Open AccessImpact of Fine Particulate Matter ( PM 2.5 ) Exposure During Wildfires on Cardiovascular Health Outcomes
Author(s) -
Haikerwal Anjali,
Akram Muhammad,
Del Monaco Anthony,
Smith Karen,
Sim Malcolm R.,
Meyer Mick,
Tonkin Andrew M.,
Abramson Michael J.,
Dennekamp Martine
Publication year - 2015
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.114.001653
Subject(s) - medicine , interquartile range , emergency department , myocardial infarction , emergency medicine , angina , unstable angina , epidemiology , aerodynamic diameter , particulates , ecology , psychiatry , biology
Background Epidemiological studies investigating the role of fine particulate matter ( PM 2.5 ; 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 PM 2.5 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 PM 2.5 , 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/m 3 in PM 2.5 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 PM 2.5 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 PM 2.5 may act as a triggering factor for acute coronary events during wildfire episodes.