School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Respiratory Medicine, the Alfred Hospital, Melbourne, Victoria, Australia.
Ann Am Thorac Soc. 2022 Feb;19(2):186-195. doi: 10.1513/AnnalsATS.202012-1544OC.
In 2014, the Hazelwood open-cut coal mine in southeastern Australia burned for 6 weeks, exposing nearby residents to high concentrations of fine particulate matter (PM). The long-term health consequences are unknown and are being evaluated as part of the Hazelwood Health Study. To explore the association between PM exposure and chronic obstructive pulmonary disease (COPD). A sample of 346 exposed and 173 unexposed adults participated in the longitudinal Respiratory Stream of the Hazelwood Health Study. Participants underwent spirometry and gas transfer measurements and answered validated respiratory questionnaires 3.5-4 years after the fire. Individual-level mine fire-related PM exposure was modeled. Multivariate linear regression and logistic models were fitted to analyze associations between mean and peak PM exposure and clinical outcomes, stratified by smoking status. A 10 μg/m increase in mean PM exposure was associated with a 69% (95% confidence interval [CI], 11-158%) increase in odds of spirometry consistent with COPD among nonsmokers and increased odds of chest tightness (odds ratio [OR], 1.30; 95% CI, 1.03-1.64) and chronic cough (OR, 1.24; 95% CI, 1.02-1.51) in the previous 12 months in all participants. For current smokers, increments in mean PM exposure were associated with higher odds of chronic cough in the preceding 12 months (OR, 2.13; 95% CI, 1.24-3.65). Almost 4 years after a 6-week period of coal fire PM exposure, we identified a dose-response association between exposure and COPD in nonsmokers. With climate change a likely contributor to increased risk of landscape fires, the findings will inform policy decisions during future sustained smoke events.
2014 年,澳大利亚东南部的黑泽伍德露天煤矿燃烧了 6 个星期,附近居民暴露在高浓度的细颗粒物 (PM) 中。长期健康后果尚不清楚,正在作为黑泽伍德健康研究的一部分进行评估。 为了探讨 PM 暴露与慢性阻塞性肺疾病(COPD)之间的关系。 一项由 346 名暴露组和 173 名非暴露组成年人参与的纵向呼吸流黑泽伍德健康研究。参与者接受了肺活量测定和气体转移测量,并在火灾发生 3.5-4 年后回答了经过验证的呼吸问卷。对个体的矿山火灾相关 PM 暴露进行了建模。对多元线性回归和逻辑模型进行了拟合,以分析吸烟状况分层后平均和峰值 PM 暴露与临床结果之间的关联。 平均 PM 暴露每增加 10 μg/m,与非吸烟者的肺活量测定一致的 COPD 的几率增加 69%(95%置信区间 [CI],11-158%),并且所有参与者中 12 个月内出现胸闷的几率增加(比值比 [OR],1.30;95% CI,1.03-1.64)和慢性咳嗽(OR,1.24;95% CI,1.02-1.51)。对于当前吸烟者,平均 PM 暴露的增加与前 12 个月内慢性咳嗽的几率增加相关(OR,2.13;95% CI,1.24-3.65)。 在经历了长达 6 周的煤矿火灾 PM 暴露后将近 4 年,我们发现暴露与非吸烟者 COPD 之间存在剂量反应关系。随着气候变化可能导致景观火灾风险增加,这些发现将为未来持续烟雾事件期间的政策决策提供信息。