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/Title (Health Impacts of Wildfires � PLOS Currents Disasters)
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Health Impacts of Wildfires)] TJ ET
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BT 15.000 700.036 Td /F3 9.8 Tf  [(November 2, 2012)] TJ ET
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BT 96.510 700.036 Td /F3 9.8 Tf  [(Research Article)] TJ ET
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BT 26.250 624.294 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 604.340 Td /F1 9.8 Tf  [(Introduction)] TJ ET
BT 26.250 592.435 Td /F1 9.8 Tf  [(Wildfires are common globally. Although there has been considerable work done on the health effects of wildfires in countries )] TJ ET
BT 26.250 580.530 Td /F1 9.8 Tf  [(such as the USA where they occur frequently there has been relatively little work to investigate health effects in the United )] TJ ET
BT 26.250 568.626 Td /F1 9.8 Tf  [(Kingdom. Climate change may increase the risk of increasing wildfire frequency, therefore there is an urgent need to further )] TJ ET
BT 26.250 556.721 Td /F1 9.8 Tf  [(understand the health effects and public awareness of wildfires. This study was designed to review current evidence about the )] TJ ET
BT 26.250 544.816 Td /F1 9.8 Tf  [(health effects of wildfires from the UK standpoint.)] TJ ET
BT 26.250 525.411 Td /F1 9.8 Tf  [(Methods)] TJ ET
BT 26.250 513.507 Td /F1 9.8 Tf  [(A comprehensive literature review of international evidence regarding wildfire related health effects was conducted in January )] TJ ET
BT 26.250 501.602 Td /F1 9.8 Tf  [(2012. Further information was gathered from authors� focus groups.)] TJ ET
BT 26.250 482.197 Td /F1 9.8 Tf  [(Results)] TJ ET
BT 26.250 470.292 Td /F1 9.8 Tf  [(A review of the published evidence shows that human health can be severely affected by wildfires. Certain populations are )] TJ ET
BT 26.250 458.388 Td /F1 9.8 Tf  [(particularly vulnerable. Wood smoke has high levels of particulate matter and toxins. Respiratory morbidity predominates, but )] TJ ET
BT 26.250 446.483 Td /F1 9.8 Tf  [(cardiovascular, ophthalmic and psychiatric problems can also result. In addition severe burns resulting from direct contact with )] TJ ET
BT 26.250 434.578 Td /F1 9.8 Tf  [(the fire require care in special units and carry a risk of multi � organ complications. The wider health implications from spreading )] TJ ET
BT 26.250 422.673 Td /F1 9.8 Tf  [(air, water and land pollution are of concern. Access to affected areas and communication with populations living within them is )] TJ ET
BT 26.250 410.769 Td /F1 9.8 Tf  [(crucial in mitigating risk.)] TJ ET
BT 26.250 391.364 Td /F1 9.8 Tf  [(Conclusion)] TJ ET
BT 26.250 379.459 Td /F1 9.8 Tf  [(This study has identified factors that may reduce public health risk from wildfires. However more research is needed to evaluate )] TJ ET
BT 26.250 367.554 Td /F1 9.8 Tf  [(longer term health effects from wildfires. An understanding of such factors is vital to ensure preparedness within health care )] TJ ET
BT 26.250 355.650 Td /F1 9.8 Tf  [(services for such events.)] TJ ET
BT 26.250 319.047 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 299.093 Td /F1 9.8 Tf  [(Wildfires, in the form of bush fires, vegetation fires, forest fires, heath and grass fires, are prevalent throughout the world. )] TJ ET
BT 26.250 287.188 Td /F1 9.8 Tf  [(Recent high profile events in Chile )] TJ ET
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BT 302.981 287.188 Td /F1 9.8 Tf  [( have reminded the global community of the devastating effects )] TJ ET
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BT 121.032 184.450 Td /F1 9.8 Tf  [(. The health effects of heat waves and heat exposure are well documented, but the health effects of )] TJ ET
BT 26.250 172.545 Td /F1 9.8 Tf  [(wildfires are less widely known. Whilst much work has been done by agencies such as the Forestry Commission, the )] TJ ET
BT 26.250 160.641 Td /F1 9.8 Tf  [(Meteorological Office and the Fire and Rescue Service to investigate how best to predict and limit damage from fires, little )] TJ ET
BT 26.250 148.736 Td /F1 9.8 Tf  [(equivalent work has been done from the perspective of healthcare. Understanding the health impacts of wildfires and ensuring )] TJ ET
BT 26.250 136.831 Td /F1 9.8 Tf  [(that our front line health care services are equipped to deal with them can help to reduce suffering in the aftermath of a wildfire.)] TJ ET
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BT 96.510 700.036 Td /F3 9.8 Tf  [(Research Article)] TJ ET
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BT 31.254 677.023 Td /F1 9.0 Tf  [( Health Protection Agency, )] TJ ET
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BT 145.311 677.023 Td /F1 9.0 Tf  [( Forest Research)] TJ ET
BT 26.250 665.301 Td /F1 9.8 Tf  [(Finlay SE, Moffat A, Gazzard R, Baker D, Murray V. Health Impacts of Wildfires. PLOS Currents Disasters. 2012 Nov 2 . )] TJ ET
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BT 26.250 624.294 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 604.340 Td /F1 9.8 Tf  [(Introduction)] TJ ET
BT 26.250 592.435 Td /F1 9.8 Tf  [(Wildfires are common globally. Although there has been considerable work done on the health effects of wildfires in countries )] TJ ET
BT 26.250 580.530 Td /F1 9.8 Tf  [(such as the USA where they occur frequently there has been relatively little work to investigate health effects in the United )] TJ ET
BT 26.250 568.626 Td /F1 9.8 Tf  [(Kingdom. Climate change may increase the risk of increasing wildfire frequency, therefore there is an urgent need to further )] TJ ET
BT 26.250 556.721 Td /F1 9.8 Tf  [(understand the health effects and public awareness of wildfires. This study was designed to review current evidence about the )] TJ ET
BT 26.250 544.816 Td /F1 9.8 Tf  [(health effects of wildfires from the UK standpoint.)] TJ ET
BT 26.250 525.411 Td /F1 9.8 Tf  [(Methods)] TJ ET
BT 26.250 513.507 Td /F1 9.8 Tf  [(A comprehensive literature review of international evidence regarding wildfire related health effects was conducted in January )] TJ ET
BT 26.250 501.602 Td /F1 9.8 Tf  [(2012. Further information was gathered from authors� focus groups.)] TJ ET
BT 26.250 482.197 Td /F1 9.8 Tf  [(Results)] TJ ET
BT 26.250 470.292 Td /F1 9.8 Tf  [(A review of the published evidence shows that human health can be severely affected by wildfires. Certain populations are )] TJ ET
BT 26.250 458.388 Td /F1 9.8 Tf  [(particularly vulnerable. Wood smoke has high levels of particulate matter and toxins. Respiratory morbidity predominates, but )] TJ ET
BT 26.250 446.483 Td /F1 9.8 Tf  [(cardiovascular, ophthalmic and psychiatric problems can also result. In addition severe burns resulting from direct contact with )] TJ ET
BT 26.250 434.578 Td /F1 9.8 Tf  [(the fire require care in special units and carry a risk of multi � organ complications. The wider health implications from spreading )] TJ ET
BT 26.250 422.673 Td /F1 9.8 Tf  [(air, water and land pollution are of concern. Access to affected areas and communication with populations living within them is )] TJ ET
BT 26.250 410.769 Td /F1 9.8 Tf  [(crucial in mitigating risk.)] TJ ET
BT 26.250 391.364 Td /F1 9.8 Tf  [(Conclusion)] TJ ET
BT 26.250 379.459 Td /F1 9.8 Tf  [(This study has identified factors that may reduce public health risk from wildfires. However more research is needed to evaluate )] TJ ET
BT 26.250 367.554 Td /F1 9.8 Tf  [(longer term health effects from wildfires. An understanding of such factors is vital to ensure preparedness within health care )] TJ ET
BT 26.250 355.650 Td /F1 9.8 Tf  [(services for such events.)] TJ ET
BT 26.250 319.047 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 299.093 Td /F1 9.8 Tf  [(Wildfires, in the form of bush fires, vegetation fires, forest fires, heath and grass fires, are prevalent throughout the world. )] TJ ET
BT 26.250 287.188 Td /F1 9.8 Tf  [(Recent high profile events in Chile )] TJ ET
0.267 0.267 0.267 rg
BT 176.897 288.695 Td /F4 8.7 Tf  [(1)] TJ ET
0.271 0.267 0.267 rg
BT 181.716 287.188 Td /F1 9.8 Tf  [(, Australia )] TJ ET
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BT 232.594 287.188 Td /F1 9.8 Tf  [( and California )] TJ ET
0.267 0.267 0.267 rg
BT 298.162 288.695 Td /F4 8.7 Tf  [(3)] TJ ET
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BT 302.981 287.188 Td /F1 9.8 Tf  [( have reminded the global community of the devastating effects )] TJ ET
BT 26.250 275.283 Td /F1 9.8 Tf  [(uncontrolled fire may cause. The threat is closer to home too; there are on average 70 000 forest fires annually in Europe alone )] TJ ET
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BT 26.250 264.886 Td /F4 8.7 Tf  [(4)] TJ ET
0.271 0.267 0.267 rg
BT 31.069 263.379 Td /F1 9.8 Tf  [(, and whilst these predominantly occur in countries with warmer climates such as Portugal and Greece, wildfires, in the form of )] TJ ET
BT 26.250 251.474 Td /F1 9.8 Tf  [(uncontrolled burning of vegetation \(albeit not full forest fires\), do occur with increasing frequency in the UK )] TJ ET
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BT 486.333 252.981 Td /F4 8.7 Tf  [(5)] TJ ET
0.271 0.267 0.267 rg
BT 491.152 251.474 Td /F1 9.8 Tf  [(. According to the )] TJ ET
BT 26.250 239.569 Td /F1 9.8 Tf  [(Department for Communities and Local Government, Fire Statistics Branch, there were over 58 000 grass and heathland fires in )] TJ ET
BT 26.250 227.664 Td /F1 9.8 Tf  [(Great Britain in 2010/11 )] TJ ET
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BT 131.930 229.172 Td /F4 8.7 Tf  [(6)] TJ ET
0.271 0.267 0.267 rg
BT 136.749 227.664 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 208.260 Td /F1 9.8 Tf  [(The UK Climate Change Risk Assessment \(CCRA\) 2012 has cited wildfires amongst the top seven risks to the natural )] TJ ET
BT 26.250 196.355 Td /F1 9.8 Tf  [(environment in England )] TJ ET
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BT 131.384 197.862 Td /F4 8.7 Tf  [(7)] TJ ET
0.271 0.267 0.267 rg
BT 136.203 196.355 Td /F1 9.8 Tf  [(. With climate change, the risk of wildfires is likely to increase and a 30% to 50% increase in wildfires )] TJ ET
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0.267 0.267 0.267 rg
BT 116.213 185.957 Td /F4 8.7 Tf  [(8)] TJ ET
0.271 0.267 0.267 rg
BT 121.032 184.450 Td /F1 9.8 Tf  [(. The health effects of heat waves and heat exposure are well documented, but the health effects of )] TJ ET
BT 26.250 172.545 Td /F1 9.8 Tf  [(wildfires are less widely known. Whilst much work has been done by agencies such as the Forestry Commission, the )] TJ ET
BT 26.250 160.641 Td /F1 9.8 Tf  [(Meteorological Office and the Fire and Rescue Service to investigate how best to predict and limit damage from fires, little )] TJ ET
BT 26.250 148.736 Td /F1 9.8 Tf  [(equivalent work has been done from the perspective of healthcare. Understanding the health impacts of wildfires and ensuring )] TJ ET
BT 26.250 136.831 Td /F1 9.8 Tf  [(that our front line health care services are equipped to deal with them can help to reduce suffering in the aftermath of a wildfire.)] TJ ET
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Health Impacts of Wildfires)] TJ ET
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BT 91.635 700.036 Td /F3 9.8 Tf  [(�)] TJ ET
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BT 96.510 700.036 Td /F3 9.8 Tf  [(Research Article)] TJ ET
BT 26.250 688.195 Td /F1 9.8 Tf  [(Sarah Elise Finlay)] TJ ET
0.271 0.267 0.267 rg
BT 104.816 692.083 Td /F1 8.7 Tf  [(1)] TJ ET
BT 109.634 688.195 Td /F1 9.8 Tf  [(, )] TJ ET
0.267 0.267 0.267 rg
BT 115.055 688.195 Td /F1 9.8 Tf  [(Andrew Moffat)] TJ ET
0.271 0.267 0.267 rg
BT 177.913 692.083 Td /F1 8.7 Tf  [(2)] TJ ET
BT 182.732 688.195 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 188.153 688.195 Td /F1 9.8 Tf  [(Rob Gazzard)] TJ ET
0.271 0.267 0.267 rg
BT 245.590 688.195 Td /F1 9.8 Tf  [(, )] TJ ET
0.267 0.267 0.267 rg
BT 251.011 688.195 Td /F1 9.8 Tf  [(David Baker)] TJ ET
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BT 304.110 692.083 Td /F1 8.7 Tf  [(1)] TJ ET
BT 308.929 688.195 Td /F1 9.8 Tf  [(, )] TJ ET
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BT 314.350 688.195 Td /F1 9.8 Tf  [(Virginia Murray)] TJ ET
0.271 0.267 0.267 rg
BT 379.899 692.083 Td /F1 8.7 Tf  [(1)] TJ ET
BT 26.250 677.023 Td /F4 9.0 Tf  [(1)] TJ ET
BT 31.254 677.023 Td /F1 9.0 Tf  [( Health Protection Agency, )] TJ ET
BT 140.307 677.023 Td /F4 9.0 Tf  [(2)] TJ ET
BT 145.311 677.023 Td /F1 9.0 Tf  [( Forest Research)] TJ ET
BT 26.250 665.301 Td /F1 9.8 Tf  [(Finlay SE, Moffat A, Gazzard R, Baker D, Murray V. Health Impacts of Wildfires. PLOS Currents Disasters. 2012 Nov 2 . )] TJ ET
BT 546.968 665.301 Td /F1 9.8 Tf  [(Edition )] TJ ET
BT 26.250 653.397 Td /F1 9.8 Tf  [(1. doi: 10.1371/4f959951cce2c.)] TJ ET
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15.000 -113.800 577.500 764.815 re W n
0.271 0.267 0.267 rg
BT 26.250 624.294 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 604.340 Td /F1 9.8 Tf  [(Introduction)] TJ ET
BT 26.250 592.435 Td /F1 9.8 Tf  [(Wildfires are common globally. Although there has been considerable work done on the health effects of wildfires in countries )] TJ ET
BT 26.250 580.530 Td /F1 9.8 Tf  [(such as the USA where they occur frequently there has been relatively little work to investigate health effects in the United )] TJ ET
BT 26.250 568.626 Td /F1 9.8 Tf  [(Kingdom. Climate change may increase the risk of increasing wildfire frequency, therefore there is an urgent need to further )] TJ ET
BT 26.250 556.721 Td /F1 9.8 Tf  [(understand the health effects and public awareness of wildfires. This study was designed to review current evidence about the )] TJ ET
BT 26.250 544.816 Td /F1 9.8 Tf  [(health effects of wildfires from the UK standpoint.)] TJ ET
BT 26.250 525.411 Td /F1 9.8 Tf  [(Methods)] TJ ET
BT 26.250 513.507 Td /F1 9.8 Tf  [(A comprehensive literature review of international evidence regarding wildfire related health effects was conducted in January )] TJ ET
BT 26.250 501.602 Td /F1 9.8 Tf  [(2012. Further information was gathered from authors� focus groups.)] TJ ET
BT 26.250 482.197 Td /F1 9.8 Tf  [(Results)] TJ ET
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BT 26.250 410.769 Td /F1 9.8 Tf  [(crucial in mitigating risk.)] TJ ET
BT 26.250 391.364 Td /F1 9.8 Tf  [(Conclusion)] TJ ET
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BT 26.250 355.650 Td /F1 9.8 Tf  [(services for such events.)] TJ ET
BT 26.250 319.047 Td /F4 12.0 Tf  [(Introduction)] TJ ET
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39.078 428.104 39.522 428.288 39.838 428.604 c
40.154 428.920 40.337 429.364 40.337 429.810 c f
BT 45.750 426.843 Td /F1 9.8 Tf  [(All subjective reports containing no scientific data)] TJ ET
40.337 414.155 m 
40.337 414.602 40.154 415.046 39.838 415.362 c
39.522 415.678 39.078 415.862 38.631 415.862 c
38.185 415.862 37.741 415.678 37.425 415.362 c
37.109 415.046 36.925 414.602 36.925 414.155 c
36.925 413.709 37.109 413.265 37.425 412.949 c
37.741 412.633 38.185 412.449 38.631 412.449 c
39.078 412.449 39.522 412.633 39.838 412.949 c
40.154 413.265 40.337 413.709 40.337 414.155 c f
BT 45.750 411.188 Td /F1 9.8 Tf  [(Reports relating only to geographical and forestry issues around wildfires)] TJ ET
40.337 398.501 m 
40.337 398.947 40.154 399.391 39.838 399.707 c
39.522 400.023 39.078 400.207 38.631 400.207 c
38.185 400.207 37.741 400.023 37.425 399.707 c
37.109 399.391 36.925 398.947 36.925 398.501 c
36.925 398.054 37.109 397.610 37.425 397.294 c
37.741 396.978 38.185 396.794 38.631 396.794 c
39.078 396.794 39.522 396.978 39.838 397.294 c
40.154 397.610 40.337 398.054 40.337 398.501 c f
BT 45.750 395.533 Td /F1 9.8 Tf  [(Literature relating to smoke and fires from sources other than vegetation)] TJ ET
BT 26.250 372.378 Td /F4 9.8 Tf  [(Information Sources)] TJ ET
BT 26.250 352.974 Td /F1 9.8 Tf  [(The following databases were searched)] TJ ET
40.337 336.536 m 
40.337 336.983 40.154 337.427 39.838 337.743 c
39.522 338.059 39.078 338.243 38.631 338.243 c
38.185 338.243 37.741 338.059 37.425 337.743 c
37.109 337.427 36.925 336.983 36.925 336.536 c
36.925 336.090 37.109 335.646 37.425 335.330 c
37.741 335.014 38.185 334.830 38.631 334.830 c
39.078 334.830 39.522 335.014 39.838 335.330 c
40.154 335.646 40.337 336.090 40.337 336.536 c f
BT 45.750 333.569 Td /F1 9.8 Tf  [(Medline)] TJ ET
40.337 320.882 m 
40.337 321.328 40.154 321.772 39.838 322.088 c
39.522 322.404 39.078 322.588 38.631 322.588 c
38.185 322.588 37.741 322.404 37.425 322.088 c
37.109 321.772 36.925 321.328 36.925 320.882 c
36.925 320.435 37.109 319.991 37.425 319.675 c
37.741 319.359 38.185 319.175 38.631 319.175 c
39.078 319.175 39.522 319.359 39.838 319.675 c
40.154 319.991 40.337 320.435 40.337 320.882 c f
BT 45.750 317.914 Td /F1 9.8 Tf  [(Embase)] TJ ET
40.337 305.227 m 
40.337 305.674 40.154 306.118 39.838 306.434 c
39.522 306.749 39.078 306.933 38.631 306.933 c
38.185 306.933 37.741 306.749 37.425 306.434 c
37.109 306.118 36.925 305.674 36.925 305.227 c
36.925 304.780 37.109 304.336 37.425 304.020 c
37.741 303.705 38.185 303.521 38.631 303.521 c
39.078 303.521 39.522 303.705 39.838 304.020 c
40.154 304.336 40.337 304.780 40.337 305.227 c f
BT 45.750 302.259 Td /F1 9.8 Tf  [(Cochrane)] TJ ET
40.337 289.572 m 
40.337 290.019 40.154 290.463 39.838 290.779 c
39.522 291.095 39.078 291.278 38.631 291.278 c
38.185 291.278 37.741 291.095 37.425 290.779 c
37.109 290.463 36.925 290.019 36.925 289.572 c
36.925 289.126 37.109 288.682 37.425 288.366 c
37.741 288.050 38.185 287.866 38.631 287.866 c
39.078 287.866 39.522 288.050 39.838 288.366 c
40.154 288.682 40.337 289.126 40.337 289.572 c f
BT 45.750 286.605 Td /F1 9.8 Tf  [(Google Scholar)] TJ ET
BT 26.250 263.450 Td /F4 9.8 Tf  [(Search)] TJ ET
q
26.250 253.569 555.000 0.000 re W n
Q
0.965 0.965 0.965 rg
