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McCracken T, Chen P, Metcalf A, Fan C. Quantifying the impacts of Canadian wildfires on regional air pollution networks. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172461. [PMID: 38615767 DOI: 10.1016/j.scitotenv.2024.172461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
Wildfire smoke greatly impacts regional atmospheric systems, causing changes in the behavior of pollution. However, the impacts of wildfire smoke on pollution behavior are not easily quantifiable due to the complex nature of atmospheric systems. Air pollution correlation networks have been used to quantify air pollution behavior during ambient conditions. However, it is unknown how extreme pollution events impact these networks. Therefore, we propose a multidimensional air pollution correlation network framework to quantify the impacts of wildfires on air pollution behavior. The impacts are quantified by comparing two time periods, one during the 2023 Canadian wildfires and one during normal conditions with two complex network types for each period. In this study, the value network represents PM2.5 concentrations and the rate network represents the rate of change of PM2.5 concentrations. Wildfires' impacts on air pollution behavior are captured by structural changes in the networks. The wildfires caused a discontinuous phase transition during percolation in both network types which represents non-random organization of the most significant spatiotemporal correlations. Additionally, wildfires caused changes to the connectivity of stations leading to more interconnected networks with different influential stations. During the wildfire period, highly polluted areas are more likely to form connections in the network, quantified by an 86 % and 19 % increase in the connectivity of the value and rate networks respectively compared to the normal period. In this study, we create novel understandings of the impacts of wildfires on air pollution correlation networks, show how our method can create important insights into air pollution patterns, and discuss potential applications of our methodologies. This study aims to enhance capabilities for wildfire smoke exposure mitigation and response strategies.
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Affiliation(s)
- Teague McCracken
- School of Civil and Environmental Engineering, Clemson University, 455 Bracket Hall, Clemson, SC 29631, USA.
| | - Pei Chen
- Department of Computer Science and Engineering, Texas A&M University, L.F. Peterson Building, College Station, TX 77843, USA.
| | - Andrew Metcalf
- School of Civil and Environmental Engineering, Clemson University, 455 Bracket Hall, Clemson, SC 29631, USA.
| | - Chao Fan
- School of Civil and Environmental Engineering, Clemson University, 455 Bracket Hall, Clemson, SC 29631, USA.
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Raab H, Moyer J, Afrin S, Garcia-Menendez F, Ward-Caviness CK. Prescribed fires, smoke exposure, and hospital utilization among heart failure patients. Environ Health 2023; 22:86. [PMID: 38087300 PMCID: PMC10717133 DOI: 10.1186/s12940-023-01032-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients' hospital utilization. METHODS We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients' primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). RESULTS Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. CONCLUSIONS Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.
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Affiliation(s)
- Henry Raab
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Joshua Moyer
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Sadia Afrin
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Present address: MIT Laboratory for Aviation and the Environment, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Fernando Garcia-Menendez
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA.
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Chen AI, Ebisu K, Benmarhnia T, Basu R. Emergency department visits associated with wildfire smoke events in California, 2016-2019. ENVIRONMENTAL RESEARCH 2023; 238:117154. [PMID: 37716386 DOI: 10.1016/j.envres.2023.117154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023]
Abstract
Wildfire smoke has been associated with adverse respiratory outcomes, but the impacts of wildfire on other health outcomes and sensitive subpopulations are not fully understood. We examined associations between smoke events and emergency department visits (EDVs) for respiratory, cardiovascular, diabetes, and mental health outcomes in California during the wildfire season June-December 2016-2019. Daily, zip code tabulation area-level wildfire-specific fine particulate matter (PM2.5) concentrations were aggregated to air basins. A "smoke event" was defined as an air basin-day with a wildfire-specific PM2.5 concentration at or above the 98th percentile across all air basin-days (threshold = 13.5 μg/m3). We conducted a two-stage time-series analysis using quasi-Poisson regression considering lag effects and random effects meta-analysis. We also conducted analyses stratified by race/ethnicity, age, and sex to assess potential effect modification. Smoke events were associated with an increased risk of EDVs for all respiratory diseases at lag 1 [14.4%, 95% confidence interval (CI): (6.8, 22.5)], asthma at lag 0 [57.1% (44.5, 70.8)], and chronic lower respiratory disease at lag 0 [12.7% (6.2, 19.6)]. We also found positive associations with EDVs for all cardiovascular diseases at lag 10. Mixed results were observed for mental health outcomes. Stratified results revealed potential disparities by race/ethnicity. Short-term exposure to smoke events was associated with increased respiratory and schizophrenia EDVs. Cardiovascular impacts may be delayed compared to respiratory outcomes.
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Affiliation(s)
- Annie I Chen
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
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4
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Xue T, Li J, Tong M, Fan X, Li P, Wang R, Li Y, Zheng Y, Li J, Guan T, Zhu T. Stillbirths attributable to open fires and their geographic disparities in non-Western countries. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 334:122170. [PMID: 37451590 DOI: 10.1016/j.envpol.2023.122170] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Due to global warming, an increased number of open fires is becoming a major contributor to PM2.5 pollution and thus a threat to public health. However, the burden of stillbirths attributable to fire-sourced PM2.5 is unknown. In low- and middle-income countries (LMICs), there is a co-occurrence of high baseline stillbirth rates and frequent firestorms, which may lead to a geographic disparity. Across 54 LMICs, we conducted a self-matched case-control study, making stillbirths comparable to the corresponding livebirths in terms of time-invariant characteristics (e.g., genetics) and duration of gestational exposure. We established a joint-exposure-response function (JERF) by simultaneously associating stillbirth with fire- and non-fire-sourced PM2.5 concentrations, which were estimated by fusing multi-source data, such as chemical transport model simulations and satellite observations. During 2000-2014, 35,590 pregnancies were selected from multiple Demographic and Health Surveys. In each mother, a case of stillbirth was compared to her livebirth(s) based on gestational exposure to fire-sourced PM2.5. We further applied the JERF to assess stillbirths attributable to fire-sourced PM2.5 in 136 non-Western countries. The disparity was evaluated using the Gini index. The risk of stillbirth increased by 17.4% (95% confidence interval [CI]: 1.6-35.7%) per 10 μg/m3 increase in fire-sourced PM2.5. In 2014, referring to a minimum-risk exposure level of 10 μg/m3, total and fire-sourced PM2.5 contributed to 922,860 (95% CI: 578,451-1,183,720) and 49,951 (95% CI: 3,634-92,629) stillbirths, of which 10% were clustered within the 6.4% and 0.6% highest-exposure pregnancies, respectively. The Gini index of stillbirths attributable to fire-sourced PM2.5 was 0.65, much higher than for total PM2.5 (0.28). Protecting pregnant women against PM2.5 exposure during wildfires is critical to avoid stillbirths, as the burden of fire-associated stillbirths leads to a geographic disparity in maternal health.
