Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25
Filtrar
1.
Environ Res ; 252(Pt 3): 119014, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38685296

RESUMO

In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM2.5). We investigated whether the long-term effects of PM2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events.


Assuntos
Dieta , Material Particulado , Humanos , Material Particulado/análise , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Vitória/epidemiologia , Idoso , Adulto , Incêndios , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Exposição Ambiental/efeitos adversos , Minas de Carvão , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/induzido quimicamente
2.
BMC Public Health ; 23(1): 1573, 2023 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-37596570

RESUMO

BACKGROUND: Wildfires cause significant physical and mental ill-health. How physical and mental symptoms interact following wildfire smoke exposure is unclear, particularly in the context of repeated exposures. In this cross-sectional study we investigated how posttraumatic stress and general psychological distress associated with somatic symptoms in a community exposed to multiple smoke events. METHODS: A random weighted sample of 709 adults exposed to smoke during the 2014 Hazelwood coal mine fire in south-eastern Australia completed a survey in 2020. The survey coincided with the Black Summer wildfires that caused a similar period of smoke haze in the region. Participants self-reported somatic symptoms (PHQ-15) and mine fire-related posttraumatic stress (IES-R) experienced over the previous week, general psychological distress (K10) experienced over the previous four weeks, lifetime health diagnoses and demographic information. Associations between posttraumatic stress, general psychological distress, and each PHQ-15 somatic symptom were analysed using ordinal logistic regression models. RESULTS: Overall, 36.2% of participants reported moderate- or high-level somatic symptomology. The most frequent somatic symptoms were fatigue, limb pain, trouble sleeping, back pain, headaches, and shortness of breath. After controlling for confounding factors, general psychological distress and posttraumatic stress were independently associated with all somatic symptoms (except menstrual problems in females for posttraumatic stress). CONCLUSIONS: Results highlight the high prevalence of somatic symptoms and their association with general psychological distress and posttraumatic stress within a community in the midst of a second large-scale smoke event. It is essential that healthcare providers and public health authorities consider the interconnections of these conditions when supporting communities affected by climate-related disasters.


Assuntos
Desastres , Incêndios , Sintomas Inexplicáveis , Adulto , Feminino , Humanos , Estudos Transversais , Estações do Ano
3.
J Trauma Stress ; 36(2): 465-473, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37005219

RESUMO

The 2014 Hazelwood coal mine fire in the Latrobe Valley, Australia, distributed toxic smoke into surrounding communities over 45 days. This study investigated risk and protective factors associated with four trajectories of posttraumatic distress (resilient, recovery, delayed-onset, chronic) among exposed adults. Participants (N = 709) completed surveys in 2016-2017 and 2019-2020 assessing mine fire-related particulate matter (PM2.5 ) exposure; sociodemographic, physical, and mental health variables; and exposure to other traumatic and recent stressful events. Mine fire-related posttraumatic distress was measured using the IES-R; trajectories were determined according to established clinical significance thresholds. Relative risk ratios (RRRs) were generated from multivariate multinomial regressions. The resilient trajectory was most common (77.0%). The chronic trajectory (8.5%) was associated with loneliness, RRR = 2.59, 95% CI [1.30, 5.16], and physical health diagnoses, RRR = 2.31, 95% CI [1.32, 4.02]. The delayed-onset trajectory (9.1%) was associated with multiple recent stressful events, RRR = 2.51, 95% CI [1.37, 4.59]; mental health diagnoses, RRR = 2.30, 95% CI [1.25, 4.24]; loneliness, RRR = 2.05, 95% CI [1.09, 3.88]; and male gender, RRR = 2.01, 95% CI [1.18, 3.44]. Socioeconomic advantage protected against chronic, RRR = 0.68, 95% CI [0.53, 0.86], and delayed-onset trajectory membership, RRR = 0.68, 95% CI [0.50, 0.94]; social support protected against chronic trajectory membership, RRR = 0.67, 95% CI [0.49, 0.92]. PM2.5 exposure did not determine trajectory. These findings enhance understanding of longer-term posttraumatic responses to large-scale smoke events and can inform mental health initiatives within at-risk communities.