26.250 230.161 555.000 23.408 re f
0.267 0.267 0.267 rg
0.267 0.267 0.267 RG
26.250 253.569 m 581.250 253.569 l 580.500 252.819 l 27.000 252.819 l  f
581.250 253.569 m 581.250 230.161 l 580.500 230.161 l 580.500 252.819 l  f
26.250 253.569 m 26.250 230.161 l 27.000 230.161 l 27.000 252.819 l  f
0.271 0.267 0.267 rg
BT 33.000 239.493 Td /F1 9.0 Tf  [(Search items included in various searches were:)] TJ ET
1.000 1.000 1.000 rg
26.250 133.374 555.000 96.788 re f
0.267 0.267 0.267 rg
26.625 229.036 554.250 0.750 re f
26.625 213.155 0.750 16.631 re f
580.125 213.155 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 219.181 Td /F1 9.8 Tf  [(Wildfires)] TJ ET
0.267 0.267 0.267 rg
26.625 213.155 554.250 0.750 re f
26.625 197.274 0.750 16.631 re f
580.125 197.274 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 203.300 Td /F1 9.8 Tf  [(Forest Fires)] TJ ET
0.267 0.267 0.267 rg
26.625 197.274 554.250 0.750 re f
26.625 181.393 0.750 16.631 re f
580.125 181.393 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 187.419 Td /F1 9.8 Tf  [(Bushfire)] TJ ET
0.267 0.267 0.267 rg
26.625 181.393 554.250 0.750 re f
26.625 165.511 0.750 16.631 re f
580.125 165.511 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 171.538 Td /F1 9.8 Tf  [(Grass Fire)] TJ ET
0.267 0.267 0.267 rg
26.625 165.511 554.250 0.750 re f
26.625 149.630 0.750 16.631 re f
580.125 149.630 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 155.656 Td /F1 9.8 Tf  [(Health)] TJ ET
0.267 0.267 0.267 rg
26.625 149.630 554.250 0.750 re f
26.625 133.749 554.250 0.750 re f
26.625 133.749 0.750 16.631 re f
580.125 133.749 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 139.775 Td /F1 9.8 Tf  [(Human)] TJ ET
BT 26.250 78.850 Td /F1 9.8 Tf  [(These were used in varying combinations using OVID as the primary interface. The Cochrane database was searched but )] TJ ET
BT 26.250 66.945 Td /F1 9.8 Tf  [(revealed no further relevant papers. The first 100 hits on google scholar were reviewed by title alone, which revealed some )] TJ ET
BT 26.250 55.041 Td /F1 9.8 Tf  [(useful background literature but no further key papers.)] TJ ET
Q
q
15.000 45.160 577.500 731.840 re W n
0.965 0.965 0.965 rg
26.250 705.373 555.000 71.627 re f
0.267 0.267 0.267 rg
0.267 0.267 0.267 RG
26.250 705.373 m 581.250 705.373 l 581.250 706.123 l 26.250 706.123 l  f
q
35.250 716.623 537.000 60.377 re W n
0.271 0.267 0.267 rg
BT 35.250 767.476 Td /F4 9.8 Tf  [(Fig. 1: Location and size of Wildfires in England FY 2009/10 � 2010/11)] TJ ET
BT 35.250 748.106 Td /F1 9.8 Tf  [(Courtesy of Forestry Commission England.)] TJ ET
BT 35.250 726.870 Td /F1 9.8 Tf  [(Data source: Department for Communities and Local Government \(National Incident Recording System\))] TJ ET
Q
BT 26.250 671.151 Td /F4 12.0 Tf  [(Aim)] TJ ET
BT 26.250 651.197 Td /F1 9.8 Tf  [(The object of this study was to collate and review the evidence regarding human health impacts from global wildfire experience. )] TJ ET
BT 26.250 639.292 Td /F1 9.8 Tf  [(Understanding these impacts, and mitigation measures adopted in other countries, should help to increase awareness amongst )] TJ ET
BT 26.250 627.387 Td /F1 9.8 Tf  [(health professionals and enable the UK to prepare effectively for the increase in wildfires that are likely to occur during this )] TJ ET
BT 26.250 615.483 Td /F1 9.8 Tf  [(century as a result of climate change.)] TJ ET
BT 26.250 578.880 Td /F4 12.0 Tf  [(Methods)] TJ ET
BT 26.250 558.926 Td /F4 9.8 Tf  [(Protocol)] TJ ET
BT 26.250 539.521 Td /F1 9.8 Tf  [(A search strategy was devised to study the available literature across various databases. Literature up to the end of January )] TJ ET
BT 26.250 527.616 Td /F1 9.8 Tf  [(2012 was included.)] TJ ET
BT 26.250 508.212 Td /F4 9.8 Tf  [(Eligibility Criteria)] TJ ET
BT 26.250 488.807 Td /F1 9.8 Tf  [(Inclusion criteria were:)] TJ ET
0.271 0.267 0.267 RG
40.337 472.370 m 
40.337 472.816 40.154 473.260 39.838 473.576 c
39.522 473.892 39.078 474.076 38.631 474.076 c
38.185 474.076 37.741 473.892 37.425 473.576 c
37.109 473.260 36.925 472.816 36.925 472.370 c
36.925 471.923 37.109 471.479 37.425 471.163 c
37.741 470.847 38.185 470.663 38.631 470.663 c
39.078 470.663 39.522 470.847 39.838 471.163 c
40.154 471.479 40.337 471.923 40.337 472.370 c f
BT 45.750 469.402 Td /F1 9.8 Tf  [(All papers relating to wildfires and human health)] TJ ET
BT 26.250 446.247 Td /F1 9.8 Tf  [(Exclusion criteria were:)] TJ ET
40.337 429.810 m 
40.337 430.257 40.154 430.701 39.838 431.017 c
39.522 431.333 39.078 431.516 38.631 431.516 c
38.185 431.516 37.741 431.333 37.425 431.017 c
37.109 430.701 36.925 430.257 36.925 429.810 c
36.925 429.364 37.109 428.920 37.425 428.604 c
37.741 428.288 38.185 428.104 38.631 428.104 c
39.078 428.104 39.522 428.288 39.838 428.604 c
40.154 428.920 40.337 429.364 40.337 429.810 c f
BT 45.750 426.843 Td /F1 9.8 Tf  [(All subjective reports containing no scientific data)] TJ ET
40.337 414.155 m 
40.337 414.602 40.154 415.046 39.838 415.362 c
39.522 415.678 39.078 415.862 38.631 415.862 c
38.185 415.862 37.741 415.678 37.425 415.362 c
37.109 415.046 36.925 414.602 36.925 414.155 c
36.925 413.709 37.109 413.265 37.425 412.949 c
37.741 412.633 38.185 412.449 38.631 412.449 c
39.078 412.449 39.522 412.633 39.838 412.949 c
40.154 413.265 40.337 413.709 40.337 414.155 c f
BT 45.750 411.188 Td /F1 9.8 Tf  [(Reports relating only to geographical and forestry issues around wildfires)] TJ ET
40.337 398.501 m 
40.337 398.947 40.154 399.391 39.838 399.707 c
39.522 400.023 39.078 400.207 38.631 400.207 c
38.185 400.207 37.741 400.023 37.425 399.707 c
37.109 399.391 36.925 398.947 36.925 398.501 c
36.925 398.054 37.109 397.610 37.425 397.294 c
37.741 396.978 38.185 396.794 38.631 396.794 c
39.078 396.794 39.522 396.978 39.838 397.294 c
40.154 397.610 40.337 398.054 40.337 398.501 c f
BT 45.750 395.533 Td /F1 9.8 Tf  [(Literature relating to smoke and fires from sources other than vegetation)] TJ ET
BT 26.250 372.378 Td /F4 9.8 Tf  [(Information Sources)] TJ ET
BT 26.250 352.974 Td /F1 9.8 Tf  [(The following databases were searched)] TJ ET
40.337 336.536 m 
40.337 336.983 40.154 337.427 39.838 337.743 c
39.522 338.059 39.078 338.243 38.631 338.243 c
38.185 338.243 37.741 338.059 37.425 337.743 c
37.109 337.427 36.925 336.983 36.925 336.536 c
36.925 336.090 37.109 335.646 37.425 335.330 c
37.741 335.014 38.185 334.830 38.631 334.830 c
39.078 334.830 39.522 335.014 39.838 335.330 c
40.154 335.646 40.337 336.090 40.337 336.536 c f
BT 45.750 333.569 Td /F1 9.8 Tf  [(Medline)] TJ ET
40.337 320.882 m 
40.337 321.328 40.154 321.772 39.838 322.088 c
39.522 322.404 39.078 322.588 38.631 322.588 c
38.185 322.588 37.741 322.404 37.425 322.088 c
37.109 321.772 36.925 321.328 36.925 320.882 c
36.925 320.435 37.109 319.991 37.425 319.675 c
37.741 319.359 38.185 319.175 38.631 319.175 c
39.078 319.175 39.522 319.359 39.838 319.675 c
40.154 319.991 40.337 320.435 40.337 320.882 c f
BT 45.750 317.914 Td /F1 9.8 Tf  [(Embase)] TJ ET
40.337 305.227 m 
40.337 305.674 40.154 306.118 39.838 306.434 c
39.522 306.749 39.078 306.933 38.631 306.933 c
38.185 306.933 37.741 306.749 37.425 306.434 c
37.109 306.118 36.925 305.674 36.925 305.227 c
36.925 304.780 37.109 304.336 37.425 304.020 c
37.741 303.705 38.185 303.521 38.631 303.521 c
39.078 303.521 39.522 303.705 39.838 304.020 c
40.154 304.336 40.337 304.780 40.337 305.227 c f
BT 45.750 302.259 Td /F1 9.8 Tf  [(Cochrane)] TJ ET
40.337 289.572 m 
40.337 290.019 40.154 290.463 39.838 290.779 c
39.522 291.095 39.078 291.278 38.631 291.278 c
38.185 291.278 37.741 291.095 37.425 290.779 c
37.109 290.463 36.925 290.019 36.925 289.572 c
36.925 289.126 37.109 288.682 37.425 288.366 c
37.741 288.050 38.185 287.866 38.631 287.866 c
39.078 287.866 39.522 288.050 39.838 288.366 c
40.154 288.682 40.337 289.126 40.337 289.572 c f
BT 45.750 286.605 Td /F1 9.8 Tf  [(Google Scholar)] TJ ET
BT 26.250 263.450 Td /F4 9.8 Tf  [(Search)] TJ ET
q
26.250 253.569 555.000 0.000 re W n
Q
0.965 0.965 0.965 rg
26.250 230.161 555.000 23.408 re f
0.267 0.267 0.267 rg
0.267 0.267 0.267 RG
26.250 253.569 m 581.250 253.569 l 580.500 252.819 l 27.000 252.819 l  f
581.250 253.569 m 581.250 230.161 l 580.500 230.161 l 580.500 252.819 l  f
26.250 253.569 m 26.250 230.161 l 27.000 230.161 l 27.000 252.819 l  f
0.271 0.267 0.267 rg
BT 33.000 239.493 Td /F1 9.0 Tf  [(Search items included in various searches were:)] TJ ET
1.000 1.000 1.000 rg
26.250 133.374 555.000 96.788 re f
0.267 0.267 0.267 rg
26.625 229.036 554.250 0.750 re f
26.625 213.155 0.750 16.631 re f
580.125 213.155 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 219.181 Td /F1 9.8 Tf  [(Wildfires)] TJ ET
0.267 0.267 0.267 rg
26.625 213.155 554.250 0.750 re f
26.625 197.274 0.750 16.631 re f
580.125 197.274 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 203.300 Td /F1 9.8 Tf  [(Forest Fires)] TJ ET
0.267 0.267 0.267 rg
26.625 197.274 554.250 0.750 re f
26.625 181.393 0.750 16.631 re f
580.125 181.393 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 187.419 Td /F1 9.8 Tf  [(Bushfire)] TJ ET
0.267 0.267 0.267 rg
26.625 181.393 554.250 0.750 re f
26.625 165.511 0.750 16.631 re f
580.125 165.511 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 171.538 Td /F1 9.8 Tf  [(Grass Fire)] TJ ET
0.267 0.267 0.267 rg
26.625 165.511 554.250 0.750 re f
26.625 149.630 0.750 16.631 re f
580.125 149.630 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 155.656 Td /F1 9.8 Tf  [(Health)] TJ ET
0.267 0.267 0.267 rg
26.625 149.630 554.250 0.750 re f
26.625 133.749 554.250 0.750 re f
26.625 133.749 0.750 16.631 re f
580.125 133.749 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 139.775 Td /F1 9.8 Tf  [(Human)] TJ ET
BT 26.250 78.850 Td /F1 9.8 Tf  [(These were used in varying combinations using OVID as the primary interface. The Cochrane database was searched but )] TJ ET
BT 26.250 66.945 Td /F1 9.8 Tf  [(revealed no further relevant papers. The first 100 hits on google scholar were reviewed by title alone, which revealed some )] TJ ET
BT 26.250 55.041 Td /F1 9.8 Tf  [(useful background literature but no further key papers.)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(2)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
0.39 w 1 J 1 j
Q
endstream
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<< /Type /Page
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>>
endobj
114 0 obj
<<
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stream

0.271 0.267 0.267 rg
0.267 0.267 0.267 RG
q
15.000 40.561 577.500 736.439 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(There is no set definition of a �wildfire� but it is widely understood to mean the uncontrolled burning of vegetation. The search )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(terms were chosen after a collective discussion between experts in the field to select the most appropriate terminology )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(accounting for both technical and colloquial description of the above.)] TJ ET
q
26.250 720.049 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 722.797 Td /F1 9.8 Tf  [(Search � Examples of search using Ovid interface)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 552.237 555.000 160.312 re f
0.267 0.267 0.267 rg
26.625 711.424 54.881 0.750 re f
26.625 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 701.569 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
80.756 711.424 500.119 0.750 re f
80.756 695.543 0.750 16.631 re f
580.125 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 701.569 Td /F1 9.8 Tf  [(\(forest and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 695.543 54.881 0.750 re f
26.625 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 685.688 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
80.756 695.543 500.119 0.750 re f
80.756 679.662 0.750 16.631 re f
580.125 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 685.688 Td /F1 9.8 Tf  [(\(Grass and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 679.662 54.881 0.750 re f
26.625 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 669.807 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
80.756 679.662 500.119 0.750 re f
80.756 663.781 0.750 16.631 re f
580.125 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 669.807 Td /F1 9.8 Tf  [(\(Wild and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 663.781 54.881 0.750 re f
26.625 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 653.926 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
80.756 663.781 500.119 0.750 re f
80.756 647.899 0.750 16.631 re f
580.125 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 653.926 Td /F1 9.8 Tf  [(\(Bush and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 647.899 54.881 0.750 re f
26.625 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.044 Td /F1 9.8 Tf  [(5)] TJ ET
0.267 0.267 0.267 rg
80.756 647.899 500.119 0.750 re f
80.756 632.018 0.750 16.631 re f
580.125 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 638.044 Td /F1 9.8 Tf  [(health.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 632.018 54.881 0.750 re f
26.625 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.163 Td /F1 9.8 Tf  [(6)] TJ ET
0.267 0.267 0.267 rg
80.756 632.018 500.119 0.750 re f
80.756 616.137 0.750 16.631 re f
580.125 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 622.163 Td /F1 9.8 Tf  [(human.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 616.137 54.881 0.750 re f
26.625 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.282 Td /F1 9.8 Tf  [(7)] TJ ET
0.267 0.267 0.267 rg
80.756 616.137 500.119 0.750 re f
80.756 600.256 0.750 16.631 re f
580.125 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 606.282 Td /F1 9.8 Tf  [(1 OR 2 OR 3 OR 4)] TJ ET
0.267 0.267 0.267 rg
26.625 600.256 54.881 0.750 re f
26.625 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 590.401 Td /F1 9.8 Tf  [(8)] TJ ET
0.267 0.267 0.267 rg
80.756 600.256 500.119 0.750 re f
80.756 584.374 0.750 16.631 re f
580.125 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 590.401 Td /F1 9.8 Tf  [(5 AND 6)] TJ ET
0.267 0.267 0.267 rg
26.625 584.374 54.881 0.750 re f
26.625 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 574.519 Td /F1 9.8 Tf  [(9)] TJ ET
0.267 0.267 0.267 rg
80.756 584.374 500.119 0.750 re f
80.756 568.493 0.750 16.631 re f
580.125 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 574.519 Td /F1 9.8 Tf  [(7 AND 8)] TJ ET
0.267 0.267 0.267 rg
26.625 568.493 54.881 0.750 re f
26.625 552.612 54.881 0.750 re f
26.625 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 558.638 Td /F1 9.8 Tf  [(10)] TJ ET
0.267 0.267 0.267 rg
80.756 568.493 500.119 0.750 re f
80.756 552.612 500.119 0.750 re f
80.756 552.612 0.750 16.631 re f
580.125 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 558.638 Td /F1 9.8 Tf  [(limit 9 to \(clinical medicine and original articles\))] TJ ET
BT 26.250 497.713 Td /F1 9.8 Tf  [(Total hits: 424)] TJ ET
BT 26.250 478.308 Td /F1 9.8 Tf  [(\(Hand searched by abstract to include relevant papers only\))] TJ ET
BT 26.250 458.904 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 439.499 Td /F1 9.8 Tf  [(Studies were selected by review of titles and abstracts. If full text was readily available this was also reviewed. The )] TJ ET
BT 26.250 427.594 Td /F1 9.8 Tf  [(bibliographies of each relevant paper were hand searched for further relevant documents.)] TJ ET
BT 26.250 408.189 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 388.785 Td /F1 9.8 Tf  [(A total of 81 useful and relevant papers were identified from the literature searches and bibliography searches. These were )] TJ ET
BT 26.250 376.880 Td /F1 9.8 Tf  [(mainly in English although one Spanish document was identified.)] TJ ET
BT 26.250 357.475 Td /F4 9.8 Tf  [(Risk of bias in individual studies)] TJ ET
BT 26.250 338.070 Td /F1 9.8 Tf  [(There is a risk of selection and observational bias within the papers chosen, but due to the paucity of original research in this )] TJ ET
BT 26.250 326.166 Td /F1 9.8 Tf  [(area, studies were not excluded because of this risk alone.)] TJ ET
BT 26.250 306.761 Td /F4 9.8 Tf  [(Risk of bias across studies)] TJ ET
BT 26.250 287.356 Td /F1 9.8 Tf  [(Publication bias may also be an issue as it is likely that data from high profile wildfires is more likely to reach the public domain )] TJ ET
BT 26.250 275.451 Td /F1 9.8 Tf  [(than that from smaller episodes. Funding bias may also be an issue as the chance of gaining sponsorship to investigate and )] TJ ET
BT 26.250 263.547 Td /F1 9.8 Tf  [(report effects from smaller fires may be difficult.)] TJ ET
BT 26.250 244.142 Td /F1 9.8 Tf  [(Grey literature was reviewed and expert opinions sought. Meetings and telephone conferences were arranged with experts in )] TJ ET
BT 26.250 232.237 Td /F1 9.8 Tf  [(the field, including representatives from the Forestry Commission and Fire Services.)] TJ ET
BT 26.250 195.635 Td /F4 12.0 Tf  [(Results)] TJ ET
BT 26.250 175.680 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 156.276 Td /F1 9.8 Tf  [(A total of 76 relevant papers were identified from the literature searches and bibliography searches. These were mainly in )] TJ ET
BT 26.250 144.371 Td /F1 9.8 Tf  [(English although one Spanish document was identified.)] TJ ET
BT 26.250 124.966 Td /F4 9.8 Tf  [(Study Characteristics)] TJ ET
BT 26.250 105.561 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 86.157 Td /F1 9.8 Tf  [(In light of the high incidence of wildfires, there is surprisingly little literature relating solely to their health effects. Much of the )] TJ ET
BT 26.250 74.252 Td /F1 9.8 Tf  [(literature refers to just a few renowned events, some of which are presented below \(table 1\) whilst examples of recent wildfires )] TJ ET
BT 26.250 62.347 Td /F1 9.8 Tf  [(in England illustrate the fact that although these wildfires may be smaller than those abroad, their potential impact may be )] TJ ET
BT 26.250 50.442 Td /F1 9.8 Tf  [(significant \(table 2\).)] TJ ET