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Affiliation(s)
- Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
| | - Jiajianghui Li
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China.
| | - Mingkun Tong
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China.
| | - Xinguang Fan
- Department of Sociology, Peking University, Beijing, China.
| | - Pengfei Li
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China; National Institute of Health Data Science, Peking University, Beijing, China.
| | - Ruohan Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China.
| | - Yanshun Li
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA.
| | - Yixuan Zheng
- Center of Air Quality Simulation and System Analysis, Chinese Academy of Environmental Planning, Beijing, China.
| | - Jiwei Li
- School of Computer Science, Zhejiang University, Hangzhou, China.
| | - Tianjia Guan
- Department of Health Policy, School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Tong Zhu
- College of Environmental Science and Engineering, Peking University, Beijing, 100084, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
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McBrien H, Rowland ST, Benmarhnia T, Tartof SY, Steiger B, Casey JA. Wildfire Exposure and Health Care Use Among People Who Use Durable Medical Equipment in Southern California. Epidemiology 2023; 34:700-711. [PMID: 37255240 PMCID: PMC10524711 DOI: 10.1097/ede.0000000000001634] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND People using electricity-dependent durable medical equipment (DME) may be vulnerable to health effects from wildfire smoke, residence near wildfires, or residence in evacuation zones. To our knowledge, no studies have examined their healthcare utilization during wildfires. METHODS We obtained 2016-2020 counts of residential Zip Code Tabulation Area (ZCTA) level outpatient, emergency department (ED), and inpatient visits made by DME-using Kaiser Permanente Southern California members 45+. We linked counts to daily ZCTA-level wildfire particulate matter (PM) 2.5 and wildfire boundary and evacuation data from the 2018 Woolsey and 2019 Getty wildfires. We estimated the association of lagged (up to 7 days) wildfire PM 2.5 and residence near a fire or in an evacuation zone and healthcare visit frequency with negative binomial and difference-in-differences models. RESULTS Among 236,732 DME users, 10 µg/m 3 increases in wildfire PM 2.5 concentration were associated with the reduced rate (RR = 0.96; 95% confidence interval [CI] = 0.94, 0.99) of all-cause outpatient visits 1 day after exposure and increased rate on 4 of 5 subsequent days (RR range 1.03-1.12). Woolsey Fire proximity (<20 km) was associated with reduced all-cause outpatient visits, whereas evacuation and proximity were associated with increased inpatient cardiorespiratory visits (proximity RR = 1.45; 95% CI = 0.99, 2.12, evacuation RR = 1.72; 95% CI = 1.00, 2.96). Neither Getty Fire proximity nor evacuation was associated with healthcare visit frequency. CONCLUSIONS Our results support the hypothesis that wildfire smoke or proximity interrupts DME users' routine outpatient care, via sheltering in place. However, wildfire exposures were also associated with increased urgent healthcare utilization in this vulnerable group.
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Affiliation(s)
- Heather McBrien
- From the Environmental Health Sciences, Columbia Mailman School of Public Health
| | - Sebastian T Rowland
- From the Environmental Health Sciences, Columbia Mailman School of Public Health
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego
| | - Sara Y Tartof
- Research & Evaluation, Kaiser Permanente Southern California
| | - Benjamin Steiger
- From the Environmental Health Sciences, Columbia Mailman School of Public Health
| | - Joan A Casey
- From the Environmental Health Sciences, Columbia Mailman School of Public Health
- Environmental and Occupational Health Sciences, University of Washington School of Public Health, WA
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6
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Dhingra R, Keeler C, Staley BS, Jardel HV, Ward-Caviness C, Rebuli ME, Xi Y, Rappazzo K, Hernandez M, Chelminski AN, Jaspers I, Rappold AG. Wildfire smoke exposure and early childhood respiratory health: a study of prescription claims data. Environ Health 2023; 22:48. [PMID: 37370168 PMCID: PMC10294519 DOI: 10.1186/s12940-023-00998-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Wildfire smoke is associated with short-term respiratory outcomes including asthma exacerbation in children. As investigations into developmental wildfire smoke exposure on children's longer-term respiratory health are sparse, we investigated associations between developmental wildfire smoke exposure and first use of respiratory medications. Prescription claims from IBM MarketScan Commercial Claims and Encounters database were linked with wildfire smoke plume data from NASA satellites based on Metropolitan Statistical Area (MSA). A retrospective cohort of live infants (2010-2016) born into MSAs in six western states (U.S.A.), having prescription insurance, and whose birthdate was estimable from claims data was constructed (N = 184,703); of these, gestational age was estimated for 113,154 infants. The residential MSA, gestational age, and birthdate were used to estimate average weekly smoke exposure days (smoke-day) for each developmental period: three trimesters, and two sequential 12-week periods post-birth. Medications treating respiratory tract inflammation were classified using active ingredient and mode of administration into three categories:: 'upper respiratory', 'lower respiratory', 'systemic anti-inflammatory'. To evaluate associations between wildfire smoke exposure and medication usage, Cox models associating smoke-days with first observed prescription of each medication category were adjusted for infant sex, birth-season, and birthyear with a random intercept for MSA. Smoke exposure during postnatal periods was associated with earlier first use of upper respiratory medications (1-12 weeks: hazard ratio (HR) = 1.094 per 1-day increase in average weekly smoke-day, 95%CI: (1.005,1.191); 13-24 weeks: HR = 1.108, 95%CI: (1.016,1.209)). Protective associations were observed during gestational windows for both lower respiratory and systemic anti-inflammatory medications; it is possible that these associations may be a consequence of live-birth bias. These findings suggest wildfire smoke exposure during early postnatal developmental periods impact subsequent early life respiratory health.
