Coal-mine fire-related fine particulate matter and medical-service utilization in Australia: a time-series analysis from the Hazelwood Health Study

Amanda L Johnson; Caroline X Gao; Martine Dennekamp; Grant J Williamson; Matthew T C Carroll; Christina Dimitriadis; Joanna F Dipnall; Jillian F Ikin; Fay H Johnston; Alexander C McFarlane; Malcolm R Sim; Dion A Stub; Michael J Abramson; Yuming Guo

doi:10.1093/ije/dyz219

Coal-mine fire-related fine particulate matter and medical-service utilization in Australia: a time-series analysis from the Hazelwood Health Study

Int J Epidemiol. 2020 Feb 1;49(1):80-93. doi: 10.1093/ije/dyz219.

Authors

Affiliations

¹ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
² School of Natural Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia.
³ Monash Rural Health-Churchill, Monash University, Churchill, Australia.
⁴ IMPACT SRC, School of Medicine, Faculty of Health, Deakin University, Australia.
⁵ Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
⁶ Centre for Traumatic Stress Studies, The University of Adelaide, South Australia, Australia.
⁷ Ambulance Victoria, Doncaster, Victoria, Australia.

PMID: 31651952
DOI: 10.1093/ije/dyz219

Abstract

Background: This study assessed the association between coal-mine-fire-related fine particulate matter (PM2.5) and medical-service utilization, following a 6-week coal-mine fire in Australia, in 2014. Areas in the immediate vicinity of the mine experienced hourly mine-fire-related PM2.5 concentrations of up to 3700 μg/m3.

Methods: Data on medical-service utilization were collected from the Medicare Benefits Schedule-a national database of payment for medical services. PM2.5 concentrations were modelled using atmospheric chemical transport modelling. Quasi-Poisson interrupted distributed lag time-series analysis examined the association between daily mine-fire-related PM2.5 concentrations and medical-service utilization, including General Practitioner (GP) consultations and respiratory, cardiovascular and mental health services. Confounders included seasonality, long-term trend, day of the week, maximum daily temperature and public holidays. Gender and age stratification were conducted.

Results: A 10-μg/m3 increase in PM2.5 was associated with an increased relative risk of service usage for all long and short GP consultations [11% (95% confidence interval: 7 to 15%)] and respiratory services [22% (4 to 43%)] in both men and women. Sex stratification found an increased relative risk in mental health consultations in men [32% (2 to 72%)] but not women. No associations were found for cardiovascular services in men or women.

Conclusions: Coal-mine-fire-related PM2.5 exposure was associated with increased use of medical services for GP consultations and respiratory services in men and women and mental health consultations in men. These findings can inform the development of future public-health-policy responses in the event of major air-pollution episodes.

Keywords: Fine particulate matter (PM2.5); coal-mine fire; medical-service utilization; physician visits; smoke exposure; time series.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Air Pollutants / adverse effects*
Air Pollution / adverse effects*
Australia
Cardiovascular Diseases / etiology
Cardiovascular Diseases / therapy*
Coal Mining*
Emergency Service, Hospital / statistics & numerical data*
Female
Fires*
General Practice / statistics & numerical data*
Humans
Inhalation Exposure / adverse effects*
Male
Middle Aged
Particulate Matter / toxicity*
Respiratory Tract Diseases / epidemiology*
Time Factors

Substances

Air Pollutants
Particulate Matter