Q
q
15.000 40.561 577.500 736.439 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(There is no set definition of a �wildfire� but it is widely understood to mean the uncontrolled burning of vegetation. The search )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(terms were chosen after a collective discussion between experts in the field to select the most appropriate terminology )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(accounting for both technical and colloquial description of the above.)] TJ ET
q
26.250 720.049 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 722.797 Td /F1 9.8 Tf  [(Search � Examples of search using Ovid interface)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 552.237 555.000 160.312 re f
0.267 0.267 0.267 rg
26.625 711.424 54.881 0.750 re f
26.625 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 701.569 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
80.756 711.424 500.119 0.750 re f
80.756 695.543 0.750 16.631 re f
580.125 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 701.569 Td /F1 9.8 Tf  [(\(forest and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 695.543 54.881 0.750 re f
26.625 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 685.688 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
80.756 695.543 500.119 0.750 re f
80.756 679.662 0.750 16.631 re f
580.125 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 685.688 Td /F1 9.8 Tf  [(\(Grass and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 679.662 54.881 0.750 re f
26.625 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 669.807 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
80.756 679.662 500.119 0.750 re f
80.756 663.781 0.750 16.631 re f
580.125 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 669.807 Td /F1 9.8 Tf  [(\(Wild and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 663.781 54.881 0.750 re f
26.625 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 653.926 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
80.756 663.781 500.119 0.750 re f
80.756 647.899 0.750 16.631 re f
580.125 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 653.926 Td /F1 9.8 Tf  [(\(Bush and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 647.899 54.881 0.750 re f
26.625 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.044 Td /F1 9.8 Tf  [(5)] TJ ET
0.267 0.267 0.267 rg
80.756 647.899 500.119 0.750 re f
80.756 632.018 0.750 16.631 re f
580.125 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 638.044 Td /F1 9.8 Tf  [(health.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 632.018 54.881 0.750 re f
26.625 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.163 Td /F1 9.8 Tf  [(6)] TJ ET
0.267 0.267 0.267 rg
80.756 632.018 500.119 0.750 re f
80.756 616.137 0.750 16.631 re f
580.125 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 622.163 Td /F1 9.8 Tf  [(human.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 616.137 54.881 0.750 re f
26.625 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.282 Td /F1 9.8 Tf  [(7)] TJ ET
0.267 0.267 0.267 rg
80.756 616.137 500.119 0.750 re f
80.756 600.256 0.750 16.631 re f
580.125 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 606.282 Td /F1 9.8 Tf  [(1 OR 2 OR 3 OR 4)] TJ ET
0.267 0.267 0.267 rg
26.625 600.256 54.881 0.750 re f
26.625 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 590.401 Td /F1 9.8 Tf  [(8)] TJ ET
0.267 0.267 0.267 rg
80.756 600.256 500.119 0.750 re f
80.756 584.374 0.750 16.631 re f
580.125 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 590.401 Td /F1 9.8 Tf  [(5 AND 6)] TJ ET
0.267 0.267 0.267 rg
26.625 584.374 54.881 0.750 re f
26.625 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 574.519 Td /F1 9.8 Tf  [(9)] TJ ET
0.267 0.267 0.267 rg
80.756 584.374 500.119 0.750 re f
80.756 568.493 0.750 16.631 re f
580.125 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 574.519 Td /F1 9.8 Tf  [(7 AND 8)] TJ ET
0.267 0.267 0.267 rg
26.625 568.493 54.881 0.750 re f
26.625 552.612 54.881 0.750 re f
26.625 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 558.638 Td /F1 9.8 Tf  [(10)] TJ ET
0.267 0.267 0.267 rg
80.756 568.493 500.119 0.750 re f
80.756 552.612 500.119 0.750 re f
80.756 552.612 0.750 16.631 re f
580.125 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 558.638 Td /F1 9.8 Tf  [(limit 9 to \(clinical medicine and original articles\))] TJ ET
BT 26.250 497.713 Td /F1 9.8 Tf  [(Total hits: 424)] TJ ET
BT 26.250 478.308 Td /F1 9.8 Tf  [(\(Hand searched by abstract to include relevant papers only\))] TJ ET
BT 26.250 458.904 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 439.499 Td /F1 9.8 Tf  [(Studies were selected by review of titles and abstracts. If full text was readily available this was also reviewed. The )] TJ ET
BT 26.250 427.594 Td /F1 9.8 Tf  [(bibliographies of each relevant paper were hand searched for further relevant documents.)] TJ ET
BT 26.250 408.189 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 388.785 Td /F1 9.8 Tf  [(A total of 81 useful and relevant papers were identified from the literature searches and bibliography searches. These were )] TJ ET
BT 26.250 376.880 Td /F1 9.8 Tf  [(mainly in English although one Spanish document was identified.)] TJ ET
BT 26.250 357.475 Td /F4 9.8 Tf  [(Risk of bias in individual studies)] TJ ET
BT 26.250 338.070 Td /F1 9.8 Tf  [(There is a risk of selection and observational bias within the papers chosen, but due to the paucity of original research in this )] TJ ET
BT 26.250 326.166 Td /F1 9.8 Tf  [(area, studies were not excluded because of this risk alone.)] TJ ET
BT 26.250 306.761 Td /F4 9.8 Tf  [(Risk of bias across studies)] TJ ET
BT 26.250 287.356 Td /F1 9.8 Tf  [(Publication bias may also be an issue as it is likely that data from high profile wildfires is more likely to reach the public domain )] TJ ET
BT 26.250 275.451 Td /F1 9.8 Tf  [(than that from smaller episodes. Funding bias may also be an issue as the chance of gaining sponsorship to investigate and )] TJ ET
BT 26.250 263.547 Td /F1 9.8 Tf  [(report effects from smaller fires may be difficult.)] TJ ET
BT 26.250 244.142 Td /F1 9.8 Tf  [(Grey literature was reviewed and expert opinions sought. Meetings and telephone conferences were arranged with experts in )] TJ ET
BT 26.250 232.237 Td /F1 9.8 Tf  [(the field, including representatives from the Forestry Commission and Fire Services.)] TJ ET
BT 26.250 195.635 Td /F4 12.0 Tf  [(Results)] TJ ET
BT 26.250 175.680 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 156.276 Td /F1 9.8 Tf  [(A total of 76 relevant papers were identified from the literature searches and bibliography searches. These were mainly in )] TJ ET
BT 26.250 144.371 Td /F1 9.8 Tf  [(English although one Spanish document was identified.)] TJ ET
BT 26.250 124.966 Td /F4 9.8 Tf  [(Study Characteristics)] TJ ET
BT 26.250 105.561 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 86.157 Td /F1 9.8 Tf  [(In light of the high incidence of wildfires, there is surprisingly little literature relating solely to their health effects. Much of the )] TJ ET
BT 26.250 74.252 Td /F1 9.8 Tf  [(literature refers to just a few renowned events, some of which are presented below \(table 1\) whilst examples of recent wildfires )] TJ ET
BT 26.250 62.347 Td /F1 9.8 Tf  [(in England illustrate the fact that although these wildfires may be smaller than those abroad, their potential impact may be )] TJ ET
BT 26.250 50.442 Td /F1 9.8 Tf  [(significant \(table 2\).)] TJ ET
Q
q
15.000 40.561 577.500 736.439 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(There is no set definition of a �wildfire� but it is widely understood to mean the uncontrolled burning of vegetation. The search )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(terms were chosen after a collective discussion between experts in the field to select the most appropriate terminology )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(accounting for both technical and colloquial description of the above.)] TJ ET
q
26.250 720.049 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 722.797 Td /F1 9.8 Tf  [(Search � Examples of search using Ovid interface)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 552.237 555.000 160.312 re f
0.267 0.267 0.267 rg
26.625 711.424 54.881 0.750 re f
26.625 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 701.569 Td /F1 9.8 Tf  [(1)] TJ ET
0.267 0.267 0.267 rg
80.756 711.424 500.119 0.750 re f
80.756 695.543 0.750 16.631 re f
580.125 695.543 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 701.569 Td /F1 9.8 Tf  [(\(forest and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 695.543 54.881 0.750 re f
26.625 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 685.688 Td /F1 9.8 Tf  [(2)] TJ ET
0.267 0.267 0.267 rg
80.756 695.543 500.119 0.750 re f
80.756 679.662 0.750 16.631 re f
580.125 679.662 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 685.688 Td /F1 9.8 Tf  [(\(Grass and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 679.662 54.881 0.750 re f
26.625 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 669.807 Td /F1 9.8 Tf  [(3)] TJ ET
0.267 0.267 0.267 rg
80.756 679.662 500.119 0.750 re f
80.756 663.781 0.750 16.631 re f
580.125 663.781 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 669.807 Td /F1 9.8 Tf  [(\(Wild and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 663.781 54.881 0.750 re f
26.625 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 653.926 Td /F1 9.8 Tf  [(4)] TJ ET
0.267 0.267 0.267 rg
80.756 663.781 500.119 0.750 re f
80.756 647.899 0.750 16.631 re f
580.125 647.899 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 653.926 Td /F1 9.8 Tf  [(\(Bush and fire\).mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 647.899 54.881 0.750 re f
26.625 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.044 Td /F1 9.8 Tf  [(5)] TJ ET
0.267 0.267 0.267 rg
80.756 647.899 500.119 0.750 re f
80.756 632.018 0.750 16.631 re f
580.125 632.018 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 638.044 Td /F1 9.8 Tf  [(health.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 632.018 54.881 0.750 re f
26.625 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.163 Td /F1 9.8 Tf  [(6)] TJ ET
0.267 0.267 0.267 rg
80.756 632.018 500.119 0.750 re f
80.756 616.137 0.750 16.631 re f
580.125 616.137 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 622.163 Td /F1 9.8 Tf  [(human.mp. [mp=title, abstract, full text, caption text])] TJ ET
0.267 0.267 0.267 rg
26.625 616.137 54.881 0.750 re f
26.625 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.282 Td /F1 9.8 Tf  [(7)] TJ ET
0.267 0.267 0.267 rg
80.756 616.137 500.119 0.750 re f
80.756 600.256 0.750 16.631 re f
580.125 600.256 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 606.282 Td /F1 9.8 Tf  [(1 OR 2 OR 3 OR 4)] TJ ET
0.267 0.267 0.267 rg
26.625 600.256 54.881 0.750 re f
26.625 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 590.401 Td /F1 9.8 Tf  [(8)] TJ ET
0.267 0.267 0.267 rg
80.756 600.256 500.119 0.750 re f
80.756 584.374 0.750 16.631 re f
580.125 584.374 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 590.401 Td /F1 9.8 Tf  [(5 AND 6)] TJ ET
0.267 0.267 0.267 rg
26.625 584.374 54.881 0.750 re f
26.625 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 574.519 Td /F1 9.8 Tf  [(9)] TJ ET
0.267 0.267 0.267 rg
80.756 584.374 500.119 0.750 re f
80.756 568.493 0.750 16.631 re f
580.125 568.493 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 574.519 Td /F1 9.8 Tf  [(7 AND 8)] TJ ET
0.267 0.267 0.267 rg
26.625 568.493 54.881 0.750 re f
26.625 552.612 54.881 0.750 re f
26.625 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 558.638 Td /F1 9.8 Tf  [(10)] TJ ET
0.267 0.267 0.267 rg
80.756 568.493 500.119 0.750 re f
80.756 552.612 500.119 0.750 re f
80.756 552.612 0.750 16.631 re f
580.125 552.612 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 86.006 558.638 Td /F1 9.8 Tf  [(limit 9 to \(clinical medicine and original articles\))] TJ ET
BT 26.250 497.713 Td /F1 9.8 Tf  [(Total hits: 424)] TJ ET
BT 26.250 478.308 Td /F1 9.8 Tf  [(\(Hand searched by abstract to include relevant papers only\))] TJ ET
BT 26.250 458.904 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 439.499 Td /F1 9.8 Tf  [(Studies were selected by review of titles and abstracts. If full text was readily available this was also reviewed. The )] TJ ET
BT 26.250 427.594 Td /F1 9.8 Tf  [(bibliographies of each relevant paper were hand searched for further relevant documents.)] TJ ET
BT 26.250 408.189 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 388.785 Td /F1 9.8 Tf  [(A total of 81 useful and relevant papers were identified from the literature searches and bibliography searches. These were )] TJ ET
BT 26.250 376.880 Td /F1 9.8 Tf  [(mainly in English although one Spanish document was identified.)] TJ ET
BT 26.250 357.475 Td /F4 9.8 Tf  [(Risk of bias in individual studies)] TJ ET
BT 26.250 338.070 Td /F1 9.8 Tf  [(There is a risk of selection and observational bias within the papers chosen, but due to the paucity of original research in this )] TJ ET
BT 26.250 326.166 Td /F1 9.8 Tf  [(area, studies were not excluded because of this risk alone.)] TJ ET
BT 26.250 306.761 Td /F4 9.8 Tf  [(Risk of bias across studies)] TJ ET
BT 26.250 287.356 Td /F1 9.8 Tf  [(Publication bias may also be an issue as it is likely that data from high profile wildfires is more likely to reach the public domain )] TJ ET
BT 26.250 275.451 Td /F1 9.8 Tf  [(than that from smaller episodes. Funding bias may also be an issue as the chance of gaining sponsorship to investigate and )] TJ ET
BT 26.250 263.547 Td /F1 9.8 Tf  [(report effects from smaller fires may be difficult.)] TJ ET
BT 26.250 244.142 Td /F1 9.8 Tf  [(Grey literature was reviewed and expert opinions sought. Meetings and telephone conferences were arranged with experts in )] TJ ET
BT 26.250 232.237 Td /F1 9.8 Tf  [(the field, including representatives from the Forestry Commission and Fire Services.)] TJ ET
BT 26.250 195.635 Td /F4 12.0 Tf  [(Results)] TJ ET
BT 26.250 175.680 Td /F4 9.8 Tf  [(Study Selection)] TJ ET
BT 26.250 156.276 Td /F1 9.8 Tf  [(A total of 76 relevant papers were identified from the literature searches and bibliography searches. These were mainly in )] TJ ET
BT 26.250 144.371 Td /F1 9.8 Tf  [(English although one Spanish document was identified.)] TJ ET
BT 26.250 124.966 Td /F4 9.8 Tf  [(Study Characteristics)] TJ ET
BT 26.250 105.561 Td /F1 9.8 Tf  [(The majority of literature pertaining to this subject was in the form of epidemiological observational studies and case reports.)] TJ ET
BT 26.250 86.157 Td /F1 9.8 Tf  [(In light of the high incidence of wildfires, there is surprisingly little literature relating solely to their health effects. Much of the )] TJ ET
BT 26.250 74.252 Td /F1 9.8 Tf  [(literature refers to just a few renowned events, some of which are presented below \(table 1\) whilst examples of recent wildfires )] TJ ET
BT 26.250 62.347 Td /F1 9.8 Tf  [(in England illustrate the fact that although these wildfires may be smaller than those abroad, their potential impact may be )] TJ ET
BT 26.250 50.442 Td /F1 9.8 Tf  [(significant \(table 2\).)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(3)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
0.39 w 1 J 1 j
Q
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0.271 0.267 0.267 rg
q
15.000 24.741 577.500 752.259 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 1 � Case studies: reports of international wildfire events of note)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 526.835 555.000 228.929 re f
0.965 0.965 0.965 rg
27.000 742.734 83.778 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 84.153 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Location, date)] TJ ET
0.965 0.965 0.965 rg
110.778 742.734 469.722 12.280 re f
0.267 0.267 0.267 rg
110.778 754.639 470.097 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 115.278 745.490 Td /F4 9.8 Tf  [(Details)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 84.528 0.750 re f
26.625 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Sydney, 1994)] TJ ET
0.267 0.267 0.267 rg
110.403 742.359 470.472 0.750 re f
110.403 708.264 0.750 34.844 re f
580.125 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 115.653 732.504 Td /F1 9.8 Tf  [(Over 800 extensive bush fires spread along the coast of New South Wales in summer 1993-1994. Four )] TJ ET
BT 115.653 724.873 Td /F1 9.8 Tf  [(people were killed � two civilians and two fire fighters, and 27 250 people were evacuated. 800 000 )] TJ ET
BT 115.653 714.881 Td /F1 9.8 Tf  [(hectares were burnt. 225 homes and other buildings destroyed and a further 150 were damaged )] TJ ET
0.267 0.267 0.267 rg
BT 532.953 715.330 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 537.771 714.881 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 708.264 84.528 0.750 re f
26.625 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 31.875 698.409 Td /F1 9.8 Tf  [(Indonesia, 1997)] TJ ET
0.267 0.267 0.267 rg
110.403 708.264 470.472 0.750 re f
110.403 678.850 0.750 30.164 re f
580.125 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 115.653 696.049 Td /F1 9.8 Tf  [(Widespread bushfires in Indonesia in 1997 \(over 5 018 000 hectares )] TJ ET
0.267 0.267 0.267 rg
BT 413.720 696.498 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 423.357 696.049 Td /F1 9.8 Tf  [( resulted in a haze of air pollution )] TJ ET
BT 115.653 685.467 Td /F1 9.8 Tf  [(which resulted in severe adverse health effects in Indonesia, Malaysia and Singapore )] TJ ET
0.267 0.267 0.267 rg
BT 486.328 685.916 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 495.965 685.467 Td /F1 9.8 Tf  [( .)] TJ ET
0.267 0.267 0.267 rg
26.625 678.850 84.528 0.750 re f
26.625 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 668.995 Td /F1 9.8 Tf  [(Canada, 2003)] TJ ET
0.267 0.267 0.267 rg