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Affiliation(s)
- Radhika Dhingra
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, C.B 7431, Chapel Hill, NC, 27599, USA.
- Brody School of Medicine, East Carolina University, Greenville, NC, USA.
| | - Corinna Keeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke S Staley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hanna V Jardel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA
| | - Cavin Ward-Caviness
- Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA
| | - Meghan E Rebuli
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yuzhi Xi
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, C.B 7431, Chapel Hill, NC, 27599, USA
| | - Kristen Rappazzo
- Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA
| | - Michelle Hernandez
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ann N Chelminski
- Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA
| | - Ilona Jaspers
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ana G Rappold
- Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA
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Moore LE, Oliveira A, Zhang R, Behjat L, Hicks A. Impacts of Wildfire Smoke and Air Pollution on a Pediatric Population with Asthma: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031937. [PMID: 36767304 PMCID: PMC9914777 DOI: 10.3390/ijerph20031937] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 05/26/2023]
Abstract
Wildfires are increasing yearly in number and severity as a part of the evolving climate crisis. These fires are a significant source of air pollution, a common driver of flares in cardiorespiratory disease, including asthma, which is the most common chronic disease of childhood. Poorly controlled asthma leads to significant societal costs through morbidity, mortality, lost school and work time and healthcare utilization. This retrospective cohort study set in Calgary, Canada evaluates the relationship between asthma exacerbations during wildfire smoke events and equivalent low-pollution periods in a pediatric asthma population. Air pollution was based on daily average levels of PM2.5. Wildfire smoke events were determined by combining information from provincial databases and local monitors. Exposures were assumed using postal codes in the health record at the time of emergency department visits. Provincial claims data identified 27,501 asthma exacerbations in 57,375 children with asthma between 2010 to 2021. Wildfire smoke days demonstrated an increase in asthma exacerbations over the baseline (incidence rate ratio: 1.13; 95% CI: 1.02-1.24); this was not seen with air pollution in general. Increased rates of asthma exacerbations were also noted yearly in September. Asthma exacerbations were significantly decreased during periods of COVID-19 healthcare precautions.
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Affiliation(s)
- Linn E. Moore
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Andre Oliveira
- Department of Electrical and Software Engineering, University of Calgary, 2500 University Drive, Calgary, AB T3L 2M6, Canada
| | - Raymond Zhang
- Department of Computer Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Laleh Behjat
- Department of Electrical and Software Engineering, University of Calgary, 2500 University Drive, Calgary, AB T3L 2M6, Canada
| | - Anne Hicks
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
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Elser H, Rowland ST, Marek MS, Kiang MV, Shea B, Do V, Benmarhnia T, Schneider ALC, Casey JA. Wildfire smoke exposure and emergency department visits for headache: A case-crossover analysis in California, 2006-2020. Headache 2023; 63:94-103. [PMID: 36651537 PMCID: PMC10066880 DOI: 10.1111/head.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM2.5 ) and wildfire-specific PM2.5 with emergency department (ED) visits for headache. BACKGROUND Studies have reported associations between PM2.5 exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM2.5 may contribute to more frequent headaches. METHODS Our study included adult Californian members (aged ≥18 years) of a large de-identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension-type headache, migraine headache, cluster headache, and "other" primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire-specific PM2.5 to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM2.5 concentrations, first for primary headache disorders combined, and then by headache subtype. RESULTS Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (N = 5534/13,623 [47.6%]) followed by "other" primary headache (N = 6489/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7-day average wildfire PM2.5 (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95-1.44 per 10 μg/m3 increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM2.5 for tension-type headache (OR 1.42, 95% CI 0.91-2.22), "other" primary headache (OR 1.40, 95% CI 0.96-2.05), and cluster headache (OR 1.29, 95% CI 0.71-2.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM2.5 was associated with tension-type headache (OR 1.29, 95% CI 1.03-1.62), but not migraine, cluster, or "other" primary headaches. CONCLUSIONS Although imprecise, these results suggest short-term wildfire PM2.5 exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache-related healthcare needs in the wake of wildfires and on poor air quality days.
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Affiliation(s)
- Holly Elser
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Population Health Sciences, Stanford University, Stanford, California, USA
| | - Sebastian T Rowland
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA.,PSE Healthy Energy, Oakland, New York, USA
| | - Maksym S Marek
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mathew V Kiang
- Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Brittany Shea
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Vivian Do
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California, USA
| | - Andrea L C Schneider
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Joan A Casey
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
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9
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Bae HR, Chandy M, Aguilera J, Smith EM, Nadeau KC, Wu JC, Paik DT. Adverse effects of air pollution-derived fine particulate matter on cardiovascular homeostasis and disease. Trends Cardiovasc Med 2022; 32:487-498. [PMID: 34619335 PMCID: PMC9063923 DOI: 10.1016/j.tcm.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Air pollution is a rapidly growing major health concern around the world. Atmospheric particulate matter that has a diameter of less than 2.5 µm (PM2.5) refers to an air pollutant composed of particles and chemical compounds that originate from various sources. While epidemiological studies have established the association between PM2.5 exposure and cardiovascular diseases, the precise cellular and molecular mechanisms by which PM2.5 promotes cardiovascular complications are yet to be fully elucidated. In this review, we summarize the various sources of PM2.5, its components, and the concentrations of ambient PM2.5 in various settings. We discuss the experimental findings to date that evaluate the potential adverse effects of PM2.5 on cardiovascular homeostasis and function, and the possible therapeutic options that may alleviate PM2.5-driven cardiovascular damage.
