Asthma and Australian Dust Storms

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Australian dust storm September 23, 2009. Image from NASA (CC)

As a kid growing up in the North Island of New Zealand, I don’t recall ever seeing dust storms of the type seen in the Australian outback. In recent weeks, we’ve seen clouds of ochre dust blowing in from South Australia. The worst dust storms converge on the eastern seaboard, shrouding cities in an eerie, fog-like miasma.

You may recall the really bad one (September 2009) when motorists in Sydney and Brisbane drove with their lights on in the middle of the day.

Fortunately, the red dust (which gets into everything), lasts only a few days, although the customary early spring westerlies tend to blow them east in sequence.

While he was writing about the Dust of Uruzgan (Afghanistan) at the time, songwriter Fred Smith could have been describing dust storm conditions in the outback.

It’s as fine as talcum powder on the ground and in the air
And it gets in to your eyes and it gets in to your hair
It gets in the machinery and foils every plan…”

Yes, and it gets in rainwater tanks when the next rains wash the dust off iron roofs. Residents of Auckland, some 1,500 kms away, have previously reported how dust storm drift from Australia turned their roofs a curious pink colour.

While New Zealand can fairly claim that it does not have dust storms in-country, it certainly sees the worst of them drifting across the Tasman. Reports of red ochre dust settling on the New Zealand Alps date back more than a century. You may have seen reports like these in recent years:

A series of dust storms in 2019, intermingling with smoke from bushfires, reached New Zealand\s Southern Alps, some 2,000 kms away. The ABC published photos, taken by adventurer Liz Carlsson, of the Mount Aspiring glacier sporting a red/pink discolouration.

University of Queensland geographer Hamish McGowan told the ABC it was not uncommon for this to occur during periods of severe drought in eastern Australia.

“In the right conditions, dust particles can be blown across the Tasman Sea by north-westerly winds, coming down on the Southern Alps in rain or snow and leaving behind an orange discolouration, Professor McGowan said.

The same phenomenon can be seen in the Australian Alps. Black or grey discolouration is more likely to be ash falling from bushfire smoke clouds. The population in general is more aware, now that we have the technology to show images taken on mobile devices, or from satellites or drones.

Dust storms quickly remind me that I should take my asthma preventer medication as directed. Like so many asthmatics, I’m guilty of forgetting/ignoring the inhalant medication if I’m feeling free of symptoms. Australia’s 2.7 million asthmatics ought to know that asthma attacks can be random. They are also triggered by air quality factors including industrial air pollution, a high pollen count, smoke, dust and indoor environmental hazards (house dust, pet dander).

I do remember that 2009 dust storm, as we were in Brisbane for Queensland Ballet’s season launch at QPAC. People with any kind of respiratory condition should be on red alert when a dust storm comes calling. Luckily, I had my asthma inhaler with me (and needed it).

The numbers of people presenting at hospital emergency departments with respiratory symptoms were well above average on that day. Analysis of the air pollution found the 2009 dust storm to be far worse than any bushfire or dust storm event of the previous 15 years.

The Environmental Health Journal said extremely high levels of particulate matter were recorded on September 23, 2009.

Daily average levels of coarse matter (<10 microns (μm) peaked over 11,000 μg/m3 and fine (<2.5 μm) particles over 1,600 μg/m3.

The World Heath Organisation guideline is that any level of fine particulate matter over 35 μg/m is considered unhealthy.

(We should also remember that major cities known for air pollution routinely record <2.5 μm levels of 50 and higher).

The EHJ authors reported that the dust storm returned on September 26, with elevated PM (particulate matter) levels of an unprecedented order of magnitude higher than those experienced during previous years.” 

The fine particles are the main problem for people with respiratory complaints, as they deeply penetrate the airways.

The 2009 dust storm originated in drought-stricken western New South Wales. Last week’s storms reportedly started in outback South Australia.

Reports of giant dust storms in Australia pre-date the technology which can now spot them from above. Dust storms were common during the series of droughts that afflicted Australia in the last decade of the 19th century. Still, scientists are predicting that climate change will make dust storms larger and more frequent.

A Science Daily report predicts that climate change will amplify dust activity in parts of the US in the latter half of the 21st century.

A statistical model developed by researchers at Princeton University and the National Oceanic and Atmospheric Administration (NOAA) predicts that climate change may lead to the increased frequency of spectacular dust storms that will have far-reaching impacts on public health and infrastructure.

Despite their dramatic visual impact, Australia’s dust storms are a blip on the the global chart. The World Meteorological  Organisation says most sand and dust storms occur in the arid and semi-arid regions of Northern Africa, the Arabian Peninsula, Central Asia and China. Australia, America and South Africa make minor, but still important, contributions.