Assuntos
Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Masculino , Material Particulado/análise , Material Particulado/toxicidade , Carvão Mineral/análise , Fumar
4.
Environ Res ; 223: 115440, 2023 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-36758918

RESUMO

BACKGROUND: In 2014, wildfires ignited a coal mine in Australia, burning for 6 weeks, releasing large amounts of fine particulate matter ≤2.5 µm in diameter (PM2.5). We investigated the association between individual PM2.5 exposure and emergency department presentations (EDPs) within 5 years post-fire. METHODS: Survey and exposure data for 2725 residents from an exposed and unexposed town were linked with ED administrative data from 2009 to 2019. The association between individual PM2.5 and EDPs was assessed using recurrent survival analysis. RESULTS: A 10 µg/m3 increase in PM2.5 was associated with a 10% increase in respiratory EDPs (HR = 1.10; 95%CI:1.00-1.22) over 5 years post-fire. Increased risks of EDPs for ischaemic heart disease (HR = 1.39; 95%CI:1.12-1.73), atherothrombotic disease (HR = 1.27; 95%CI:1.08-1.50), and cardiovascular disease (HR = 1.10, 95%CI:0.99-1.22) were evident within 2.5 years. CONCLUSION: PM2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory conditions. An increased risk of CVD within 2.5 years post-fire subsided after this time.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doenças Cardiovasculares , Humanos , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Material Particulado/análise , Austrália/epidemiologia , Doenças Cardiovasculares/induzido quimicamente , Serviço Hospitalar de Emergência , Carvão Mineral , Exposição Ambiental/análise , Poluição do Ar/análise , Fumaça/análise
5.
Vasc Health Risk Manag ; 18: 253-265, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35444423

RESUMO

Background and Aims: Mega-wild fires are exposing large communities to weeks or months of high concentration smoke-related fine particulate air pollution (PM). However, little research has examined the long-term vascular responses from exposure to PM of this concentration and duration. We investigated whether level of exposure to 6 weeks of PM from the 2014 Hazelwood coal mine fire was associated with abnormal vascular responses approximately four years later. Methods: A cross-sectional analysis was undertaken of 387 participants (225 exposed, 162 unexposed) aged 55-89 years, 3.5-4 years after the mine fire. The primary outcome was flow-mediated dilatation (FMD), with time to reach peak diameter as the secondary outcome. Other secondary markers included high-sensitivity C-reactive protein (hsCRP) and ischaemic Electrocardiogram (ECG) changes. Results: There was no evidence of a difference in FMD between participants with high, medium, low or no mine-fire related PM2.5 exposure (4.09% vs 4.06% vs 4.02% vs 3.98%, respectively, p=0.99). Likewise, there was no difference in hsCRP or ischaemic ECG changes. In contrast, there was evidence of a difference in time to peak diameter (p=0.002) with more unexposed participants reaching peak diameter within 30 seconds (36%) compared to those who had high, medium, or low exposure (23%, 22%, 13%, respectively). Multivariate ordinal logistic regression analysis suggested that township, Morwell (exposed) vs Sale (unexposed), but not level of PM2.5 exposure, was associated with delayed time to peak diameter (OR 2.71; 95% CI 1.56, 4.69). Smokers also had delayed time to peak diameter. Conclusion: There was no association between level of exposure to PM2.5 from the 6-week Hazelwood coal mine fire smoke event and reduced FMD, elevated hsCRP or ischaemic ECG four years later. Evidence of delayed time to peak diameter observed in adults from the exposed town, compared to an unexposed town, requires further investigation.


Assuntos
Poluentes Atmosféricos , Carvão Mineral , Adulto , Poluentes Atmosféricos/análise , Proteína C-Reativa/análise , Carvão Mineral/análise , Estudos Transversais , Exposição Ambiental/análise , Humanos , Material Particulado/análise
6.
J Asthma ; 59(2): 213-222, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33962539