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Affiliation(s)
- Hye Ryeong Bae
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Mark Chandy
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA; Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Juan Aguilera
- Sean N. Parker Center for Allergy and Asthma Research and the Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Eric M Smith
- Sean N. Parker Center for Allergy and Asthma Research and the Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research and the Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA; Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - David T Paik
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA; Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
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Basilio E, Chen R, Fernandez AC, Padula AM, Robinson JF, Gaw SL. Wildfire Smoke Exposure during Pregnancy: A Review of Potential Mechanisms of Placental Toxicity, Impact on Obstetric Outcomes, and Strategies to Reduce Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13727. [PMID: 36360613 PMCID: PMC9657128 DOI: 10.3390/ijerph192113727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Climate change is accelerating the intensity and frequency of wildfires globally. Understanding how wildfire smoke (WS) may lead to adverse pregnancy outcomes and alterations in placental function via biological mechanisms is critical to mitigate the harms of exposure. We aim to review the literature surrounding WS, placental biology, biological mechanisms underlying adverse pregnancy outcomes as well as interventions and strategies to avoid WS exposure in pregnancy. This review includes epidemiologic and experimental laboratory-based studies of WS, air pollution, particulate matter (PM), and other chemicals related to combustion in relation to obstetric outcomes and placental biology. We summarized the available clinical, animal, and placental studies with WS and other combustion products such as tobacco, diesel, and wood smoke. Additionally, we reviewed current recommendations for prevention of WS exposure. We found that there is limited data specific to WS; however, studies on air pollution and other combustion sources suggest a link to inflammation, oxidative stress, endocrine disruption, DNA damage, telomere shortening, epigenetic changes, as well as metabolic, vascular, and endothelial dysregulation in the maternal-fetal unit. These alterations in placental biology contribute to adverse obstetric outcomes that disproportionally affect the most vulnerable. Limiting time outdoors, wearing N95 respirator face masks and using high quality indoor air filters during wildfire events reduces exposure to related environmental exposures and may mitigate morbidities attributable to WS.
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Affiliation(s)
- Emilia Basilio
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
| | - Rebecca Chen
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
| | | | - Amy M. Padula
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
| | - Joshua F. Robinson
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
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11
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Koman PD, Billmire M, Baker KR, Carter JM, Thelen BJ, French NHF, Bell SA. Using wildland fire smoke modeling data in gerontological health research (California, 2007-2018). THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156403. [PMID: 35660427 DOI: 10.1016/j.scitotenv.2022.156403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Widespread population exposure to wildland fire smoke underscores the urgent need for new techniques to characterize fire-derived pollution for epidemiologic studies and to build climate-resilient communities especially for aging populations. Using atmospheric chemical transport modeling, we examined air quality with and without wildland fire smoke PM2.5. In 12-km gridded output, the 24-hour average concentration of all-source PM2.5 in California (2007-2018) was 5.16 μg/m3 (S.D. 4.66 μg/m3). The average concentration of fire-PM2.5 in California by year was 1.61 μg/m3 (~30% of total PM2.5). The contribution of fire-source PM2.5 ranged from 6.8% to 49%. We define a "smokewave" as two or more consecutive days with modeled levels above 35 μg/m3. Based on model-derived fire-PM2.5, 99.5% of California's population lived in a county that experienced at least one smokewave from 2007 to 2018, yet understanding of the impact of smoke on the health of aging populations is limited. Approximately 2.7 million (56%) of California residents aged 65+ years lived in counties representing the top 3 quartiles of fire-PM2.5 concentrations (2007-2018). For each year (2007-2018), grid cells containing skilled nursing facilities had significantly higher mean concentrations of all-source PM2.5 than cells without those facilities, but they also had generally lower mean concentrations of wildland fire-specific PM2.5. Compared to rural monitors in California, model predictions of wildland fire impacts on daily average PM2.5 carbon (organic and elemental) performed well most years but tended to overestimate wildland fire impacts for high-fire years. The modeling system isolated wildland fire PM2.5 from other sources at monitored and unmonitored locations, which is important for understanding exposures for aging population in health studies.
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Affiliation(s)
- Patricia D Koman
- University of Michigan, School of Public Health, Environmental Health Sciences, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Michael Billmire
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Kirk R Baker
- U.S. Environmental Protection Agency, Office of Air and Radiation, Office of Air Quality Planning & Standards, Research Triangle Park, NC 27709, USA.
| | - Julie M Carter
- University of Michigan, School of Public Health, Environmental Health Sciences, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Brian J Thelen
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Nancy H F French
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Sue Anne Bell
- University of Michigan, School of Nursing, Ann Arbor, MI 48109, USA.
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12
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Balasooriya NN, Bandara JS, Rohde N. Air pollution and health outcomes: Evidence from Black Saturday Bushfires in Australia. Soc Sci Med 2022; 306:115165. [PMID: 35767903 DOI: 10.1016/j.socscimed.2022.115165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/30/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
This paper presents new evidence of the causal effect of air pollution on Australian health outcomes, using the Black Saturday bushfires (BSB) in 2009 as a natural experiment. This event was one of the largest bushfires in Australian history and emitted approximately four million tonnes of CO2 into the atmosphere. We use data from the Household Income and Labour Dynamic Australia (HILDA) panel and compare the health status of individuals who were living in affected and unaffected regions before and after the event. Using a triple differences procedure, we further examine whether a difference in vulnerability to bushfire smoke exists comparing people living in urban or regional areas. We find that ambient air pollution had significant negative effects on health and that the magnitudes were actually larger for individuals residing in urban areas.
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Affiliation(s)
- Namal N Balasooriya
- Department of Accounting, Finance and Economics, Griffith University, Brisbane, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland; Department of Social Statistics, University of Kelaniya, Kelaniya, Sri Lanka.
| | - Jayatilleke S Bandara
- Department of Accounting, Finance and Economics, Griffith University, Brisbane, Australia.
| | - Nicholas Rohde
- Department of Accounting, Finance and Economics, Griffith University, Gold Coast, Australia.
