School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Anaesthetics, Perioperative Medicine & Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Respirology. 2021 Sep;26(9):861-868. doi: 10.1111/resp.14102. Epub 2021 Jun 28.
In 2014, a 6-week-long fire at the Hazelwood coal mine exposed residents in the adjacent town of Morwell to high concentrations of fine particulate matter with an aerodynamic diameter < 2.5 μm (PM ). The long-term health consequences are being evaluated as part of the Hazelwood Health Study.
Approximately 3.5-4 years after the mine fire, adults from Morwell (n = 346) and the comparison town Sale (n = 173) participated in the longitudinal Respiratory Stream of the Study. Individual PM exposure was retrospectively modelled. Lung mechanics were assessed using the forced oscillation technique (FOT), utilizing pressure waves to measure respiratory system resistance (Rrs) and reactance (Xrs). Multivariate linear regression was used to evaluate associations between PM and transformed Rrs at 5 Hz, area under the reactance curve (AX5) and Xrs at 5 Hz controlling for key confounders.
There were clear dose-response relationships between increasing mine fire PM and worsening lung mechanics, including a reduction in post-bronchodilator (BD) Xrs5 and an increase in AX5. A 10 μg/m increase in mine fire-related PM was associated with a 0.015 (95% CI: 0.004, 0.027) reduction in exponential (Xrs5) post-BD, which was comparable to 4.7 years of ageing. Similarly, the effect of exposure was associated with a 0.072 (0.005, 0.138) increase in natural log (lnAX5) post-BD, equivalent to 3.9 years of ageing.
This is the first study using FOT in adults evaluating long-term respiratory outcomes after medium-term ambient PM exposure to coal mine fire smoke. These results should inform public health policies and planning for future events.
2014 年，黑泽伍德煤矿发生了一场为期六周的大火，导致邻近的莫尔韦尔镇居民暴露在高浓度的细颗粒物中，这些颗粒物的空气动力学直径小于 2.5μm（PM ）。作为黑泽伍德健康研究的一部分，正在评估长期健康后果。
在矿难发生大约 3.5-4 年后，莫尔韦尔（n=346）和比较城镇赛尔（n=173）的成年人参加了该研究的呼吸流纵向研究。个体 PM 暴露情况采用回顾性模型进行模拟。采用强迫振荡技术（FOT）评估肺力学，利用压力波测量呼吸系统阻力（Rrs）和电抗（Xrs）。采用多元线性回归评估 PM 与经支气管扩张剂后 5Hz 时转化的 Rrs（Rrs5）、电抗曲线下面积（AX5）和 5Hz 时的 Xrs 之间的关联，同时控制关键混杂因素。
在黑泽伍德矿火相关 PM 增加与肺功能恶化之间存在明显的剂量反应关系，包括支气管扩张剂后（BD）Xrs5 降低和 AX5 增加。与矿火相关的 PM 每增加 10μg/m，BD 后指数（Xrs5）减少 0.015（95%置信区间：0.004，0.027），相当于 4.7 年的衰老。同样，暴露的影响与 BD 后自然对数（lnAX5）增加 0.072（0.005，0.138）有关，相当于 3.9 年的衰老。
这是第一项使用 FOT 评估成年人在中长期环境 PM 暴露于煤矿火灾烟雾后长期呼吸道结果的研究。这些结果应告知公共卫生政策和未来事件的规划。