RESUMO

OBJECTIVE: In 2014, a fire at an open cut coal mine in South-eastern Australia burned for about 6 weeks. Residents of the adjacent town were exposed to high levels of fine particulate matter (PM2.5) during this period. Three and a half years after the event, this study aimed to investigate potential long-term impacts of short-term exposure to coal mine fire smoke on asthma. METHODS: A cross-sectional analysis was undertaken in a group of exposed participants with asthma from Morwell (n = 165) and a group of unexposed participants with asthma from the control town of Sale (n = 64). Exposure was determined by modeled PM2.5 data for the mine fire period. Respiratory symptoms were assessed with a validated respiratory health questionnaire and symptom severity score. Asthma control was assessed with a validated questionnaire. Lung function testing included spirometry, bronchodilator response, and fraction of exhaled nitric oxide. RESULTS: There was no evidence that exposed participants had more severe asthma symptoms, worse lung function, or more eosinophilic airway inflammation than unexposed participants. However, there was some evidence that Morwell participants had more uncontrolled than well-controlled asthma, compared to the participants from Sale (adjusted relative risk ratio 2.71 95% CI: 1.02, 7.21, p = .046). CONCLUSION: Three and a half years after exposure, coal mine fire smoke did not appear to be associated with more severe asthma symptoms or worse lung function but might be associated with poorer asthma control.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/epidemiologia , Asma/etiologia , Carvão Mineral/efeitos adversos , Carvão Mineral/análise , Estudos Transversais , Exposição Ambiental/análise , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , Fumaça/efeitos adversos , Nicotiana
7.
Ann Am Thorac Soc ; 19(2): 186-195, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34491155

RESUMO

Rationale: In 2014, the Hazelwood open-cut coal mine in southeastern Australia burned for 6 weeks, exposing nearby residents to high concentrations of fine particulate matter (PM2.5). The long-term health consequences are unknown and are being evaluated as part of the Hazelwood Health Study. Objectives: To explore the association between PM2.5 exposure and chronic obstructive pulmonary disease (COPD). Methods: A sample of 346 exposed and 173 unexposed adults participated in the longitudinal Respiratory Stream of the Hazelwood Health Study. Participants underwent spirometry and gas transfer measurements and answered validated respiratory questionnaires 3.5-4 years after the fire. Individual-level mine fire-related PM2.5 exposure was modeled. Multivariate linear regression and logistic models were fitted to analyze associations between mean and peak PM2.5 exposure and clinical outcomes, stratified by smoking status. Results: A 10 µg/m3 increase in mean PM2.5 exposure was associated with a 69% (95% confidence interval [CI], 11-158%) increase in odds of spirometry consistent with COPD among nonsmokers and increased odds of chest tightness (odds ratio [OR], 1.30; 95% CI, 1.03-1.64) and chronic cough (OR, 1.24; 95% CI, 1.02-1.51) in the previous 12 months in all participants. For current smokers, increments in mean PM2.5 exposure were associated with higher odds of chronic cough in the preceding 12 months (OR, 2.13; 95% CI, 1.24-3.65). Conclusions: Almost 4 years after a 6-week period of coal fire PM2.5 exposure, we identified a dose-response association between exposure and COPD in nonsmokers. With climate change a likely contributor to increased risk of landscape fires, the findings will inform policy decisions during future sustained smoke events.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Carvão Mineral/toxicidade , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/etiologia
8.
Stress Health ; 38(2): 364-374, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34478608

RESUMO

We investigated the association between respiratory symptoms and psychological distress in the context of a prolonged smoke event, and evaluated whether smoke exposure, or pre-existing respiratory and mental health conditions, influenced the association. Three thousand ninety-six residents of a rural town heavily exposed to smoke from the 6-week Hazelwood coal mine fire, and 960 residents of a nearby unexposed town, completed Kessler's psychological distress questionnaire (K10) and a modified European Community Respiratory Health Survey. Logistic regression models evaluated associations between distress and respiratory symptoms, with interactions fitted to evaluate effect modification. Smoke exposed participants reported higher levels of distress than those unexposed, and participants reporting respiratory symptoms recorded higher levels of distress than participants without respiratory symptoms, irrespective of exposure. 5-unit increments in K10 scores were associated with 21%-48% increases in the odds of reporting respiratory symptoms. There were significant interactions with pre-existing asthma, chronic obstructive pulmonary disease and mental health conditions, but not with smoke exposure. Although participants with pre-existing conditions were more likely to report respiratory symptoms, increasing distress was most strongly associated with respiratory symptoms among those without pre-existing conditions. Communities exposed to landscape fire smoke could benefit from interventions to reduce both psychological and respiratory distress.