110.403 678.850 470.472 0.750 re f
110.403 637.125 0.750 42.476 re f
580.125 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 666.635 Td /F1 9.8 Tf  [(2500 fires started in British Columbia in 2003 during a period of particularly hot, dry weather )] TJ ET
0.267 0.267 0.267 rg
BT 513.404 667.084 Td /F4 8.7 Tf  [(12)] TJ ET
0.271 0.267 0.267 rg
BT 523.041 666.635 Td /F1 9.8 Tf  [(. Many )] TJ ET
BT 115.653 658.413 Td /F1 9.8 Tf  [(urban areas were affected; 334 homes were destroyed and 45 000 people evacuated. The total cost of )] TJ ET
BT 115.653 650.782 Td /F1 9.8 Tf  [(the fire storm is thought to be around $700 million \(Canadian dollars\). Three deaths were reported � all )] TJ ET
BT 115.653 643.151 Td /F1 9.8 Tf  [(pilots who died when trying to put out the blaze.)] TJ ET
0.267 0.267 0.267 rg
26.625 637.125 84.528 0.750 re f
26.625 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 31.875 627.270 Td /F1 9.8 Tf  [(California, 2007)] TJ ET
0.267 0.267 0.267 rg
110.403 637.125 470.472 0.750 re f
110.403 610.661 0.750 27.213 re f
580.125 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 115.653 627.270 Td /F1 9.8 Tf  [(Wildfires in Southern California in October 2007 burnt over an area of 202 300 hectares, destroying )] TJ ET
BT 115.653 617.278 Td /F1 9.8 Tf  [(around 1 500 homes. Nine people died )] TJ ET
0.267 0.267 0.267 rg
BT 286.375 617.727 Td /F4 8.7 Tf  [(13)] TJ ET
0.271 0.267 0.267 rg
BT 296.012 617.278 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 610.661 84.528 0.750 re f
26.625 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 600.806 Td /F1 9.8 Tf  [(Victoria, )] TJ ET
BT 31.875 593.175 Td /F1 9.8 Tf  [(Australia, 2009)] TJ ET
0.267 0.267 0.267 rg
110.403 610.661 470.472 0.750 re f
110.403 568.936 0.750 42.476 re f
580.125 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 600.806 Td /F1 9.8 Tf  [(Black Saturday, one of Australia�s worst natural disasters occurred on 7 February 2009, when )] TJ ET
BT 115.653 593.175 Td /F1 9.8 Tf  [(temperatures in Melbourne reached 46.4�C \(the hottest on record\). Bushfires which had started earlier in )] TJ ET
BT 115.653 585.544 Td /F1 9.8 Tf  [(the day swept across the region, blown by 100km/h winds. Over 141 600 hectares burned. 173 people )] TJ ET
BT 115.653 575.552 Td /F1 9.8 Tf  [(died, 414 were injured )] TJ ET
0.267 0.267 0.267 rg
BT 214.284 576.001 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 223.921 575.552 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 568.936 84.528 0.750 re f
26.625 527.210 84.528 0.750 re f
26.625 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 559.081 Td /F1 9.8 Tf  [(Russia, 2010)] TJ ET
0.267 0.267 0.267 rg
110.403 568.936 470.472 0.750 re f
110.403 527.210 470.472 0.750 re f
110.403 527.210 0.750 42.476 re f
580.125 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 559.081 Td /F1 9.8 Tf  [(In summer 2010, the western part of the Russian Federation experienced extreme heat and severe )] TJ ET
BT 115.653 551.449 Td /F1 9.8 Tf  [(wildfires. More than 20 000 forest fires over an area of 2800 km2 were recorded, emitting high levels of )] TJ ET
BT 115.653 543.818 Td /F1 9.8 Tf  [(carbon monoxide and particulate matter. Cumulative excess deaths in July and August of 2010 amounted )] TJ ET
BT 115.653 533.826 Td /F1 9.8 Tf  [(to 54 000 compared to the same period in 2009 )] TJ ET
0.267 0.267 0.267 rg
BT 323.230 534.275 Td /F4 8.7 Tf  [(15)] TJ ET
0.271 0.267 0.267 rg
BT 332.867 533.826 Td /F1 9.8 Tf  [(.)] TJ ET
q
26.250 468.099 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 470.846 Td /F1 9.8 Tf  [(Table 2 � Case studies 2: Examples of recent wildfires in England)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 311.060 555.000 149.539 re f
0.965 0.965 0.965 rg
27.000 447.569 83.012 12.280 re f
0.267 0.267 0.267 rg
26.625 459.474 83.387 0.750 re f
26.625 447.194 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 450.325 Td /F4 9.8 Tf  [(Location, date)] TJ ET
0.965 0.965 0.965 rg
110.012 447.569 470.488 12.280 re f
0.267 0.267 0.267 rg
110.012 459.474 470.863 0.750 re f
580.125 447.194 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 114.512 450.325 Td /F4 9.8 Tf  [(Details)] TJ ET
0.267 0.267 0.267 rg
26.625 447.194 83.762 0.750 re f
26.625 394.886 0.750 53.058 re f
0.271 0.267 0.267 rg
BT 31.875 437.339 Td /F1 9.8 Tf  [(Swinley Forest, )] TJ ET
BT 31.875 429.708 Td /F1 9.8 Tf  [(May 2011)] TJ ET
0.267 0.267 0.267 rg
109.637 447.194 471.238 0.750 re f
109.637 394.886 0.750 53.058 re f
580.125 394.886 0.750 53.058 re f
0.271 0.267 0.267 rg
BT 114.887 434.978 Td /F1 9.8 Tf  [(May 2011 saw one of the biggest English wildfires � in Swinley, Berkshire )] TJ ET
0.267 0.267 0.267 rg
BT 434.600 435.427 Td /F4 8.7 Tf  [(16)] TJ ET
0.271 0.267 0.267 rg
BT 444.237 434.978 Td /F1 9.8 Tf  [(. Over 105 hectares of forest )] TJ ET
BT 114.887 424.396 Td /F1 9.8 Tf  [(burnt, fanned by strong winds on a background temperature of 30�C )] TJ ET
0.267 0.267 0.267 rg
BT 411.443 424.845 Td /F4 8.7 Tf  [(17)] TJ ET
0.271 0.267 0.267 rg
BT 421.081 424.396 Td /F1 9.8 Tf  [(. Several local schools were closed )] TJ ET
BT 114.887 416.175 Td /F1 9.8 Tf  [(due to the risk of smoke induced illnesses. The fire spread close to Broadmoor high security hospital, and )] TJ ET
BT 114.887 408.544 Td /F1 9.8 Tf  [(urgent plans for evacuation of patients were made. Several local homes adjacent to the site were )] TJ ET
BT 114.887 400.912 Td /F1 9.8 Tf  [(evacuated.)] TJ ET
0.267 0.267 0.267 rg
26.625 394.886 83.762 0.750 re f
26.625 345.529 0.750 50.107 re f
0.271 0.267 0.267 rg
BT 31.875 385.031 Td /F1 9.8 Tf  [(Pitbright )] TJ ET
BT 31.875 377.400 Td /F1 9.8 Tf  [(Ranges, 2003 )] TJ ET
BT 31.875 369.769 Td /F1 9.8 Tf  [(and 2010)] TJ ET
0.267 0.267 0.267 rg
109.637 394.886 471.238 0.750 re f
109.637 345.529 0.750 50.107 re f
580.125 345.529 0.750 50.107 re f
0.271 0.267 0.267 rg
BT 114.887 382.671 Td /F1 9.8 Tf  [(In 2003 and 2010 over 850 hectares of lowland heath burnt at Pirbright Ranges )] TJ ET
0.267 0.267 0.267 rg
BT 459.043 383.120 Td /F4 8.7 Tf  [(18)] TJ ET
0.271 0.267 0.267 rg
BT 468.680 382.671 Td /F1 9.8 Tf  [(, owned by the Ministry )] TJ ET
BT 114.887 374.449 Td /F1 9.8 Tf  [(of Defence. Again high temperature, low humidity and strong winds created a large fire front, at times 2 )] TJ ET
BT 114.887 366.818 Td /F1 9.8 Tf  [(km wide. Along with road closures and significant local disruption, military housing adjacent to the ranges )] TJ ET
BT 114.887 359.187 Td /F1 9.8 Tf  [(was evacuated and smoke threatened a large housing estate to the west with vegetation ash landing )] TJ ET
BT 114.887 351.555 Td /F1 9.8 Tf  [(several km away in Farnborough and Aldershot.)] TJ ET
0.267 0.267 0.267 rg
26.625 345.529 83.762 0.750 re f
26.625 311.435 83.762 0.750 re f
26.625 311.435 0.750 34.845 re f
0.271 0.267 0.267 rg
BT 31.875 335.674 Td /F1 9.8 Tf  [(Thursley )] TJ ET
BT 31.875 328.043 Td /F1 9.8 Tf  [(Common, 2006)] TJ ET
0.267 0.267 0.267 rg
109.637 345.529 471.238 0.750 re f
109.637 311.435 471.238 0.750 re f
109.637 311.435 0.750 34.845 re f
580.125 311.435 0.750 34.845 re f
0.271 0.267 0.267 rg
BT 114.887 335.674 Td /F1 9.8 Tf  [(Natural England�s National Nature Reserve in Surrey burnt in 2006, the wildfire covering over 160 )] TJ ET
BT 114.887 325.682 Td /F1 9.8 Tf  [(hectares )] TJ ET
0.267 0.267 0.267 rg
BT 154.989 326.131 Td /F4 8.7 Tf  [(19)] TJ ET
0.271 0.267 0.267 rg
BT 164.627 325.682 Td /F1 9.8 Tf  [(. As well as threatening several private properties adjacent to the site and closing several )] TJ ET
BT 114.887 317.461 Td /F1 9.8 Tf  [(roads, three fire fighters suffered burns requiring hospital treatment.)] TJ ET
BT 26.250 256.536 Td /F1 9.8 Tf  [(Results from the searches can be summarised as follows:)] TJ ET
0.271 0.267 0.267 RG
40.337 240.099 m 
40.337 240.545 40.154 240.989 39.838 241.305 c
39.522 241.621 39.078 241.805 38.631 241.805 c
38.185 241.805 37.741 241.621 37.425 241.305 c
37.109 240.989 36.925 240.545 36.925 240.099 c
36.925 239.652 37.109 239.208 37.425 238.892 c
37.741 238.576 38.185 238.392 38.631 238.392 c
39.078 238.392 39.522 238.576 39.838 238.892 c
40.154 239.208 40.337 239.652 40.337 240.099 c f
BT 45.750 237.131 Td /F5 9.8 Tf  [(Health threats and the Source-Pathway-Receptor model.)] TJ ET
BT 290.690 237.131 Td /F1 9.8 Tf  [( This is a model of the means by which wildfires and health )] TJ ET
BT 45.750 225.226 Td /F1 9.8 Tf  [(concerns can be explored further \(see below\).)] TJ ET
40.337 212.539 m 
40.337 212.986 40.154 213.430 39.838 213.746 c
39.522 214.062 39.078 214.245 38.631 214.245 c
38.185 214.245 37.741 214.062 37.425 213.746 c
37.109 213.430 36.925 212.986 36.925 212.539 c
36.925 212.093 37.109 211.649 37.425 211.333 c
37.741 211.017 38.185 210.833 38.631 210.833 c
39.078 210.833 39.522 211.017 39.838 211.333 c
40.154 211.649 40.337 212.093 40.337 212.539 c f
BT 45.750 209.572 Td /F5 9.8 Tf  [(Toxicology of wildfire smoke.)] TJ ET
BT 170.365 209.572 Td /F1 9.8 Tf  [( Some research has been done looking at the toxicology of wildfire smoke. Identifying its toxic )] TJ ET
BT 45.750 197.667 Td /F1 9.8 Tf  [(components could help improve our understanding of adverse health effects caused. Particulate matter from wildfire has )] TJ ET
BT 45.750 185.762 Td /F1 9.8 Tf  [(been shown to differ from other sources of particulate matter, of relevance to our understanding of its toxicology.)] TJ ET
40.337 173.075 m 
40.337 173.522 40.154 173.966 39.838 174.282 c
39.522 174.597 39.078 174.781 38.631 174.781 c
38.185 174.781 37.741 174.597 37.425 174.282 c
37.109 173.966 36.925 173.522 36.925 173.075 c
36.925 172.628 37.109 172.184 37.425 171.868 c
37.741 171.553 38.185 171.369 38.631 171.369 c
39.078 171.369 39.522 171.553 39.838 171.868 c
40.154 172.184 40.337 172.628 40.337 173.075 c f
BT 45.750 170.107 Td /F5 9.8 Tf  [(Health effects. )] TJ ET
BT 110.782 170.107 Td /F1 9.8 Tf  [(Many systems are affected by wildfire smoke, predominantly through the respiratory system. Cardiovascular )] TJ ET
BT 45.750 158.203 Td /F1 9.8 Tf  [(effects and ocular problems can also occur as well as acute burns. Psychological and psychiatric effects can be significant )] TJ ET
BT 45.750 146.298 Td /F1 9.8 Tf  [(in relation to larger fires.)] TJ ET
40.337 133.611 m 
40.337 134.057 40.154 134.501 39.838 134.817 c
39.522 135.133 39.078 135.317 38.631 135.317 c
38.185 135.317 37.741 135.133 37.425 134.817 c
37.109 134.501 36.925 134.057 36.925 133.611 c
36.925 133.164 37.109 132.720 37.425 132.404 c
37.741 132.088 38.185 131.904 38.631 131.904 c
39.078 131.904 39.522 132.088 39.838 132.404 c
40.154 132.720 40.337 133.164 40.337 133.611 c f
BT 45.750 130.643 Td /F5 9.8 Tf  [(Water and land pollution. )] TJ ET
BT 156.305 130.643 Td /F1 9.8 Tf  [(Both water and soil pollution can cause longer term threats to human and ecosystem health after )] TJ ET
BT 45.750 118.738 Td /F1 9.8 Tf  [(a wildfire.)] TJ ET
40.337 106.051 m 
40.337 106.498 40.154 106.942 39.838 107.258 c
39.522 107.574 39.078 107.757 38.631 107.757 c
38.185 107.757 37.741 107.574 37.425 107.258 c
37.109 106.942 36.925 106.498 36.925 106.051 c
36.925 105.605 37.109 105.161 37.425 104.845 c
37.741 104.529 38.185 104.345 38.631 104.345 c
39.078 104.345 39.522 104.529 39.838 104.845 c
40.154 105.161 40.337 105.605 40.337 106.051 c f
BT 45.750 103.084 Td /F5 9.8 Tf  [(Resource and access. )] TJ ET
BT 144.917 103.084 Td /F1 9.8 Tf  [(The effect that a wildfire has on access to healthcare services and vital resources can adversely )] TJ ET
BT 45.750 91.179 Td /F1 9.8 Tf  [(affect health. Serious wildfires could overwhelm local healthcare resources unless a clear plan is in place.)] TJ ET
40.337 78.492 m 
40.337 78.938 40.154 79.382 39.838 79.698 c
39.522 80.014 39.078 80.198 38.631 80.198 c
38.185 80.198 37.741 80.014 37.425 79.698 c
37.109 79.382 36.925 78.938 36.925 78.492 c
36.925 78.045 37.109 77.601 37.425 77.285 c
37.741 76.969 38.185 76.785 38.631 76.785 c
39.078 76.785 39.522 76.969 39.838 77.285 c
40.154 77.601 40.337 78.045 40.337 78.492 c f
BT 45.750 75.524 Td /F5 9.8 Tf  [(Communication. )] TJ ET
BT 118.894 75.524 Td /F1 9.8 Tf  [(The importance of effective communication in mitigating against adverse health effects is emphasised.)] TJ ET
Q
q
15.000 24.741 577.500 752.259 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 1 � Case studies: reports of international wildfire events of note)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 526.835 555.000 228.929 re f
0.965 0.965 0.965 rg
27.000 742.734 83.778 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 84.153 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Location, date)] TJ ET
0.965 0.965 0.965 rg
110.778 742.734 469.722 12.280 re f
0.267 0.267 0.267 rg
110.778 754.639 470.097 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 115.278 745.490 Td /F4 9.8 Tf  [(Details)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 84.528 0.750 re f
26.625 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Sydney, 1994)] TJ ET
0.267 0.267 0.267 rg
110.403 742.359 470.472 0.750 re f
110.403 708.264 0.750 34.844 re f
580.125 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 115.653 732.504 Td /F1 9.8 Tf  [(Over 800 extensive bush fires spread along the coast of New South Wales in summer 1993-1994. Four )] TJ ET
BT 115.653 724.873 Td /F1 9.8 Tf  [(people were killed � two civilians and two fire fighters, and 27 250 people were evacuated. 800 000 )] TJ ET
BT 115.653 714.881 Td /F1 9.8 Tf  [(hectares were burnt. 225 homes and other buildings destroyed and a further 150 were damaged )] TJ ET
0.267 0.267 0.267 rg
BT 532.953 715.330 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 537.771 714.881 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 708.264 84.528 0.750 re f
26.625 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 31.875 698.409 Td /F1 9.8 Tf  [(Indonesia, 1997)] TJ ET
0.267 0.267 0.267 rg
110.403 708.264 470.472 0.750 re f
110.403 678.850 0.750 30.164 re f
580.125 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 115.653 696.049 Td /F1 9.8 Tf  [(Widespread bushfires in Indonesia in 1997 \(over 5 018 000 hectares )] TJ ET
0.267 0.267 0.267 rg
BT 413.720 696.498 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 423.357 696.049 Td /F1 9.8 Tf  [( resulted in a haze of air pollution )] TJ ET
BT 115.653 685.467 Td /F1 9.8 Tf  [(which resulted in severe adverse health effects in Indonesia, Malaysia and Singapore )] TJ ET
0.267 0.267 0.267 rg
BT 486.328 685.916 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 495.965 685.467 Td /F1 9.8 Tf  [( .)] TJ ET
0.267 0.267 0.267 rg
26.625 678.850 84.528 0.750 re f
26.625 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 668.995 Td /F1 9.8 Tf  [(Canada, 2003)] TJ ET
0.267 0.267 0.267 rg
110.403 678.850 470.472 0.750 re f
110.403 637.125 0.750 42.476 re f
580.125 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 666.635 Td /F1 9.8 Tf  [(2500 fires started in British Columbia in 2003 during a period of particularly hot, dry weather )] TJ ET
0.267 0.267 0.267 rg
BT 513.404 667.084 Td /F4 8.7 Tf  [(12)] TJ ET
0.271 0.267 0.267 rg
BT 523.041 666.635 Td /F1 9.8 Tf  [(. Many )] TJ ET
BT 115.653 658.413 Td /F1 9.8 Tf  [(urban areas were affected; 334 homes were destroyed and 45 000 people evacuated. The total cost of )] TJ ET
BT 115.653 650.782 Td /F1 9.8 Tf  [(the fire storm is thought to be around $700 million \(Canadian dollars\). Three deaths were reported � all )] TJ ET
BT 115.653 643.151 Td /F1 9.8 Tf  [(pilots who died when trying to put out the blaze.)] TJ ET
0.267 0.267 0.267 rg
26.625 637.125 84.528 0.750 re f
26.625 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 31.875 627.270 Td /F1 9.8 Tf  [(California, 2007)] TJ ET
0.267 0.267 0.267 rg
110.403 637.125 470.472 0.750 re f
110.403 610.661 0.750 27.213 re f
580.125 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 115.653 627.270 Td /F1 9.8 Tf  [(Wildfires in Southern California in October 2007 burnt over an area of 202 300 hectares, destroying )] TJ ET
BT 115.653 617.278 Td /F1 9.8 Tf  [(around 1 500 homes. Nine people died )] TJ ET
0.267 0.267 0.267 rg
BT 286.375 617.727 Td /F4 8.7 Tf  [(13)] TJ ET
0.271 0.267 0.267 rg
BT 296.012 617.278 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 610.661 84.528 0.750 re f
26.625 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 600.806 Td /F1 9.8 Tf  [(Victoria, )] TJ ET
BT 31.875 593.175 Td /F1 9.8 Tf  [(Australia, 2009)] TJ ET
0.267 0.267 0.267 rg
110.403 610.661 470.472 0.750 re f
110.403 568.936 0.750 42.476 re f
580.125 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 600.806 Td /F1 9.8 Tf  [(Black Saturday, one of Australia�s worst natural disasters occurred on 7 February 2009, when )] TJ ET
BT 115.653 593.175 Td /F1 9.8 Tf  [(temperatures in Melbourne reached 46.4�C \(the hottest on record\). Bushfires which had started earlier in )] TJ ET
BT 115.653 585.544 Td /F1 9.8 Tf  [(the day swept across the region, blown by 100km/h winds. Over 141 600 hectares burned. 173 people )] TJ ET
BT 115.653 575.552 Td /F1 9.8 Tf  [(died, 414 were injured )] TJ ET
0.267 0.267 0.267 rg
BT 214.284 576.001 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 223.921 575.552 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 568.936 84.528 0.750 re f
26.625 527.210 84.528 0.750 re f
26.625 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 559.081 Td /F1 9.8 Tf  [(Russia, 2010)] TJ ET
0.267 0.267 0.267 rg
110.403 568.936 470.472 0.750 re f
110.403 527.210 470.472 0.750 re f
110.403 527.210 0.750 42.476 re f
580.125 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 559.081 Td /F1 9.8 Tf  [(In summer 2010, the western part of the Russian Federation experienced extreme heat and severe )] TJ ET
BT 115.653 551.449 Td /F1 9.8 Tf  [(wildfires. More than 20 000 forest fires over an area of 2800 km2 were recorded, emitting high levels of )] TJ ET
BT 115.653 543.818 Td /F1 9.8 Tf  [(carbon monoxide and particulate matter. Cumulative excess deaths in July and August of 2010 amounted )] TJ ET
