和气象数据从一个中央监测站点获取。
在我们的研究期间，有2046例推测为心脏病因的OHCA。在火灾季节的男性中，随着直径≤2.5μm（PM2.5）（8.05%；95%CI：2.30，14.13%；IQR = 6.1μg/m³）或≤10μm（PM10）（11.1%；95%CI：1.55，21.48%；IQR = 13.7μg/m³）以及一氧化碳（35.7%；95%CI：8.98，68.92%；IQR = 0.3ppm）的IQR增加，观察到OHCA有更大幅度的增加。女性的OHCA发生率与空气污染物之间没有显著关联。在2006/2007火灾季节的12天中，确定了174个“火灾小时”（即墨尔本空气质量受森林火灾烟雾影响的小时数），估计在这些火灾小时期间，由于PM2.5升高，会额外发生23.9例（95%CI：3.1，40.2）OHCA。
本研究发现森林火灾烟雾暴露与OHCA发生率增加之间存在关联。这些发现对于提高社区意识的公共卫生信息以及森林火灾季节的应急服务规划具有启示意义。
