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Cited by 35Air Quality and Health ImpactsAsthma and respiratory diseasesIndoor Air Quality and Microbial Exposure

‘Breathing Fire’: Impact of Prolonged Bushfire Smoke Exposure in People with Severe Asthma

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Beyene, Tesfalidet, Harvey, Erin S., Van Buskirk, Joseph, McDonald, Vanessa M., Jensen, Megan E., Horvat, Jay C., Morgan, Geoffrey G., Zosky, Graeme R. +19 more·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph19127419PMC PMC9224478
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Abstract

Wildfires are increasing and cause health effects. The immediate and ongoing health impacts of prolonged wildfire smoke exposure in severe asthma are unknown. This longitudinal study examined the experiences and health impacts of prolonged wildfire (bushfire) smoke exposure in adults with severe asthma during the 2019/2020 Australian bushfire period. Participants from Eastern/Southern Australia who had previously enrolled in an asthma registry completed a questionnaire survey regarding symptoms, asthma attacks, quality of life and smoke exposure mitigation during the bushfires and in the months following exposure. Daily individualized exposure to bushfire particulate matter (PM2.5) was estimated by geolocation and validated modelling. Respondents (n = 240) had a median age of 63 years, 60% were female and 92% had severe asthma. They experienced prolonged intense PM2.5 exposure (mean PM2.5 32.5 μg/m3 on 55 bushfire days). Most (83%) of the participants experienced symptoms during the bushfire period, including: breathlessness (57%); wheeze/whistling chest (53%); and cough (50%). A total of 44% required oral corticosteroid treatment for an asthma attack and 65% reported reduced capacity to participate in usual activities. About half of the participants received information/advice regarding asthma management (45%) and smoke exposure minimization strategies (52%). Most of the participants stayed indoors (88%) and kept the windows/doors shut when inside (93%), but this did not clearly mitigate the symptoms. Following the bushfire period, 65% of the participants reported persistent asthma symptoms. Monoclonal antibody use for asthma was associated with a reduced risk of persistent symptoms. Intense and prolonged PM2.5 exposure during the 2019/2020 bushfires was associated with acute and persistent symptoms among people with severe asthma. There are opportunities to improve the exposure mitigation strategies and communicate these to people with severe asthma.

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  • An Australian study noted that 30.8% of participants required an unscheduled doctor visit for asthma during a wildfire period compared to 11.5% for the same period in the previous non-fire year (p < 0.001).

    “An Australian study noted that 30.8% of participants required an unscheduled doctor visit for asthma during a wildfire period compared to 11.5% for the same period in the previous non‐fire year (p < 0.001) [22].”

    From Wildfires and Atopic Diseases: A Review (2026) · cites this paper as [22]

    Results §3.5 reports 30.8% versus 11.5% for unscheduled doctor visits, with p < 0.001, but identifies the 11.5% comparator as the pre-bushfire visit—not the same period in the previous year. Results §3.4 separately compares the 2019/2020 and 2018/2019 periods and reports p < 0.05 for unscheduled visits. (LLM, conf=0.91)

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References 34 · Cited by 35

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Authors
Beyene, T., Harvey, E. S., Van Buskirk, J., McDonald, V. M., Jensen, M. E., Horvat, J. C., Morgan, G. G., Zosky, G. R., Jegasothy, E., Hanigan, I., Murphy, V. E., Holliday, E. G., Vertigan, A. E., Peters, M., Farah, C. S., Jenkins, C. R., Katelaris, C. H., Harrington, J., Langton, D., Bardin, P., Katsoulotos, G. P., Upham, J. W., Chien, J., Bowden, J. J., Rimmer, J., Bell, R., & Gibson, P. G.
Affiliations
  • School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
  • John Hunter Hospital (AU)
  • Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
  • University of Newcastle Australia (AU)
  • The University of Sydney (AU)
  • University of Tasmania (AU)
  • Concord Hospital (US)
  • Camden and Campbelltown Hospitals (AU)
  • Frankston Hospital (AU)
  • Monash Medical Centre (AU)
  • Woolcock Institute of Medical Research (AU)
  • The University of Queensland (AU)
  • Flinders University (AU)
  • Asthma Australia (AU)
Corresponding author
Gibson, Peter G.
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-06-16
Volume
19
Issue
12
Pages
7419
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph19127419
PMC
PMC9224478
OpenAlex
W4283033551
Cited by
35
References
34
Citations by year
2026: 3 · 2025: 11 · 2024: 9 · 2023: 11 · 2022: 1
FWCI
3.14
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Figshare (submittedVersion)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
Funders
  • Medical Research Future Fund’s Emerging Priorities and Consumer Driven Research Initiative 2020 Bushfire Impact Research (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • Hunter Medical Research Institute Research (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • Australian Research Council (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • National Health and Medical Research Council (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • Australian National Data Service (ANDS) SWISH Climate Impacts project (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • GlaxoSmithKline Investigator-Sponsored Studies program (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
  • AstraZeneca, GlaxoSmithKline, Novartis, Boehringer Ingelheim and Roche (APP1201288, G2000105, LP0882048, 490057, AP07, 207455)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
bushfire smoke, severe asthma, PM2.5 exposure, asthma symptoms, asthma exacerbations, quality of life, indoor air quality, monoclonal antibodies, 2019-2020 Australian bushfires
MeSH terms
Adult, Air Pollutants, Asthma, Australia, Environmental Exposure, Female, Fires, Humans, Longitudinal Studies, Male, Middle Aged, Quality of Life, Smoke, Particulate Matter

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