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13
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Cleland SE, Wyatt LH, Wei L, Paul N, Serre ML, West JJ, Henderson SB, Rappold AG. Short-Term Exposure to Wildfire Smoke and PM2.5 and Cognitive Performance in a Brain-Training Game: A Longitudinal Study of U.S. Adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:67005. [PMID: 35700064 PMCID: PMC9196888 DOI: 10.1289/ehp10498] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND There is increasing evidence that long-term exposure to fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] may adversely impact cognitive performance. Wildfire smoke is one of the biggest sources of PM2.5 and concentrations are likely to increase under climate change. However, little is known about how short-term exposure impacts cognitive function. OBJECTIVES We aimed to evaluate the associations between daily and subdaily (hourly) PM2.5 and wildfire smoke exposure and cognitive performance in adults. METHODS Scores from 20 plays of an attention-oriented brain-training game were obtained for 10,228 adults in the United States (U.S.). We estimated daily and hourly PM2.5 exposure through a data fusion of observations from multiple monitoring networks. Daily smoke exposure in the western U.S. was obtained from satellite-derived estimates of smoke plume density. We used a longitudinal repeated measures design with linear mixed effects models to test for associations between short-term exposure and attention score. Results were also stratified by age, gender, user behavior, and region. RESULTS Daily and subdaily PM2.5 were negatively associated with attention score. A 10 μg/m3 increase in PM2.5 in the 3 h prior to gameplay was associated with a 21.0 [95% confidence interval (CI): 3.3, 38.7]-point decrease in score. PM2.5 exposure over 20 plays accounted for an estimated average 3.7% (95% CI: 0.7%, 6.7%) reduction in final score. Associations were more pronounced in the wildfire-impacted western U.S. Medium and heavy smoke density were also negatively associated with score. Heavy smoke density the day prior to gameplay was associated with a 117.0 (95% CI: 1.7, 232.3)-point decrease in score relative to no smoke. Although differences between subgroups were not statistically significant, associations were most pronounced for younger (18-29 y), older (≥70y), habitual, and male users. DISCUSSION Our results indicate that PM2.5 and wildfire smoke were associated with reduced attention in adults within hours and days of exposure, but further research is needed to elucidate these relationships. https://doi.org/10.1289/EHP10498.
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Affiliation(s)
- Stephanie E. Cleland
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development (ORD), U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Lauren H. Wyatt
- Center for Public Health and Environmental Assessment, ORD, U.S. EPA, Research Triangle Park, North Carolina, USA
| | - Linda Wei
- Center for Public Health and Environmental Assessment, ORD, U.S. EPA, Research Triangle Park, North Carolina, USA
| | - Naman Paul
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Marc L. Serre
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J. Jason West
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Ana G. Rappold
- Center for Public Health and Environmental Assessment, ORD, U.S. EPA, Research Triangle Park, North Carolina, USA
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Peng RD, Liu JC, McCormack MC, Mickley LJ, Bell ML. Estimating the health effects of environmental mixtures using principal stratification. Stat Med 2022; 41:1815-1828. [PMID: 35088427 PMCID: PMC9303396 DOI: 10.1002/sim.9330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
The control of ambient air quality in the United States has been a major public health success since the passing of the Clean Air Act, with particulate matter (PM) reductions resulting in an estimated 160 000 premature deaths prevented in 2010 alone. Currently, public policy is oriented around lowering the levels of individual pollutants and this focus has driven the nature of much epidemiological research. Recently, attention has been given to viewing air pollution as a complex mixture and to developing a multi-pollutant approach to controlling ambient concentrations. We present a statistical approach for estimating the health impacts of complex environmental mixtures using a mixture-altering contrast, which is any comparison, intervention, policy, or natural experiment that changes a mixture's composition. We combine the notion of mixture-altering contrasts with sliced inverse regression, propensity score matching, and principal stratification to assess the health effects of different air pollution chemical mixtures. We demonstrate the application of this approach in an analysis of the health effects of wildfire PM air pollution in the Western US.
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Affiliation(s)
- Roger D Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jia C Liu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Loretta J Mickley
- School of Engineering and Applied Sciences, Harvard University, Boston, Massachusetts, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
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15
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Park BY, Boles I, Monavvari S, Patel S, Alvarez A, Phan M, Perez M, Yao R. The association between wildfire exposure in pregnancy and foetal gastroschisis: A population-based cohort study. Paediatr Perinat Epidemiol 2022; 36:45-53. [PMID: 34797578 DOI: 10.1111/ppe.12823] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Global climate change has led to an increase in the prevalence and severity of wildfires. Pollutants released into air, soil and groundwater from wildfires may impact embryo development leading to gastroschisis. OBJECTIVE The objective of this study was to determine the association between wildfire exposure before and during pregnancy and the risk of foetal gastroschisis development. METHODS This was a retrospective cohort study using The California Office of Statewide Health Planning and Development Linked Birth File linked to The California Department of Forestry and Fire Protection data between 2007 and 2010. Pregnancies complicated by foetal gastroschisis were identified by neonatal hospital discharge ICD-9 code. Pregnancies were considered exposed to wildfire if the mother's primary residence zip code was within 15 miles to the closest edge of a wildfire. The exposure was further stratified by trimester or if exposed within 30 days prior to pregnancy. Multivariable log-binomial regression analyses were performed to estimate the association between wildfire exposure in each pregnancy epoch and foetal gastroschisis. RESULTS Between 2007 and 2010, 844,348 (40%) births were exposed to wildfire in California. Compared with births without wildfire exposure, those with first-trimester exposure were associated with higher rates of gastroschisis, 7.8 vs. 5.7 per 10,000 births (adjusted relative risk [aRR] 1.28, 95% confidence interval [CI] 1.07, 1.54). Furthermore, those with prepregnancy wildfire exposure were also found to have higher rates of gastroschisis, 12.5 vs. 5.7 per 10,000 births, (aRR 2.17, 95% CI 1.42, 3.52). In contrast, second- and third-trimester wildfire exposures were not associated with foetal gastroschisis. CONCLUSIONS Wildfire exposure within 30 days before pregnancy was associated with more than two times higher risk of foetal gastroschisis, whereas a 28% higher risk was demonstrated if exposure was in the first trimester.
