‘Breathing fire’: impact of prolonged bushfire smoke exposure in people with severe asthma

Tesfalidet Beyene, Erin S. Harvey, Joseph Van Buskirk, Vanessa M. McDonald, Megan E. Jensen, Jay C. Horvat, Geoffrey G. Morgan, Graeme R. Zosky, Edward Jegasothy, Ivan Hanigan, Vanessa E. Murphy, Elizabeth G. Holliday, Anne E. Vertigan, Matthew Peters, Claude S. Farah, Christine R. Jenkins, Constance H. Katelaris, John Harrington, David Langton, Philip BardinGregory P. Katsoulotos, John W. Upham, Jimmy Chien, Jeffrey J. Bowden, Janet Rimmer, Rose Bell, Peter G. Gibson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)
42 Downloads (Pure)


Wildfires are increasing and cause health effects. The immediate and ongoing health impacts of prolonged wildfire smoke exposure in severe asthma are unknown. This longitudinal study examined the experiences and health impacts of prolonged wildfire (bushfire) smoke exposure in adults with severe asthma during the 2019/2020 Australian bushfire period. Participants from East-ern/Southern Australia who had previously enrolled in an asthma registry completed a questionnaire survey regarding symptoms, asthma attacks, quality of life and smoke exposure mitigation during the bushfires and in the months following exposure. Daily individualized exposure to bush-fire particulate matter (PM2.5) was estimated by geolocation and validated modelling. Respondents (n = 240) had a median age of 63 years, 60% were female and 92% had severe asthma. They experienced prolonged intense PM2.5 exposure (mean PM2.5 32.5μg/m3 on 55 bushfire days). Most (83%) of the participants experienced symptoms during the bushfire period, including: breathlessness (57%); wheeze/whistling chest (53%); and cough (50%). A total of 44% required oral corticosteroid treatment for an asthma attack and 65% reported reduced capacity to participate in usual activities. About half of the participants received information/advice regarding asthma management (45%) and smoke exposure minimization strategies (52%). Most of the participants stayed indoors (88%) and kept the windows/doors shut when inside (93%), but this did not clearly mitigate the symptoms. Following the bushfire period, 65% of the participants reported persistent asthma symptoms. Monoclonal antibody use for asthma was associated with a reduced risk of persistent symptoms. Intense and prolonged PM2.5 exposure during the 2019/2020 bushfires was associated with acute and persistent symptoms among people with severe asthma. There are opportunities to improve the exposure mitigation strategies and communicate these to people with severe asthma.

Original languageEnglish
Article number7419
Pages (from-to)1-15
Number of pages15
JournalInternational Journal of Environmental Research and Public Health
Issue number12
Publication statusPublished - 16 Jun 2022
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • bushfire smoke
  • particulate matter
  • severe asthma
  • wildfire smoke


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