The WMO estimates that 40% of aerosols in the troposphere (the lowest layer of Earth’s atmosphere) are dust particles from wind erosion. Global estimates of dust emissions vary between one and three gigatons per year.

Spectacular though they are when they appear on the horizon, dust storms are infrequent and often blow over in a day or two. Bushfire smoke, however, as the 2019/2020 Black Summer bushfires demonstrated, have far more serious ongoing health effects.

An Asthma Australia report details the effects of the bushfire smoke between July 2019 and March 2020. The air pollution caused a public health emergency, adding to the direct bushfire impacts already felt by communities. Bushfire smoke contains high concentrations of fine particulate matter.

At its worst, the smoke resulted in the Air Quality Index reaching more than 25 times the hazardous level (in Canberra, January 1 2020),” the report states.

The Air Quality Index reached greater than 10 times the hazardous rating on multiple occasions in certain areas of Sydney between November and January.

It is estimated the bushfire smoke was responsible for more than 400 deaths, 2,000 respiratory hospitalisations and 1,300 presentations to the Emergency Department for asthma.”

The most recent study by the Australian Bureau of Statistics found that 2.7 million Australians (one in nine or 11.2% of the total population) had asthma in 2017-18.

Over the last 10 years, the prevalence of asthma increased in the Australian population from 9.9% in 2007-08 to 11.2% in 2017-18″. 

This is as good a time as any to remind you that September 1-7 is National Asthma Awareness Week.

Don’t leave home without your puffer.

 

 

Bushfire smoke, dust storms and asthma

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Image: Bushfire smoke over Brisbane CBD from the Convention Centre, November 11, 2019. David Kapernick © David Kapernick Photography

Images of Brisbane shrouded in an asthma-inducing smoky haze on Monday reminded me of Queensland Ballet’s season launch in 2009. We had driven down for the matinee on a day when a massive dust storm was predicted. By the time we came out, the dust haze was so thick you could barely see the ABC headquarters across the road from the Lyric Theatre.

No doubt those of you who remember that were reliving it on Monday, only this time it was bushfire smoke, drifting in from all sides: NSW, the Sunshine Coast or from Cunningham’s Gap where the highway has been closed since Sunday .

ABC’s 7.30 report invited an air quality specialist on to the programme who judged Brisbane’s air quality on November 11 to be 6 times above the level when air pollution starts to cause problems for people with respiratory problems. On that day, air quality in Queensland’s capital city (population 2.28 million) was worse than China’s biggest city, Beijing (population 21.24 million).

We tend not to get such alarmist warnings on days when plain vanilla air pollution is bad. It is the obvious nature of bushfire smoke (the smell, the poor visibility, the 24/7 media attention), that raises it to public alert level.

The reason health authorities get worried about bushfire smoke in the atmosphere is that the fine particulate matter in the smoke is hazardous to health. Moreover, the longer it takes to clear, the more serious the risk of exposure becomes. Particulate matter known as P10 and P2.5 are harmful to humans and animals: other sources of these fine particulates include power stations, vehicles, aircraft, and dust from unsealed roads, residential wood fire smoke, bushfires and dust storms.

Brisbane’s topography doesn’t help – the city lies in a basin and is prone to temperature inversions, which trap polluted air. Many cities around the world share this fate. Temperature inversions happen when the air is warmer above the pollution that the air on the ground. The smog is trapped, to the detriment of inhabitants in cities including Beijing, Los Angeles, Chengdu, Lima, Milan and Mexico City.

Before we get into air pollution and air quality monitoring, let’s run a short history of asthma, for the benefit of the nine out of 10 lucky Australians who don’t suffer from it.

In 400 BC, Hippocrates came up with the Greek word for asthma (άσθμα), to describe noisy breathing, the characteristic wheezing which so often signals an asthma attack.  Hippocrates (himself) was the first physician to link asthma to environmental triggers and specific, hazardous trades like metalwork.

In layman’s terms, asthma is describes the situation in which you can breathe in but have difficulty breathing out. Someone in the throes of a bad asthma attack is over-inflating their lungs, quite possibly making it worse by hyperventilating.

Medically, it is described as a narrowing of the airways, usually averted by the administering of an inhaled bronchodilator medication or a steroid-based preventer.

Patients presenting at emergency departments with severe asthma are often put on a nebuliser, a machine which administers an inhaled bronchodilator through a mask worn over the mouth and nose.  As I recall, last time I was on a nebuliser (when suffering anaphylaxis), relief was rapid and restorative.

Excuse me if I sound really old, but I recall taking tablets for asthma, before inhalers became commonly prescribed. In the 1940s and 50s, asthmatics were either given epinephrine injections (adrenaline) or aminophylline tablets. As I recall, the latter made me jittery, wakeful and a bit weird, although childhood friends would tell you I was like that already.