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Affiliation(s)
- Bo Young Park
- Department of Public Health, California State University - Fullerton, Fullerton, CA, USA.,Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Ian Boles
- Center for Demographic Research, Fullerton, CA, USA
| | - Samira Monavvari
- Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Shivani Patel
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Arriel Alvarez
- Department of Public Health, California State University - Fullerton, Fullerton, CA, USA
| | - Mie Phan
- Department of Public Health, California State University - Fullerton, Fullerton, CA, USA
| | - Maria Perez
- St. George's University School of Medicine, St George's, Grenada
| | - Ruofan Yao
- Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA, USA
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16
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Assessment of Smoke Pollution Caused by Wildfires in the Baikal Region (Russia). ATMOSPHERE 2021. [DOI: 10.3390/atmos12121542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Climate change has increased the prevalence of wildfires, resulting in longer fire seasons and larger geographic area burned. The aim of this work was to assess the air pollution and health risk to the population caused during exposure to smoke in fire season. The study design included: an analysis of long-term air pollution to determine background levels; an analysis of short-term (<24 h) and subchronic (10–14 days) concentrations during wildfires; and an assessment of the health risk in the industrial center of the Baikal region (Russia). In Irkutsk, at a distance of 2000 km from the fire focal points, the maximum short-term concentrations of pollution were noted during the smoke period, when the average CO level increased 2.4 times, and PM1 increased 1.4 times relative to the background levels in August 2021. In Bratsk, located near the fires, the increases in short-term concentrations were: CO—21.0; SO2—13.0; formaldehyde—12.0; TPM—4.4 times. The hazard indices of respiratory and coronary diseases in the burning period exceeded the acceptable level. Acute reactions to smoke can be expected in 30% of the exposed population near fires and 11% in remote areas (Bratsk). The results obtained from the remote sensing of atmospheric smoke can be used to urgently resolve the issue of organizing medical assistance or evacuating the population groups most sensitive to the effects of smoke in fire season.
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17
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Malig BJ, Fairley D, Pearson D, Wu X, Ebisu K, Basu R. Examining fine particulate matter and cause-specific morbidity during the 2017 North San Francisco Bay wildfires. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 787:147507. [PMID: 35142610 DOI: 10.1016/j.scitotenv.2021.147507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/18/2021] [Accepted: 04/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Recent increases in wildfire frequency and severity necessitate better understanding of health effects of wildfire smoke to protect affected populations. OBJECTIVES We examined relationships between fine particulate matter (PM2.5) and morbidity during wildfires in California, and whether those relationships differed during the fire compared to a similar non-fire period. METHODS For nine San Francisco Bay Area counties, daily county-level diagnosis-specific counts of emergency department visits (EDVs) and hospitalizations were linked with county-level estimates of daily mean PM2.5 during the October 2017 Northern California wildfires and similar October days in 2015, 2016, and 2017. Associations were estimated using Poisson regression. RESULTS The median difference between county PM2.5 during the fire versus the non-fire period was 23.4 μg/m3, with days exceeding 80 μg/m3 in some counties. Over the entire study period, PM2.5 was most consistently linked to EDVs for respiratory disease (RREDV(lag0) per 23.4 μg/m3 increase: 1.25, 95% CI: 1.21, 1.30), asthma, chronic lower respiratory disease (CLRD; RREDV(lag0): 1.18, 95% CI: 1.10, 1.27), and acute myocardial infarction (RREDV(lag0): 1.14, 95% CI: 1.03, 1.25). Increases in acute upper respiratory infections and decreases in mental/behavioral EDVs were observed but were sensitive to model specification, specifically the inclusion of time-related covariates. Comparing fire and non-fire period EDV associations, we observed indications that PM2.5 during the fire was more strongly associated with asthma (RRlag0: 1.46, 95% CI: 1.38, 1.55) compared to non-fire period PM2.5 (RRlag0: 0.77, 95% CI: 0.55, 1.08), and the opposite observed for dysrhythmia, with the asthma difference being particularly robust to model choice. For hospitalizations, the most robust PM2.5 relationships were positive associations with respiratory, CLRD, and diabetes, and inverse associations with pneumonia. Respiratory and CLRD effect estimates were generally similar or smaller than for EDVs. CONCLUSIONS Elevated short-term PM2.5 levels from wildfire smoke appears to impact respiratory and other health domains.
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Affiliation(s)
- Brian J Malig
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - David Fairley
- Bay Area Air Quality Management District, San Francisco, CA, USA
| | - Dharshani Pearson
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Xiangmei Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
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18
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Assessing the Risk of Respiratory-Related Healthcare Visits Associated with Wildfire Smoke Exposure in Children 0-18 Years Old: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168799. [PMID: 34444546 PMCID: PMC8392577 DOI: 10.3390/ijerph18168799] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 12/03/2022]
Abstract
Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children < 5 years old.
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Cleland SE, Serre ML, Rappold AG, West JJ. Estimating the Acute Health Impacts of Fire-Originated PM 2.5 Exposure During the 2017 California Wildfires: Sensitivity to Choices of Inputs. GEOHEALTH 2021; 5:e2021GH000414. [PMID: 34250370 PMCID: PMC8247531 DOI: 10.1029/2021gh000414] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/07/2021] [Accepted: 05/23/2021] [Indexed: 05/27/2023]
Abstract
Exposure to wildfire smoke increases the risk of respiratory and cardiovascular hospital admissions. Health impact assessments, used to inform decision-making processes, characterize the health impacts of environmental exposures by combining preexisting epidemiological concentration-response functions (CRFs) with estimates of exposure. These two key inputs influence the magnitude and uncertainty of the health impacts estimated, but for wildfire-related impact assessments the extent of their impact is largely unknown. We first estimated the number of respiratory, cardiovascular, and asthma hospital admissions attributable to fire-originated PM2.5 exposure in central California during the October 2017 wildfires, using Monte Carlo simulations to quantify uncertainty with respect to the exposure and epidemiological inputs. We next conducted sensitivity analyses, comparing four estimates of fire-originated PM2.5 and two CRFs, wildfire and nonwildfire specific, to understand their impact on the estimation of excess admissions and sources of uncertainty. We estimate the fires accounted for an excess 240 (95% CI: 114, 404) respiratory, 68 (95% CI: -10, 159) cardiovascular, and 45 (95% CI: 18, 81) asthma hospital admissions, with 56% of admissions occurring in the Bay Area. Although differences between impact assessment methods are not statistically significant, the admissions estimates' magnitude is particularly sensitive to the CRF specified while the uncertainty is most sensitive to estimates of fire-originated PM2.5. Not accounting for the exposure surface's uncertainty leads to an underestimation of the uncertainty of the health impacts estimated. Employing context-specific CRFs and using accurate exposure estimates that combine multiple data sets generates more certain estimates of the acute health impacts of wildfires.