BT 115.653 533.826 Td /F1 9.8 Tf  [(to 54 000 compared to the same period in 2009 )] TJ ET
0.267 0.267 0.267 rg
BT 323.230 534.275 Td /F4 8.7 Tf  [(15)] TJ ET
0.271 0.267 0.267 rg
BT 332.867 533.826 Td /F1 9.8 Tf  [(.)] TJ ET
q
26.250 468.099 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 470.846 Td /F1 9.8 Tf  [(Table 2 � Case studies 2: Examples of recent wildfires in England)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 311.060 555.000 149.539 re f
0.965 0.965 0.965 rg
27.000 447.569 83.012 12.280 re f
0.267 0.267 0.267 rg
26.625 459.474 83.387 0.750 re f
26.625 447.194 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 450.325 Td /F4 9.8 Tf  [(Location, date)] TJ ET
0.965 0.965 0.965 rg
110.012 447.569 470.488 12.280 re f
0.267 0.267 0.267 rg
110.012 459.474 470.863 0.750 re f
580.125 447.194 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 114.512 450.325 Td /F4 9.8 Tf  [(Details)] TJ ET
0.267 0.267 0.267 rg
26.625 447.194 83.762 0.750 re f
26.625 394.886 0.750 53.058 re f
0.271 0.267 0.267 rg
BT 31.875 437.339 Td /F1 9.8 Tf  [(Swinley Forest, )] TJ ET
BT 31.875 429.708 Td /F1 9.8 Tf  [(May 2011)] TJ ET
0.267 0.267 0.267 rg
109.637 447.194 471.238 0.750 re f
109.637 394.886 0.750 53.058 re f
580.125 394.886 0.750 53.058 re f
0.271 0.267 0.267 rg
BT 114.887 434.978 Td /F1 9.8 Tf  [(May 2011 saw one of the biggest English wildfires � in Swinley, Berkshire )] TJ ET
0.267 0.267 0.267 rg
BT 434.600 435.427 Td /F4 8.7 Tf  [(16)] TJ ET
0.271 0.267 0.267 rg
BT 444.237 434.978 Td /F1 9.8 Tf  [(. Over 105 hectares of forest )] TJ ET
BT 114.887 424.396 Td /F1 9.8 Tf  [(burnt, fanned by strong winds on a background temperature of 30�C )] TJ ET
0.267 0.267 0.267 rg
BT 411.443 424.845 Td /F4 8.7 Tf  [(17)] TJ ET
0.271 0.267 0.267 rg
BT 421.081 424.396 Td /F1 9.8 Tf  [(. Several local schools were closed )] TJ ET
BT 114.887 416.175 Td /F1 9.8 Tf  [(due to the risk of smoke induced illnesses. The fire spread close to Broadmoor high security hospital, and )] TJ ET
BT 114.887 408.544 Td /F1 9.8 Tf  [(urgent plans for evacuation of patients were made. Several local homes adjacent to the site were )] TJ ET
BT 114.887 400.912 Td /F1 9.8 Tf  [(evacuated.)] TJ ET
0.267 0.267 0.267 rg
26.625 394.886 83.762 0.750 re f
26.625 345.529 0.750 50.107 re f
0.271 0.267 0.267 rg
BT 31.875 385.031 Td /F1 9.8 Tf  [(Pitbright )] TJ ET
BT 31.875 377.400 Td /F1 9.8 Tf  [(Ranges, 2003 )] TJ ET
BT 31.875 369.769 Td /F1 9.8 Tf  [(and 2010)] TJ ET
0.267 0.267 0.267 rg
109.637 394.886 471.238 0.750 re f
109.637 345.529 0.750 50.107 re f
580.125 345.529 0.750 50.107 re f
0.271 0.267 0.267 rg
BT 114.887 382.671 Td /F1 9.8 Tf  [(In 2003 and 2010 over 850 hectares of lowland heath burnt at Pirbright Ranges )] TJ ET
0.267 0.267 0.267 rg
BT 459.043 383.120 Td /F4 8.7 Tf  [(18)] TJ ET
0.271 0.267 0.267 rg
BT 468.680 382.671 Td /F1 9.8 Tf  [(, owned by the Ministry )] TJ ET
BT 114.887 374.449 Td /F1 9.8 Tf  [(of Defence. Again high temperature, low humidity and strong winds created a large fire front, at times 2 )] TJ ET
BT 114.887 366.818 Td /F1 9.8 Tf  [(km wide. Along with road closures and significant local disruption, military housing adjacent to the ranges )] TJ ET
BT 114.887 359.187 Td /F1 9.8 Tf  [(was evacuated and smoke threatened a large housing estate to the west with vegetation ash landing )] TJ ET
BT 114.887 351.555 Td /F1 9.8 Tf  [(several km away in Farnborough and Aldershot.)] TJ ET
0.267 0.267 0.267 rg
26.625 345.529 83.762 0.750 re f
26.625 311.435 83.762 0.750 re f
26.625 311.435 0.750 34.845 re f
0.271 0.267 0.267 rg
BT 31.875 335.674 Td /F1 9.8 Tf  [(Thursley )] TJ ET
BT 31.875 328.043 Td /F1 9.8 Tf  [(Common, 2006)] TJ ET
0.267 0.267 0.267 rg
109.637 345.529 471.238 0.750 re f
109.637 311.435 471.238 0.750 re f
109.637 311.435 0.750 34.845 re f
580.125 311.435 0.750 34.845 re f
0.271 0.267 0.267 rg
BT 114.887 335.674 Td /F1 9.8 Tf  [(Natural England�s National Nature Reserve in Surrey burnt in 2006, the wildfire covering over 160 )] TJ ET
BT 114.887 325.682 Td /F1 9.8 Tf  [(hectares )] TJ ET
0.267 0.267 0.267 rg
BT 154.989 326.131 Td /F4 8.7 Tf  [(19)] TJ ET
0.271 0.267 0.267 rg
BT 164.627 325.682 Td /F1 9.8 Tf  [(. As well as threatening several private properties adjacent to the site and closing several )] TJ ET
BT 114.887 317.461 Td /F1 9.8 Tf  [(roads, three fire fighters suffered burns requiring hospital treatment.)] TJ ET
BT 26.250 256.536 Td /F1 9.8 Tf  [(Results from the searches can be summarised as follows:)] TJ ET
0.271 0.267 0.267 RG
40.337 240.099 m 
40.337 240.545 40.154 240.989 39.838 241.305 c
39.522 241.621 39.078 241.805 38.631 241.805 c
38.185 241.805 37.741 241.621 37.425 241.305 c
37.109 240.989 36.925 240.545 36.925 240.099 c
36.925 239.652 37.109 239.208 37.425 238.892 c
37.741 238.576 38.185 238.392 38.631 238.392 c
39.078 238.392 39.522 238.576 39.838 238.892 c
40.154 239.208 40.337 239.652 40.337 240.099 c f
BT 45.750 237.131 Td /F5 9.8 Tf  [(Health threats and the Source-Pathway-Receptor model.)] TJ ET
BT 290.690 237.131 Td /F1 9.8 Tf  [( This is a model of the means by which wildfires and health )] TJ ET
BT 45.750 225.226 Td /F1 9.8 Tf  [(concerns can be explored further \(see below\).)] TJ ET
40.337 212.539 m 
40.337 212.986 40.154 213.430 39.838 213.746 c
39.522 214.062 39.078 214.245 38.631 214.245 c
38.185 214.245 37.741 214.062 37.425 213.746 c
37.109 213.430 36.925 212.986 36.925 212.539 c
36.925 212.093 37.109 211.649 37.425 211.333 c
37.741 211.017 38.185 210.833 38.631 210.833 c
39.078 210.833 39.522 211.017 39.838 211.333 c
40.154 211.649 40.337 212.093 40.337 212.539 c f
BT 45.750 209.572 Td /F5 9.8 Tf  [(Toxicology of wildfire smoke.)] TJ ET
BT 170.365 209.572 Td /F1 9.8 Tf  [( Some research has been done looking at the toxicology of wildfire smoke. Identifying its toxic )] TJ ET
BT 45.750 197.667 Td /F1 9.8 Tf  [(components could help improve our understanding of adverse health effects caused. Particulate matter from wildfire has )] TJ ET
BT 45.750 185.762 Td /F1 9.8 Tf  [(been shown to differ from other sources of particulate matter, of relevance to our understanding of its toxicology.)] TJ ET
40.337 173.075 m 
40.337 173.522 40.154 173.966 39.838 174.282 c
39.522 174.597 39.078 174.781 38.631 174.781 c
38.185 174.781 37.741 174.597 37.425 174.282 c
37.109 173.966 36.925 173.522 36.925 173.075 c
36.925 172.628 37.109 172.184 37.425 171.868 c
37.741 171.553 38.185 171.369 38.631 171.369 c
39.078 171.369 39.522 171.553 39.838 171.868 c
40.154 172.184 40.337 172.628 40.337 173.075 c f
BT 45.750 170.107 Td /F5 9.8 Tf  [(Health effects. )] TJ ET
BT 110.782 170.107 Td /F1 9.8 Tf  [(Many systems are affected by wildfire smoke, predominantly through the respiratory system. Cardiovascular )] TJ ET
BT 45.750 158.203 Td /F1 9.8 Tf  [(effects and ocular problems can also occur as well as acute burns. Psychological and psychiatric effects can be significant )] TJ ET
BT 45.750 146.298 Td /F1 9.8 Tf  [(in relation to larger fires.)] TJ ET
40.337 133.611 m 
40.337 134.057 40.154 134.501 39.838 134.817 c
39.522 135.133 39.078 135.317 38.631 135.317 c
38.185 135.317 37.741 135.133 37.425 134.817 c
37.109 134.501 36.925 134.057 36.925 133.611 c
36.925 133.164 37.109 132.720 37.425 132.404 c
37.741 132.088 38.185 131.904 38.631 131.904 c
39.078 131.904 39.522 132.088 39.838 132.404 c
40.154 132.720 40.337 133.164 40.337 133.611 c f
BT 45.750 130.643 Td /F5 9.8 Tf  [(Water and land pollution. )] TJ ET
BT 156.305 130.643 Td /F1 9.8 Tf  [(Both water and soil pollution can cause longer term threats to human and ecosystem health after )] TJ ET
BT 45.750 118.738 Td /F1 9.8 Tf  [(a wildfire.)] TJ ET
40.337 106.051 m 
40.337 106.498 40.154 106.942 39.838 107.258 c
39.522 107.574 39.078 107.757 38.631 107.757 c
38.185 107.757 37.741 107.574 37.425 107.258 c
37.109 106.942 36.925 106.498 36.925 106.051 c
36.925 105.605 37.109 105.161 37.425 104.845 c
37.741 104.529 38.185 104.345 38.631 104.345 c
39.078 104.345 39.522 104.529 39.838 104.845 c
40.154 105.161 40.337 105.605 40.337 106.051 c f
BT 45.750 103.084 Td /F5 9.8 Tf  [(Resource and access. )] TJ ET
BT 144.917 103.084 Td /F1 9.8 Tf  [(The effect that a wildfire has on access to healthcare services and vital resources can adversely )] TJ ET
BT 45.750 91.179 Td /F1 9.8 Tf  [(affect health. Serious wildfires could overwhelm local healthcare resources unless a clear plan is in place.)] TJ ET
40.337 78.492 m 
40.337 78.938 40.154 79.382 39.838 79.698 c
39.522 80.014 39.078 80.198 38.631 80.198 c
38.185 80.198 37.741 80.014 37.425 79.698 c
37.109 79.382 36.925 78.938 36.925 78.492 c
36.925 78.045 37.109 77.601 37.425 77.285 c
37.741 76.969 38.185 76.785 38.631 76.785 c
39.078 76.785 39.522 76.969 39.838 77.285 c
40.154 77.601 40.337 78.045 40.337 78.492 c f
BT 45.750 75.524 Td /F5 9.8 Tf  [(Communication. )] TJ ET
BT 118.894 75.524 Td /F1 9.8 Tf  [(The importance of effective communication in mitigating against adverse health effects is emphasised.)] TJ ET
Q
q
15.000 24.741 577.500 752.259 re W n
q
26.250 763.264 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 766.011 Td /F1 9.8 Tf  [(Table 1 � Case studies: reports of international wildfire events of note)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 526.835 555.000 228.929 re f
0.965 0.965 0.965 rg
27.000 742.734 83.778 12.280 re f
0.267 0.267 0.267 rg
26.625 754.639 84.153 0.750 re f
26.625 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 31.500 745.490 Td /F4 9.8 Tf  [(Location, date)] TJ ET
0.965 0.965 0.965 rg
110.778 742.734 469.722 12.280 re f
0.267 0.267 0.267 rg
110.778 754.639 470.097 0.750 re f
580.125 742.359 0.750 13.030 re f
0.271 0.267 0.267 rg
BT 115.278 745.490 Td /F4 9.8 Tf  [(Details)] TJ ET
0.267 0.267 0.267 rg
26.625 742.359 84.528 0.750 re f
26.625 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 31.875 732.504 Td /F1 9.8 Tf  [(Sydney, 1994)] TJ ET
0.267 0.267 0.267 rg
110.403 742.359 470.472 0.750 re f
110.403 708.264 0.750 34.844 re f
580.125 708.264 0.750 34.844 re f
0.271 0.267 0.267 rg
BT 115.653 732.504 Td /F1 9.8 Tf  [(Over 800 extensive bush fires spread along the coast of New South Wales in summer 1993-1994. Four )] TJ ET
BT 115.653 724.873 Td /F1 9.8 Tf  [(people were killed � two civilians and two fire fighters, and 27 250 people were evacuated. 800 000 )] TJ ET
BT 115.653 714.881 Td /F1 9.8 Tf  [(hectares were burnt. 225 homes and other buildings destroyed and a further 150 were damaged )] TJ ET
0.267 0.267 0.267 rg
BT 532.953 715.330 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 537.771 714.881 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 708.264 84.528 0.750 re f
26.625 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 31.875 698.409 Td /F1 9.8 Tf  [(Indonesia, 1997)] TJ ET
0.267 0.267 0.267 rg
110.403 708.264 470.472 0.750 re f
110.403 678.850 0.750 30.164 re f
580.125 678.850 0.750 30.164 re f
0.271 0.267 0.267 rg
BT 115.653 696.049 Td /F1 9.8 Tf  [(Widespread bushfires in Indonesia in 1997 \(over 5 018 000 hectares )] TJ ET
0.267 0.267 0.267 rg
BT 413.720 696.498 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 423.357 696.049 Td /F1 9.8 Tf  [( resulted in a haze of air pollution )] TJ ET
BT 115.653 685.467 Td /F1 9.8 Tf  [(which resulted in severe adverse health effects in Indonesia, Malaysia and Singapore )] TJ ET
0.267 0.267 0.267 rg
BT 486.328 685.916 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 495.965 685.467 Td /F1 9.8 Tf  [( .)] TJ ET
0.267 0.267 0.267 rg
26.625 678.850 84.528 0.750 re f
26.625 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 668.995 Td /F1 9.8 Tf  [(Canada, 2003)] TJ ET
0.267 0.267 0.267 rg
110.403 678.850 470.472 0.750 re f
110.403 637.125 0.750 42.476 re f
580.125 637.125 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 666.635 Td /F1 9.8 Tf  [(2500 fires started in British Columbia in 2003 during a period of particularly hot, dry weather )] TJ ET
0.267 0.267 0.267 rg
BT 513.404 667.084 Td /F4 8.7 Tf  [(12)] TJ ET
0.271 0.267 0.267 rg
BT 523.041 666.635 Td /F1 9.8 Tf  [(. Many )] TJ ET
BT 115.653 658.413 Td /F1 9.8 Tf  [(urban areas were affected; 334 homes were destroyed and 45 000 people evacuated. The total cost of )] TJ ET
BT 115.653 650.782 Td /F1 9.8 Tf  [(the fire storm is thought to be around $700 million \(Canadian dollars\). Three deaths were reported � all )] TJ ET
BT 115.653 643.151 Td /F1 9.8 Tf  [(pilots who died when trying to put out the blaze.)] TJ ET
0.267 0.267 0.267 rg
26.625 637.125 84.528 0.750 re f
26.625 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 31.875 627.270 Td /F1 9.8 Tf  [(California, 2007)] TJ ET
0.267 0.267 0.267 rg
110.403 637.125 470.472 0.750 re f
110.403 610.661 0.750 27.213 re f
580.125 610.661 0.750 27.213 re f
0.271 0.267 0.267 rg
BT 115.653 627.270 Td /F1 9.8 Tf  [(Wildfires in Southern California in October 2007 burnt over an area of 202 300 hectares, destroying )] TJ ET
BT 115.653 617.278 Td /F1 9.8 Tf  [(around 1 500 homes. Nine people died )] TJ ET
0.267 0.267 0.267 rg
BT 286.375 617.727 Td /F4 8.7 Tf  [(13)] TJ ET
0.271 0.267 0.267 rg
BT 296.012 617.278 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 610.661 84.528 0.750 re f
26.625 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 600.806 Td /F1 9.8 Tf  [(Victoria, )] TJ ET
BT 31.875 593.175 Td /F1 9.8 Tf  [(Australia, 2009)] TJ ET
0.267 0.267 0.267 rg
110.403 610.661 470.472 0.750 re f
110.403 568.936 0.750 42.476 re f
580.125 568.936 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 600.806 Td /F1 9.8 Tf  [(Black Saturday, one of Australia�s worst natural disasters occurred on 7 February 2009, when )] TJ ET
BT 115.653 593.175 Td /F1 9.8 Tf  [(temperatures in Melbourne reached 46.4�C \(the hottest on record\). Bushfires which had started earlier in )] TJ ET
BT 115.653 585.544 Td /F1 9.8 Tf  [(the day swept across the region, blown by 100km/h winds. Over 141 600 hectares burned. 173 people )] TJ ET
BT 115.653 575.552 Td /F1 9.8 Tf  [(died, 414 were injured )] TJ ET
0.267 0.267 0.267 rg
BT 214.284 576.001 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 223.921 575.552 Td /F1 9.8 Tf  [(.)] TJ ET
0.267 0.267 0.267 rg
26.625 568.936 84.528 0.750 re f
26.625 527.210 84.528 0.750 re f
26.625 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 31.875 559.081 Td /F1 9.8 Tf  [(Russia, 2010)] TJ ET
0.267 0.267 0.267 rg
110.403 568.936 470.472 0.750 re f
110.403 527.210 470.472 0.750 re f
110.403 527.210 0.750 42.476 re f
580.125 527.210 0.750 42.476 re f
0.271 0.267 0.267 rg
BT 115.653 559.081 Td /F1 9.8 Tf  [(In summer 2010, the western part of the Russian Federation experienced extreme heat and severe )] TJ ET
BT 115.653 551.449 Td /F1 9.8 Tf  [(wildfires. More than 20 000 forest fires over an area of 2800 km2 were recorded, emitting high levels of )] TJ ET
BT 115.653 543.818 Td /F1 9.8 Tf  [(carbon monoxide and particulate matter. Cumulative excess deaths in July and August of 2010 amounted )] TJ ET
BT 115.653 533.826 Td /F1 9.8 Tf  [(to 54 000 compared to the same period in 2009 )] TJ ET
0.267 0.267 0.267 rg
BT 323.230 534.275 Td /F4 8.7 Tf  [(15)] TJ ET
0.271 0.267 0.267 rg
BT 332.867 533.826 Td /F1 9.8 Tf  [(.)] TJ ET
q
26.250 468.099 555.000 13.736 re W n
0.271 0.267 0.267 rg
BT 26.250 470.846 Td /F1 9.8 Tf  [(Table 2 � Case studies 2: Examples of recent wildfires in England)] TJ ET
Q
1.000 1.000 1.000 rg
26.250 311.060 555.000 149.539 re f
0.965 0.965 0.965 rg
27.000 447.569 83.012 12.280 re f
0.267 0.267 0.267 rg
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BT 114.512 450.325 Td /F4 9.8 Tf  [(Details)] TJ ET
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0.271 0.267 0.267 rg
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BT 31.875 429.708 Td /F1 9.8 Tf  [(May 2011)] TJ ET
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580.125 394.886 0.750 53.058 re f
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BT 114.887 424.396 Td /F1 9.8 Tf  [(burnt, fanned by strong winds on a background temperature of 30�C )] TJ ET
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BT 114.887 416.175 Td /F1 9.8 Tf  [(due to the risk of smoke induced illnesses. The fire spread close to Broadmoor high security hospital, and )] TJ ET
BT 114.887 408.544 Td /F1 9.8 Tf  [(urgent plans for evacuation of patients were made. Several local homes adjacent to the site were )] TJ ET
BT 114.887 400.912 Td /F1 9.8 Tf  [(evacuated.)] TJ ET
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580.125 345.529 0.750 50.107 re f
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BT 114.887 351.555 Td /F1 9.8 Tf  [(several km away in Farnborough and Aldershot.)] TJ ET
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26.625 311.435 83.762 0.750 re f
26.625 311.435 0.750 34.845 re f
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39.078 238.392 39.522 238.576 39.838 238.892 c
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38.185 214.245 37.741 214.062 37.425 213.746 c
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39.078 210.833 39.522 211.017 39.838 211.333 c
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40.337 173.075 m 
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39.078 171.369 39.522 171.553 39.838 171.868 c
40.154 172.184 40.337 172.628 40.337 173.075 c f
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BT 45.750 130.643 Td /F5 9.8 Tf  [(Water and land pollution. )] TJ ET
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BT 26.250 699.015 Td /F4 9.8 Tf  [(Source)] TJ ET
BT 26.250 679.610 Td /F1 9.8 Tf  [(Heat and smoke from burning vegetation can cause adverse health effects. The majority of UK wildfires are small and )] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(contained, but as shown in 2010 and 2011 larger, more landscape scale incident can occur. The most significant land use type )] TJ ET
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BT 26.250 643.896 Td /F1 9.8 Tf  [(conditions and topography can all affect fire intensity, and thus the degree and type of health effect )] TJ ET
