The impact of prolonged landscape fire smoke exposure on women with asthma in Australia

Abstract

Background Little is known about the physical and mental health impact of exposure to landscape fire smoke in women with asthma. This study examined the health impacts and information-seeking behaviours of women with asthma exposed to the 2019/2020 Australian fires, including women who were pregnant. Methods Women with asthma were recruited from the Breathing for Life Trial in Australia. Following the landscape fire exposure period, self-reported data were collected regarding symptoms (respiratory and non-respiratory), asthma exacerbations, wellbeing, quality of life, information seeking, and landscape fire smoke exposure mitigation strategies. Participants’ primary residential location and fixed site monitoring was used to geolocate and estimate exposure to landscape fire-related fine Particulate Matter (PM2.5). Results The survey was completed by 81 pregnant, 70 breastfeeding and 232 non-pregnant and non-breastfeeding women with asthma. Participants had a median daily average of 17 μg/m3 PM2.5 and 105 μg/m3 peak PM2.5 exposure over the fire period (October 2019 to February 2020). Over 80% of participants reported non-respiratory and respiratory symptoms during the fire period and 41% reported persistent symptoms. Over 82% reported asthma symptoms and exacerbations of asthma during the fire period. Half the participants sought advice from a health professional for their symptoms. Most (97%) kept windows/doors shut when inside and 94% stayed indoors to minimise exposure to landscape fire smoke. Over two in five (43%) participants reported that their capacity to participate in usual activities was reduced due to prolonged smoke exposure during the fire period. Participants reported greater anxiety during the fire period than after the fire period (mean (SD) = 53(13) versus 39 (13); p < 0.001). Two in five (38%) pregnant participants reported having concerns about the effect of fire events on their pregnancy. Conclusion Prolonged landscape fire smoke exposure during the 2019/2020 Australian fire period had a significant impact on the health and wellbeing of women with asthma, including pregnant women with asthma. This was despite most women taking actions to minimise exposure to landscape fire smoke. Effective and consistent public health messaging is needed during landscape fire events to guard the health of women with asthma.

The impact of the 2019/2020 Australian landscape fires on infant feeding and contaminants in breast milk in women with asthma

“…The results related to respiratory and non-respiratory symptoms, asthma symptoms and exacerbation and mental health are reported elsewhere [ 34 ]; briefly, 82% participants experienced respiratory and non-respiratory symptoms and 85% asthma symptoms during the landscape fire period [ 34 ]. Furthermore, 86% reported having an asthma exacerbation during the fire period, with 20% reporting they started/increased OCS use for an asthma exacerbation(s) during the fire period.…”

“…Participants had a median [Q1, Q3] age of 30 [ 28 , 34 ] years and BMI of 27.6 [25.5, 33.5] kg/m 2 . Most (75%) participants were overweight or obese and 4% were current smokers.…”

“…We conducted a retrospective, cross-sectional study to assess the impact of landscape fire smoke exposure in women with asthma during the 2019/2020 Australian fire period (1 October 2019 to 29 February 2020). The survey, results of which are reported elsewhere [ 34 ], collected information on general and asthma-specific symptoms, risk mitigation strategies and sources of information utilised during the fire period by mothers with asthma; the data relating to infant/toddler feeding is presented herein. A template of the tool was developed using REDCap (Research Electronic Data Capture) to capture the survey responses [ 35 , 36 ].…”

Pregnant women’s experiences of extreme exposure to bushfire associated smoke: a qualitative study

“…Our participants acknowledged the utility of such messaging and their reliance on it in their preparations for possible evacuation. However, their comments suggested that there was a lack of information specific to pregnant women or women with young children and this made it more difficult for them to feel, or be, adequately prepared, particularly in the midst of experiencing a heightened sense of risk [22]. The impact of the fires on both traditional lines of communication and household amenities (relied upon to provide care for newborns) made it difficult for the participants to act with the same level of certainty in decisions about their personal crisis/disaster management preparations.…”

Asthma and landscape fire smoke: A Thoracic Society of Australia and New Zealand position statement

“…Exposure to LFS in pregnant women may have a direct impact on asthma, increasing airway inflammation and reducing lung function causing asthma exacerbations, which may increase the risk of adverse pregnancy outcomes including low‐birth weight and preterm birth 22,23 . A study of the health impact of the 2019–20 Australian bushfire period found that pregnant women with asthma were more likely to report respiratory and non‐respiratory symptoms during compared to after this periods 24 . Moreover, pregnant women with asthma also had higher anxiety scores during compared to after the fires 24 .…”