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It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached. [ABSTRACT FROM AUTHOR]

In February 2014, the coalmine adjacent to the Hazelwood Power Station in the Latrobe Valley of Victoria, Australia, caught fire, with residents from the nearby town of Morwell and the wider area exposed to smoke for six weeks. Although there was evidence linking the mine-fire event with psychological distress, no studies have evaluated the degree of distress in relation to the level of smoke exposure. We aimed to investigate the exposure-response relationship between particulate matter 2.5 μm or less in diameter (PM 2.5) released during the Hazelwood mine fire event and long-term symptoms of posttraumatic distress in the affected community, including the consideration of other key factors. A total of 3096 Morwell residents, and 960 residents from the largely unexposed comparison community of Sale, were assessed for symptoms of posttraumatic distress 2.5 years after the Hazelwood incident using the Impact of Events Scale-Revised (IES-R). Individual-level PM 2.5 exposure was estimated by mapping participants' self-reported location data on modelled PM 2.5 concentrations related to the mine fire. Multivariate linear regression was used to evaluate the exposure-response relationship. Both mean and peak exposure to mine fire-related PM 2.5 were found to be associated with participant IES-R scores with an interaction effect between age and mean PM 2.5 exposure also identified. Each 10 μg/m3 increase in mean PM 2.5 exposure corresponded to a 0.98 increase in IES-R score (95% CI: 0.36 to 1.61), and each 100 μg/m3 increase in peak PM 2.5 exposure corresponded to a 0.36 increase (95% CI: 0.06 to 0.67). An age-effect was observed, with the exposure-response association found to be stronger for younger adults. The results suggest that increased exposure to PM 2.5 emissions from the Hazelwood mine fire event was associated with higher levels of psychological distress associated with the mine fire and the most pronounced effect was on younger adults living in the affected community. Image 1 • PM 2.5 exposure was objectively estimated at an individual level. • An exposure-response relationship was observed between PM 2.5 and distress. • Younger adults reported higher distress in response to increased exposure. • Other factors such as prior traumatic experiences were related to distress. • This work provides a nuanced understanding of distress following a pollution event. [ABSTRACT FROM AUTHOR]

Limited research has examined the impacts of coal mine fire smoke on human health. The aim of this study was to assess the association between prolonged smoke PM 2.5 exposure from a brown coal mine fire that burned over a seven week period in 2014 and medications dispensed across five localities in South-eastern Victoria, Australia. Spatially resolved PM 2.5 concentrations were retrospectively estimated using a dispersion model coupled with a chemical transport model. Data on medications dispensed were collected from the national Pharmaceutical Benefits Schedule database for 2013-2016. Poisson distributed lag time series analysis was used to examine associations between daily mine fire-related PM 2.5 concentrations and daily counts of medications dispensed for respiratory, cardiovascular or psychiatric conditions. Factors controlled for included: seasonality, long-term trend, day of the week, maximum ambient temperature and public holidays. Positive associations were found between mine fire-related PM 2.5 and increased risks of medications dispensed for respiratory, cardiovascular and psychiatric conditions, over a lag range of 3-7 days. A 10 μg/m 3 increase in coal mine fire-related PM 2.5 was associated with a 25% (95%CI 19-32%) increase in respiratory medications, a 10% (95%CI 7-13%) increase in cardiovascular medications and a 12% (95%CI 8-16%) increase in psychiatric medications dispensed. These findings have the potential to better prepare for and develop more appropriate public health responses in the event of future coal mine fires., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries., Objective: In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke., Methods: We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (≥ 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site., Results: There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter ≤ 2.5 μm (PM2.5) (8.05%; 95% CI: 2.30, 14.13%; IQR = 6.1 μg/m(3)) or ≤ 10 μm (PM10) (11.1%; 95% CI: 1.55, 21.48%; IQR = 13.7 μg/m(3)) and carbon monoxide (35.7%; 95% CI: 8.98, 68.92%; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventy-four "fire-hours" (i.e., hours in which Melbourne's air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95% CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations in PM2.5 during these fire-hours., Conclusions: This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency services during forest fire seasons.

Background: Epidemiological studies investigating the role of fine particulate matter (PM2.5; 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 PM2.5 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 PM2.5, 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 PM2.5 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: PM2.5 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 PM2.5 may act as a triggering factor for acute coronary events during wildfire episodes., (© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)

Objectives: To investigate the relationship between sociodemographic, individual and work place factors, and neck pain alone, shoulder pain alone, and neck and shoulder pain among nurses working across three public hospitals in Melbourne, Australia., Methods: Information on participant demographics, somatisation tendency, health beliefs, mental and physical health status, workplace physical and psychosocial factors, and musculoskeletal symptoms and pain at several body sites was collected., Results: 1111 participants (response rate 38.6%) were included in the study: 17.2% reported neck pain alone, 11.6% shoulder pain alone and 15.8% both neck and shoulder pain in the past month. Self-reported neck and shoulder pain were independently associated with poorer mental (OR 0.96, 95% CI 0.94 to 0.98) and physical (0.92, 0.90 to 0.95) health and well-being, somatisation (1.77, 1.03 to 3.04) and negative work-causation beliefs (2.51, 1.57 to 3.99). Neck pain alone was more consistently associated with sociodemographic factors, mental (0.97, 0.96 to 0.99) and physical (0.97, 0.94 to 0.99) health and well-being, and shoulder pain alone was associated with physical health and well-being (0.95, 0.92 to 0.98) and fear-avoidance beliefs (0.45, 0.24 to 0.86)., Conclusion: Risk factors for self-reported pain between regions of the neck and shoulder alone, and neck and shoulder differed. While neck and shoulder pain was consistently associated with several risk factors, neck and shoulder pain in isolation were both associated with physical health and well-being and individually associated with sociodemographic and health beliefs, respectively. These findings suggest that different factors may be associated with a single pain region versus pain in two regions.

Background: Although the aetiology of glioma is poorly understood, the higher incidence in males has long suggested an occupational cause., Aim: To investigate possible associations between occupational exposure to ionizing, ultraviolet (UV), radiofrequency (RF) and extremely low frequency (ELF) radiation and adult glioma risk., Methods: Case-control study using histologically confirmed cases of glioma first diagnosed between 1987 and 1991 in Melbourne, Australia, matched by age, sex and postcode of residence. A detailed occupational history was obtained for each subject. Exposure to radiation was assessed using a Finnish job exposure matrix (FINJEM) for all the radiation types as well as self-reports and expert hygienist review for RF and ionizing radiation. For ELF and UV, gender-specific FINJEM analysis was performed., Results: The study population consisted of 416 cases of glioma and 422 controls. The risk estimates given by FINJEM for ELF, RF and ionizing radiation were close to or below unity. Gender-specific analysis for UV showed odds ratios of 1.60 [95% confidence interval (CI) 0.95-2.69] and 0.54 (95% CI 0.27-1.07) for the highest exposed group of men and women, respectively (corresponding P value for trend was 0.03 and 0.04)., Conclusions: We did not find evidence of an association between glioma and occupational exposure to ELF, RF and ionizing radiation. UV radiation was associated with increased glioma risk for men but this result could have been confounded by other predominantly male occupational and lifestyle exposures associated with high UV. Further investigation of UV radiation and glioma risk is suggested.