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Affiliation(s)
- Stephanie E. Cleland
- Department of Environmental Sciences and EngineeringGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
- Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental AssessmentOffice of Research and DevelopmentUnited States Environmental Protection AgencyResearch Triangle ParkNCUSA
| | - Marc L. Serre
- Department of Environmental Sciences and EngineeringGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Ana G. Rappold
- Center for Public Health and Environmental AssessmentOffice of Research and DevelopmentUnited States Environmental Protection AgencyResearch Triangle ParkNCUSA
| | - J. Jason West
- Department of Environmental Sciences and EngineeringGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
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20
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Neumann JE, Amend M, Anenberg S, Kinney PL, Sarofim M, Martinich J, Lukens J, Xu JW, Roman H. Estimating PM2.5-related premature mortality and morbidity associated with future wildfire emissions in the western US. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2021; 16:10.1088/1748-9326/abe82b. [PMID: 33868453 PMCID: PMC8048092 DOI: 10.1088/1748-9326/abe82b] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Wildfire activity in the western United States (US) has been increasing, a trend that has been correlated with changing patterns of temperature and precipitation associated with climate change. Health effects associated with exposure to wildfire smoke and fine particulate matter (PM2.5) include short- and long-term premature mortality, hospital admissions, emergency department visits, and other respiratory and cardiovascular incidents. We estimate PM2.5 exposure and health impacts for the entire continental US from current and future western US wildfire activity projected for a range of future climate scenarios through the 21st century. We use a simulation approach to estimate wildfire activity, area burned, fine particulate emissions, air quality concentrations, health effects, and economic valuation of health effects, using established and novel methodologies. We find that climatic factors increase wildfire pollutant emissions by an average of 0.40% per year over the 2006-2100 period under Representative Concentration Pathway (RCP) 4.5 (lower emissions scenarios) and 0.71% per year for RCP8.5. As a consequence, spatially weighted wildfire PM2.5 concentrations more than double for some climate model projections by the end of the 21st century. PM2.5 exposure changes, combined with population projections, result in a wildfire PM2.5-related premature mortality excess burden in the 2090 RCP8.5 scenario that is roughly 3.5 times larger than in the baseline period. The combined effect of increased wildfire activity, population growth, and increase in the valuation of avoided risk of premature mortality over time results in a large increase in total economic impact of wildfire-related PM2.5 mortality and morbidity in the continental US, from roughly $7 billion per year in the baseline period to roughly $36 billion per year in 2090 for RCP4.5, and $43 billion per year in RCP8.5. The climate effect alone accounts for a roughly 60% increase in wildfire PM2.5-related premature mortality in the RCP8.5 scenario, relative to baseline conditions.
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Affiliation(s)
- James E Neumann
- Industrial Economics, Inc., Cambridge, MA, United States of America
| | - Meredith Amend
- Industrial Economics, Inc., Cambridge, MA, United States of America
| | - Susan Anenberg
- George Washington University, Washington, DC, United States of America
| | - Patrick L Kinney
- School of Public Health, Boston University, Boston, MA, United States of America
| | - Marcus Sarofim
- US Environmental Protection Agency, Washington, DC, United States of America
| | - Jeremy Martinich
- US Environmental Protection Agency, Washington, DC, United States of America
| | - Julia Lukens
- Industrial Economics, Inc., Cambridge, MA, United States of America
| | - Jun-Wei Xu
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry Roman
- Industrial Economics, Inc., Cambridge, MA, United States of America
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Magzamen S, Gan RW, Liu J, O’Dell K, Ford B, Berg K, Bol K, Wilson A, Fischer EV, Pierce JR. Differential Cardiopulmonary Health Impacts of Local and Long-Range Transport of Wildfire Smoke. GEOHEALTH 2021; 5:e2020GH000330. [PMID: 35281479 PMCID: PMC8900982 DOI: 10.1029/2020gh000330] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 05/26/2023]
Abstract
We estimated cardiopulmonary morbidity and mortality associated with wildfire smoke (WFS) fine particulate matter (PM2.5) in the Front Range of Colorado from 2010 to 2015. To estimate WFS PM2.5, we developed a daily kriged PM2.5 surface at a 15 × 15 km resolution based on the Environmental Protection Agency Air Quality System monitors for the western United States; we subtracted out local seasonal-average PM2.5 of nonsmoky days, identified using satellite-based smoke plume estimates, from the local daily estimated PM2.5 if smoke was identified by National Oceanic and Atmospheric Administration's Hazard Mapping System. We implemented time-stratified case-crossover analyses to estimate the effect of a 10 µg/m3 increase in WFS PM2.5 with cardiopulmonary hospitalizations and deaths using single and distributed lag models for lags 0-5 and distinct annual impacts based on local and long-range smoke during 2012, and long-range transport of smoke in 2015. A 10 µg/m3 increase in WFS was associated with all respiratory, asthma, and chronic obstructive pulmonary disease hospitalizations for lag day 3 and hospitalizations for ischemic heart disease at lag days 2 and 3. Cardiac arrest deaths were associated with WFS PM2.5 at lag day 0. For 2012 local wildfires, asthma hospitalizations had an inverse association with WFS PM2.5 (OR: 0.716, 95% CI: 0.517-0.993), but a positive association with WFS PM2.5 during the 2015 long-range transport event (OR: 1.455, 95% CI: 1.093-1.939). Cardiovascular mortality was associated with the 2012 long-range transport event (OR: 1.478, 95% CI: 1.124-1.944).
