• Energy Research

Observed increases in the frequency and intensity of heatwave events, together with the projected acceleration of these events worldwide, has led to a rapid expansion in research on the health impacts of extreme heat.To examine how research on heatwaves and their health-related impact is distributed globally.A systematic review was undertaken. Four online databases were searched for articles examining links between specific historical heatwave events and their impact on mortality or morbidity. The locations of these events were mapped at a global scale, and compared to other known characteristics that influence heat-related illness and death.When examining the location of heatwave and health impact research worldwide, studies were concentrated on mid-latitude, high-income countries of low- to medium-population density. Regions projected to experience the most extreme heatwaves in the future were not represented. Furthermore, the majority of studies examined mortality as a key indicator of population-wide impact, rather than the more sensitive indicator of morbidity.While global heatwave and health impact research is prolific in some regions, the global population most at risk of death and illness from extreme heat is under-represented. Heatwave and health impact research is needed in regions where this impact is expected to be most severe.

The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020 and 2021. It examines five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the fifth year of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Within just two years, Australia has experienced two unprecedented national catastrophes - the 2019-2020 summer heatwaves and bushfires and the 2021-2022 torrential rains and flooding. Such events are costing lives and displacing tens of thousands of people. Further, our analysis shows that there are clear signs that Australia's health emergency management capacity substantially decreased in 2021. We find some signs of progress with respect to health and climate change. The states continue to lead the way in health and climate change adaptation planning, with the Victorian plan being published in early 2022. At the national level, we note progress in health and climate change research funding by the National Health and Medical Research Council. We now also see an acceleration in the uptake of electric vehicles and continued uptake of and employment in renewable energy. However, we also find Australia's transition to renewables and zero carbon remains unacceptably slow, and the Australian Government's continuing failure to produce a national climate change and health adaptation plan places the health and lives of Australians at unnecessary risk today, which does not bode well for the future.

The island state of Tasmania has marked seasonal variations of fine particulate matter (PM2.5) concentrations related to wood heating during winter, planned forest fires during autumn and spring, and bushfires during summer. Biomass smoke causes considerable health harms and associated costs. We estimated the historical health burden from PM2.5 attributable to wood heater smoke (WHS) and landscape fire smoke (LFS) in Tasmania between 2010 and 2019. We calculated the daily population level exposure to WHS- and LFS-related PM2.5 and estimated the number of cases and health costs due to premature mortality, cardiorespiratory hospital admissions, and asthma emergency department (ED) visits. We estimated 69 deaths, 86 hospital admissions, and 15 asthma ED visits, each year, with over 74% of impacts attributed to WHS. Average yearly costs associated with WHS were of AUD$ 293 million and AUD$ 16 million for LFS. The latter increased up to more than AUD$ 34 million during extreme bushfire seasons. This is the first study to quantify the health impacts attributable to biomass smoke for Tasmania. We estimated substantial impacts, which could be reduced through replacing heating technologies, improving fire management, and possibly implementing integrated strategies. This would most likely produce important and cost-effective health benefits.

Understanding exposure to air pollution during extreme events such as fire emergencies is critical for assessing their potential health impacts. However, air pollution emergencies often affect places without a network of air quality monitoring and characterising exposure retrospectively is methodologically challenging due to the complex behaviour of smoke and other air pollutants. Here we test the potential of roof cavity (attic) dust to act as a robust household-level exposure proxy, using a major air pollution event associated with a coal mine fire in the Latrobe Valley, Australia, as an illustrative study. To assess the relationship between roof cavity dust composition and mine fire exposure, we analysed the elemental and polycyclic aromatic hydrocarbon composition of roof cavity dust (<150μm) from 39 homes along a gradient of exposure to the mine fire plume. These homes were grouped into 12 zones along this exposure gradient: eight zones across Morwell, where mine fire impacts were greatest, and four in other Latrobe Valley towns at increasing distance from the fire. We identified two elements-barium and magnesium-as 'chemical markers' that show a clear and theoretically grounded relationship with the brown coal mine fire plume exposure. This relationship is robust to the influence of plausible confounders and contrasts with other, non-mine fire related elements, which showed distinct and varied distributional patterns. We conclude that targeted components of roof cavity dust can be a useful empirical marker of household exposure to severe air pollution events and their use could support epidemiological studies by providing spatially-resolved exposure estimates post-event.

