Long-term effects of a coalmine fire on hospital and ambulance use: An interrupted time series study
In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance us...
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Published in | Environmental research Vol. 261; p. 119693 |
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Abstract | In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire.
Using Victorian hospital (Jan 2009–Jun 2022) and ambulance (Jan 2013–Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM2.5. Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury).
There were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased.
Our findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services.
•Overall hospital use in smoke-affected areas increased, no change in ambulance use.•Mental health and injury-related conditions increased the most proportionally.•Cardiovascular-related hospital use increased while ambulance use decreased.•Unclear whether effects are due to smoke exposure or disruption from a disaster. |
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AbstractList | In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire.
Using Victorian hospital (Jan 2009–Jun 2022) and ambulance (Jan 2013–Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM2.5. Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury).
There were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased.
Our findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services.
•Overall hospital use in smoke-affected areas increased, no change in ambulance use.•Mental health and injury-related conditions increased the most proportionally.•Cardiovascular-related hospital use increased while ambulance use decreased.•Unclear whether effects are due to smoke exposure or disruption from a disaster. In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire. Using Victorian hospital (Jan 2009-Jun 2022) and ambulance (Jan 2013-Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM . Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury). There were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased. Our findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services. In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire.BACKGROUNDIn 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire.Using Victorian hospital (Jan 2009-Jun 2022) and ambulance (Jan 2013-Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM2.5. Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury).METHODSUsing Victorian hospital (Jan 2009-Jun 2022) and ambulance (Jan 2013-Dec 2021) data, we conducted an interrupted time series of changes to the rate of hospital admissions, emergency presentations, and ambulance attendances. A categorical exposure model compared two locations, most-exposed Morwell and less-exposed Latrobe Valley, to the rest of regional Victoria. A continuous exposure model used spatial estimates of fire-related PM2.5. Analyses were stratified by sex, age group (<65/65+ years), and condition (cardiovascular, respiratory, mental health, injury).There were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased.RESULTSThere were small but significant increases in overall hospital admissions and emergency presentations across all analyses, but little evidence of change in overall ambulance attendances. Effects varied considerably by condition, with the biggest relative increases observed among hospital admissions for mental health conditions and injuries. While cardiovascular-related hospital admissions and emergency presentations increased post-fire, ambulance attendances decreased.Our findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services.CONCLUSIONSOur findings suggest the Hazelwood coalmine fire likely increased hospital usage. However, it is unclear whether this was due to the direct effects of smoke exposure on health, or the disruptive socioeconomic and behavioural impacts of an environmental disaster that affected how communities engaged with various health services. |
ArticleNumber | 119693 |
Author | Abramson, Michael J. Nehme, Emily Carroll, Matthew T.C. Smith, Catherine L. Lane, Tyler J. Gao, Caroline X. Xu, Rongbin Guo, Yuming Ikin, Jillian F. |
Author_xml | – sequence: 1 givenname: Tyler J. orcidid: 0000-0001-6089-1827 surname: Lane fullname: Lane, Tyler J. email: tyler.lane@monash.edu organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 2 givenname: Catherine L. orcidid: 0000-0001-9327-0154 surname: Smith fullname: Smith, Catherine L. organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 3 givenname: Caroline X. surname: Gao fullname: Gao, Caroline X. organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 4 givenname: Jillian F. orcidid: 0000-0003-0794-0129 surname: Ikin fullname: Ikin, Jillian F. organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 5 givenname: Rongbin surname: Xu fullname: Xu, Rongbin organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 6 givenname: Matthew T.C. orcidid: 0000-0002-6396-8364 surname: Carroll fullname: Carroll, Matthew T.C. organization: Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia – sequence: 7 givenname: Emily orcidid: 0000-0002-1579-9279 surname: Nehme fullname: Nehme, Emily organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 8 givenname: Michael J. orcidid: 0000-0002-9954-0538 surname: Abramson fullname: Abramson, Michael J. organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia – sequence: 9 givenname: Yuming surname: Guo fullname: Guo, Yuming organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia |
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