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'Breathing Fire': impact of prolonged bushfire smoke exposure in people with severe asthma


Beyene, T and Harvey, ES and Van Buskirk, J and McDonald, VM and Jensen, ME and Horvat, JC and Morgan, GG and Zosky, GR and Jegasothy, E and Hanigan, I and Murphy, VE and Holliday, EG and Vertigan, AE and Peters, M and Farah, CS and Jenkins, CR and Katelaris, CH and Harrington, J and Langton, D and Bardin, P and Katsoulotos, GP and Upham, JW and Chien, J and Bowden, JJ and Rimmer, Janet and Bell, R and Gibson, PG, 'Breathing Fire': impact of prolonged bushfire smoke exposure in people with severe asthma, International Journal of Environmental Research and Public Health, 19, (12) Article 7419. ISSN 1660-4601 (2022) [Refereed Article]

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2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License (, which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

DOI: doi:10.3390/ijerph19127419


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.

Item Details

Item Type:Refereed Article
Keywords:severe asthma; particulate matter; wildfire smoke; bushfire smoke
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Prevention of human diseases and conditions
UTAS Author:Zosky, GR (Professor Graeme Zosky)
ID Code:153967
Year Published:2022
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-10-19
Last Modified:2022-11-04
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