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保护心血管健康免受野火烟雾影响。

Protecting Cardiovascular Health From Wildfire Smoke.

作者信息

Hadley Michael B, Henderson Sarah B, Brauer Michael, Vedanthan Rajesh

机构信息

Icahn School of Medicine at Mount Sinai, New York, NY (M.B.H.).

British Columbia Centre for Disease Control, Vancouver, Canada (S.B.H.).

出版信息

Circulation. 2022 Sep 6;146(10):788-801. doi: 10.1161/CIRCULATIONAHA.121.058058.

Abstract

Wildfire smoke is a rapidly growing threat to global cardiovascular health. We review the literature linking wildfire smoke exposures to cardiovascular effects. We find substantial evidence that short-term exposures are associated with key cardiovascular outcomes, including mortality, hospitalization, and acute coronary syndrome. Wildfire smoke exposures will continue to increase over the majority of Earth's surface. For example, the United States alone has experienced a 5-fold increase in annual area burned since 1972, with 82 million individuals estimated to be exposed to wildfire smoke by midcentury. The associated rise in excess morbidity and mortality constitutes a growing global public health crisis. Fortunately, the effect of wildfire smoke on cardiovascular health is modifiable at the individual and population levels through specific interventions. Health systems therefore have an opportunity to help safeguard patients from smoke exposures. We provide a roadmap of evidence-based interventions to reduce risk and protect cardiovascular health. Key interventions include preparing health systems for smoke events; identifying and educating vulnerable patients; reducing outdoor activities; creating cleaner air environments; using air filtration devices and personal respirators; and aggressive management of chronic diseases and traditional risk factors. Further research is needed to test the efficacy of interventions on reducing cardiovascular outcomes.

摘要

野火烟雾对全球心血管健康构成的威胁正在迅速增长。我们回顾了将野火烟雾暴露与心血管影响联系起来的文献。我们发现大量证据表明,短期暴露与关键的心血管结局相关,包括死亡率、住院率和急性冠状动脉综合征。在地球大部分地区,野火烟雾暴露将持续增加。例如,仅美国自1972年以来每年的烧毁面积就增加了5倍,预计到本世纪中叶有8200万人会暴露于野火烟雾中。与之相关的超额发病率和死亡率的上升构成了日益严重的全球公共卫生危机。幸运的是,通过特定干预措施,野火烟雾对心血管健康的影响在个体和人群层面上是可以改变的。因此,卫生系统有机会帮助保护患者免受烟雾暴露的影响。我们提供了一个基于证据的干预措施路线图,以降低风险并保护心血管健康。关键干预措施包括让卫生系统为烟雾事件做好准备;识别并教育易受影响的患者;减少户外活动;创造更清洁的空气环境;使用空气过滤设备和个人呼吸器;以及积极管理慢性病和传统风险因素。需要进一步研究来测试这些干预措施在降低心血管结局方面的效果。

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