Fay Johnston

Fay Johnston
University of Tasmania · Menzies Research Institute

BMBS; MAppEpi, FAFPHM, FACRRM, PhD

About

201
Publications
66,408
Reads
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13,082
Citations
Additional affiliations
January 2008 - present
University of Tasmania
Position
  • Senior Research Fellow, Public Health Physician

Publications

Publications (201)
Article
Background Anthropogenic climate change globally increases wildfire risk. Understanding how wildfire threats impact community-wide risk perceptions and response options will critically inform resilience education strategies. Aim To gain an increased understanding of wildfire risk perceptions and self-evacuation intentions among residents in the wil...
Article
OBJECTIVE To evaluate associations of wildfire fine particulate matter (PM2.5) with diabetes across multiple countries and territories. RESEARCH DESIGN AND METHODS We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000–2019. Daily wildfire-spe...
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Background Chronic, low-intensity air pollution exposure has been consistently associated with increased atherosclerosis in adults. However, there was limited research regarding the implications of acute, high-intensity air pollution exposure during childhood. We aimed to determine whether there were any associations between early-life exposure to...
Article
Savanna fires are a major source of greenhouse gas (GHG) and particulate pollution globally. Since mid-2006, an Australian Government carbon offset program has incentivised Northern Territory land managers to undertake early dry-season savanna burning with the aim of reducing late dry-season wildfires and associated GHG emissions. The focus of this...
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AirRater is a free environmental health smartphone app developed and available in Australia that collects individual health data and disseminates environmental hazard information to populations. Following previous evaluations with app users, the aim of this study was to better understand how clinicians, government agency and non-government advocacy...
Article
Background and Objective Chronic, low‐intensity air pollution exposure has been consistently associated with reduced lung function throughout childhood. However, there is limited research regarding the implications of acute, high‐intensity air pollution exposure. We aimed to determine whether there were any associations between early life exposure...
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Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fi...
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Background Evidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels...
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Objectives To estimate the number of deaths and the cost of deaths attributable to wood heater smoke in the Australian Capital Territory. Study design Rapid health impact assessment, based on fine particulate matter (PM 2.5 ) data from three outdoor air pollution monitors and published exposure–response functions for natural cause mortality attrib...
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Climate change presents a major public health concern in Australia, marked by unprecedented wildfires, heatwaves, floods, droughts, and the spread of climate-sensitive infectious diseases. Despite these challenges, Australia's response to the climate crisis has been inadequate and subject to change by politics, public sentiment, and global developm...
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Background: Episodic spikes in air pollution due to landscape fires are increasing, and their potential for longer term health impacts is uncertain. Objective: Our objective is to evaluate associations between exposure in utero and in infancy to severe pollution from a mine fire, background ambient air pollution, and subsequent hospital care. M...
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Anthropogenic climate change is causing a rise in global temperatures, with this trend projected to increase into the future. Rising temperatures result in an increase in the frequency and severity of heatwave events, with an associated increase in poor health outcomes for vulnerable individuals. This places an increasing strain on health care serv...
Article
Landscape fires are increasing in frequency and severity globally. In Australia, extreme bushfires cause a large and increasing health and socioeconomic burden for communities and governments. People with asthma are particularly vulnerable to the effects of landscape fire smoke (LFS) exposure. Here, we present a position statement from the Thoracic...
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Background and objective: Little is known about the association between ambient air pollution and idiopathic pulmonary fibrosis (IPF) in areas with lower levels of exposure. We aimed to investigate the impact of air pollution on lung function and rapid progression of IPF in Australia. Methods: Participants were recruited from the Australian IPF...
Preprint
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BACKGROUND Evidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels...
Article
Full-text available
Background and objective Studies linking early life exposure to air pollution and subsequent impaired lung health have focused on chronic, low-level exposures in urban settings. We aimed to determine whether in utero exposure to an acute, high-intensity air pollution episode impaired lung function 7-years later. Method We conducted a prospective c...