Assuntos
Incêndios , Angústia Psicológica , Humanos , Material Particulado/análise , Autorrelato , Inquéritos e Questionários
9.
Int J Epidemiol ; 51(1): 179-190, 2022 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-34871381

RESUMO

BACKGROUND: Little is known about the long-term health impacts of exposures to landscape fire smoke. We aimed to evaluate the association between exposure to coal mine fire-related particulate matter 2.5 µm or less in diameter (PM2.5) and hospitalisation in the 5 years following the 6-week Hazelwood coal mine fire in Australia in 2014. METHODS: We surveyed 2725 residents (mean age: 58.3 years; 54.3% female) from an exposed and a comparison town. Individual PM2.5 exposures during the event were estimated using modelled PM2.5 concentrations related to the coal mine fire and self-reported location data. The individual exposure and survey data were linked with hospitalisation records between January 2009 and February 2019. Recurrent event survival analysis was used to evaluate relationships between PM2.5 exposure and hospitalisation following mine fire, adjusting for important covariates. RESULTS: Each 10-µg/m3 increase in mine fire-related PM2.5 was associated with a 9% increased hazard [hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01, 1.17] of respiratory hospitalisation over the next 5 years, with stronger associations observed for females (HR = 1.16; 95% CI: 1.06, 1.27) than males (HR = 0.99; 95% CI: 0.89, 1.11). In particular, increased hazards were observed for hospitalisations for asthma (HR = 1.43; 95% CI: 1.19, 1.73) and chronic obstructive pulmonary disease (HR = 1.14; 95% CI: 1.02, 1.28). No such association was found for hospitalisations for cardiovascular diseases, mental illness, injuries, type 2 diabetes, renal diseases or neoplasms. CONCLUSIONS: A 6-week exposure to coal mine fire-related PM2.5 was associated with increased hazard of respiratory hospitalisations over the following 5 years, particularly for females.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Carvão Mineral , Material Particulado , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Diabetes Mellitus Tipo 2 , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , Material Particulado/toxicidade
10.
Environ Health Insights ; 15: 11786302211059722, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34819732

RESUMO

No studies have investigated the cancer outcomes from high level medium duration coal mine fire fine particulate matter ⩽2.5 µm in diameter (PM2.5) exposure. We included 2208 Morwell residents (exposed) and 646 Sale residents (unexposed) who participated in the Hazelwood Health Study Adult Survey. Competing risk regression models were used to evaluate relationships between coal mine fire exposure and cancer incidence, adjusting for known confounders. There were 137 cancers in the exposed and 27 in the unexposed over 14 849 person-years of follow-up. A higher risk of cancer incidence was observed for Morwell participants (HR = 1.67 [95% CI 1.05-2.67]), but no evidence to suggest associations between PM2.5 exposure and incidence of all cancers (HR = 1.02 [95% CI 0.91-1.13]), or site-specific cancers. There is no strong evidence that exposure to high concentrations of mine fire-related PM2.5 over a prolonged period could explain the higher risk in exposed population in this study.

11.
Chemosphere ; 285: 131351, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34329135

RESUMO

BACKGROUND: In 2014, the Morwell brown coal mine, located in the Latrobe Valley of South eastern Australia, caught fire covering nearby areas in plumes of smoke over a 6-week period. AIMS: To investigate the association between exposure to mine fire related air pollution and the risk of mortality. METHODS: Time series models were used to evaluate the risk of mortality during the first 30 days of the mine fire, when the smoke was most intense, and in the following six months. Associations were also investigated between mine fire related PM2.5 and mortality. RESULTS: During the 30-day mine fire period, there was an increased risk of death from injury in the most exposed town of Morwell, however no increased risk was observed for all-cause, cardiovascular or respiratory mortality. In the broader Latrobe Valley, males and residents aged 80 and above were at greatest risk of death from injury during the mine fire. In Morwell, during the six months after the mine fire there was an increased risk of all-cause mortality and death from Ischaemic Heart Disease (IHD). Males and residents aged 80 and above in the broader Latrobe Valley, were at increased risk of death from IHD six months after the fire. CONCLUSIONS: Coal mine fire exposure was associated with an increase in injury deaths during the mine fire and cardiovascular deaths in the six months after the fire. These findings assist in identifying at risk groups, and improving targeted health advice for future air pollution exposures in the community.


Assuntos
Exposição Ambiental , Incêndios , Mortalidade , Material Particulado , Idoso de 80 Anos ou mais , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Carvão Mineral , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Masculino , Mortalidade/tendências , Material Particulado/efeitos adversos
12.
Artigo em Inglês | MEDLINE | ID: mdl-33567509

RESUMO

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.