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39.522 242.735 39.078 242.918 38.631 242.918 c
38.185 242.918 37.741 242.735 37.425 242.419 c
37.109 242.103 36.925 241.659 36.925 241.212 c
36.925 240.766 37.109 240.322 37.425 240.006 c
37.741 239.690 38.185 239.506 38.631 239.506 c
39.078 239.506 39.522 239.690 39.838 240.006 c
40.154 240.322 40.337 240.766 40.337 241.212 c f
BT 45.750 238.245 Td /F1 9.8 Tf  [(Exposure to smoke from burning or smouldering material dispersed through the air;)] TJ ET
40.337 225.557 m 
40.337 226.004 40.154 226.448 39.838 226.764 c
39.522 227.080 39.078 227.264 38.631 227.264 c
38.185 227.264 37.741 227.080 37.425 226.764 c
37.109 226.448 36.925 226.004 36.925 225.557 c
36.925 225.111 37.109 224.667 37.425 224.351 c
37.741 224.035 38.185 223.851 38.631 223.851 c
39.078 223.851 39.522 224.035 39.838 224.351 c
40.154 224.667 40.337 225.111 40.337 225.557 c f
BT 45.750 222.590 Td /F1 9.8 Tf  [(Exposure to Land/soil contaminated by the chemical products of burning vegetation, from soil erosion caused by vegetation )] TJ ET
BT 45.750 210.685 Td /F1 9.8 Tf  [(removal during the fire, or from suspended dust dispersed through the air;)] TJ ET
40.337 197.998 m 
40.337 198.445 40.154 198.889 39.838 199.205 c
39.522 199.520 39.078 199.704 38.631 199.704 c
38.185 199.704 37.741 199.520 37.425 199.205 c
37.109 198.889 36.925 198.445 36.925 197.998 c
36.925 197.551 37.109 197.107 37.425 196.791 c
37.741 196.476 38.185 196.292 38.631 196.292 c
39.078 196.292 39.522 196.476 39.838 196.791 c
40.154 197.107 40.337 197.551 40.337 197.998 c f
BT 45.750 195.030 Td /F1 9.8 Tf  [(Water contamination, caused by particulate matter deposition on water or leachates from the land directly affected by fire.)] TJ ET
BT 26.250 171.876 Td /F4 9.8 Tf  [(Receptor)] TJ ET
BT 26.250 152.471 Td /F1 9.8 Tf  [(The receptors in this study are humans who live in the vicinity of the fires who may experience adverse health effects. The )] TJ ET
BT 26.250 140.566 Td /F1 9.8 Tf  [(vulnerability of the population to potential harm depends on many factors )] TJ ET
0.267 0.267 0.267 rg
BT 342.745 142.073 Td /F4 8.7 Tf  [(23)] TJ ET
0.271 0.267 0.267 rg
BT 352.382 140.566 Td /F1 9.8 Tf  [(, most notably:)] TJ ET
40.337 124.129 m 
40.337 124.576 40.154 125.020 39.838 125.336 c
39.522 125.651 39.078 125.835 38.631 125.835 c
38.185 125.835 37.741 125.651 37.425 125.336 c
37.109 125.020 36.925 124.576 36.925 124.129 c
36.925 123.682 37.109 123.238 37.425 122.922 c
37.741 122.607 38.185 122.423 38.631 122.423 c
39.078 122.423 39.522 122.607 39.838 122.922 c
40.154 123.238 40.337 123.682 40.337 124.129 c f
BT 45.750 121.161 Td /F1 9.8 Tf  [(Prevalence of demographically vulnerable groups such as those at the extremes of age, pregnant women, those of poor )] TJ ET
BT 45.750 109.257 Td /F1 9.8 Tf  [(socio-economic status)] TJ ET
40.337 96.569 m 
40.337 97.016 40.154 97.460 39.838 97.776 c
39.522 98.092 39.078 98.276 38.631 98.276 c
38.185 98.276 37.741 98.092 37.425 97.776 c
37.109 97.460 36.925 97.016 36.925 96.569 c
36.925 96.123 37.109 95.679 37.425 95.363 c
37.741 95.047 38.185 94.863 38.631 94.863 c
39.078 94.863 39.522 95.047 39.838 95.363 c
40.154 95.679 40.337 96.123 40.337 96.569 c f
BT 45.750 93.602 Td /F1 9.8 Tf  [(Prevalence of pre-existing disease in the community \(especially cardiac and respiratory\))] TJ ET
40.337 80.915 m 
40.337 81.361 40.154 81.805 39.838 82.121 c
39.522 82.437 39.078 82.621 38.631 82.621 c
38.185 82.621 37.741 82.437 37.425 82.121 c
37.109 81.805 36.925 81.361 36.925 80.915 c
36.925 80.468 37.109 80.024 37.425 79.708 c
37.741 79.392 38.185 79.208 38.631 79.208 c
39.078 79.208 39.522 79.392 39.838 79.708 c
40.154 80.024 40.337 80.468 40.337 80.915 c f
BT 45.750 77.947 Td /F1 9.8 Tf  [(Access to publically � available information on risk mitigation)] TJ ET
40.337 65.260 m 
40.337 65.707 40.154 66.151 39.838 66.467 c
39.522 66.782 39.078 66.966 38.631 66.966 c
38.185 66.966 37.741 66.782 37.425 66.467 c
37.109 66.151 36.925 65.707 36.925 65.260 c
36.925 64.813 37.109 64.369 37.425 64.053 c
37.741 63.738 38.185 63.554 38.631 63.554 c
39.078 63.554 39.522 63.738 39.838 64.053 c
40.154 64.369 40.337 64.813 40.337 65.260 c f
BT 45.750 62.292 Td /F1 9.8 Tf  [(Emergency Preparedness including the presence of an early warning system)] TJ ET
40.337 49.605 m 
40.337 50.052 40.154 50.496 39.838 50.812 c
39.522 51.128 39.078 51.311 38.631 51.311 c
38.185 51.311 37.741 51.128 37.425 50.812 c
37.109 50.496 36.925 50.052 36.925 49.605 c
36.925 49.159 37.109 48.715 37.425 48.399 c
37.741 48.083 38.185 47.899 38.631 47.899 c
39.078 47.899 39.522 48.083 39.838 48.399 c
40.154 48.715 40.337 49.159 40.337 49.605 c f
BT 45.750 46.638 Td /F1 9.8 Tf  [(Location of dwellings, workplaces and critical infrastructure in relation to the fire, and access/egress from them. )] TJ ET
Q
q
15.000 44.257 577.500 732.743 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Health Threats: source-pathway-receptor model)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(The Source-Pathway-Receptor Exposure Model, used for risk assessing the impact of acute and chronic chemical exposures on )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(health e.g. in flooding and contaminated land studies )] TJ ET
0.267 0.267 0.267 rg
BT 256.594 719.927 Td /F4 8.7 Tf  [(20)] TJ ET
0.271 0.267 0.267 rg
BT 266.231 718.419 Td /F1 9.8 Tf  [( can also be used to examine the potential health effects of wildfires.)] TJ ET
BT 26.250 699.015 Td /F4 9.8 Tf  [(Source)] TJ ET
BT 26.250 679.610 Td /F1 9.8 Tf  [(Heat and smoke from burning vegetation can cause adverse health effects. The majority of UK wildfires are small and )] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(contained, but as shown in 2010 and 2011 larger, more landscape scale incident can occur. The most significant land use type )] TJ ET
BT 26.250 655.800 Td /F1 9.8 Tf  [(of areas burnt were open habitats \(mountain, moor, heath and grasslands\). Types and amount of fuel, past and present weather )] TJ ET
BT 26.250 643.896 Td /F1 9.8 Tf  [(conditions and topography can all affect fire intensity, and thus the degree and type of health effect )] TJ ET
0.267 0.267 0.267 rg
BT 454.421 645.403 Td /F4 8.7 Tf  [(21)] TJ ET
0.271 0.267 0.267 rg
BT 464.059 643.896 Td /F1 9.8 Tf  [(. Even within England, )] TJ ET
BT 26.250 631.991 Td /F1 9.8 Tf  [(sources of fuel for wildfires vary significantly \(Figure 2\).)] TJ ET
0.965 0.965 0.965 rg
26.250 309.733 555.000 312.377 re f
0.267 0.267 0.267 rg
0.267 0.267 0.267 RG
26.250 622.110 m 581.250 622.110 l 581.250 621.360 l 26.250 621.360 l  f
26.250 309.733 m 581.250 309.733 l 581.250 310.483 l 26.250 310.483 l  f
q
159.000 0 0 225.000 35.250 387.360 cm /I4 Do
Q 
q
35.250 320.983 537.000 60.377 re W n
0.271 0.267 0.267 rg
BT 35.250 371.836 Td /F4 9.8 Tf  [(Fig. 2: Land types burnt in wildfires FY2009/10-2010/11)] TJ ET
BT 35.250 352.466 Td /F1 9.8 Tf  [(Courtesy of Forestry Commission England.)] TJ ET
BT 35.250 331.230 Td /F1 9.8 Tf  [(Data source: Department for Communities and Local Government \(National Incident Recording System\) )] TJ ET
0.267 0.267 0.267 rg
BT 486.080 334.202 Td /F4 8.7 Tf  [(22)] TJ ET
Q
0.271 0.267 0.267 rg
BT 26.250 292.709 Td /F4 9.8 Tf  [(Pathway)] TJ ET
BT 26.250 273.304 Td /F1 9.8 Tf  [(Four main exposure pathways exist:)] TJ ET
0.271 0.267 0.267 RG
40.337 256.867 m 
40.337 257.314 40.154 257.758 39.838 258.074 c
39.522 258.389 39.078 258.573 38.631 258.573 c
38.185 258.573 37.741 258.389 37.425 258.074 c
37.109 257.758 36.925 257.314 36.925 256.867 c
36.925 256.420 37.109 255.976 37.425 255.660 c
37.741 255.345 38.185 255.161 38.631 255.161 c
39.078 255.161 39.522 255.345 39.838 255.660 c
40.154 255.976 40.337 256.420 40.337 256.867 c f
BT 45.750 253.899 Td /F1 9.8 Tf  [(Direct exposure to the flames and radiant heat;)] TJ ET
40.337 241.212 m 
40.337 241.659 40.154 242.103 39.838 242.419 c
39.522 242.735 39.078 242.918 38.631 242.918 c
38.185 242.918 37.741 242.735 37.425 242.419 c
37.109 242.103 36.925 241.659 36.925 241.212 c
36.925 240.766 37.109 240.322 37.425 240.006 c
37.741 239.690 38.185 239.506 38.631 239.506 c
39.078 239.506 39.522 239.690 39.838 240.006 c
40.154 240.322 40.337 240.766 40.337 241.212 c f
BT 45.750 238.245 Td /F1 9.8 Tf  [(Exposure to smoke from burning or smouldering material dispersed through the air;)] TJ ET
40.337 225.557 m 
40.337 226.004 40.154 226.448 39.838 226.764 c
39.522 227.080 39.078 227.264 38.631 227.264 c
38.185 227.264 37.741 227.080 37.425 226.764 c
37.109 226.448 36.925 226.004 36.925 225.557 c
36.925 225.111 37.109 224.667 37.425 224.351 c
37.741 224.035 38.185 223.851 38.631 223.851 c
39.078 223.851 39.522 224.035 39.838 224.351 c
40.154 224.667 40.337 225.111 40.337 225.557 c f
BT 45.750 222.590 Td /F1 9.8 Tf  [(Exposure to Land/soil contaminated by the chemical products of burning vegetation, from soil erosion caused by vegetation )] TJ ET
BT 45.750 210.685 Td /F1 9.8 Tf  [(removal during the fire, or from suspended dust dispersed through the air;)] TJ ET
40.337 197.998 m 
40.337 198.445 40.154 198.889 39.838 199.205 c
39.522 199.520 39.078 199.704 38.631 199.704 c
38.185 199.704 37.741 199.520 37.425 199.205 c
37.109 198.889 36.925 198.445 36.925 197.998 c
36.925 197.551 37.109 197.107 37.425 196.791 c
37.741 196.476 38.185 196.292 38.631 196.292 c
39.078 196.292 39.522 196.476 39.838 196.791 c
40.154 197.107 40.337 197.551 40.337 197.998 c f
BT 45.750 195.030 Td /F1 9.8 Tf  [(Water contamination, caused by particulate matter deposition on water or leachates from the land directly affected by fire.)] TJ ET
BT 26.250 171.876 Td /F4 9.8 Tf  [(Receptor)] TJ ET
BT 26.250 152.471 Td /F1 9.8 Tf  [(The receptors in this study are humans who live in the vicinity of the fires who may experience adverse health effects. The )] TJ ET
BT 26.250 140.566 Td /F1 9.8 Tf  [(vulnerability of the population to potential harm depends on many factors )] TJ ET
0.267 0.267 0.267 rg
BT 342.745 142.073 Td /F4 8.7 Tf  [(23)] TJ ET
0.271 0.267 0.267 rg
BT 352.382 140.566 Td /F1 9.8 Tf  [(, most notably:)] TJ ET
40.337 124.129 m 
40.337 124.576 40.154 125.020 39.838 125.336 c
39.522 125.651 39.078 125.835 38.631 125.835 c
38.185 125.835 37.741 125.651 37.425 125.336 c
37.109 125.020 36.925 124.576 36.925 124.129 c
36.925 123.682 37.109 123.238 37.425 122.922 c
37.741 122.607 38.185 122.423 38.631 122.423 c
39.078 122.423 39.522 122.607 39.838 122.922 c
40.154 123.238 40.337 123.682 40.337 124.129 c f
BT 45.750 121.161 Td /F1 9.8 Tf  [(Prevalence of demographically vulnerable groups such as those at the extremes of age, pregnant women, those of poor )] TJ ET
BT 45.750 109.257 Td /F1 9.8 Tf  [(socio-economic status)] TJ ET
40.337 96.569 m 
40.337 97.016 40.154 97.460 39.838 97.776 c
39.522 98.092 39.078 98.276 38.631 98.276 c
38.185 98.276 37.741 98.092 37.425 97.776 c
37.109 97.460 36.925 97.016 36.925 96.569 c
36.925 96.123 37.109 95.679 37.425 95.363 c
37.741 95.047 38.185 94.863 38.631 94.863 c
39.078 94.863 39.522 95.047 39.838 95.363 c
40.154 95.679 40.337 96.123 40.337 96.569 c f
BT 45.750 93.602 Td /F1 9.8 Tf  [(Prevalence of pre-existing disease in the community \(especially cardiac and respiratory\))] TJ ET
40.337 80.915 m 
40.337 81.361 40.154 81.805 39.838 82.121 c
39.522 82.437 39.078 82.621 38.631 82.621 c
38.185 82.621 37.741 82.437 37.425 82.121 c
37.109 81.805 36.925 81.361 36.925 80.915 c
36.925 80.468 37.109 80.024 37.425 79.708 c
37.741 79.392 38.185 79.208 38.631 79.208 c
39.078 79.208 39.522 79.392 39.838 79.708 c
40.154 80.024 40.337 80.468 40.337 80.915 c f
BT 45.750 77.947 Td /F1 9.8 Tf  [(Access to publically � available information on risk mitigation)] TJ ET
40.337 65.260 m 
40.337 65.707 40.154 66.151 39.838 66.467 c
39.522 66.782 39.078 66.966 38.631 66.966 c
38.185 66.966 37.741 66.782 37.425 66.467 c
37.109 66.151 36.925 65.707 36.925 65.260 c
36.925 64.813 37.109 64.369 37.425 64.053 c
37.741 63.738 38.185 63.554 38.631 63.554 c
39.078 63.554 39.522 63.738 39.838 64.053 c
40.154 64.369 40.337 64.813 40.337 65.260 c f
BT 45.750 62.292 Td /F1 9.8 Tf  [(Emergency Preparedness including the presence of an early warning system)] TJ ET
40.337 49.605 m 
40.337 50.052 40.154 50.496 39.838 50.812 c
39.522 51.128 39.078 51.311 38.631 51.311 c
38.185 51.311 37.741 51.128 37.425 50.812 c
37.109 50.496 36.925 50.052 36.925 49.605 c
36.925 49.159 37.109 48.715 37.425 48.399 c
37.741 48.083 38.185 47.899 38.631 47.899 c
39.078 47.899 39.522 48.083 39.838 48.399 c
40.154 48.715 40.337 49.159 40.337 49.605 c f
BT 45.750 46.638 Td /F1 9.8 Tf  [(Location of dwellings, workplaces and critical infrastructure in relation to the fire, and access/egress from them. )] TJ ET
Q
q
15.000 44.257 577.500 732.743 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Health Threats: source-pathway-receptor model)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(The Source-Pathway-Receptor Exposure Model, used for risk assessing the impact of acute and chronic chemical exposures on )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(health e.g. in flooding and contaminated land studies )] TJ ET
0.267 0.267 0.267 rg
BT 256.594 719.927 Td /F4 8.7 Tf  [(20)] TJ ET
0.271 0.267 0.267 rg
BT 266.231 718.419 Td /F1 9.8 Tf  [( can also be used to examine the potential health effects of wildfires.)] TJ ET
BT 26.250 699.015 Td /F4 9.8 Tf  [(Source)] TJ ET
BT 26.250 679.610 Td /F1 9.8 Tf  [(Heat and smoke from burning vegetation can cause adverse health effects. The majority of UK wildfires are small and )] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(contained, but as shown in 2010 and 2011 larger, more landscape scale incident can occur. The most significant land use type )] TJ ET
BT 26.250 655.800 Td /F1 9.8 Tf  [(of areas burnt were open habitats \(mountain, moor, heath and grasslands\). Types and amount of fuel, past and present weather )] TJ ET
BT 26.250 643.896 Td /F1 9.8 Tf  [(conditions and topography can all affect fire intensity, and thus the degree and type of health effect )] TJ ET
0.267 0.267 0.267 rg
BT 454.421 645.403 Td /F4 8.7 Tf  [(21)] TJ ET
0.271 0.267 0.267 rg
BT 464.059 643.896 Td /F1 9.8 Tf  [(. Even within England, )] TJ ET
BT 26.250 631.991 Td /F1 9.8 Tf  [(sources of fuel for wildfires vary significantly \(Figure 2\).)] TJ ET
0.965 0.965 0.965 rg
26.250 309.733 555.000 312.377 re f
0.267 0.267 0.267 rg
0.267 0.267 0.267 RG
26.250 622.110 m 581.250 622.110 l 581.250 621.360 l 26.250 621.360 l  f
26.250 309.733 m 581.250 309.733 l 581.250 310.483 l 26.250 310.483 l  f
q
159.000 0 0 225.000 35.250 387.360 cm /I4 Do
Q 
q
35.250 320.983 537.000 60.377 re W n
0.271 0.267 0.267 rg
BT 35.250 371.836 Td /F4 9.8 Tf  [(Fig. 2: Land types burnt in wildfires FY2009/10-2010/11)] TJ ET
BT 35.250 352.466 Td /F1 9.8 Tf  [(Courtesy of Forestry Commission England.)] TJ ET
BT 35.250 331.230 Td /F1 9.8 Tf  [(Data source: Department for Communities and Local Government \(National Incident Recording System\) )] TJ ET
0.267 0.267 0.267 rg
BT 486.080 334.202 Td /F4 8.7 Tf  [(22)] TJ ET
Q
0.271 0.267 0.267 rg
BT 26.250 292.709 Td /F4 9.8 Tf  [(Pathway)] TJ ET
BT 26.250 273.304 Td /F1 9.8 Tf  [(Four main exposure pathways exist:)] TJ ET
0.271 0.267 0.267 RG
40.337 256.867 m 
40.337 257.314 40.154 257.758 39.838 258.074 c
39.522 258.389 39.078 258.573 38.631 258.573 c
38.185 258.573 37.741 258.389 37.425 258.074 c
37.109 257.758 36.925 257.314 36.925 256.867 c
36.925 256.420 37.109 255.976 37.425 255.660 c
37.741 255.345 38.185 255.161 38.631 255.161 c
39.078 255.161 39.522 255.345 39.838 255.660 c
40.154 255.976 40.337 256.420 40.337 256.867 c f
BT 45.750 253.899 Td /F1 9.8 Tf  [(Direct exposure to the flames and radiant heat;)] TJ ET
40.337 241.212 m 
40.337 241.659 40.154 242.103 39.838 242.419 c
39.522 242.735 39.078 242.918 38.631 242.918 c
38.185 242.918 37.741 242.735 37.425 242.419 c
37.109 242.103 36.925 241.659 36.925 241.212 c
36.925 240.766 37.109 240.322 37.425 240.006 c
37.741 239.690 38.185 239.506 38.631 239.506 c
39.078 239.506 39.522 239.690 39.838 240.006 c
40.154 240.322 40.337 240.766 40.337 241.212 c f
BT 45.750 238.245 Td /F1 9.8 Tf  [(Exposure to smoke from burning or smouldering material dispersed through the air;)] TJ ET
40.337 225.557 m 
40.337 226.004 40.154 226.448 39.838 226.764 c
39.522 227.080 39.078 227.264 38.631 227.264 c
38.185 227.264 37.741 227.080 37.425 226.764 c
37.109 226.448 36.925 226.004 36.925 225.557 c
36.925 225.111 37.109 224.667 37.425 224.351 c
37.741 224.035 38.185 223.851 38.631 223.851 c
39.078 223.851 39.522 224.035 39.838 224.351 c
40.154 224.667 40.337 225.111 40.337 225.557 c f
BT 45.750 222.590 Td /F1 9.8 Tf  [(Exposure to Land/soil contaminated by the chemical products of burning vegetation, from soil erosion caused by vegetation )] TJ ET
BT 45.750 210.685 Td /F1 9.8 Tf  [(removal during the fire, or from suspended dust dispersed through the air;)] TJ ET
40.337 197.998 m 
40.337 198.445 40.154 198.889 39.838 199.205 c
39.522 199.520 39.078 199.704 38.631 199.704 c
38.185 199.704 37.741 199.520 37.425 199.205 c
37.109 198.889 36.925 198.445 36.925 197.998 c
36.925 197.551 37.109 197.107 37.425 196.791 c
37.741 196.476 38.185 196.292 38.631 196.292 c
39.078 196.292 39.522 196.476 39.838 196.791 c
40.154 197.107 40.337 197.551 40.337 197.998 c f
BT 45.750 195.030 Td /F1 9.8 Tf  [(Water contamination, caused by particulate matter deposition on water or leachates from the land directly affected by fire.)] TJ ET
BT 26.250 171.876 Td /F4 9.8 Tf  [(Receptor)] TJ ET
BT 26.250 152.471 Td /F1 9.8 Tf  [(The receptors in this study are humans who live in the vicinity of the fires who may experience adverse health effects. The )] TJ ET
BT 26.250 140.566 Td /F1 9.8 Tf  [(vulnerability of the population to potential harm depends on many factors )] TJ ET
0.267 0.267 0.267 rg
BT 342.745 142.073 Td /F4 8.7 Tf  [(23)] TJ ET
