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.
Highlights
During the summer of late 2019 and early 2020, extensive areas of south-eastern Australia experienced one of the most severe bushfire seasons in recorded history
Bushfire-related air pollution has been associated with increases in mortality [10,11,12] and the effects of smoke can be more severe in populations with particular vulnerability, such as those with preexisting medical conditions including cardiovascular disease or respiratory conditions [13, 14]
This paper presents the findings of a cross-sectional study examining the effects of prolonged exposure to hazardous levels of bushfire smoke-related air pollution on the physical health, mental health, and sleep patterns of residents of the Australian Capital Territory (ACT) region during the 2019–20 bushfire season and how these vary by demographic and lifestyle factors
Summary
During the summer of late 2019 and early 2020, extensive areas of south-eastern Australia experienced one of the most severe bushfire seasons in recorded history. Bushfire smoke-related air pollution reached hazardous levels in major metropolitan areas including Canberra, Australia’s capital, in the Australian Capital Territory (ACT). Bushfire is an inevitable and essential part of natural Australian ecosystems; the severity and duration of fire seasons are projected to increase globally with climate change [3]. The public health impacts of bushfire extend beyond direct exposure to the fire itself, with increasing awareness of the effects of bushfire smoke-related air pollution [5]. Bushfire-related air pollution has been associated with increases in mortality [10,11,12] and the effects of smoke can be more severe in populations with particular vulnerability, such as those with preexisting medical conditions including cardiovascular disease or respiratory conditions [13, 14]
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