Tasmania has smoke health problems, and they’re not just cigarettes. In recent years we have had notable problems with summer bushfire smoke as well as forestry burns at other times of the years. A group of scholars at the ANU is proposing a national approach to environmental smoke and health based on their research into the problem. 

It is time to establish an independent national expert committee on air pollution and health protection to support environmental health decision-making. So say the authors of a report published online today by the Medical Journal of Australia.

Professor Sotiris Vardoulakis, Professor of Global Environmental Health at National Centre for Epidemiology and Population Health at the Australian National University, and colleagues, made the recommendation on the back of a catastrophic bushfire season. Smoke blanketed large areas, from major population centres to small towns, for long periods of time.

“Existing health protection advice … mainly focuses on shorter and more localised smoke episodes,” he said. “It is important that health professionals and patients, as well as healthy individuals and those at higher risk develop a good understanding of the available health protection measures and their effectiveness and potential trade-offs,” Vardoulakis and colleagues wrote.

The group argue that current health protection advice related to bushfire smoke mainly focuses on short term measures aimed at reducing personal exposure to pollution.  These include advice to stay indoors with windows and doors closed, reduce strenuous physical exercise outdoors and so on. Such advice would ‘become impractical’ over the longer periods of high PM2.5 levels such as those experienced over the past summer.

Manly Beach this summer. Image courtesy Laurie Wilson (FL). (CC BY-NC-ND 2.0)

Fine particulates

“A major public health concern is population exposure to atmospheric particulate matter (PM) with a diameter < 2.5 μm (PM2.5),” they said. These particulates can deeply penetrate the respiratory system, inducing oxidative stress and inflammation, and translocate into the bloodstream.

“Mortality rates have been found to increase in Sydney on days with high bushfire smoke pollution. Hospital admissions, emergency department attendances, ambulance call-outs and GP consultations – particularly for respiratory conditions – all increase during periods of severe PM2.5 from bushfires.”

There were also inconsistencies between states and other jurisdictions about air-quality measurement and its communication to the public.

They are calling for more nuanced advice that would allow individuals to be guided by location-specific air quality forecasts. These could include the pattern of hourly PM2.5 concentrations at nearby air quality monitoring locations. This would assist people to plan their daily activities in ways that minimise exposure to pollution.

An example identified was PM2.5 being lower in most of Sydney in early morning hours during the December 2019 bushfire smoke episode. “Exercising outdoors and cycling or walking to school or work within this time window would help maintain good physical activity levels without substantially increasing exposure to smoke,” they wrote.

“Real time information on the temporal and spatial variation of air pollution in all jurisdictions should be made available online and through other media to enable individuals to assess nearby air quality.”

“Consistency of air quality information and related public health advice across jurisdictions is essential,” Vardoulakis and colleagues concluded.

The group have developed a comprehensive set of factsheets on How to protect yourself and others from bushfire smoke, which have been widely disseminate and translated into several languages:

“Further research is needed into the longer term effects of smoke pollution, as well as the effectiveness of related health protection advice.”

Climate change

They believe that working towards ambitious climate change mitigation targets is an essential long term strategy for managing the underlying causes of the increasing bushfire risk in Australia.

“It is time for an independent national expert committee on air pollution and health protection to be established to support environmental health decision making in Australia.”

“This new expert committee should have a clear mandate and resources to develop evidence-based, accurate, practical and consistent advice on health protection against bushfire smoke, and air pollution.” To be most effective the experts should be empowered to work broadly, across jurisdictions, they said.