Impact of recent catastrophic bushfires on people with asthma in Australia: Health, social and financial burdens

Bui, Dinh; Davis, Sharon; Flynn, Anthony; Bell, Rose

doi:10.1111/resp.14013

Cited by 10 publications

(29 citation statements)

References 7 publications

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“…Overall, people with asthma reported more symptoms, greater use of healthcare resources (hospitalization and emergency department visits), greater need for OCS and greater financial burden due to reduced work, more costs associated with doctor visits, medication needs and protective equipment (masks) than people without asthma. 2 A review by Walter et al 3 evaluated Australian epidemiological studies reporting on the effects of pollution from landscape fire smoke (LFS) to emphasize the effects of fires on cardiorespiratory outcomes. Overall, nine studies were included, all of which reported significant associations between LFS and respiratory impacts.…”

Section: Disasters Bushfiresmentioning

confidence: 99%

“…Of those, the majority (93.6%) reported respiratory symptoms during the event compared to 70.2% of the population without asthma. Overall, people with asthma reported more symptoms, greater use of healthcare resources (hospitalization and emergency department visits), greater need for OCS and greater financial burden due to reduced work, more costs associated with doctor visits, medication needs and protective equipment (masks) than people without asthma 2 …”

Section: Disastersmentioning

confidence: 99%

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Contemporary Concise Review 2020: Asthma

Wang

McDonald

2021

Respirology

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Bushfires and coronavirus 2019 (COVID-19) were dominate features of 2020.• Patients with asthma were significantly affected by the 2019/2020 bushfire season with an increased burden compared to the general population. • Patients with controlled asthma do not appear to be at higher risk of severe COVID-19 infection or death than the general population. • Personalized medicine is proposed as the next era for asthma management, with treatable traits as a strategy to implement personalized medicine into practice. • Patient engagement in personalized medicine strategies is important and needs to be further explored. • Oral corticosteroid (OCS) use in asthma is common and contributes a major burden. OCS stewardship is recommended. • Biologic therapies reduce exacerbations of severe asthma and biomarkers can be used to predict treatment responders. • Epithelia at mucosal and cutaneous surfaces are components in asthma pathogenesis, through airway immunity and inflammation. • Dysregulation of resident microbial communities in the lung, gut and skin microbiome is relevant to asthma pathogenesis, but there are still many unknowns in this field.

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Section: Disasters Bushfiresmentioning

confidence: 99%

Section: Disastersmentioning

confidence: 99%

Contemporary Concise Review 2020: Asthma

Wang

McDonald

2021

Respirology

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“…Recent bushfire crises in Australia and other parts of the world bring into question the effect of bushfire smoke on vulnerable population groups, including pregnant women and their infants. The Australian bushfire events of 2019/2020 resulted in extreme smoke exposure in Eastern Australia, with heightened levels of PM2.5 (fine particulate matter <2.5 µm in size) [ 4 ] and stress among pregnant women with asthma (Asthma Australia, personal communication) [ 5 ]. Both stress and air pollutant exposure during pregnancy have been linked to poor perinatal outcomes, such as preterm birth, and the development of asthma, via epigenetic mechanisms [ 2 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The 2019/2020 Eastern Australian bushfires were of unprecedented scale both in terms of duration (>133-day exposure) and intensity. A survey completed by 7285 people with asthma and 4867 people without asthma at the height of the fire event (December 2019–January 2020) demonstrated the substantial acute impact of the crisis particularly on people with asthma [ 5 ]. Children with asthma were more likely to have emergency department (ED) visits or hospital admissions as a result of exposure to bushfire smoke [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…A survey completed by 7285 people with asthma and 4867 people without asthma at the height of the fire event (December 2019–January 2020) demonstrated the substantial acute impact of the crisis particularly on people with asthma [ 5 ]. Children with asthma were more likely to have emergency department (ED) visits or hospital admissions as a result of exposure to bushfire smoke [ 5 ]. The significant, immediate health burden of this prolonged fire activity included an estimated 417 (95% confidence interval [CI] 153–680) excess deaths, and 1305 (95% CI 705–1908) additional ED presentations for asthma due to bushfire smoke exposure [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Exposure to Stress and Air Pollution from Bushfires during Pregnancy: Could Epigenetic Changes Explain Effects on the Offspring?

Murphy

Karmaus

Mattes

et al. 2021

IJERPH

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Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.

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