Chronic Obstructive Pulmonary Disease in Adults Exposed to Fine Particles from a Coal Mine Fire

• Published in: Annals of the American Thoracic Society Vol. 19; no. 2; pp. 186 - 195
• Main Authors: Prasad, Shivonne, Gao, Caroline X, Borg, Brigitte, Broder, Jonathan, Brown, David, Ikin, Jillian F, Makar, Annie, McCrabb, Tom, Hoy, Ryan, Thompson, Bruce, Abramson, Michael J
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 01-02-2022
• Subjects: Adult; Air Pollutants - analysis; Air Pollutants - toxicity; Air Pollution - analysis; Air Pollution - statistics & numerical data; Chronic obstructive pulmonary disease; Coal - toxicity; Coal mining; Environmental Exposure - statistics & numerical data; Fires; Humans; Particulate Matter - analysis; Particulate Matter - toxicity; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - etiology; Risk factors; Smoking; obstructive lung diseases; particulate matter; spirometry; cough; environmental exposure
• ISSN: 2329-6933; 2325-6621
• DOI: 10.1513/AnnalsATS.202012-1544OC

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 (PM
). The long-term health consequences are unknown and are being evaluated as part of the Hazelwood Health Study.
To explore the association between PM
exposure and chronic obstructive pulmonary disease (COPD).
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 PM
exposure was modeled. Multivariate linear regression and logistic models were fitted to analyze associations between mean and peak PM
exposure and clinical outcomes, stratified by smoking status.
A 10 μg/m
increase in mean PM
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 PM
exposure were associated with higher odds of chronic cough in the preceding 12 months (OR, 2.13; 95% CI, 1.24-3.65).
Almost 4 years after a 6-week period of coal fire PM
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.