Markers of Cardiovascular Disease among Adults Exposed to Smoke from the Hazelwood Coal Mine Fire.

Juliana Betts,Michael J Abramson,Sinjini Biswas,David W Brown,Danny Liew,Elizabeth M Dewar,Jillian F Ikin,Berihun M Zeleke,Dion Stub,Caroline X Gao

doi:10.3390/ijerph18041587

Abstract

Little research has examined the effects of high concentration, medium-duration smoke exposure on cardiovascular health. We investigated whether six weeks of exposure to smoke from the 2014 Hazelwood coal mine fire in Victoria (Australia), was associated with long-term clinical or subclinical cardiovascular disease approximately four years later, in adult residents of the towns of Morwell (exposed, n = 336) and Sale (unexposed, n = 162). The primary outcome was serum high sensitivity (hs) C-reactive protein (CRP). Blood pressure, electrocardiogram, flow mediated dilatation and serum levels of hs-troponin, N-terminal pro B-type natriuretic peptide and lipids were secondary outcomes. There was no significant difference in weighted median hsCRP levels between exposed and unexposed participants (1.9 mg/L vs. 1.6 mg/L, p = 0.273). Other outcomes were comparable between the groups. hsCRP was associated in a predictable manner with current smoking, obesity and use of lipid-lowering therapy. Four years after a 6-week coal mine fire, this study found no association between smoke exposure and markers of clinical or subclinical cardiovascular disease in exposed adults.

Highlights

Accepted: 1 February 2021Exposure to long-term ambient air pollution, especially fine particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5 ), is associated with adverse cardiovascular health consequences such as ischaemic heart disease (IHD), heart failure and stroke [1,2]
In 2015 it was estimated that over 2 million deaths and 50 million disability-adjusted life-years resulted from pollution-attributable cardiovascular disease (CVD)—evidence of the significant additional disease burden imposed by this novel risk factor [5]
This latest analysis from the Hazelwood Health Study showed that adults from the community most highly exposed to PM2.5 from the mine fire smoke, did not exhibit consistent evidence of clinical or subclinical CVD as measured by serum biomarkers, blood pressure, flow-mediated dilatation (FMD) and ECG approximately four years after the event

Summary

Introduction

Exposure to long-term ambient air pollution, especially fine particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5 ), is associated with adverse cardiovascular health consequences such as ischaemic heart disease (IHD), heart failure and stroke [1,2]. Studies of long-term ambient PM2.5 exposure are often based in urban areas and draw upon concentrations from sources such as traffic emissions, wood heaters and industry [6,7]. Some studies of acute changes in PM2.5 investigate daily changes in the same urban settings, whilst others investigate the effects of discrete high concentration particulate generating events, such as landscape fires which might dissipate in hours or days [8,9]. There is little evidence available in regard to the long-term health effects of high concentration, medium-duration PM2.5 exposures.

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