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Background: Due to climate change, landscape fires account for an increasing proportion of air pollution emissions, and their impacts on primary and pharmaceutical care are little understood. Objectives: To evaluate associations between exposure in two early life periods to severe levels of PM2.5 from a mine fire, background PM2.5, and primary a...
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One of the important adverse impacts of climate change on human health is increases in allergic respiratory diseases such as allergic rhinitis and asthma. This impact is via the effects of increases in atmospheric carbon dioxide concentration and air temperature on sources of airborne allergens such as pollen and fungal spores. This review describe...
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Introduction: Healthcare facilities are high-risk settings for coronavirus disease 2019 (COVID-19) transmission. Early in the COVID-19 pandemic, the first large healthcare-associated outbreak within Australia occurred in Tasmania. Several operational research studies were conducted amongst workers from the implicated hospital campus, to learn more...
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Background Climate change is projected to increase environmental health hazard risks through fire-related air pollution and increased airborne pollen levels. To protect vulnerable populations, it is imperative that evidence-based and accessible interventions are available. The environmental health app, AirRater, was developed in 2015 in Australia t...
Article
Background Bushfire smoke is a major ongoing environmental hazard in Australia. In the summer of 2019-2020 smoke from an extreme bushfire event exposed large populations to high concentrations of particulate matter (PM) pollution. In this study we aimed to estimate the effect of bushfire-related PM of less than 2.5 μ m in diameter (PM2.5) on the ri...
Article
Background Air pollution is associated with cardiovascular disease and mortality. Most studies have focussed on urban or traffic-related pollution, and less is known about the impacts from bushfire smoke on cardiovascular autonomic function, although it is associated with increased sudden cardiac death and mortality. We sought to investigate its in...
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The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020 and 2021. It examines five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co...
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Extreme heat and poor air quality arising from landscape fires are an increasing global concern driven by anthropogenic climate change. Previous studies have shown these environmental conditions are associated with negative health outcomes for vulnerable people. Managing and adapting to these conditions in a warming climate can present substantial...
Article
Background & aims: Over the past decades, particulate matter (PM), especially fine PM <2.5 μm in aerodynamic diameter (PM2.5) has been a major research focus. However, the air pollutant is a mixture of gases or vapour-phase compounds, such as carbon monoxide (C), nitrogen oxides (NOx), photochemical oxidants (Ox), and sulfur dioxide (SO2). Little...
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Autoantibodies to multiple targets are found during acute COVID-19. Whether all, or some, persist after 6 months, and their correlation with sustained anti-SARS-CoV-2 immunity, is still controversial. Herein, we measured antibodies to multiple SARS-CoV-2 antigens (Wuhan-Hu-1 nucleoprotein (NP), whole spike (S), spike subunits (S1, S2 and receptor b...
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Colonialism has disrupted Indigenous socioecological systems around the globe, including those supported by intentional landscape burning. Because most disruptions happened centuries ago, our understanding of Indigenous fire management is largely inferential and open to debate. Here, we investigate the ecological consequences of the loss of traditi...
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Savanna fire management is a topic of global debate, with early dry season burning promoted as a large-scale emissions reduction opportunity. To date, discussions have centred on carbon abatement efficacy, biodiversity and cultural benefits and/or risks. Here we use a case study of Darwin, Australia to highlight smoke pollution as another critical...
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Introduction By subsidising access to direct acting antivirals (DAAs) for all people living with hepatitis C (HCV) in 2016, Australia is positioned to eliminate HCV as a public health threat. However, uptake of DAAs has declined over recent years and new initiatives are needed to engage people living with HCV in care. Active follow-up of HCV notifi...
Article
Background While the relationship between outdoor particulate matter (PM) and lower respiratory tract infections in children and adolescents is accepted, we know little about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory tract infections (URTIs). Methods We aimed to review the literature examining the relatio...