0.271 0.267 0.267 rg
BT 352.382 140.566 Td /F1 9.8 Tf  [(, most notably:)] TJ ET
40.337 124.129 m 
40.337 124.576 40.154 125.020 39.838 125.336 c
39.522 125.651 39.078 125.835 38.631 125.835 c
38.185 125.835 37.741 125.651 37.425 125.336 c
37.109 125.020 36.925 124.576 36.925 124.129 c
36.925 123.682 37.109 123.238 37.425 122.922 c
37.741 122.607 38.185 122.423 38.631 122.423 c
39.078 122.423 39.522 122.607 39.838 122.922 c
40.154 123.238 40.337 123.682 40.337 124.129 c f
BT 45.750 121.161 Td /F1 9.8 Tf  [(Prevalence of demographically vulnerable groups such as those at the extremes of age, pregnant women, those of poor )] TJ ET
BT 45.750 109.257 Td /F1 9.8 Tf  [(socio-economic status)] TJ ET
40.337 96.569 m 
40.337 97.016 40.154 97.460 39.838 97.776 c
39.522 98.092 39.078 98.276 38.631 98.276 c
38.185 98.276 37.741 98.092 37.425 97.776 c
37.109 97.460 36.925 97.016 36.925 96.569 c
36.925 96.123 37.109 95.679 37.425 95.363 c
37.741 95.047 38.185 94.863 38.631 94.863 c
39.078 94.863 39.522 95.047 39.838 95.363 c
40.154 95.679 40.337 96.123 40.337 96.569 c f
BT 45.750 93.602 Td /F1 9.8 Tf  [(Prevalence of pre-existing disease in the community \(especially cardiac and respiratory\))] TJ ET
40.337 80.915 m 
40.337 81.361 40.154 81.805 39.838 82.121 c
39.522 82.437 39.078 82.621 38.631 82.621 c
38.185 82.621 37.741 82.437 37.425 82.121 c
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BT 65.250 767.476 Td /F1 9.8 Tf  [(An example of this is the 2011 Swinley Wildfire in Berkshire that threatened buildings including Broadmoor Psychiatric )] TJ ET
BT 65.250 755.571 Td /F1 9.8 Tf  [(Hospital \(Case studies 2\).)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Vulnerable populations are more likely to suffer adverse effects from wildfire smoke, thus actions should be taken to mitigate )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(risk where possible, for example by ensuring clear access to reliable public information and a robust system of emergency )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(preparedness.)] TJ ET
BT 26.250 685.452 Td /F4 9.8 Tf  [(Toxicology of wildfire smoke)] TJ ET
BT 26.250 666.048 Td /F1 9.8 Tf  [(Wildfire smoke consists of particulate matter and gaseous products of combustion. Adverse health effects, including an increase )] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(in daily mortality, have been linked to air pollution associated with bushfires and dust storms. A recent Australian study looking )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(at the effects of bushfires between 1997 and 2004 illustrates this )] TJ ET
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BT 306.991 643.745 Td /F4 8.7 Tf  [(24)] TJ ET
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BT 316.629 642.238 Td /F1 9.8 Tf  [(: A 5% increase in non-accidental mortality \(OR 1.05 )] TJ ET
BT 26.250 630.333 Td /F1 9.8 Tf  [(\(95%CI: 1.00�1.10\)\) was observed on days of high air pollution from bushfire smoke.)] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(Particulate matter is the predominant air pollutant seen in bushfire smoke, caused especially by the burning of vegetation and )] TJ ET
BT 26.250 599.024 Td /F1 9.8 Tf  [(wood )] TJ ET
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BT 52.263 600.531 Td /F4 8.7 Tf  [(25)] TJ ET
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BT 61.900 599.024 Td /F1 9.8 Tf  [(. PM)] TJ ET
BT 81.946 596.960 Td /F1 8.7 Tf  [(10 )] TJ ET
BT 93.993 599.024 Td /F1 9.8 Tf  [(particles \(which are able to pass through the upper respiratory tract and are deposited in the airways\), and PM)] TJ ET
BT 568.701 596.960 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 26.250 587.119 Td /F1 9.8 Tf  [(particles \(may be respired deeper within the lungs and deposited in the gaseous exchange region of terminal bronchi and )] TJ ET
BT 26.250 575.214 Td /F1 9.8 Tf  [(alveoli\) are produced by burning vegetation. Health effects of particulate matter are well documented: a 0.5-2% increase in )] TJ ET
BT 26.250 563.310 Td /F1 9.8 Tf  [(mortality with each increase of 10 ?g/m)] TJ ET
BT 195.315 567.198 Td /F1 8.7 Tf  [(3 )] TJ ET
BT 202.543 563.310 Td /F1 9.8 Tf  [( of urban PM)] TJ ET
BT 258.362 561.245 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 272.818 563.310 Td /F1 9.8 Tf  [(has been observed )] TJ ET
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BT 358.452 564.817 Td /F4 8.7 Tf  [(26)] TJ ET
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BT 368.089 563.310 Td /F1 9.8 Tf  [(. COMEAP have reported a 6% \(2- 11 95%CI\) )] TJ ET
BT 26.250 551.405 Td /F1 9.8 Tf  [(increase in all cause mortality associated with this increase in PM)] TJ ET
BT 308.551 549.341 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 323.007 551.405 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 532.000 Td /F1 9.8 Tf  [(Gaseous emissions including carbon monoxide, nitrous oxides and benzene are produced )] TJ ET
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BT 417.517 533.507 Td /F4 8.7 Tf  [(27)] TJ ET
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BT 427.155 532.000 Td /F1 9.8 Tf  [(, as are carcinogens including )] TJ ET
BT 26.250 520.095 Td /F1 9.8 Tf  [(polycyclic aromatic hydrocarbons \(also be present on particulate matter\), aldehydes, and volatile organic compounds )] TJ ET
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BT 532.372 521.603 Td /F4 8.7 Tf  [(28)] TJ ET
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BT 542.010 520.095 Td /F1 9.8 Tf  [(. These )] TJ ET
BT 26.250 508.191 Td /F1 9.8 Tf  [(compounds would also be expected to be adsorbed on the surface of the particulate products. Levels of ozone and nitrous )] TJ ET
BT 26.250 496.286 Td /F1 9.8 Tf  [(dioxide are also seen to rise )] TJ ET
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BT 150.348 497.793 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 159.985 496.286 Td /F1 9.8 Tf  [(. Wildfires often have a high proportion of smouldering fuel \(i.e. thermal breakdown of fuel in a )] TJ ET
BT 26.250 484.381 Td /F1 9.8 Tf  [(normal oxygen level without flame\). This is a form of incomplete combustion and is likely to produce high levels of toxins )] TJ ET
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BT 555.543 484.381 Td /F1 9.8 Tf  [(. As )] TJ ET
BT 26.250 472.476 Td /F1 9.8 Tf  [(the fires are open air, the direct health effect of these toxins is likely to be low as their concentration is quickly dispersed, and )] TJ ET
BT 26.250 460.572 Td /F1 9.8 Tf  [(toxins such as carbon monoxide are unlikely to cause immediate clinical concern. However, the longer term health effects from )] TJ ET
BT 26.250 448.667 Td /F1 9.8 Tf  [(low level exposure to aldehydes and other carcinogens from bushfire smoke may remain a cause for medical concern.)] TJ ET
BT 26.250 429.262 Td /F1 9.8 Tf  [(Tan et al. )] TJ ET
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BT 69.608 430.769 Td /F4 8.7 Tf  [(30)] TJ ET
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BT 79.246 429.262 Td /F1 9.8 Tf  [( monitored white blood count levels in humans after the Indonesian wildfires \(case studies 1\) and found increased )] TJ ET
BT 26.250 417.357 Td /F1 9.8 Tf  [(levels of polymorphonucleocytes indicating possible increased bone marrow activity which may be linked \(although )] TJ ET
BT 26.250 405.453 Td /F1 9.8 Tf  [(inconclusively\) to the toxins in wildfire smoke.)] TJ ET
BT 26.250 386.048 Td /F4 9.8 Tf  [(Studies of the effects of particulate matter in wildfire smoke)] TJ ET
BT 26.250 366.643 Td /F1 9.8 Tf  [(PM)] TJ ET
BT 40.875 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 50.512 366.643 Td /F1 9.8 Tf  [(from wildfires appear to have different effects on health than urban PM)] TJ ET
BT 354.537 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 364.174 366.643 Td /F1 9.8 Tf  [(. An 8 year study investigating air pollution levels, )] TJ ET
BT 26.250 354.738 Td /F1 9.8 Tf  [(including those from bushfires, and hospital admissions showed that a 10 �g/m)] TJ ET
BT 366.574 358.627 Td /F1 8.7 Tf  [(3)] TJ ET
BT 371.392 354.738 Td /F1 9.8 Tf  [( increase in bushfire \(but not urban\) PM)] TJ ET
BT 542.632 352.674 Td /F1 8.7 Tf  [(10)] TJ ET
BT 552.269 354.738 Td /F1 9.8 Tf  [( was )] TJ ET
BT 26.250 342.834 Td /F1 9.8 Tf  [(associated with a 1.24% increase in all respiratory admissions, a 3.80% increase in COPD admission and a 5.02% increase in )] TJ ET
BT 26.250 330.929 Td /F1 9.8 Tf  [(adult asthma admissions. Increased levels of urban PM)] TJ ET
BT 265.222 328.865 Td /F1 8.7 Tf  [(10)] TJ ET
BT 274.860 330.929 Td /F1 9.8 Tf  [( were associated with an increase in all-cause and cardiovascular )] TJ ET
BT 26.250 319.024 Td /F1 9.8 Tf  [(mortality but not respiratory mortality )] TJ ET
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BT 196.265 319.024 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 299.619 Td /F1 9.8 Tf  [(Studies from Darwin, Australia, are particularly useful as there is very little background urban PM)] TJ ET
BT 442.936 297.555 Td /F1 8.7 Tf  [(10)] TJ ET
BT 452.573 299.619 Td /F1 9.8 Tf  [( pollution and therefore most )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(rises in air pollution are secondary to bushfires )] TJ ET
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BT 229.996 289.222 Td /F4 8.7 Tf  [(32)] TJ ET
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BT 239.633 287.715 Td /F1 9.8 Tf  [(. Studies from this area )] TJ ET
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BT 352.230 291.603 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 354.640 289.222 Td /F4 8.7 Tf  [(34)] TJ ET
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BT 364.277 287.715 Td /F1 9.8 Tf  [( report a significant increase in asthma and )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(COPD presentations associated with raised PM)] TJ ET
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BT 241.252 275.810 Td /F1 9.8 Tf  [( levels from bushfire smoke.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(The difference between urban and wildfire smoke is also illustrated in a study looking at the effect on macrophages exposed to )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(wildfire and urban smoke in a murine model )] TJ ET
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BT 227.163 244.500 Td /F1 9.8 Tf  [(. This showed that although cytokine production in response to wildfire smoke )] TJ ET
BT 26.250 232.596 Td /F1 9.8 Tf  [(was lower than with urban derived particles, there was increased inflammatory \(determined by measuring proinflammatory )] TJ ET
BT 26.250 220.691 Td /F1 9.8 Tf  [(cytokines\) and cytotoxic activity \(as measured by biochemical markers of toxicity, apoptotic activity and nitrous oxide )] TJ ET
BT 26.250 208.786 Td /F1 9.8 Tf  [(production\) per cubic metre of air containing wildfire particles than with air containing only urban particulate matter. This was )] TJ ET
BT 26.250 196.881 Td /F1 9.8 Tf  [(probably as a result of a higher concentration of PM)] TJ ET
BT 249.525 194.817 Td /F1 8.7 Tf  [(10)] TJ ET
BT 259.162 196.881 Td /F1 9.8 Tf  [( particles in the wildfire smoke \(10.3�g/m3 compared with 5.5�g/m3 in )] TJ ET
BT 26.250 184.977 Td /F1 9.8 Tf  [(urban air\). This increased particulate size means that particles can accumulate in the lung more easily, which may have public )] TJ ET
BT 26.250 173.072 Td /F1 9.8 Tf  [(health implications.)] TJ ET
BT 26.250 153.667 Td /F1 9.8 Tf  [(Wood smoke particles have also been shown to cause an inflammatory response in otherwise healthy humans. Ghio et al.�s )] TJ ET
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BT 26.250 129.858 Td /F1 9.8 Tf  [(influx into the lung from bronchial and bronchoalveolar lavage samples. Although it was a small study, the authors suggest that )] TJ ET
BT 26.250 117.953 Td /F1 9.8 Tf  [(systemic and pulmonary inflammation in human subjects can result from exposure to wood smoke particles.)] TJ ET
BT 26.250 98.548 Td /F1 9.8 Tf  [(Firefighters are at particular risk of inhalation of wildfire smoke particles. In recognition of this, suitable filters need to be used in )] TJ ET
BT 26.250 86.643 Td /F1 9.8 Tf  [(breathing apparatus., such as the POVF \(particulate/organic vapour/formaldehyde\) filter )] TJ ET
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BT 407.212 88.151 Td /F4 8.7 Tf  [(37)] TJ ET
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BT 416.849 86.643 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 67.239 Td /F1 9.8 Tf  [(A crude extrapolated estimate from Finland suggested that high PM)] TJ ET
BT 317.804 65.174 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 329.851 67.239 Td /F1 9.8 Tf  [( levels following wildfires in 2002 caused additional total )] TJ ET
BT 26.250 55.334 Td /F1 9.8 Tf  [(mortality of 9-34 cases in a population of 3.4 million compared with what would normally be expected )] TJ ET
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BT 463.557 56.841 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 473.194 55.334 Td /F1 9.8 Tf  [(. High levels of PM)] TJ ET
BT 554.470 53.270 Td /F1 8.7 Tf  [(10)] TJ ET
BT 26.250 43.429 Td /F1 9.8 Tf  [(\(both urban and from bushfires\) were associated with a 1.8% increase in ED attendances in a study in Victoria \(carried out )] TJ ET
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BT 65.250 767.476 Td /F1 9.8 Tf  [(An example of this is the 2011 Swinley Wildfire in Berkshire that threatened buildings including Broadmoor Psychiatric )] TJ ET
BT 65.250 755.571 Td /F1 9.8 Tf  [(Hospital \(Case studies 2\).)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Vulnerable populations are more likely to suffer adverse effects from wildfire smoke, thus actions should be taken to mitigate )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(risk where possible, for example by ensuring clear access to reliable public information and a robust system of emergency )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(preparedness.)] TJ ET
BT 26.250 685.452 Td /F4 9.8 Tf  [(Toxicology of wildfire smoke)] TJ ET
BT 26.250 666.048 Td /F1 9.8 Tf  [(Wildfire smoke consists of particulate matter and gaseous products of combustion. Adverse health effects, including an increase )] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(in daily mortality, have been linked to air pollution associated with bushfires and dust storms. A recent Australian study looking )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(at the effects of bushfires between 1997 and 2004 illustrates this )] TJ ET
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BT 306.991 643.745 Td /F4 8.7 Tf  [(24)] TJ ET
0.271 0.267 0.267 rg
BT 316.629 642.238 Td /F1 9.8 Tf  [(: A 5% increase in non-accidental mortality \(OR 1.05 )] TJ ET
BT 26.250 630.333 Td /F1 9.8 Tf  [(\(95%CI: 1.00�1.10\)\) was observed on days of high air pollution from bushfire smoke.)] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(Particulate matter is the predominant air pollutant seen in bushfire smoke, caused especially by the burning of vegetation and )] TJ ET
BT 26.250 599.024 Td /F1 9.8 Tf  [(wood )] TJ ET
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BT 52.263 600.531 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 61.900 599.024 Td /F1 9.8 Tf  [(. PM)] TJ ET
BT 81.946 596.960 Td /F1 8.7 Tf  [(10 )] TJ ET
BT 93.993 599.024 Td /F1 9.8 Tf  [(particles \(which are able to pass through the upper respiratory tract and are deposited in the airways\), and PM)] TJ ET
BT 568.701 596.960 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 26.250 587.119 Td /F1 9.8 Tf  [(particles \(may be respired deeper within the lungs and deposited in the gaseous exchange region of terminal bronchi and )] TJ ET
BT 26.250 575.214 Td /F1 9.8 Tf  [(alveoli\) are produced by burning vegetation. Health effects of particulate matter are well documented: a 0.5-2% increase in )] TJ ET
BT 26.250 563.310 Td /F1 9.8 Tf  [(mortality with each increase of 10 ?g/m)] TJ ET
BT 195.315 567.198 Td /F1 8.7 Tf  [(3 )] TJ ET
BT 202.543 563.310 Td /F1 9.8 Tf  [( of urban PM)] TJ ET
BT 258.362 561.245 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 272.818 563.310 Td /F1 9.8 Tf  [(has been observed )] TJ ET
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BT 358.452 564.817 Td /F4 8.7 Tf  [(26)] TJ ET
0.271 0.267 0.267 rg
BT 368.089 563.310 Td /F1 9.8 Tf  [(. COMEAP have reported a 6% \(2- 11 95%CI\) )] TJ ET
BT 26.250 551.405 Td /F1 9.8 Tf  [(increase in all cause mortality associated with this increase in PM)] TJ ET
BT 308.551 549.341 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 323.007 551.405 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 532.000 Td /F1 9.8 Tf  [(Gaseous emissions including carbon monoxide, nitrous oxides and benzene are produced )] TJ ET
0.267 0.267 0.267 rg
BT 417.517 533.507 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 427.155 532.000 Td /F1 9.8 Tf  [(, as are carcinogens including )] TJ ET
BT 26.250 520.095 Td /F1 9.8 Tf  [(polycyclic aromatic hydrocarbons \(also be present on particulate matter\), aldehydes, and volatile organic compounds )] TJ ET
0.267 0.267 0.267 rg
BT 532.372 521.603 Td /F4 8.7 Tf  [(28)] TJ ET
0.271 0.267 0.267 rg
BT 542.010 520.095 Td /F1 9.8 Tf  [(. These )] TJ ET
BT 26.250 508.191 Td /F1 9.8 Tf  [(compounds would also be expected to be adsorbed on the surface of the particulate products. Levels of ozone and nitrous )] TJ ET
BT 26.250 496.286 Td /F1 9.8 Tf  [(dioxide are also seen to rise )] TJ ET
0.267 0.267 0.267 rg
BT 150.348 497.793 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 159.985 496.286 Td /F1 9.8 Tf  [(. Wildfires often have a high proportion of smouldering fuel \(i.e. thermal breakdown of fuel in a )] TJ ET
BT 26.250 484.381 Td /F1 9.8 Tf  [(normal oxygen level without flame\). This is a form of incomplete combustion and is likely to produce high levels of toxins )] TJ ET