To evaluate associations between exposure during early life to mine fire smoke and parent-reported indicators of respiratory and atopic illness 2-4 years later.The Hazelwood coalmine fire exposed a regional Australian community to markedly increased air pollution during February - March 2014. During June 2016 - October 2018 we conducted a prospective cohort study of children from the Latrobe Valley.Seventy-nine children exposed to smoke in utero, 81 exposed during early childhood (0-2 years of age), and 129 children conceived after the fire (ie, unexposed).Individualised mean daily and peak 24-hour fire-attributable fine particulate matter (PM2.5 ) exposure during the fire period, based on modelled air quality and time-activity data.Parent-reported symptoms, medications use, and contacts with medical professionals, collected in monthly online diaries for 29 months, 2-4 years after the fire.In the in utero exposure analysis (2678 monthly diaries for 160 children exposed in utero or unexposed), each 10 μg/m3 increase in mean daily PM2.5 exposure was associated with increased reports of runny nose/cough (relative risk [RR], 1.09; 95% CI, 1.02-1.17), wheeze (RR, 1.56; 95% CI, 1.18-2.07), seeking health professional advice (RR, 1.17; 95% CI 1.06-1.29), and doctor diagnoses of upper respiratory tract infections, cold or flu (RR, 1.35; 95% CI, 1.14-1.60). Associations with peak 24-hour PM2.5 exposure were similar. In the early childhood exposure analysis (3290 diaries for 210 children exposed during early childhood, or unexposed), each 100 μg/m3 increase in peak 24-hour PM2.5 exposure was associated with increased use of asthma inhalers (RR, 1.26; 95% CI, 1.01-1.58).Exposure to mine fire smoke in utero was associated with increased reports by parents of respiratory infections and wheeze in their children 2-4 years later.

ABSTRACTBackground and objectiveLong‐term respiratory risks following exposure to relatively short periods of poor air quality early in life are unknown. We aimed to evaluate the association between exposure to a 6‐week episode of air pollution from a coal mine fire in children aged <2 years, and their lung function 3 years after the fire.MethodsWe conducted a prospective cohort study. Individual exposure to 24‐h average and peak concentrations of particulate matter with an aerodynamic diameter <2.5 μm in diameter (PM2.5) during the fire were estimated using dispersion and chemical transport modelling. Lung function was measured using the forced oscillation technique (FOT), generating standardized Z‐scores for resistance and reactance at a frequency of 5 Hz (Rrs5 and Xrs5), and area under the reactance curve (AX). We used linear regression models to assess the associations between PM2.5 exposure and lung function, adjusted for potential confounders.ResultsOf the 203 infants originally recruited, 84 aged 4.3 ± 0.5 years completed FOT testing. Median (interquartile range, IQR) for average and peak PM2.5 were 7.9 (6.8–16.8) and 103.4 (60.6–150.7) μg/m3, respectively. The mean ± SD Z‐scores for Rrs5, Xrs5 and AX were 0.56 ± 0.80, –0.76 ± 0.88 and 0.72 ± 0.92, respectively. After adjustment for potential confounders including maternal smoking during pregnancy, a 10 μg/m3 increase in average PM2.5 was significantly associated with worsening AX (β‐coefficient: 0.260; 95% CI: 0.019, 0.502), while the association between a 100‐μg/m3 increase in peak PM2.5 and AX was borderline (0.166; 95% CI: −0.002, 0.334).ConclusionInfant exposure to coal mine fire emissions could be associated with long‐term impairment of lung reactance.

Wildfires, Global Climate Change, and Human Health Wildfires are increasingly common and projected to worsen with climate change. Health consequences include burns and mental health effects, as wel...