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54 RESPIRATORY HEALTH PREPARE FOR PARTICULAR PROBLEMS BWy Peter Howard. e’re told the average with respiratory health issues during the coming summer months, this article explores the latest health recommendations to emerge as a result of the black summer bushfires. We share the expert opinions of Asthma Australia CEO Michele Goldman and National Asthma Council Asthma and Respiratory Educator Marg Gordon and learn from a pharmacy owner who was there, working on the frontline as the bushfires burned. The summer of statistics The black summer bushfires between July 2019 and March 2020 were unprecedented, with populations in NSW, Queensland, the ACT, Victoria and South Australia severely affected. In addition to the direct impact felt by some communities, the bushfire smoke created a wider public health emergency, with flights, major sport and outdoor events cancelled due to the poor and at times hazardous air quality. At its worst, the smoke in Canberra caused the Air Quality Index to reach more than 25 times the hazardous level. In Sydney, between November and January, the index reached more than 10 times the hazardous level on multiple occasions. Bushfire smoke contains high concentrations of fine particulate matter, which is harmful to human health. However, the harmful effects of smoke are unevenly distributed across the population. People with asthma or other chronic conditions, very young children, pregnant women and the elderly are especially vulnerable to its impacts. A recently published evaluation of the health burden from the increased particulate matter across eastern Australia estimates the bushfire smoke affected 11.3 million Australians, was responsible for 417 excess deaths, more than 1,000 cardiovascular hospitalisations, more than 2,000 respiratory hospitalisations and 1,300 presentations to hospital emergency departments for asthma during the 19 weeks of continuous fires. The scale and duration of smoke exposure was beyond anything on record, and the health impacts are expected to also be unprecedented as they continue to unfold. The wound repair cycle In May 2020, seeking more knowledge about the potential burden, the Australian government made available $5 million for research into the health impacts of bushfires on the nation’s communities. Among the successful applicants person can survive up to four weeks without food, or four days without water, but when it comes to surviving without air, we’re in trouble after two minutes. In the game of staying alive, it seems air is the most valuable resource, yet it’s free. We can manage without air for brief periods, like those who enjoy diving underwater, holding their breath until their lungs scream for oxygen. They’re in full control, confident in the knowledge they can surface and draw a long, deep and satisfying breath when it’s needed. However, those with asthma or other respiratory conditions, despite not being underwater, will at times experience that same, desperate need for oxygen. For them, there’s no control, and drawing in a long, deep and satisfying breath is nothing more than a dream. It’s these people who’ll recall the terrible impact of the smoke from last summer’s catastrophic bushfires and, as the first of those fires started back in late July, they’ll be conscious this year’s fire season has arrived. They’re among the vulnerable, and pharmacies can be a source of support and improved protection. To help pharmacies support those RETAIL PHARMACY • AUG 2020