Primary and pharmaceutical care usage concurrent associations with a severe smoke episode and low ambient air pollution in early life.

Autor: Ziou M; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia., Gao CX; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia., Wheeler AJ; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia; Commonwealth Scientific and Industrial Research Organisation (CSIRO) Oceans and Atmosphere, Aspendale, Victoria 3195, Australia., Zosky GR; Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania 7000, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia., Stephens N; Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania 7000, Australia., Knibbs LD; School of Public Health, The University of Sydney, NSW 2006, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia., Williamson GJ; School of Natural Sciences, University of Tasmania, Sandy Bay, Tasmania 7005, Australia., Melody SM; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia., Venn AJ; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia., Dalton MF; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia., Dharmage SC; Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Carlton, Victoria 3052, Australia., Johnston FH; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia. Electronic address: Fay.Johnston@utas.edu.au.
Jazyk: angličtina
Zdroj: The Science of the total environment [Sci Total Environ] 2023 Jul 20; Vol. 883, pp. 163580. Date of Electronic Publication: 2023 Apr 24.
DOI: 10.1016/j.scitotenv.2023.163580
Abstrakt: Background: Due to climate change, landscape fires account for an increasing proportion of air pollution emissions, and their impacts on primary and pharmaceutical care are little understood.
Objectives: To evaluate associations between exposure in two early life periods to severe levels of PM 2.5 from a mine fire, background PM 2.5 , and primary and pharmaceutical care.
Methods: We linked records of births, general practitioner (GP) presentations and prescription dispensing for children born in the Latrobe Valley, Australia, 2012-2014, where a severe mine fire occurred in February-March 2014 in an area with otherwise low levels of ambient PM 2.5 . We assigned modelled exposure estimates for fire-related (cumulative over the fire and peak 24-hour average) and annual ambient PM 2.5 to residential address. Associations with GP presentations and dispensing of prescribed medications in the first two years of life (exposure in utero) and in the two years post-fire (exposure in infancy) were estimated using two-pollutant quasi-Poisson regression models.
Results: Exposure in utero to fire-related PM 2.5 was associated with an increase in systemic steroid dispensing (Cumulative: IRR = 1.11, 95%CI = 1.00-1.24 per 240 μg/m 3 ; Peak: IRR = 1.15, 95%CI = 1.00-1.32 per 45 μg/m 3 ), while exposure in infancy was associated with antibiotic dispensing (Cumulative: IRR = 1.05, 95%CI = 1.00-1.09; Peak: IRR = 1.06, 95%CI = 1.00-1.12). Exposure in infancy to ambient PM 2.5 , despite relatively low levels from a global perspective (Median = 6.1 μg/m 3 ), was associated with an increase in antibiotics (IRR = 1.10, 95%CI = 1.01-1.19 per 1.4 μg/m 3 ) and in GP presentations (IRR = 1.05, 95%CI = 1.00-1.11), independently from exposure to the fire. We also observed differences in associations between sexes with GP presentations (stronger in girls) and steroid skin cream dispensing (stronger in boys).
Discussion: Severe medium-term concentrations of PM 2.5 were linked with increased pharmaceutical treatment for infections, while chronic low levels were associated with increased prescriptions dispensed for infections and primary care usage. Our findings also indicated differences between sexes.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fay Johnston reports financial support was provided by Victoria Department of Health and Human Services. Shyamali Dharmage reports a relationship with AstraZeneca plc that includes: funding grants. Shyamali Dharmage reports a relationship with GSK plc that includes: funding grants.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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