Lung function may recover after exposure to smoke from a coal mine fire: cohort study

N. Holt, C. L. Smith, C. X. Gao, B. Borg, T. J. Lane, D. Brown, J. Ikin, A. Makar, T. McCrabb, M. Thomas, K. Nilsen, B. Thompson, M. Abramson
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Abstract

Background and objective: The 2014 Hazelwood coalmine fire exposed residents in nearby Morwell to high concentrations of particulate matter <2.5 m (PM2.5) for approximately 6 weeks. This analysis aimed to evaluate the long-term impact on respiratory health. Methods: Adults from Morwell and the unexposed town of Sale completed validated respiratory questionnaires and performed spirometry, gas transfer and oscillometry 3.5-4 years (Round 1) and 7.3-7.8 years (Round 2) after the fire. Individual PM2.5 exposure levels were estimated using chemical transport models mapped onto participant-reported time-location data. Mixed-effects regression models were fitted to analyse associations between PM2.5 exposure and outcomes, controlling for key confounders. Results: From 519 (346 exposed) Round 1 participants, 329 (217 exposed) participated in Round 2. Spirometry and gas transfer in Round 2 were mostly lower compared with Round 1, excepting FVC (increased) and FEV1 (minimal change). The effect of mine fire-related PM2.5 exposure changed from a negative effect in Round 1 to no effect in Round 2 for both pre- (p=0.005) and post-bronchodilator FVC (p=0.032). PM2.5 was not associated with gas transfer in either round. For post-bronchodilator reactance and area under the curve, a negative impact of PM2.5 in Round 1 showed signs of recovery in Round 2 (both p<0.001). Conclusion: In this novel study evaluating long-term respiratory outcomes after medium-duration high concentration PM2.5 exposure, the attenuated associations between exposure and respiratory function may indicate some recovery in lung function. With increased frequency and severity of landscape fires observed globally, these results inform public health policies and planning.
接触煤矿火灾烟雾后肺功能可能会恢复:队列研究
背景和目标:2014 年的黑泽尔伍德煤矿大火使附近莫韦尔的居民在大约 6 周的时间里暴露在浓度小于 2.5 米的高浓度颗粒物(PM2.5)中。本分析旨在评估对呼吸系统健康的长期影响。分析方法火灾发生后 3.5-4 年(第一轮)和 7.3-7.8 年(第二轮),来自莫韦尔和未受影响的萨利镇的成年人填写了有效的呼吸系统问卷,并进行了肺活量测定、气体传输和振荡测定。利用映射到参与者报告的时间地点数据上的化学迁移模型估算了个人的 PM2.5 暴露水平。混合效应回归模型用于分析 PM2.5 暴露与结果之间的关系,同时控制主要的混杂因素。研究结果在 519 名(346 名暴露者)第一轮参与者中,有 329 名(217 名暴露者)参加了第二轮。与第一轮相比,第二轮的肺活量和气体转移量大多较低,但 FVC(增加)和 FEV1(变化极小)除外。与矿井火灾有关的 PM2.5 暴露对肺活量测定前(p=0.005)和支气管舒张后(p=0.032)的影响从第一轮的负面影响变为第二轮的无影响。PM2.5在两轮中均与气体转移无关。对于支气管舒张后反应性和曲线下面积,PM2.5 在第一轮的负面影响在第二轮有恢复迹象(均 p<0.001)。结论在这项评估中长期高浓度 PM2.5 暴露后长期呼吸系统结果的新研究中,暴露与呼吸功能之间的关联减弱可能表明肺功能有所恢复。随着全球景观火灾频率和严重程度的增加,这些结果将为公共卫生政策和规划提供参考。
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