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2 Respiratory and cardiovascular diseases and cancer among residents in the Hunter New England Area Health Service XXXXXX HNE Respi Cardio Disease Outer v04.indd 5 05/05/2010 2:51:29 PM NSW DEPARTMENT OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) 9391 9000 Fax. (02) 9391 9101 TTY. (02) 9391 9900 www.health.nsw.gov.au Produced by: Population Health Division NSW Department for Health Tel. (02) 9816 0373 Fax. (02) 9816 0240 Email. [email protected] This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the NSW Department of Health. © NSW Department of Health 2010 SHPN: (PHPP) 100110 ISBN: 978-1-74187-537-9 For further copies of this document please contact: Better Health Centre – Publications Warehouse PO Box 672 North Ryde BC, NSW 2113 Tel. (02) 9887 5450 Fax. (02) 9887 5452 Further copies of this document can be downloaded from the NSW Health website www.health.nsw.gov.au May 2010 XXXXXX HNE Respi Cardio Disease Outer v04.indd 6 05/05/2010 2:51:29 PM Contents Introduction.................................................................................................................................................. 3 Presentation of data including data type, source and presentation........................................................ 5 Section 1 The population of Hunter New England..................................................................................................... 7 Section 2 Emergency department presentations for respiratory illness and asthma............................................11 Section 3 Hospital separations from respiratory diseases, asthma and cardiovascular diseases.......................19 Section 4 Self-reported data on overall health, asthma and smoking................................................................... 29 Section 5 Mortality...................................................................................................................................................... 37 Section 6 Cancer.........................................................................................................................................................41 Section 7 Drinking water quality.................................................................................................................................51 Commentary............................................................................................................................................... 53 Findings...................................................................................................................................................... 55 Conclusions from the data........................................................................................................................ 57 Next steps.................................................................................................................................................. 58 Companion Report.................................................................................................................................... 59 References................................................................................................................................................. 60 Glossary of terms....................................................................................................................................... 62 Appendix A................................................................................................................................................. 65 Appendix B................................................................................................................................................. 66 Appendix C................................................................................................................................................. 67 Appendix D................................................................................................................................................. 68 Appendix E................................................................................................................................................110 Respiratory and cardiovascular diseases and cancer among residents in the Hunter New England Area Health Service NSW HEAltH PAGE 1 XXXXXX HNE Respi Cardio Disease Inner v06.indd 1 05/05/2010 2:55:08 PM PAGE 2 NSW HEAltH Respiratory and cardiovascular diseases and cancer among residents in the Hunter New England Area Health Service XXXXXX HNE Respi Cardio Disease Inner v06.indd 2 05/05/2010 2:55:08 PM Introduction This report focuses on those diseases and causes of death exposure to particulate matter far outweighs that that have been found to be associated with exposure to air attributable to other ambient air pollutants. Particulate pollutants. Analysis has also been undertaken on some matter from open-cut coal mining activities consists almost diseases about which the community of the Hunter New wholly of dust and particles from the earth above the coal, England Area Health Service (HNEAHS) of New South Wales and does not contain much actual coal dust. (NSW) has expressed a concern. Particulate matter This report uses reliable, routinely collected health data to: Particulate matter can arise from various sources such as motor cars, mining activity, industrial processes, agricultural 1) assess the health of the residents of the HNEAHS practices (amplified in drought conditions), wood burning of NSW (domestic heating), unflued gas heat ing and cooking, 2) to compare the health of the residents of the HNEAHS bushfires, wind-blown dust and tobacco smoke. Particulate to the health of residents in other parts of NSW matter can affect a person’s health by aggravating 3) examine variation in health within HNEAHS in relation respiratory diseases; irritating upper airways and eyes; to the distribution of coal mining and coal-powered increasing the risk of death from chronic respiratory and electrical power generation activity within this area. cardiovascular diseases (Pope et al, 2002). What do we know about There is strong evidence for the association between high air pollution and health? levels of particulate matter and death, both soon and a long time after exposure. Where the particulate matter is Clean air is considered to be a basic requirement of less than 10 microns in diameter (PM10) exposure can lead human health and wellbeing (WHO 2005). The health to hospital admissions for cardiovascular and respiratory effects of air pollution range from mild and temporary disease, and is associated with increased symptoms of respiratory symptoms through to asthma, cardiovascular asthma and lung cancer deaths. Table 1 (Appendix A) conditions, chronic lung disease, cancer and premature shows the increased health risks associated with increasing death. Both short-term and long-term exposure to air levels of particulate matter. pollutants can cause disease as susceptibility to illness and disease depends on the duration and degree of How do we measure air quality? exposure to the pollutant. Air pollutants are particularly harmful to the very young, elderly people and people with The National Environment Protection and Heritage chronic respiratory or cardiovascular diseases (Australian Council has set national air quality standards (National Institute of Health and Welfare, 2008). Environment Protection Measures) for the six key air pollutants. Since 2002, the standards are legally binding The six key air pollutants to which most Australians are on all jurisdictions and require them to monitor air quality exposed are particulate matter, ozone, carbon monoxide, in order to identify potential air quality problems (Australian nitrogen dioxide, sulphur dioxide and lead. Of these Government. Air Quality; http://www.environment.gov.au/ major air pollutants, ozone and particulate matter are atmosphere/airquality/publications/standards.html). of most concern in ambient air. The air quality across NSW and the Hunter Valley is Dust from open-cut coal mining could contain a wide monitored by the NSW Department of the Environment, range of pollutants, but the one pollutant that is of most Climate Change and Water (DECCW). In the Hunter Valley, concern from a burden of disease perspective is particulate air quality monitors are positioned at industrial sites (mainly matter. The potential morbidity and mortality due to coal mines and power stations) for regulatory purposes. Respiratory and cardiovascular diseases and cancer among residents in the Hunter New England Area Health Service NSW HEAltH PAGE 3 XXXXXX HNE Respi Cardio Disease Inner v06.indd 3 05/05/2010 2:55:08 PM There are no DECCW air quality monitors placed in the How were the health data collected? population centres in HNEAHS outside of Newcastle. In order to assess the possible impacts of mines and coal- How do we measure health in NSW? powered power stations on the health of the people of HNEAHS, experts have collated routinely collected data NSW Health has developed a sophisticated array of and presented them in this report. Information is drawn surveillance measures which actively monitor the health from a range of reliable sources and includes data on the of the people of NSW on an ongoing basis. Statewide