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Little is known about the long-term health effects of coalmine fire smoke exposure. The 2014 Hazelwood coalmine fire event in southeast Australia released smoke into surrounding areas for 6 weeks. We aimed to investigate whether individual-level exposure to coalmine fire-related PM 2.5 was associated with a long-term increase in ambulance attendances following a coalmine fire event. A total of 2223 residents from the most exposed town of Morwell were assessed for ambulance attendances after the Hazelwood event from April 1, 2014 to December 31, 2017. PM 2.5 exposure was estimated for each individual using participant self-reported location diary data during the event and modelled PM 2.5 concentrations. Recurrent event survival analysis was used to evaluate the relationship between PM 2.5 exposure and ambulance attendances. For each 10 μg/m3 increase in mean coalmine fire-related PM 2.5 exposure, there was a 10% (adjusted hazard ratio [HR]:1.10, 95%CI:1.03–1.17) increase in the overall risk of ambulance attendances within 3.5 years after the coalmine fire. Exposure to PM 2.5 was also associated with increased risk of respiratory (HR: 1.21, 95%CI: 1.02–1.44) and cardiovascular (HR: 1.13, 95%CI: 1.01–1.28) related ambulance attendances. These results demonstrate that exposure to coalmine fire smoke during the Hazelwood event was associated with a long-term health risk post the fire event, specifically for respiratory and cardiovascular conditions. These findings are important for effective implementation of health care services following future extended coalmine fire PM 2.5 events. [Display omitted] • This is first to evaluate the long-term health impact of prolonged coalmine fire on ambulance attendances in individual level data. • Recurrent event survival analysis was used to evalute the impact of mine fire-related PM 2.5 on long-term risk of ambulance attendances. • Exposure to mire fire smoke was associated with increase in ambulance attendances, specifically for respiratory and cardiovascular conditions. [ABSTRACT FROM AUTHOR]

Little is known about the long-term health effects of coalmine fire smoke exposure. The 2014 Hazelwood coalmine fire event in southeast Australia released smoke into surrounding areas for 6 weeks. We aimed to investigate whether individual-level exposure to coalmine fire-related PM 2.5 was associated with a long-term increase in ambulance attendances following a coalmine fire event. A total of 2223 residents from the most exposed town of Morwell were assessed for ambulance attendances after the Hazelwood event from April 1, 2014 to December 31, 2017. PM 2.5 exposure was estimated for each individual using participant self-reported location diary data during the event and modelled PM 2.5 concentrations. Recurrent event survival analysis was used to evaluate the relationship between PM 2.5 exposure and ambulance attendances. For each 10 μg/m3 increase in mean coalmine fire-related PM 2.5 exposure, there was a 10% (adjusted hazard ratio [HR]:1.10, 95%CI:1.03–1.17) increase in the overall risk of ambulance attendances within 3.5 years after the coalmine fire. Exposure to PM 2.5 was also associated with increased risk of respiratory (HR: 1.21, 95%CI: 1.02–1.44) and cardiovascular (HR: 1.13, 95%CI: 1.01–1.28) related ambulance attendances. These results demonstrate that exposure to coalmine fire smoke during the Hazelwood event was associated with a long-term health risk post the fire event, specifically for respiratory and cardiovascular conditions. These findings are important for effective implementation of health care services following future extended coalmine fire PM 2.5 events. [Display omitted] • This is first to evaluate the long-term health impact of prolonged coalmine fire on ambulance attendances in individual level data. • Recurrent event survival analysis was used to evalute the impact of mine fire-related PM 2.5 on long-term risk of ambulance attendances. • Exposure to mire fire smoke was associated with increase in ambulance attendances, specifically for respiratory and cardiovascular conditions. [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]