Statistics maintained by Asthma Australia reveal the burden of the disease on individuals, their carers and Australia’s health system. The cost of the disease, measured by its long-term impacts, was $28 billion in 2015 ($11,740 per person).

In 2017-208, there were 38,792 hospitalisations in which asthma was the main diagnosis; 44% were for children aged 14 or younger,

People with asthma are more likely to report a poor quality of life, but medical practitioners now are more pro-active about encouraging patients to have an asthma plan. But more needs to be done, with fewer than one in five asthmatics aged 15 and older having a written plan.

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Bushfire smoke at Yangan, drifting in from Spicer’s Gap. Photo by Bob Wilson

(Note to self: this includes you, Bob. Make sure you have a spare puffer for times when (a) the puffer runs out (b) you have lost or misplaced it or c) the air looks like this).

The rate of deaths from asthma has remained stable since 2011. There were 441 deaths due to asthma in 2016-2017.

Mortality rates are higher for people living in remote or lower socioeconomic areas, and for Aborigines and Torres Strait Islanders.

Meanwhile, parts of Queensland and NSW remain shrouded in bushfire smoke. Numerous scientists and firefighters have voiced concerns that this may only be the beginnings of a long, dry and bushfire-prone summer. Climate change-denying pollies bewilderingly blamed the Greens for conspiring to limit hazard reduction burns.  Cathy Wilcox brilliantly summed this up in a four frame satirical cartoon (2nd one down the page).

The Guardian took the fact-checking route.

On November 11, the World Air Quality Index rated several areas of Brisbane including Rocklea, South Brisbane, Woolloongabba, Wynnum, Wynnum West, Lytton and Cannon Hill as ‘very unhealthy’.

The state’s chief health officer Jeannette Young told the ABC that everyone should stay indoors for the next 24 to 48 hours.

“Treat this seriously and don’t be complacent. Whether you’re in Logan or Lowood or anywhere in between, everyone needs to limit time spent outdoors while these conditions remain,” Dr Young said.

The term “particulate matter” – also known as particle pollution or PM, describes the extremely small solid particles and liquid droplets suspended in air. PM can include soil dust and allergens and their size affects their potential to cause health problems.

PM10 refers to particles with a diameter of 10 micrometres or less (small enough to pass through the throat and nose and enter the lungs).

PM2.5 refers to smaller particles able to enter the blood stream, causing serious adverse health effects over time.

So what’s ‘normal’ and how does that compare to Remembrance Day in Brisbane? The World Health Organisation (WHO) says the average PM2.5 level of cities across the globe measured over a 24-hour period is 35µg/m (or 3.5 micrograms per cubic metre). An ideal level of pollution (no negative health impacts), is 25µg/m.

The Brisbane CBD was at a PM10 and 180µg/m at 9:00am on Monday – 10 times the amount of pollution on an average day.

As we so often blithely say: ‘it’s a first-world problem’.

The WHO estimates that 1.6 million people die every year in India from air pollution. India has some of the most polluted cities in the world. This report from the BBC attributes air pollution in Delhi to motor vehicles, construction and industrial emissions, the burning of crop stubble and the residue of fireworks set off for a Hindu festival.

In early November P2.5 levels in Delhi were seven times higher than Beijing in early November, the report said.

If you were paying attention, those comparisons also applied to Brisbane on Remembrance Day, 2019. Lest we forget.

Further reading: https://blissair.com/what-is-pm-2-5.htm

https://bobwords.com.au/whipping-dust-storm/

 

Whipping up a dust storm in D

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Dust storm obscures Sydney Opera House, September 2009. Image by Janet Kavanagh, NSW Maritime, CC

While innocently vacuuming never-ending dust this week, I accidently sucked up the D harmonica which was lying on the coffee table. Said harmonica emitted a plaintive sound, closely resembling the wheezy noise of a piper warming up (think, You’re the Voice, Eric Burden’s Sky Pilot and that AC/DC song about it being a long way to the shop if you want a sausage roll).

Alarmed (these little blues harps cost $45 a piece), I managed to grab one end before it disappeared into the dusty bowels of the 10-year-old Wertheim. After a short struggle and a discordant approximation of the intro to Blowin’ in the Wind, I freed the harmonica and continued on my merry way.

Most household tasks have fallen my way since She Who is Ambidextrous (SWIA) broke a bone in her wrist, although to be serious, using the vacuum cleaner has always been one of my chores. This machine has seen better days, but it still does the job. The broken hose is securely held together with gaffer tape and a pair of chopsticks. A while ago I priced a replacement hose at a vacuum cleaner shop (I could have bought a budget-level machine for the same money). The enterprising young lad managed to side-track me to a really up-market vacuum cleaner which, I discovered after a 20-minute spiel, cost $1,799.