Assuntos
Poluentes Atmosféricos , Doenças Cardiovasculares , Adulto , Poluentes Atmosféricos/análise , Biomarcadores , Proteína C-Reativa , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Cidades , Carvão Mineral/análise , Humanos , Material Particulado/análise , Fatores de Risco , Fumaça/efeitos adversos , Fumaça/análise , Vitória
13.
Int J Epidemiol ; 49(1): 80-93, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31651952

RESUMO

BACKGROUND: This study assessed the association between coal-mine-fire-related fine particulate matter (PM2.5) and medical-service utilization, following a 6-week coal-mine fire in Australia, in 2014. Areas in the immediate vicinity of the mine experienced hourly mine-fire-related PM2.5 concentrations of up to 3700 µg/m3. METHODS: Data on medical-service utilization were collected from the Medicare Benefits Schedule-a national database of payment for medical services. PM2.5 concentrations were modelled using atmospheric chemical transport modelling. Quasi-Poisson interrupted distributed lag time-series analysis examined the association between daily mine-fire-related PM2.5 concentrations and medical-service utilization, including General Practitioner (GP) consultations and respiratory, cardiovascular and mental health services. Confounders included seasonality, long-term trend, day of the week, maximum daily temperature and public holidays. Gender and age stratification were conducted. RESULTS: A 10-µg/m3 increase in PM2.5 was associated with an increased relative risk of service usage for all long and short GP consultations [11% (95% confidence interval: 7 to 15%)] and respiratory services [22% (4 to 43%)] in both men and women. Sex stratification found an increased relative risk in mental health consultations in men [32% (2 to 72%)] but not women. No associations were found for cardiovascular services in men or women. CONCLUSIONS: Coal-mine-fire-related PM2.5 exposure was associated with increased use of medical services for GP consultations and respiratory services in men and women and mental health consultations in men. These findings can inform the development of future public-health-policy responses in the event of major air-pollution episodes.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/terapia , Minas de Carvão , Serviço Hospitalar de Emergência/estatística & dados numéricos , Incêndios , Medicina Geral/estatística & dados numéricos , Exposição por Inalação/efeitos adversos , Material Particulado/toxicidade , Doenças Respiratórias/epidemiologia , Adulto , Idoso , Austrália , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
14.
Artigo em Inglês | MEDLINE | ID: mdl-31684042

RESUMO

In 2014, wildfires ignited a fire in the Morwell open cut coal mine, Australia, which burned for six weeks. This study examined associations between self-reported respiratory outcomes in adults and mine fire-related PM2.5 smoke exposure. Self-reported data were collected as part of the Hazelwood Health Study Adult Survey. Eligible participants were adult residents of Morwell. Mine fire-related PM2.5 concentrations were provided by the Commonwealth Scientific and Industrial Research Organisation Oceans & Atmosphere Flagship. Personalised mean 24-h and peak 12-h mine fire-related PM2.5 exposures were estimated for each participant. Data were analysed by multivariate logistic regression. There was some evidence of an association between respiratory outcomes and mine fire PM2.5 exposure. Chronic cough was associated with an odds ratio (OR) of 1.13 (95% confidence interval 1.03 to 1.23) per 10 µg/m3 increment in mean PM2.5 and 1.07 (1.02 to 1.12) per 100 µg/m3 increment in peak PM2.5. Current wheeze was associated with peak PM2.5, OR = 1.06 (1.02 to 1.11) and chronic phlegm with mean PM2.5 OR = 1.10 (1.00 to 1.20). Coal mine PM2.5 smoke exposure was associated with increased odds of experiencing cough, phlegm and wheeze. Males, participants 18-64 years, and those residing in homes constructed from non-brick/concrete materials or homes with tin/metal roofs had higher estimated ORs. These findings contribute to the formation of public health policy responses.


