Forest-Fire Intensity and Age-Standardized Heart-Attack Hospitalization Rates in Canada, 2014–2022: An Ecological Observational Time-Series Study.
DOI :
https://doi.org/10.18192/osurj.v5i1.7767Résumé
Wildfires have become more prevalent and intense with climate change. The inhalation of wildfire smoke is known to increase systemic inflammation and oxidative stress, increasing rates of respiratory disease, and potentially some cardiovascular diseases. While some studies link PM2.5 exposure to respiratory and cardiovascular outcomes, the effect on heart-attack hospitalizations, particularly at the national scale in Canada, remains unclear. This ecological observational time-series study used 108 province-year observations between 2014 and 2022 from the CIHI age-standardized heart-attack hospitalization rates database and the National Forestry Database for all 10 Canadian provinces and 3 territories. The outcome variable was age-standardized heart-attack hospitalization rates per 100,000, and the main exposure `was a wildfire exposure index aggregating wildfire intensity metrics into a single variable. We used multiple linear regression with province-fixed effects adjusting for year (α = 0.05). Wildfire exposure was not significantly associated with heart-attack hospitalization rates (B = -0.0017, p=.338). The year showed significant negative association with heart-attack hospitalization rates (B = -5.25 per 100,000 per year, p < 0.001). The model explained a large proportion of the variance in heart-attack hospitalization rates (adjusted R2 = 0.82). At the province-year scale, wildfire intensity does not appear to be a major driver of annual heart-attack hospitalization rates. Variation in heart-attack rates is more driven by provincial differences and secular declines over time. More individual-level studies using high-resolution wildfire-smoke exposure data are required to clarify potential cardiovascular impacts.
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