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Background Public transport users often accumulate more physical activity than motor vehicle users, but most studies have been conducted in large metropolitan areas with multiple public transport options with limited knowledge of the relationship in regional and rural areas. In a regional city, this pilot study aimed to (1) test the feasibility of...
Article
Background: Little is known about the long-term health impacts of exposures to landscape fire smoke. We aimed to evaluate the association between exposure to coal mine fire-related particulate matter 2.5 lm or less in diameter (PM 2.5) and hospitalisation in the 5 years following the 6-week Hazelwood coal mine fire in Australia in 2014. Methods: W...
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Pollen allergies are responsible for a considerable global public health burden, and understanding exposure is critical to addressing the health impacts. Atmospheric pollen counts are routinely used as a predictor of risk; however, immune responses are triggered by specific proteins known as allergens, which occur both within and on the surface of...
Article
Background Asthma epidemics associated with thunderstorms have had catastrophic impacts on individuals and emergency services. Seasonal allergic rhinitis (SAR) is present in the vast majority of people who develop thunderstorm asthma (TA), but there is little evidence regarding risk factors for TA among the SAR population. Objective We sought to i...
Article
The MJA-Lancet Countdown on health and climate change in Australia was established in 2017, and produced its first national assessment in 2018, its first annual update in 2019, and its second annual update in 2020. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilie...
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Full-text available
Background Smoke from uncontrolled wildfires and deliberately set prescribed burns has the potential to produce substantial population exposure to fine particulate matter (PM2·5). We aimed to estimate historical health costs attributable to smoke-related PM2·5 from all landscape fires combined, and the relative contributions from wildfires and pres...
Article
Background Little is known about the long-term health effects of coalmine fire smoke exposure. The 2014 Hazelwood coalmine fire event in southeast Australia released smoke into surrounding areas for 6 weeks. Objectives We aimed to investigate whether individual-level exposure to coalmine fire-related PM2.5 was associated with a long-term increase...
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Objectives To estimate the annual burden of mortality and the associated health costs attributable to air pollution from wood heaters in Armidale. Design Health impact assessment (excess annual mortality and financial costs) based upon atmospheric PM2.5 measurements. Setting Armidale, a regional Australian city (population, 24 504) with high leve...
Article
Background Climate change is causing an increase in the frequency and severity of heatwave events, with a corresponding negative impact on human health. Health service utilisation during a heatwave is increased, with a greater risk of poor health outcomes identified for specific population groups. In this study, we examined the impact of heatwave e...
Article
Background and objective: The link between respiratory and vascular health is well documented in adult populations. Impaired lung function is consistently associated with thicker arteries and higher incidence of cardiovascular disease. However, there are limited data on this relationship in young children and the studies that exist have focussed o...
Article
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Pollen is a well-established trigger of asthma and allergic rhinitis, yet concentration-response relationships, lagged effects, and interactions with other environmental factors remain poorly understood. Smartphone technology offers an opportunity to address these challenges using large, multi-year datasets that capture individual symptoms and expo...
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During extreme air pollution events, such as bushfires, public health agencies often recommend that vulnerable individuals visit a nearby public building with central air conditioning to reduce their exposure to smoke. However, there is limited evidence that these “cleaner indoor air shelters” reduce exposure or health risks. We quantified the impa...
Article
Objective The aim of this study was to quantify the direct and indirect costs of asthma and allergic rhinitis (AR) for 2018 in Tasmania.Methods We used publicly available data, and Tasmanian-specific values where available, to estimate direct and indirect costs of both diseases. Direct costs included outcomes such as emergency department (ED) prese...
Article
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AirRater is a free smartphone app developed in 2015, supporting individuals to protect their health from environmental hazards. It does this by providing (i) location-specific and near real-time air quality, pollen and temperature information and (ii) personal symptom tracking functionality. This research sought to evaluate user perceptions of AirR...
