Wildfire smoke exposure and respiratory health outcomes in young adults born extremely preterm or extremely low birthweight

Anjali Haikerwal; Lex W Doyle; John D Wark; Louis Irving; Jeanie Ly Cheong

doi:10.1016/j.envres.2021.111159

Wildfire smoke exposure and respiratory health outcomes in young adults born extremely preterm or extremely low birthweight

Environ Res. 2021 Jun:197:111159. doi: 10.1016/j.envres.2021.111159. Epub 2021 Apr 21.

Authors

Anjali Haikerwal¹, Lex W Doyle², John D Wark³, Louis Irving⁴, Jeanie Ly Cheong⁵

Affiliations

¹ Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: anjali.haikerwal@thewomens.org.au.
² Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
³ Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia; Bone and Mineral Medicine, The Royal Melbourne Hospital, Melbourne, Australia.
⁴ Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Melbourne, Australia.
⁵ Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.

PMID: 33894239
DOI: 10.1016/j.envres.2021.111159

Abstract

Objective: Adults born either extremely preterm (EP, <28 weeks gestation) or extremely low birthweight (ELBW, <1000 g birthweight) have more obstructive airflow than controls of normal birthweight (>2499 g). We compared self-reported adverse respiratory health outcomes in young adults born EP/ELBW with controls following smoke exposure from the 2019/2020 wildfires in the Australian state of Victoria, and explored if any effects were mediated by airway obstruction, reflected in the forced expiratory volume in 1 second (FEV₁).

Methods: EP/ELBW participants were derived from all survivors born in the state of Victoria in 1991-92. Contemporaneous controls of normal birthweight (>2499 g) were recruited in the newborn period and matched for sociodemographic variables. Both groups had been assessed at intervals through childhood and into adulthood. Those who participated in the most recent follow-up assessment at 25 years of age, when FEV₁ had been measured, were sent a survey when they were approximately 28 years of age asking about respiratory health related outcomes (respiratory symptoms, health services usage, medication uptake) following wildfire smoke exposure over the southern hemisphere summer of 2019-20.

Results: A total of 296 participants (166 EP/ELBW; 130 controls) were sent the survey; 44% of the EP/ELBW group and 47% of the control group responded. Compared with controls, EP/ELBW respondents reported more overall respiratory problems (30%vs 20%) and specific respiratory symptoms (breathlessness, wheezing, cough and chest tightness) following wildfire smoke exposure, as well as higher health services usage (e.g. local health clinic, hospital emergency department) and medication uptake for respiratory-related problems. Higher FEV₁ values were associated with lower odds of most self-reported respiratory symptoms; adjusting for FEV₁ attenuated the differences between EP/ELW and control groups.

Conclusion: Survivors born EP/ELBW may be at an increased risk of adverse respiratory health outcomes following wildfire smoke exposure in early adulthood, in part related to worse expiratory airflows.

Keywords: Extremely low birthweight; Extremely preterm; Respiratory health; Wildfire smoke; Young adults.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Birth Weight
Child
Female
Humans
Infant, Extremely Premature
Infant, Newborn
Outcome Assessment, Health Care
Smoke / adverse effects
Wildfires*
Young Adult

Substances

Smoke