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Affiliation(s)
- Sheryl Magzamen
- Department of Environmental and Radiological Health SciencesColorado State UniversityFort CollinsCOUSA
| | - Ryan W. Gan
- Department of Environmental and Radiological Health SciencesColorado State UniversityFort CollinsCOUSA
| | - Jingyang Liu
- Department of Environmental and Radiological Health SciencesColorado State UniversityFort CollinsCOUSA
| | - Katelyn O’Dell
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Bonne Ford
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Kevin Berg
- Colorado Department of Public Health and EnvironmentDenverCOUSA
| | - Kirk Bol
- Colorado Department of Public Health and EnvironmentDenverCOUSA
| | - Ander Wilson
- Department of StatisticsColorado State UniversityFort CollinsCOUSA
| | - Emily V. Fischer
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Jeffrey R. Pierce
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
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22
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Schuller A, Montrose L. Influence of Woodsmoke Exposure on Molecular Mechanisms Underlying Alzheimer's Disease: Existing Literature and Gaps in Our Understanding. Epigenet Insights 2020; 13:2516865720954873. [PMID: 32974607 PMCID: PMC7493275 DOI: 10.1177/2516865720954873] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022] Open
Abstract
Woodsmoke poses a significant health risk as a growing component of ambient air pollution in the United States. While there is a long history of association between woodsmoke exposure and diseases of the respiratory, circulatory, and cardiovascular systems, recent evidence has linked woodsmoke exposure to cognitive dysfunction, including Alzheimer’s disease dementia. Alzheimer’s disease is a progressive neurodegenerative disorder with largely idiopathic origins and no known cure. Here, we explore the growing body of literature which relates woodsmoke-generated and ambient air pollution particulate matter exposure to Alzheimer’s disease (AD) onset or exacerbation, in the context of an inflammation-centric view of AD. Epigenetic modifications, specifically changes in DNA methylation patterns, are well documented following woodsmoke exposure and have been shown to influence disease-favoring inflammatory cascades, induce oxidative stress, and modulate the immune response in vitro, in vivo, and in humans following exposure to air pollution. Though the current status of the literature does not allow us to draw definitive conclusions linking these events, this review highlights the need for additional work to fill gaps in our understanding of the directionality, causality, and susceptibility throughout the life course.
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Affiliation(s)
- Adam Schuller
- Department of Community and Environmental Health, Boise State University, Boise, Idaho, USA
| | - Luke Montrose
- Department of Community and Environmental Health, Boise State University, Boise, Idaho, USA
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23
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Milton LA, White AR. The potential impact of bushfire smoke on brain health. Neurochem Int 2020; 139:104796. [PMID: 32650032 DOI: 10.1016/j.neuint.2020.104796] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/20/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
Abstract
Smoke from bushfires (also known as wildfires or forest fires) has blanketed large regions of Australia during the southern hemisphere summer of 2019/2020, potentially endangering residents who breathe the polluted air. While such air pollution is known to cause respiratory irritation and damage, its effect on the brain is not well described. In this review, we aim to outline the potentially damaging effects of bushfire smoke on brain health. We also describe the composition of air pollution, including ambient particulate matter (PM) and bushfire PM, before covering the general health effects of each. The investigated entry routes for ambient PM and postulated entry routes for bushfire PM are discussed, along with epidemiological and experimental evidence of the effect of both PMs in the brain. It appears that bushfire PM may be more toxic than ambient PM, and that it may enter the brain through extrapulmonary or olfactory routes to cause inflammation and oxidative stress. Ultimately, this review highlights the desperate requirement of greater research into the effects of bushfire PM on brain health.
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Affiliation(s)
- Laura A Milton
- Mental Health Program, Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, Queensland, 4006, Australia
| | - Anthony R White
- Mental Health Program, Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, Queensland, 4006, Australia.
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24
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Forehead H, Barthelemy J, Arshad B, Verstaevel N, Price O, Perez P. Traffic exhaust to wildfires: PM2.5 measurements with fixed and portable, low-cost LoRaWAN-connected sensors. PLoS One 2020; 15:e0231778. [PMID: 32330173 PMCID: PMC7182254 DOI: 10.1371/journal.pone.0231778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/01/2020] [Indexed: 12/22/2022] Open
Abstract
Air pollution with PM2.5 (particulate matter smaller than 2.5 micro-metres in diameter) is a major health hazard in many cities worldwide, but since measuring instruments have traditionally been expensive, monitoring sites are rare and generally show only background concentrations. With the advent of low-cost, wirelessly connected sensors, air quality measurements are increasingly being made in places where many people spend time and pollution is much worse: on streets near traffic. In the interests of enabling members of the public to measure the air that they breathe, we took an open-source approach to designing a device for measuring PM2.5. Parts are relatively cheap, but of good quality and can be easily found in electronics or hardware stores, or on-line. Software is open source and the free LoRaWAN-based "The Things Network" the platform. A number of low-cost sensors we tested had problems, but those selected performed well when co-located with reference-quality instruments. A network of the devices was deployed in an urban centre, yielding valuable data for an extended time. Concentrations of PM2.5 at street level were often ten times worse than at air quality stations. The devices and network offer the opportunity for measurements in locations that concern the public.
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Affiliation(s)
- Hugh Forehead
- SMART Infrastructure Facility, University of Wollongong, Wollongong, Australia
- Clean Air and Urban Landscapes (CAUL) hub, Melbourne, Victoria, Australia
| | - Johan Barthelemy
- SMART Infrastructure Facility, University of Wollongong, Wollongong, Australia
| | - Bilal Arshad
- SMART Infrastructure Facility, University of Wollongong, Wollongong, Australia
| | - Nicolas Verstaevel
- SMART Infrastructure Facility, University of Wollongong, Wollongong, Australia
- Université Toulouse 1 Capitole, Institut de Recherche en Informatique de Toulouse (IRIT), Toulouse, France
| | - Owen Price
- Centre for Sustainable Ecosystem Solutions, University of Wollongong, Wollongong, Australia
| | - Pascal Perez
- SMART Infrastructure Facility, University of Wollongong, Wollongong, Australia
- Clean Air and Urban Landscapes (CAUL) hub, Melbourne, Victoria, Australia
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