School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.
Respirology. 2024 Dec;29(12):1058-1066. doi: 10.1111/resp.14817. Epub 2024 Aug 19.
The Hazelwood Health Study was set up to study long-term health effects of a mine fire that blanketed residents of the Latrobe Valley with smoke for 45 days in 2014. The Respiratory Stream specifically assessed the impact of fine particulate matter <2.5 μm diameter (PM) exposure from mine fire smoke on lung health. The multiple breath nitrogen washout (MBW) test assesses ventilation heterogeneity, which may detect sub-clinical airways dysfunction not identified using standard tests such as spirometry. This analysis assessed the association of PM exposure with measures of ventilation heterogeneity.
Exposed (Morwell) and unexposed (Sale) participants were recruited 3.5-4 years after the fire from those who had participated in an Adult Survey. MBW was performed to measure lung clearance index (LCI), functional residual capacity (FRC), acinar (Sacin) and conductive (Scond) ventilation heterogeneity. PM exposure was estimated with emission and chemical transport models. Multivariable linear regression models were fitted controlling for confounders.
We recruited 519 participants. MBW tests were conducted on 504 participants with 479 acceptable test results (40% male; 313 exposed, 166 unexposed). Exposure to mine fire-related PM was associated with increasing Scond (β = 1.57/kL, 95%CI: 0.20-2.95, p = 0.025), which was comparable to the estimated effect on Scond of 4.7 years of aging. No other MBW outcomes were statistically different.
Increasing exposure to PM was associated with increased ventilation heterogeneity in the conductive region of the lungs 4 years after the event.
Hazelwood 健康研究旨在研究 2014 年一场矿火对拉筹伯谷居民造成的长期健康影响，这场矿火持续 45 天，烟雾笼罩了当地居民。呼吸流研究专门评估了来自矿火烟雾的细颗粒物（<2.5μm 直径的 PM）暴露对肺部健康的影响。多次呼吸氮冲洗（MBW）测试评估通气异质性，这可能会检测到使用标准测试（如肺活量测定法）无法识别的亚临床气道功能障碍。本分析评估了 PM 暴露与通气异质性测量值之间的关联。
在火灾发生 3.5-4 年后，从参加成人调查的人群中招募暴露（莫尔文）和未暴露（赛尔）参与者。进行 MBW 以测量肺清除指数（LCI）、功能残气量（FRC）、腺泡（Sacin）和传导（Scond）通气异质性。使用排放和化学传输模型来估计 PM 暴露。使用多变量线性回归模型进行拟合，控制混杂因素。
我们招募了 519 名参与者。对 504 名参与者进行了 MBW 测试，其中 479 项测试结果可接受（40%为男性；313 名暴露组，166 名未暴露组）。与矿火相关的 PM 暴露与传导区的 Scond 增加有关（β=1.57/kL，95%CI：0.20-2.95，p=0.025），这与估计的 4.7 年老化对 Scond 的影响相当。其他 MBW 结果没有统计学差异。
暴露于 PM 增加与事件发生后 4 年内肺部传导区的通气异质性增加有关。
