Physical and Mental Health Effects of Bushfire and Smoke in the Australian Capital Territory 2019–20

Abstract

The 2019–20 bushfire season in south-eastern Australia was one of the most severe in recorded history. Bushfire smoke-related air pollution reached hazardous levels in major metropolitan areas, including the Australian Capital Territory (ACT), for prolonged periods of time. Bushfire smoke directly challenges human health through effects on respiratory and cardiac function, but can also indirectly affect health, wellbeing and quality of life. Few studies have examined the specific health effects of bushfire smoke, separate from direct effects of fire, and looked beyond physical health symptoms to consider effects on mental health and lifestyle in Australian communities. This paper describes an assessment of the health impacts of this prolonged exposure to hazardous levels of bushfire smoke in the ACT and surrounding area during the 2019–20 bushfire season. An online survey captured information on demographics, health (physical and mental health, sleep) and medical advice seeking from 2,084 adult participants (40% male, median age 45 years). Almost all participants (97%) experienced at least one physical health symptom that they attributed to smoke, most commonly eye or throat irritation, and cough. Over half of responders self-reported symptoms of anxiety and/or feeling depressed and approximately half reported poorer sleep. Women reported all symptoms more frequently than men. Participants with existing medical conditions or poorer self-rated health, parents and those directly affected by fire (in either the current or previous fire seasons) also experienced poorer physical, mental health and/or sleep symptoms. Approximately 17% of people sought advice from a medical health practitioner, most commonly a general practitioner, to manage their symptoms. This study demonstrated that prolonged exposure to bushfire smoke can have substantial effects on health. Holistic approaches to understanding, preventing and mitigating the effects of smoke, not just on physical health but on mental health, and the intersection of these, is important. Improved public health messaging is needed to address uncertainty about how individuals can protect their and their families health for future events. This should be informed by identifying subgroups of the population, such as those with existing health conditions, parents, or those directly exposed to fire who may be at a greater risk.

The mental health and well-being effects of wildfire smoke: a scoping review

“… Literature review Scoping review General psychosocial and mental health effects. Rodney, 2021 [ 6 ] To examine the effects of prolonged exposure to bushfire smoke-related air pollution on physical health, mental health, and sleep patterns of residents of the Australian Capital Territory region during the 2019–20 bushfire season and how these vary by demographic and lifestyle factors. Quantitative Cross-sectional (online survey) Mental health symptoms, anxiety, depression, sleep.…”

“…Rodney’s study surveyed Australian residents of thirty-one postal codes that had experienced high levels of smoke-related air pollution from the 2019–2020 Australian Capital Territory bushfire season [ 6 ]. Outcomes included self-reported physical health, mental health, and sleep patterns and whether they attributed their symptoms to smoke.…”

“…The individual level and social and community level factors are placed in the context of living and working conditions such as home evacuations [ 6 , 26 , 49 , 49 , 51 , 55 ], school relocations [ 44 , 47 ], and reductions in access to one’s livelihood [ 21 , 44 , 48 ] particularly for outdoor workers and people in the recreation and tourism industries. All of this occurs in the ecological context of increasing and possibly yearly, repeated and prolonged smoke events and the feeling of a loss of nature that occurs [ 21 , 44 , 48 ].…”

“…Wildfires are a growing public health risk due to the enormous amount of smoke related pollution produced, including carbon monoxide, nitrous oxide, volatile organic compounds and particulate matter less than 2.5 μm in diameter (PM 2.5 ), which are mixtures of solid and liquid particles that are suspended in the air. Wildfire smoke can travel thousands of kilometers from the source polluting the air over distant populations for weeks and months [ 6 ]. For example, long-range transport of pollutants from Canadian forest fires contributed to peak PM 2.5 and PM 10 values of 200 and 650 μg/m 3 in Baltimore, Maryland [ 7 ].…”

Bushfire Smoke in Our Eyes: Community Perceptions and Responses to an Intense Smoke Event in Canberra, Australia

“…On occasions, Canberra's air quality was rated the worst in the world: on New Year's Day, among others, it reached a 24-h PM2.5 concentration of 855.6 μg/m 3 h concentrations ( 8 ) which is well above the WHO standard of 15 μg/m 3 ( 9 ) and the Australian standard of 25 μg/m 3 ( 10 ). Notably, the duration of the bushfire smoke in places like Canberra was extraordinary: from late November to early February 2020 Canberra experienced approximately 40 days when the air quality was considered to be poor ( 11 ) including 17 days between 15th December and 15th Februrary when it was extremely poor (≥300 PM 2.5 μg/m 3 ) ( 12 ). During this time, the media disseminated health advice to Canberra residents to stay indoors to avoid smoke exposure.…”