Assuntos
Poluentes Atmosféricos/análise , Minas de Carvão , Tosse/epidemiologia , Material Particulado/análise , Sons Respiratórios , Adolescente , Adulto , Idoso , Austrália , Estudos Transversais , Exposição Ambiental/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Environ Pollut ; 246: 1027-1035, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31159135

RESUMO

Limited research has examined the impacts of coal mine fire smoke on human health. The aim of this study was to assess the association between prolonged smoke PM2.5 exposure from a brown coal mine fire that burned over a seven week period in 2014 and medications dispensed across five localities in South-eastern Victoria, Australia. Spatially resolved PM2.5 concentrations were retrospectively estimated using a dispersion model coupled with a chemical transport model. Data on medications dispensed were collected from the national Pharmaceutical Benefits Schedule database for 2013-2016. Poisson distributed lag time series analysis was used to examine associations between daily mine fire-related PM2.5 concentrations and daily counts of medications dispensed for respiratory, cardiovascular or psychiatric conditions. Factors controlled for included: seasonality, long-term trend, day of the week, maximum ambient temperature and public holidays. Positive associations were found between mine fire-related PM2.5 and increased risks of medications dispensed for respiratory, cardiovascular and psychiatric conditions, over a lag range of 3-7 days. A 10 µg/m3 increase in coal mine fire-related PM2.5 was associated with a 25% (95%CI 19-32%) increase in respiratory medications, a 10% (95%CI 7-13%) increase in cardiovascular medications and a 12% (95%CI 8-16%) increase in psychiatric medications dispensed. These findings have the potential to better prepare for and develop more appropriate public health responses in the event of future coal mine fires.


Assuntos
Poluentes Atmosféricos/análise , Prescrições de Medicamentos/estatística & dados numéricos , Incêndios , Exposição por Inalação/análise , Material Particulado/análise , Minas de Carvão , Humanos , Estudos Retrospectivos , Fumaça/análise , Vitória
17.
Am J Ind Med ; 58(12): 1246-54, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26497120

RESUMO

BACKGROUND: Following the 1990-1991 Gulf War, Gulf War veterans (veterans) reported health symptoms more commonly than non-deployed groups. This article examines symptom persistence, incidence and prevalence 20 years on. METHODS: In 2000-2003 and 2011-2012, a 63-item symptom checklist was administered to 697 veterans and 659 comparison group. Symptomatology was compared using log-binomial regression. RESULTS: Both veterans and comparison group reported significantly increased prevalence (3-52%) over time in more than half the symptoms, with a similar overall rate of increase. Half the symptoms had higher incidence (risk-ratios ranged 1.43-1.50) and a quarter were more persistent (risk-ratios ranged 1.12-1.20) in veterans than the comparison group. CONCLUSIONS: Symptomatology increased in both groups over time, but persisted to a similar extent and had higher incidence among veterans than the comparison group. The gap in symptom prevalence between the two groups remained unchanged. These findings suggest enduring health consequences of Gulf War service.


Assuntos
Guerra do Golfo , Síndrome do Golfo Pérsico/epidemiologia , Veteranos/estatística & dados numéricos , Adulto , Lista de Checagem , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Síndrome do Golfo Pérsico/etiologia , Prevalência , Análise de Regressão , Avaliação de Sintomas/métodos , Estados Unidos/epidemiologia
18.
J Psychosom Res ; 79(6): 566-73, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26477979

RESUMO

OBJECTIVE: Major depression occurs frequently in veterans, and is associated with comorbid psychological and physical disorders and poorer quality of life. Depression can be difficult to detect in primary care, while lengthy assessment instruments can deter use. Our study aimed to develop a brief depression screen that could be used by veterans and caregivers, and then to compare the association between the brief screen and comorbidities and quality of life with that of a longer instrument. METHODS: Our dataset comprised 1204 male Royal Australian Navy veterans of the 1990/91 Gulf War. Depressive symptoms were assessed using the General Health Questionnaire (GHQ-12), health-related quality of life by the Short-Form Health Survey (SF-12), major depression and comorbid psychiatric diagnoses such as posttraumatic disorder (PTSD) using Diagnostic and Statistical Manual (DSM-IV) criteria. Comorbid physical illnesses including musculoskeletal disorders, chronic fatigue and diabetes were examined. RESULTS: A brief depression screen of three key self-reported symptoms was identified. Veterans with major depression present according to the screen were over four times more likely to have multisymptom illness or PTSD, and almost twice as likely to have musculoskeletal disorders. Having depression according to the brief screen and having at least one other physical or psychological condition was associated with poorer quality of life. Similar results were obtained for a longer screen based on all GHQ-12 items. CONCLUSION: A 3 item depression screen performed as well as a 12 item one in identifying major depression, comorbid physical and psychological illness and poorer quality of life in veterans.


