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In 2014, wildfires ignited a coal mine in Australia, burning for 6 weeks, releasing large amounts of fine particulate matter ≤2.5 μm in diameter (PM 2.5). We investigated the association between individual PM 2.5 exposure and emergency department presentations (EDPs) within 5 years post-fire. Survey and exposure data for 2725 residents from an exposed and unexposed town were linked with ED administrative data from 2009 to 2019. The association between individual PM 2.5 and EDPs was assessed using recurrent survival analysis. A 10 μg/m3 increase in PM 2.5 was associated with a 10% increase in respiratory EDPs (HR = 1.10; 95%CI:1.00–1.22) over 5 years post-fire. Increased risks of EDPs for ischaemic heart disease (HR = 1.39; 95%CI:1.12–1.73), atherothrombotic disease (HR = 1.27; 95%CI:1.08–1.50), and cardiovascular disease (HR = 1.10, 95%CI:0.99–1.22) were evident within 2.5 years. PM 2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory conditions. An increased risk of CVD within 2.5 years post-fire subsided after this time. • PM2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory related hospital emergency department presentations (EDPs). • An increased risk of cardiovascular related EDPs in the first 2.5 years post-mine fire, subsided after this time. [ABSTRACT FROM AUTHOR]

For six weeks from February 9, 2014, smoke and ash from a fire in the Morwell open cut brown coal mine adjacent to the Hazelwood power station covered parts of the Latrobe Valley, in south eastern Australia. To evaluate the health impact of the mine fire, daily counts of ambulance attendances from July 2010 to March 2015 were analysed. Time series models were used to evaluate the relative risk of ambulance attendances during the mine fire, in comparison with the remainder of the analysis period, and to also assess the risk of ambulance attendances associated with lagged effects of exposure to mine fire-related PM 2.5 levels. The models controlled for factors likely to influence ambulance attendances including seasonality, long-term temporal trends, day of the week, daily maximum temperature and public holidays. A 10 μg/m3 increase in fire-related PM 2.5 was found to be associated with a 42% (95%CI: 14–76%) increase in ambulance attendances for respiratory conditions and a 7% (0–14%) increase in all ambulance attendances over a 20-day lag period. A smaller effect associated with exposure to fire-related PM 2.5 was identified when assuming shorter lag effects. Similar results were identified when assessing whether ambulance attendances increased during the 30-day mine fire period. There was a 15% (8–21%) increased risk of ambulance attendances for all conditions and a 47% (19–81%) increased risk for respiratory conditions during the mine fire period. Exposure to smoke and ash from a fire in an open cut brown coal mine was associated with increased ambulance attendances, particularly for respiratory conditions. These findings guide the development and implementation of effective and timely strategies and health service planning to respond and mitigate health risks that arise in affected communities during future major air pollution episodes. [Display omitted] [ABSTRACT FROM AUTHOR]