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Australian Bushfires 2019–20: Exploring the Short-Term Health Impacts

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Australian Bushfires 2019–20: Exploring the Short-Term Health Impacts The 2019–20 bushfire season saw unprecedented fires sweep across Australia with a massive impact on many communities, devastating the natural environment and compromising air quality. Australian bushfires This report examines a range of health data sources to assess the short-term health impacts of the 2019–20 bushfires, including: emergency department visits, prescription and purchase of asthma medicines, mental health service use and GP visits. Results Exploring the short-term show clear associations between increased bushfire activity, including poor air quality, and people health impacts seeking assistance for their health. aihw.gov.au Stronger evidence, better decisions, improved health and welfare Australian bushfires 2019–20 Exploring the short-term health impacts The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians. © Australian Institute of Health and Welfare 2020 This product, excluding the AIHW logo, Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark, has been released under a Creative Commons BY 3.0 (CC BY 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures. We have made all reasonable efforts to identify and label material owned by third parties. You may distribute, remix and build upon this work. However, you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at www.aihw.gov.au/copyright/. The full terms and conditions of this licence are available at http://creativecommons.org/licenses/by/3.0/au/. A complete list of the Institute’s publications is available from the Institute’s website www.aihw.gov.au. ISBN 978-1-76054-727-1 (PDF) ISBN 978-1-76054-728-8 (Print) Suggested citation Australian Institute of Health and Welfare 2020. Australian bushfires 2019–20: Exploring the short-term health impacts. Cat. no. PHE 276. Canberra: AIHW. Australian Institute of Health and Welfare Board Chair Mrs Louise Markus Director Mr Barry Sandison Any enquiries relating to copyright or comments on this publication should be directed to: Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel: (02) 6244 1000 Email: [email protected] Published by the Australian Institute of Health and Welfare. Please note that there is the potential for minor revisions of data in this report. Please check the online version at www.aihw.gov.au for any amendment. Contents Summary ..............................................................iv Key findings ......................................................................v 1 Introduction ............................................................1 1.1 Australia’s 2019–20 bushfire season at a glance ...................................1 1.2 Toll on Australians ............................................................2 2 Bushfires and health ....................................................6 2.1 Air pollution ..................................................................6 2.2 Respiratory health ...........................................................10 2.3 Cardiovascular health and stroke ..............................................17 2.4 Mental health ...............................................................18 2.5 Visits to general practitioners ..................................................20 2.6 Heat-induced illness. .21 2.7 Deaths .....................................................................21 2.8 Homelessness. 21 3 Literature on health impacts beyond the scope of this report ................23 3.1 Burns ......................................................................23 3.2 Eye health ..................................................................23 3.3 Substance use ...............................................................24 3.4 Domestic and family violence ..................................................24 4 Future work ...........................................................25 4.1 Longer term health impacts ...................................................25 4.2 Air quality data ..............................................................26 4.3 Royal Commission into National Natural Disaster Arrangements ...................27 4.4 Things to consider when interpreting results .....................................28 Appendix: Data used in this report .......................................29 Health and the health system .....................................................29 Air quality ......................................................................29 Acknowledgments. 30 Abbreviations. .30 Glossary ..............................................................31 References ............................................................34 iii Summary The bushfire season in 2019–20 saw unprecedented fires sweep across Australia with a massive impact on many communities (Australian Academy of Science 2020). In a season marked by severe and protracted drought, the natural environment was particularly devastated; scientists have estimated that, in the forests and woodlands that were burned during the 2019–20 bushfire season, there would have been almost 3 billion native vertebrates (World Wide Fund for Nature Australia 2020). Thirty-three people lost their lives in the 2019–20 bushfire season (Parliament of Australia 2020). There were substantial property losses, as well as threats to lives and property that forced people to evacuate from their homes (Biddle et al. 2020). Smoke blanketed parts of Australia as the bushfires burned, leading to public health advice to stay indoors. This report examines short-term health impacts of the 2019–20 bushfires—those that became apparent in the immediate days and weeks thereafter—with a focus on providing insights from health data. Data in this report concentrate on the period from September 2019 to March 2020. Understanding the more immediate and short-term physical and mental health impacts of bushfires can help to ensure health services are sufficiently equipped to deal with them in any future bushfire event. The full health and related impacts of the 2019–20 bushfires will not be known for some time; however, psychological health can be affected for many years and, while more research is needed into the effects of long-term exposure to bushfire smoke specifically, long-term exposure to air pollution is potentially related to a small increase in the risk of some chronic diseases (enHealth 2020). iviv Key findings What impact did the 2019–20 bushfires have on respiratory health? Hospital emergency department data for New South Wales analysed for this report show a clear increase in presentations for respiratory problems during the bushfire season compared with data for the previous year. Data for smaller geographical areas below the state level—Statistical Area Level 4 (SA4)—show strong impacts in this regard in regions where bushfires burned nearby. For example, for people residing in the Riverina SA4 where the Dunns Road megafire burned at Emergency Warning level near Batlow for several days, respiratory-related presentations to an emergency department increased by 86% for the week beginning 5 January 2020 when compared with presentations for the same week in the previous year. Sales data from pharmacies showed large increases in sales of inhalers for shortness of breath corresponding with the spread of bushfires throughout the bushfire season when compared with the same weeks in the previous year. For example, in the Mid North Coast SA4, inhaler sales increased by 144% for the week beginning 10 November 2019, when several fires were burning at Emergency Warning level in the area. Pharmaceutical Benefits Scheme (PBS) data for scripts dispensed for salbutamol (commonly marketed as Ventolin or Asmol and used for the relief of respiratory symptoms) also show changes that coincide with bushfire activity. In south-eastern New South Wales in the week beginning 29 December 2019, salbutamol prescriptions increased by 63% in the Capital Region SA4 (which includes towns such as Batemans Bay) compared with the same week in the previous year. There was a 73% increase the following week, beginning 5 January 2020. Dispensing rates for salbutamol prescriptions remained high in this SA4 up until the last week of January. Compared with the same weeks in the previous year, salbutamol scripts dispensed in the Hume SA4 in Victoria increased by 74% and 30%, respectively, in the weeks beginning 5 January 2020 and 12 January 2020 as 3 fires burned on the New South Wales and Victoria border. How did the bushfires affect mental health? Biddle and colleagues (2020) estimated that directly after the 2019–20 bushfires more than half of Australian adults felt anxious or worried about them. Bushfire-related calls to the Lifeline crisis support hotline increased, resulting in the introduction of a telephone line for people affected by the bushfires (Lifeline 2020). Additional Medicare items to allow people whose mental health was adversely affected by the 2019–20 bushfires to access mental health and wellbeing services were introduced in January 2020. From 19 January to 11 October 2020 there was an average of 498 services claimed, per week, across Australia. Although emergency department data for New South Wales
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