Assuntos
Depressão/diagnóstico , Depressão/psicologia , Guerra do Golfo , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Testes Neuropsicológicos , Veteranos/psicologia , Adulto , Austrália/epidemiologia , Comorbidade , Estudos Transversais , Depressão/complicações , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Síndrome de Fadiga Crônica/epidemiologia , Humanos , Masculino , Transtornos Mentais/complicações , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/epidemiologia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários
19.
J Affect Disord ; 125(1-3): 279-86, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20071032

RESUMO

BACKGROUND: Rates of PTSD and depression are high in Korean War veterans. The prevalence and impact of the two disorders occurring comorbidly, however, has not been investigated. This paper aims to investigate the extent to which PTSD and depression co-occur in Australian veterans of the Korean War, the symptom severity characteristics of comorbidity, the impact on life satisfaction and quality, and the association with war-related predictors. METHODS: Veterans (N=5352) completed self-report questionnaires including the Posttraumatic Stress Disorder Checklist, the Hospital Anxiety and Depression Scale, the Life Satisfaction Scale, the brief World Health Organisation Quality of Life questionnaire and the Combat Exposure Scale. RESULTS: Seventeen percent of veterans met criteria for comorbid PTSD and depression, 15% had PTSD without depression, and a further 6% had depression without PTSD. Compared with either disorder alone, comorbidity was associated with impaired life satisfaction, reduced quality of life, and greater symptom severity. Several war-related factors were associated with comorbidity and with PTSD alone, but not with depression alone. LIMITATIONS: The reliance on self-reported measures and the necessity for retrospective assessment of some deployment-related factors renders some study data vulnerable to recall bias. CONCLUSIONS: Comorbid PTSD and depression, and PTSD alone, are prevalent among Korean War veterans, are both associated with war-related factors 50 years after the Korean War, and may represent a single traumatic stress construct. The results have important implications for understanding complex psychopathology following trauma.


Assuntos
Distúrbios de Guerra/diagnóstico , Distúrbios de Guerra/epidemiologia , Avaliação da Deficiência , Guerra da Coreia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Veteranos/psicologia , Veteranos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Distúrbios de Guerra/psicologia , Comorbidade , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Humanos , Masculino , Satisfação Pessoal , Inventário de Personalidade/estatística & dados numéricos , Psicometria , Qualidade de Vida/psicologia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/psicologia
20.
Soc Psychiatry Psychiatr Epidemiol ; 45(9): 843-52, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19763364

RESUMO

BACKGROUND: Although much has been published on the effects of the 1990/1991 Gulf War on the psychological health of veterans, few studies have addressed the pattern and timing of post-war development of psychological disorders. Our study aims to identify the most common psychological disorders that first appeared post-Gulf War, the period of peak prevalence and the sequence of multiple psychological disorders. METHODS: The temporal progression of psychological disorders in male Australian naval Gulf War veterans with no prior psychological disorders was calculated across each year of the post-Gulf War period. DSM-IV diagnoses were obtained using the Composite International Diagnostic Interview. RESULTS: Psychological disorder rates peaked in the first 2 years (1991-1992) following the Gulf War. Alcohol use disorders were the most likely to appear first. Classification and regression tree analysis found that risk of disorder was exacerbated if veterans had been exposed to a high number of potential psychological stressors during their military service. Lower military rank was associated with increased risk of alcohol disorders, particularly during the first 2 years post-Gulf War. In veterans with two or more disorders, anxiety disorders and alcohol disorders tended to appear before affective disorders. CONCLUSIONS: Our study found that psychological disorders occur in sequence following Gulf War deployment. Our findings may help clinicians to anticipate, and better manage, multiple symptomatology. The findings may also assist veteran and defence organisations in planning effective mental health screening, management and prevention policy.


Assuntos
Guerra do Golfo , Transtornos Mentais/epidemiologia , Militares/psicologia , Veteranos/psicologia , Adulto , Idade de Início , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Austrália/epidemiologia , Distúrbios de Guerra/diagnóstico , Distúrbios de Guerra/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Progressão da Doença , Humanos , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Síndrome do Golfo Pérsico/diagnóstico , Síndrome do Golfo Pérsico/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Análise de Sobrevida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...