Impact of fine particulate matter (PM < inf > 2.5 < /inf > ) exposure during wildfires on cardiovascular health outcomes

Journal article


Haikerwal, Anjali, Akram, Muhammad, Del Monaco, Anthony, Smith, Karen, Sim, Malcolm R., Meyer, Mick, Tonkin, Andrew M., Abramson, Michael J. and Dennekamp, Martine. (2015) Impact of fine particulate matter (PM < inf > 2.5 < /inf > ) exposure during wildfires on cardiovascular health outcomes. Journal of the American Heart Association. 4(7), pp. 1 - 11. https://doi.org/10.1161/JAHA.114.001653
AuthorsHaikerwal, Anjali, Akram, Muhammad, Del Monaco, Anthony, Smith, Karen, Sim, Malcolm R., Meyer, Mick, Tonkin, Andrew M., Abramson, Michael J. and Dennekamp, Martine
Abstract

Background: Epidemiological studies investigating the role of fine particulate matter (PM2.5; aerodynamic diameter < 2.5 μm) in triggering acute coronary events, including out‐of‐hospital cardiac arrests and ischemic heart disease (IHD), during wildfires have been inconclusive. Methods and Results: We examined the associations of out‐of‐hospital cardiac arrests, IHD, acute myocardial infarction, and angina (hospital admissions and emergency department attendance) with PM2.5 concentrations during the 2006–2007 wildfires in Victoria, Australia, using a time‐stratified case‐crossover study design. Health data were obtained from comprehensive health‐based administrative registries for the study period (December 2006 to January 2007). Modeled and validated air exposure data from wildfire smoke emissions (daily average PM2.5, temperature, relative humidity) were also estimated for this period. There were 457 out‐of‐hospital cardiac arrests, 2106 emergency department visits, and 3274 hospital admissions for IHD. After adjusting for temperature and relative humidity, an increase in interquartile range of 9.04 μg/m3 in PM2.5 over 2 days moving average (lag 0‐1) was associated with a 6.98% (95% CI 1.03% to 13.29%) increase in risk of out‐of‐hospital cardiac arrests, with strong association shown by men (9.05%,95%CI 1.63% to 17.02%) and by older adults (aged ≥65 years) (7.25%, 95% CI 0.24% to 14.75%). Increase in risk was (2.07%, 95% CI 0.09% to 4.09%) for IHD‐related emergency department attendance and (1.86%, 95% CI: 0.35% to 3.4%) for IHD‐related hospital admissions at lag 2 days, with strong associations shown by women (3.21%, 95% CI 0.81% to 5.67%) and by older adults (2.41%, 95% CI 0.82% to 5.67%). Conclusion: PM2.5 exposure was associated with increased risk of out‐of‐hospital cardiac arrests and IHD during the 2006–2007 wildfires in Victoria. This evidence indicates that PM2.5 may act as a triggering factor for acute coronary events during wildfire episodes.

Keywordscoronary disease; heart arrest; ischemic heart disease; particulate matter; wildfires
Year2015
JournalJournal of the American Heart Association
Journal citation4 (7), pp. 1 - 11
PublisherWiley-Blackwell Publishing, Inc.
ISSN2047-9980
Digital Object Identifier (DOI)https://doi.org/10.1161/JAHA.114.001653
Scopus EID2-s2.0-85016315515
Open accessOpen access
Page range1 - 11
Research GroupMary MacKillop Institute for Health Research
Publisher's version
License
Place of publicationUnited States of America
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