“I could buy a 20-year-old Toyota Corolla for that sort of money,” I said, “Nice try, kid.

I went out of the shop happily humming ‘I love my Toyota Corolla, aha hah,’* having spent no money at all. Instead I went to one of those big red and green barns and bought a roll of gaffer tape.

Maybe 36 years ago (or more), I succumbed to a sales pitch when a colleague sent his uncle around to sell me a vacuum cleaner. I had been telling this colleague how the old machine was seriously incapable of sucking up not only dust but hair and dander from a Golden Retriever.

So Uncle Harry called around, to demonstrate the superior dust sucking power of a top of the line Electrolux, in the days when top quality appliances were manufactured here and sold door-to-door with a five or even 10-year warranty.

I bought the Electrolux on time payment, because that was the only way to finance such an extravagant purchase in those impecunious times.

I’ve earned a few million (sic. Ed.) dollars since then and that old machine refuses to die. It’s now the ‘downstairs’ vacuum cleaner, although I’ve been known to use it upstairs when (as is a common problem), temporarily unable to source the right-size dust bags.

“That old thing still does the job,” said She Who Told Me in Week 3, “I Don’t Vacuum”. (My Dr. said I shouldn’t vacuum- bad for the back. Ed.)

A while back, when the tiler had finished laying tiles in our downstairs rooms I (without thinking), took the Electrolux out and started sucking up tile dust. It was the smell that alerted me – smoke pouring out the top of the machine. The bag was chockers. I let the Electrolux cool down, put in a new bag and what do you know, it continued on untrammelled, a glass half full version of the Millennial expression, “This sucks”.

I’m completely sure no manufacturer today could produce a vacuum cleaner (or any appliance), that would last 36 years and more.

This line of thinking led me to research robotic vacuum cleaners, which can be bought for as little as $129 or as much as a 20-year-old Toyota Corolla. Choice magazine generally gave all models the thumbs down when marking them on the capacity to extract dust from carpet.

The intelligent vacuum cleaner does a pretty good job on hard floors, although why you’d prefer a round model over a square one (to get into those nasty little corners that harbour ancient dust), is a mystery.

The perplexing thing is this: where does dust come from and why does it settle again after one pass with a vacuum cleaner? As Quentin Crisp said in The Naked Civil Servant: “There is no need to do any housework at all.After the first four years the dirt doesn’t get any worse.”

Dust mites and chronic allergies

I will acknowledge to being a little bit fussy about vacuuming, ever since the allergist did the pin prick tests to show I was hyper-allergic to dust mites. On first discovering this in the 1990s, we hired a heavy duty industrial vacuum cleaner and paid an agile friend to clean the crawl space in the attic of our 60-year-old house. After the fourth big black garbage bag was passed down the ladder to the respirator-wearing assistant, our friend declared that was one job he was never doing again.

It’s not too hard to find out the answer to the question, where does dust come from? Science Daily surmises, not so surprisingly, that most house dust comes from outside. The scientists developed a computer model that could track distribution of contaminated soil and airborne particulates into residences. They found that over 60% of house dust originates outdoors. The study by the American Chemical Society found that contaminants like lead and arsenic can find their way into homes via airborne dust.

Researchers David Layton and Paloma Beamer found that household dust included dead skin shed by people, fibres from carpets and upholstered furniture and tracked-in soil and airborne particles blown in from outdoors.

The 2009 report mentioned above came out in the same year a 500 km wide dust storm the colour of Donald Trump’s complexion swept across New South Wales and Queensland. The Australian capital, Canberra, experienced the dust storm on September 22 and a day later it reached Sydney and Brisbane. Thousands of tons of dirt and soil lifted in the dust storm were dumped in Sydney Harbour and the Tasman Sea. Ah yes, you remember that.

Random dust storms aside, the real culprit feared by those suffering from asthma and hay fever is the dust mite. Scientists agree that dust mites thrive among the aforementioned dead skin discarded by humans and pets. The dustier your mattress and pillows are, the worse the problem gets. As this fascinating but skin-crawling article says, there could be between 100,000 and one million dead dust mites (and mite dung) lurking in your bed. Ugh!

What you need to do, every time you change the sheets, is to strip the bed, hang the bedding out in the sun then attach the nifty little mattress cleaner that may or may not have come with your vacuum and give the mattress a good flogging, so to speak.

Or you could buy a robot vacuum cleaner and instruct it to spend all afternoon roaming around on the bed:

As Hal said in 2001 A Space Odyssey: “I’m sorry (Bob), I’m afraid I can’t do that.”

*(a reference to Tiffany Eckhardt’s love song to her Toyota Corolla)  

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