Health consequences of thick forest fire smoke to healthy residents in Riau, Indonesia: a cross-sectional study
Abstract
BACKGROUND Indonesia forest fire in 2015 emitted a huge amount of pollutants into the air. This study was aimed to assess the health consequences of forest fire smoke in healthy residents in Riau during forest fire disaster in 2015.
METHODS This cross-sectional study was performed in healthy residents who lived in Pekanbaru, Riau Province, Sumatera, for at least 6 months during forest fire disaster in 2015, and data were taken in October 2015. Questionnaires consisting of respiratory and non-respiratory symptoms were collected. Lung function was assessed by spirometry (MIR II Spirolab™ spirometer, Medical International Research, Italy) and exhaled carbon monoxide (CO) was assessed using piCO+ Smokerlyzer®. Heart rate at rest and oxygen saturation in the room air were measured using Onyx 9591 Pulse Oximeter®.
RESULTS A total of 89 subjects were mostly female (75.3%), housewife (37.7%), nonsmoker (86.5%) with mean age of 38.9 years old. The non-respiratory and respiratory symptoms were reported in 84.7% and 71.4% subjects, respectively. Lung function was impaired in 72.6% subjects, mostly with mild obstruction and mild restriction. Exhaled CO was highly detected over normal values (mean [standard deviation] = 32.6 [9.97] ppm) with predicted carboxyhemoglobin (COHb) of 5.74 (1.56).
CONCLUSIONS Forest fire smoke exposure increased the respiratory and nonrespiratory symptoms among healthy individuals, which showed impairment in lung function, exhaled CO, and predicted COHb. Long term health effects on healthy individuals exposed to forest fire smoke warrant further evaluation.
References
World Bank Group. Indonesia Sustainable Landscape Knowledge Note: 1. The cost of fire, an economic analysis of Indonesia's 2015 fire crisis. Jakarta: The World Bank. 2016. p. 1-9.
Utah Physicians for a Healthy Environment. 2015 report on the health consequences of wood smoke. Utah: Utah Physicians for a Healthy Environment. 2015. p. 1-32.
World Health Organization. Review of evidence on health aspects of air pollution: REVIHAAP project technical report. Copenhagen: World Health Organization, Regional Office for Europe; 2013. p. 1-132.
Jayachandran S. Air quality and early-life mortality: evidence from Indonesia's wildfires. Cambridge: National Bureau of Economic Research Working Paper 14011. 2008. p. 1-50. https://doi.org/10.3386/w14011
Rosales-Rueda M, Triyana M. The persistent effects of early-life exposure to air pollution: evidence from the Indonesian forest fires. J Human Resources. 2018;54(4):1037-80. https://doi.org/10.3368/jhr.54.4.0117.8497R1
Wheeler K, McKelvey W, Thorpe L, Perrin M, Cone J. Asthma diagnosed after 11 September 2001 among rescue and recovery workers: finding from the World Trade Centre Health Registry. Environ Health Perpect 2007;115:1584-90. https://doi.org/10.1289/ehp.10248
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardization of spirometry. Eur Respir J. 2005;26:319-38. https://doi.org/10.1183/09031936.05.00034805
Alsagaff H, Mangunnegoro H. Reference spirometric values of healthy Indonesian Schoolchildren and working adults, using equipment and methods that meet ATS 1987 recommendations, The Indonesian Pneumomobile Project. Surabaya: Airlangga University Press; 1993. Indonesian.
P Crippa S, Castruccio S, Archer-Nicholls S, Lebron GB, Kuwata M, Thota A, et al. Population exposure to hazardous air quality due to 2015 fire in Equatorial Asia. Sci Rep. 2016;6:37074. https://doi.org/10.1038/srep37074
World Health Organization. Global adult tobacco survey: Indonesia report 2011. Jakarta: World Health Organization, Regional Office for South East Asia; 2012. p. 1-162.
Swiston JR, Davidson W, Attridge S, Li GT, Brauer M, van Eeden SF. Wood smoke exposure induces a pulmonary and systemic inflamatory response in firefighers. Eur Respir J. 2008;32(1):129- 38. https://doi.org/10.1183/09031936.00097707
Kunii O, Kanagawa S, Yajima I, Hisamatsu Y, Yamamura S, Amagai T, et al. The 1997 haze disaster in Indonesia: its air quality and health effects. Arch Environ Health. 2002;57(1):16-22. https://doi.org/10.1080/00039890209602912
World Health Organization. Polycyclic aromatic hydrocarbons (PAHs). Chapter 5.9. Copenhagen: World Health Organization, Regional Office for Europe; 2000. p. 1-24.
Adetona O, Hall DB, Naeher LP. Lung function changes in wildland firefighters working at prescribed burns. Inhal Toxicol. 2011;23(13):835-41. https://doi.org/10.3109/08958378.2011.617790
Slattery F, Johnston K, Paquet C, Bennett H, Crockett A. The long-term rate of change in lung function in urban professional firefighters: a systematic review. BMC Pulm Med. 2018;18(1):149. https://doi.org/10.1186/s12890-018-0711-8
Deveci SE, Deveci F, Açik Y, Ozan AT. The measurement of exhaled carbon monoxide in healthy smokers and non-smokers. Respir Med. 2004;98(6):551-6. https://doi.org/10.1016/j.rmed.2003.11.018
Griem P, Rodgers G, Iris Camacho I. Carbonmonoxide. In: National Research Council. Acute exposure guideline levels for selected airborne chemicals. Washington DC: The National Academies Press; 2010. Vol. 8. p. 49-142.
World Health Organization. Air quality guidelines for Europe. 2nd ed. Copenhagen: World Health Organization, Regional Office for Europe; 2000. p. 1-273.
Adetona O, Simpson CD, Onstad G, Naeher LP. Exposure of wildland firefighters to carbon monoxide, fine particles and levoglucosan. Ann Occup Hyg. 2013;57(8);979-91. https://doi.org/10.1289/isee.2013.P-3-04-06
Susanto DA, Nawas A, Samoedro E, Zaini J, Yunus F, Fitriani F, et al. Prevention and management of health impacts from smoke from forest fires. Jakarta: Universitas Indonesia; 2015. p. 4-11. Indonesian.
Copyright (c) 2020 Jamal Zaini, Agus Dwi Susanto, Erlang Samoedro, Vonni Christiana Bionika, Budhi Antariksa
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.