Wildfire smoke exposure and respiratory health outcomes in young adults born extremely preterm or extremely low birthweight

• Published in: Environmental research Vol. 197; p. 111159
• Main Authors: Haikerwal, Anjali, Doyle, Lex W., Wark, John D., Irving, Louis, Cheong, Jeanie LY
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.06.2021
• Subjects: Extremely low birthweight; Extremely preterm; Respiratory health; Wildfire smoke; Young adults; Wildfire smoke; Extremely preterm; Respiratory health; Young adults; Extremely low birthweight
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2021.111159

Adults born either extremely preterm (EP, <28 weeks gestation) or extremely low birthweight (ELBW, <1000 g birthweight) have more obstructive airflow than controls of normal birthweight (>2499 g). We compared self-reported adverse respiratory health outcomes in young adults born EP/ELBW with controls following smoke exposure from the 2019/2020 wildfires in the Australian state of Victoria, and explored if any effects were mediated by airway obstruction, reflected in the forced expiratory volume in 1 second (FEV1). EP/ELBW participants were derived from all survivors born in the state of Victoria in 1991–92. Contemporaneous controls of normal birthweight (>2499 g) were recruited in the newborn period and matched for sociodemographic variables. Both groups had been assessed at intervals through childhood and into adulthood. Those who participated in the most recent follow-up assessment at 25 years of age, when FEV1 had been measured, were sent a survey when they were approximately 28 years of age asking about respiratory health related outcomes (respiratory symptoms, health services usage, medication uptake) following wildfire smoke exposure over the southern hemisphere summer of 2019–20. A total of 296 participants (166 EP/ELBW; 130 controls) were sent the survey; 44% of the EP/ELBW group and 47% of the control group responded. Compared with controls, EP/ELBW respondents reported more overall respiratory problems (30%vs 20%) and specific respiratory symptoms (breathlessness, wheezing, cough and chest tightness) following wildfire smoke exposure, as well as higher health services usage (e.g. local health clinic, hospital emergency department) and medication uptake for respiratory-related problems. Higher FEV1 values were associated with lower odds of most self-reported respiratory symptoms; adjusting for FEV1 attenuated the differences between EP/ELW and control groups. Survivors born EP/ELBW may be at an increased risk of adverse respiratory health outcomes following wildfire smoke exposure in early adulthood, in part related to worse expiratory airflows. •Australia experienced unprecedented wildfires in 2019/2020.•The population was exposed to wildfire smoke related particulate pollutants for an extended period.•Adults born extremely preterm had more respiratory problems than term born controls.•Reduced expiratory airflow led to more wildfire smoke-related respiratory ill-health in ex preterm survivors.