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In flammable landscapes around the globe, longer fire seasons with larger, more severely burnt areas are causing social and economic impacts that are unsustainable. The Australian 2019–20 fire season is emblematic of this trend, burning over 8 million ha of predominately Eucalyptus forests over a six-month period. We calculated the wildfire-smoke-r...
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Ambient fine particulate matter <2.5 µm (PM2.5) air pollution increases premature mortality globally. Some PM2.5 is natural, but anthropogenic PM2.5 is comparatively avoidable. We determined the impact of long-term exposures to the anthropogenic PM component on mortality in Australia. PM2.5-attributable deaths were calculated for all Australian Sta...
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Waste-to-energy (WtE) processes, or the combustion of refuse-derived fuel (RDF) for energy generation, has the potential to reduce landfill volume while providing a renewable energy source. We aimed to systematically review and summarise current evidence on the potential health effects (benefits and risks) of exposure to WtE/RDF-related combustion...
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• The MJA–Lancet Countdown on health and climate change was established in 2017, and produced its first Australian national assessment in 2018 and its first annual update in 2019. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions...
Article
Background Victoria is a state in south-eastern Australia with a population of 6.6 million people. The 21st of November 2019 was the start of an unprecedented forest fire season during which 1.5 million hectares were burnt in Victoria. The fires were preceded by record fire danger weather in Australia and smoke affected large populations for a long...
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Background: Emergency services working to protect communities from harm during wildfires aim to provide regular public advisories on the hazards from fire and smoke. However, there are few studies evaluating the success of public health communications regarding the management of smoke exposure. We explored the responses to smoke-related health advi...
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Background In the southern hemisphere summer of 2019-2020, Australia experienced its most severe bushfire season on record. Smoke from fires affected 80% of the population, with large exceedances of the Australian National Air Quality Standard for particulate air pollution recorded in all major population centres during this period. We examined if...
Article
Objective To evaluate associations between exposure during early life to mine fire smoke and parent‐reported indicators of respiratory and atopic illness 2–4 years later. Design, setting The Hazelwood coalmine fire exposed a regional Australian community to markedly increased air pollution during February – March 2014. During June 2016 – October 2...
Article
Full-text available
In the southern hemisphere summer of 2019–20, Australia experienced its most severe bushfire season on record. Smoke from fires affected 80% of the population, with large and prolonged exceedances of the Australian National Air Quality Standard for fine particulate matter (PM2.5) recorded in all major population centers. We examined if AirRater, a...
Article
Full-text available
Vegetation fires are an essential component of the Earth system but can also cause substantial economic losses, severe air pollution, human mortality and environmental damage. Contemporary fire regimes are increasingly impacted by human activities and climate change, but, owing to the complex fire–human–climate interactions and incomplete historica...
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Walking to more distant public transport stops is commonly promoted for physical activity gain. We examined the uptake of, and reasons for, this behaviour and its correlates through a cross-sectional survey (n = 944) and independent interview study (n = 22). Quantitative analysis examined correlates of frequency of walking to more distant bus stops...
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BACKGROUND: Exposure to fine particulate matter (PM 2:5) during wildfire seasons has been associated with adverse health outcomes. Previous studies have focused on daily exposure, but PM 2:5 levels in smoke events can vary considerably within 1 d. OBJECTIVES: We aimed to assess the immediate and lagged relationship between sub-daily exposure to P...
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The island state of Tasmania has marked seasonal variations of fine particulate matter (PM2.5) concentrations related to wood heating during winter, planned forest fires during autumn and spring, and bushfires during summer. Biomass smoke causes considerable health harms and associated costs. We estimated the historical health burden from PM2.5 att...
Article
Aims: We investigated the effects of exposure to very low levels of particulate matter <2.5 µm (PM2.5) and nitrogen dioxide (NO2) on coronary calcium score (CCS) in asymptomatic adults who are free of coronary artery disease (CAD). Methods and results: This study included 606 asymptomatic adults (49% men, aged 56±7 years) recruited from communit...