0.267 0.267 0.267 rg
BT 545.905 485.888 Td /F4 8.7 Tf  [(29)] TJ ET
0.271 0.267 0.267 rg
BT 555.543 484.381 Td /F1 9.8 Tf  [(. As )] TJ ET
BT 26.250 472.476 Td /F1 9.8 Tf  [(the fires are open air, the direct health effect of these toxins is likely to be low as their concentration is quickly dispersed, and )] TJ ET
BT 26.250 460.572 Td /F1 9.8 Tf  [(toxins such as carbon monoxide are unlikely to cause immediate clinical concern. However, the longer term health effects from )] TJ ET
BT 26.250 448.667 Td /F1 9.8 Tf  [(low level exposure to aldehydes and other carcinogens from bushfire smoke may remain a cause for medical concern.)] TJ ET
BT 26.250 429.262 Td /F1 9.8 Tf  [(Tan et al. )] TJ ET
0.267 0.267 0.267 rg
BT 69.608 430.769 Td /F4 8.7 Tf  [(30)] TJ ET
0.271 0.267 0.267 rg
BT 79.246 429.262 Td /F1 9.8 Tf  [( monitored white blood count levels in humans after the Indonesian wildfires \(case studies 1\) and found increased )] TJ ET
BT 26.250 417.357 Td /F1 9.8 Tf  [(levels of polymorphonucleocytes indicating possible increased bone marrow activity which may be linked \(although )] TJ ET
BT 26.250 405.453 Td /F1 9.8 Tf  [(inconclusively\) to the toxins in wildfire smoke.)] TJ ET
BT 26.250 386.048 Td /F4 9.8 Tf  [(Studies of the effects of particulate matter in wildfire smoke)] TJ ET
BT 26.250 366.643 Td /F1 9.8 Tf  [(PM)] TJ ET
BT 40.875 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 50.512 366.643 Td /F1 9.8 Tf  [(from wildfires appear to have different effects on health than urban PM)] TJ ET
BT 354.537 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 364.174 366.643 Td /F1 9.8 Tf  [(. An 8 year study investigating air pollution levels, )] TJ ET
BT 26.250 354.738 Td /F1 9.8 Tf  [(including those from bushfires, and hospital admissions showed that a 10 �g/m)] TJ ET
BT 366.574 358.627 Td /F1 8.7 Tf  [(3)] TJ ET
BT 371.392 354.738 Td /F1 9.8 Tf  [( increase in bushfire \(but not urban\) PM)] TJ ET
BT 542.632 352.674 Td /F1 8.7 Tf  [(10)] TJ ET
BT 552.269 354.738 Td /F1 9.8 Tf  [( was )] TJ ET
BT 26.250 342.834 Td /F1 9.8 Tf  [(associated with a 1.24% increase in all respiratory admissions, a 3.80% increase in COPD admission and a 5.02% increase in )] TJ ET
BT 26.250 330.929 Td /F1 9.8 Tf  [(adult asthma admissions. Increased levels of urban PM)] TJ ET
BT 265.222 328.865 Td /F1 8.7 Tf  [(10)] TJ ET
BT 274.860 330.929 Td /F1 9.8 Tf  [( were associated with an increase in all-cause and cardiovascular )] TJ ET
BT 26.250 319.024 Td /F1 9.8 Tf  [(mortality but not respiratory mortality )] TJ ET
0.267 0.267 0.267 rg
BT 186.628 320.531 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 196.265 319.024 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 299.619 Td /F1 9.8 Tf  [(Studies from Darwin, Australia, are particularly useful as there is very little background urban PM)] TJ ET
BT 442.936 297.555 Td /F1 8.7 Tf  [(10)] TJ ET
BT 452.573 299.619 Td /F1 9.8 Tf  [( pollution and therefore most )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(rises in air pollution are secondary to bushfires )] TJ ET
0.267 0.267 0.267 rg
BT 229.996 289.222 Td /F4 8.7 Tf  [(32)] TJ ET
0.271 0.267 0.267 rg
BT 239.633 287.715 Td /F1 9.8 Tf  [(. Studies from this area )] TJ ET
0.267 0.267 0.267 rg
BT 342.593 289.222 Td /F4 8.7 Tf  [(33)] TJ ET
0.271 0.267 0.267 rg
BT 352.230 291.603 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 354.640 289.222 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 364.277 287.715 Td /F1 9.8 Tf  [( report a significant increase in asthma and )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(COPD presentations associated with raised PM)] TJ ET
BT 231.614 273.746 Td /F1 8.7 Tf  [(10)] TJ ET
BT 241.252 275.810 Td /F1 9.8 Tf  [( levels from bushfire smoke.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(The difference between urban and wildfire smoke is also illustrated in a study looking at the effect on macrophages exposed to )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(wildfire and urban smoke in a murine model )] TJ ET
0.267 0.267 0.267 rg
BT 217.525 246.008 Td /F4 8.7 Tf  [(35)] TJ ET
0.271 0.267 0.267 rg
BT 227.163 244.500 Td /F1 9.8 Tf  [(. This showed that although cytokine production in response to wildfire smoke )] TJ ET
BT 26.250 232.596 Td /F1 9.8 Tf  [(was lower than with urban derived particles, there was increased inflammatory \(determined by measuring proinflammatory )] TJ ET
BT 26.250 220.691 Td /F1 9.8 Tf  [(cytokines\) and cytotoxic activity \(as measured by biochemical markers of toxicity, apoptotic activity and nitrous oxide )] TJ ET
BT 26.250 208.786 Td /F1 9.8 Tf  [(production\) per cubic metre of air containing wildfire particles than with air containing only urban particulate matter. This was )] TJ ET
BT 26.250 196.881 Td /F1 9.8 Tf  [(probably as a result of a higher concentration of PM)] TJ ET
BT 249.525 194.817 Td /F1 8.7 Tf  [(10)] TJ ET
BT 259.162 196.881 Td /F1 9.8 Tf  [( particles in the wildfire smoke \(10.3�g/m3 compared with 5.5�g/m3 in )] TJ ET
BT 26.250 184.977 Td /F1 9.8 Tf  [(urban air\). This increased particulate size means that particles can accumulate in the lung more easily, which may have public )] TJ ET
BT 26.250 173.072 Td /F1 9.8 Tf  [(health implications.)] TJ ET
BT 26.250 153.667 Td /F1 9.8 Tf  [(Wood smoke particles have also been shown to cause an inflammatory response in otherwise healthy humans. Ghio et al.�s )] TJ ET
0.267 0.267 0.267 rg
BT 562.188 155.174 Td /F4 8.7 Tf  [(36)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 141.762 Td /F1 9.8 Tf  [(study of 10 human volunteers exposed to woodfire smoke showed an increased level of blood neutrophils, and a neutrophilic )] TJ ET
BT 26.250 129.858 Td /F1 9.8 Tf  [(influx into the lung from bronchial and bronchoalveolar lavage samples. Although it was a small study, the authors suggest that )] TJ ET
BT 26.250 117.953 Td /F1 9.8 Tf  [(systemic and pulmonary inflammation in human subjects can result from exposure to wood smoke particles.)] TJ ET
BT 26.250 98.548 Td /F1 9.8 Tf  [(Firefighters are at particular risk of inhalation of wildfire smoke particles. In recognition of this, suitable filters need to be used in )] TJ ET
BT 26.250 86.643 Td /F1 9.8 Tf  [(breathing apparatus., such as the POVF \(particulate/organic vapour/formaldehyde\) filter )] TJ ET
0.267 0.267 0.267 rg
BT 407.212 88.151 Td /F4 8.7 Tf  [(37)] TJ ET
0.271 0.267 0.267 rg
BT 416.849 86.643 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 67.239 Td /F1 9.8 Tf  [(A crude extrapolated estimate from Finland suggested that high PM)] TJ ET
BT 317.804 65.174 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 329.851 67.239 Td /F1 9.8 Tf  [( levels following wildfires in 2002 caused additional total )] TJ ET
BT 26.250 55.334 Td /F1 9.8 Tf  [(mortality of 9-34 cases in a population of 3.4 million compared with what would normally be expected )] TJ ET
0.267 0.267 0.267 rg
BT 463.557 56.841 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 473.194 55.334 Td /F1 9.8 Tf  [(. High levels of PM)] TJ ET
BT 554.470 53.270 Td /F1 8.7 Tf  [(10)] TJ ET
BT 26.250 43.429 Td /F1 9.8 Tf  [(\(both urban and from bushfires\) were associated with a 1.8% increase in ED attendances in a study in Victoria \(carried out )] TJ ET
Q
q
15.000 29.144 577.500 747.856 re W n
0.271 0.267 0.267 rg
0.271 0.267 0.267 RG
0.39 w 1 J 1 j
59.837 770.444 m 
59.837 770.890 59.654 771.334 59.338 771.650 c
59.022 771.966 58.578 772.150 58.131 772.150 c
57.685 772.150 57.241 771.966 56.925 771.650 c
56.609 771.334 56.425 770.890 56.425 770.444 c
56.425 769.997 56.609 769.553 56.925 769.237 c
57.241 768.921 57.685 768.738 58.131 768.738 c
58.578 768.738 59.022 768.921 59.338 769.237 c
59.654 769.553 59.837 769.997 59.837 770.444 c s
BT 65.250 767.476 Td /F1 9.8 Tf  [(An example of this is the 2011 Swinley Wildfire in Berkshire that threatened buildings including Broadmoor Psychiatric )] TJ ET
BT 65.250 755.571 Td /F1 9.8 Tf  [(Hospital \(Case studies 2\).)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Vulnerable populations are more likely to suffer adverse effects from wildfire smoke, thus actions should be taken to mitigate )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(risk where possible, for example by ensuring clear access to reliable public information and a robust system of emergency )] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(preparedness.)] TJ ET
BT 26.250 685.452 Td /F4 9.8 Tf  [(Toxicology of wildfire smoke)] TJ ET
BT 26.250 666.048 Td /F1 9.8 Tf  [(Wildfire smoke consists of particulate matter and gaseous products of combustion. Adverse health effects, including an increase )] TJ ET
BT 26.250 654.143 Td /F1 9.8 Tf  [(in daily mortality, have been linked to air pollution associated with bushfires and dust storms. A recent Australian study looking )] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(at the effects of bushfires between 1997 and 2004 illustrates this )] TJ ET
0.267 0.267 0.267 rg
BT 306.991 643.745 Td /F4 8.7 Tf  [(24)] TJ ET
0.271 0.267 0.267 rg
BT 316.629 642.238 Td /F1 9.8 Tf  [(: A 5% increase in non-accidental mortality \(OR 1.05 )] TJ ET
BT 26.250 630.333 Td /F1 9.8 Tf  [(\(95%CI: 1.00�1.10\)\) was observed on days of high air pollution from bushfire smoke.)] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(Particulate matter is the predominant air pollutant seen in bushfire smoke, caused especially by the burning of vegetation and )] TJ ET
BT 26.250 599.024 Td /F1 9.8 Tf  [(wood )] TJ ET
0.267 0.267 0.267 rg
BT 52.263 600.531 Td /F4 8.7 Tf  [(25)] TJ ET
0.271 0.267 0.267 rg
BT 61.900 599.024 Td /F1 9.8 Tf  [(. PM)] TJ ET
BT 81.946 596.960 Td /F1 8.7 Tf  [(10 )] TJ ET
BT 93.993 599.024 Td /F1 9.8 Tf  [(particles \(which are able to pass through the upper respiratory tract and are deposited in the airways\), and PM)] TJ ET
BT 568.701 596.960 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 26.250 587.119 Td /F1 9.8 Tf  [(particles \(may be respired deeper within the lungs and deposited in the gaseous exchange region of terminal bronchi and )] TJ ET
BT 26.250 575.214 Td /F1 9.8 Tf  [(alveoli\) are produced by burning vegetation. Health effects of particulate matter are well documented: a 0.5-2% increase in )] TJ ET
BT 26.250 563.310 Td /F1 9.8 Tf  [(mortality with each increase of 10 ?g/m)] TJ ET
BT 195.315 567.198 Td /F1 8.7 Tf  [(3 )] TJ ET
BT 202.543 563.310 Td /F1 9.8 Tf  [( of urban PM)] TJ ET
BT 258.362 561.245 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 272.818 563.310 Td /F1 9.8 Tf  [(has been observed )] TJ ET
0.267 0.267 0.267 rg
BT 358.452 564.817 Td /F4 8.7 Tf  [(26)] TJ ET
0.271 0.267 0.267 rg
BT 368.089 563.310 Td /F1 9.8 Tf  [(. COMEAP have reported a 6% \(2- 11 95%CI\) )] TJ ET
BT 26.250 551.405 Td /F1 9.8 Tf  [(increase in all cause mortality associated with this increase in PM)] TJ ET
BT 308.551 549.341 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 323.007 551.405 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 532.000 Td /F1 9.8 Tf  [(Gaseous emissions including carbon monoxide, nitrous oxides and benzene are produced )] TJ ET
0.267 0.267 0.267 rg
BT 417.517 533.507 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 427.155 532.000 Td /F1 9.8 Tf  [(, as are carcinogens including )] TJ ET
BT 26.250 520.095 Td /F1 9.8 Tf  [(polycyclic aromatic hydrocarbons \(also be present on particulate matter\), aldehydes, and volatile organic compounds )] TJ ET
0.267 0.267 0.267 rg
BT 532.372 521.603 Td /F4 8.7 Tf  [(28)] TJ ET
0.271 0.267 0.267 rg
BT 542.010 520.095 Td /F1 9.8 Tf  [(. These )] TJ ET
BT 26.250 508.191 Td /F1 9.8 Tf  [(compounds would also be expected to be adsorbed on the surface of the particulate products. Levels of ozone and nitrous )] TJ ET
BT 26.250 496.286 Td /F1 9.8 Tf  [(dioxide are also seen to rise )] TJ ET
0.267 0.267 0.267 rg
BT 150.348 497.793 Td /F4 8.7 Tf  [(27)] TJ ET
0.271 0.267 0.267 rg
BT 159.985 496.286 Td /F1 9.8 Tf  [(. Wildfires often have a high proportion of smouldering fuel \(i.e. thermal breakdown of fuel in a )] TJ ET
BT 26.250 484.381 Td /F1 9.8 Tf  [(normal oxygen level without flame\). This is a form of incomplete combustion and is likely to produce high levels of toxins )] TJ ET
0.267 0.267 0.267 rg
BT 545.905 485.888 Td /F4 8.7 Tf  [(29)] TJ ET
0.271 0.267 0.267 rg
BT 555.543 484.381 Td /F1 9.8 Tf  [(. As )] TJ ET
BT 26.250 472.476 Td /F1 9.8 Tf  [(the fires are open air, the direct health effect of these toxins is likely to be low as their concentration is quickly dispersed, and )] TJ ET
BT 26.250 460.572 Td /F1 9.8 Tf  [(toxins such as carbon monoxide are unlikely to cause immediate clinical concern. However, the longer term health effects from )] TJ ET
BT 26.250 448.667 Td /F1 9.8 Tf  [(low level exposure to aldehydes and other carcinogens from bushfire smoke may remain a cause for medical concern.)] TJ ET
BT 26.250 429.262 Td /F1 9.8 Tf  [(Tan et al. )] TJ ET
0.267 0.267 0.267 rg
BT 69.608 430.769 Td /F4 8.7 Tf  [(30)] TJ ET
0.271 0.267 0.267 rg
BT 79.246 429.262 Td /F1 9.8 Tf  [( monitored white blood count levels in humans after the Indonesian wildfires \(case studies 1\) and found increased )] TJ ET
BT 26.250 417.357 Td /F1 9.8 Tf  [(levels of polymorphonucleocytes indicating possible increased bone marrow activity which may be linked \(although )] TJ ET
BT 26.250 405.453 Td /F1 9.8 Tf  [(inconclusively\) to the toxins in wildfire smoke.)] TJ ET
BT 26.250 386.048 Td /F4 9.8 Tf  [(Studies of the effects of particulate matter in wildfire smoke)] TJ ET
BT 26.250 366.643 Td /F1 9.8 Tf  [(PM)] TJ ET
BT 40.875 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 50.512 366.643 Td /F1 9.8 Tf  [(from wildfires appear to have different effects on health than urban PM)] TJ ET
BT 354.537 364.579 Td /F1 8.7 Tf  [(10)] TJ ET
BT 364.174 366.643 Td /F1 9.8 Tf  [(. An 8 year study investigating air pollution levels, )] TJ ET
BT 26.250 354.738 Td /F1 9.8 Tf  [(including those from bushfires, and hospital admissions showed that a 10 �g/m)] TJ ET
BT 366.574 358.627 Td /F1 8.7 Tf  [(3)] TJ ET
BT 371.392 354.738 Td /F1 9.8 Tf  [( increase in bushfire \(but not urban\) PM)] TJ ET
BT 542.632 352.674 Td /F1 8.7 Tf  [(10)] TJ ET
BT 552.269 354.738 Td /F1 9.8 Tf  [( was )] TJ ET
BT 26.250 342.834 Td /F1 9.8 Tf  [(associated with a 1.24% increase in all respiratory admissions, a 3.80% increase in COPD admission and a 5.02% increase in )] TJ ET
BT 26.250 330.929 Td /F1 9.8 Tf  [(adult asthma admissions. Increased levels of urban PM)] TJ ET
BT 265.222 328.865 Td /F1 8.7 Tf  [(10)] TJ ET
BT 274.860 330.929 Td /F1 9.8 Tf  [( were associated with an increase in all-cause and cardiovascular )] TJ ET
BT 26.250 319.024 Td /F1 9.8 Tf  [(mortality but not respiratory mortality )] TJ ET
0.267 0.267 0.267 rg
BT 186.628 320.531 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 196.265 319.024 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 299.619 Td /F1 9.8 Tf  [(Studies from Darwin, Australia, are particularly useful as there is very little background urban PM)] TJ ET
BT 442.936 297.555 Td /F1 8.7 Tf  [(10)] TJ ET
BT 452.573 299.619 Td /F1 9.8 Tf  [( pollution and therefore most )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(rises in air pollution are secondary to bushfires )] TJ ET
0.267 0.267 0.267 rg
BT 229.996 289.222 Td /F4 8.7 Tf  [(32)] TJ ET
0.271 0.267 0.267 rg
BT 239.633 287.715 Td /F1 9.8 Tf  [(. Studies from this area )] TJ ET
0.267 0.267 0.267 rg
BT 342.593 289.222 Td /F4 8.7 Tf  [(33)] TJ ET
0.271 0.267 0.267 rg
BT 352.230 291.603 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 354.640 289.222 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 364.277 287.715 Td /F1 9.8 Tf  [( report a significant increase in asthma and )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(COPD presentations associated with raised PM)] TJ ET
BT 231.614 273.746 Td /F1 8.7 Tf  [(10)] TJ ET
BT 241.252 275.810 Td /F1 9.8 Tf  [( levels from bushfire smoke.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(The difference between urban and wildfire smoke is also illustrated in a study looking at the effect on macrophages exposed to )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(wildfire and urban smoke in a murine model )] TJ ET
0.267 0.267 0.267 rg
BT 217.525 246.008 Td /F4 8.7 Tf  [(35)] TJ ET
0.271 0.267 0.267 rg
BT 227.163 244.500 Td /F1 9.8 Tf  [(. This showed that although cytokine production in response to wildfire smoke )] TJ ET
BT 26.250 232.596 Td /F1 9.8 Tf  [(was lower than with urban derived particles, there was increased inflammatory \(determined by measuring proinflammatory )] TJ ET
BT 26.250 220.691 Td /F1 9.8 Tf  [(cytokines\) and cytotoxic activity \(as measured by biochemical markers of toxicity, apoptotic activity and nitrous oxide )] TJ ET
BT 26.250 208.786 Td /F1 9.8 Tf  [(production\) per cubic metre of air containing wildfire particles than with air containing only urban particulate matter. This was )] TJ ET
BT 26.250 196.881 Td /F1 9.8 Tf  [(probably as a result of a higher concentration of PM)] TJ ET
BT 249.525 194.817 Td /F1 8.7 Tf  [(10)] TJ ET
BT 259.162 196.881 Td /F1 9.8 Tf  [( particles in the wildfire smoke \(10.3�g/m3 compared with 5.5�g/m3 in )] TJ ET
BT 26.250 184.977 Td /F1 9.8 Tf  [(urban air\). This increased particulate size means that particles can accumulate in the lung more easily, which may have public )] TJ ET
BT 26.250 173.072 Td /F1 9.8 Tf  [(health implications.)] TJ ET
BT 26.250 153.667 Td /F1 9.8 Tf  [(Wood smoke particles have also been shown to cause an inflammatory response in otherwise healthy humans. Ghio et al.�s )] TJ ET
0.267 0.267 0.267 rg
BT 562.188 155.174 Td /F4 8.7 Tf  [(36)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 141.762 Td /F1 9.8 Tf  [(study of 10 human volunteers exposed to woodfire smoke showed an increased level of blood neutrophils, and a neutrophilic )] TJ ET
BT 26.250 129.858 Td /F1 9.8 Tf  [(influx into the lung from bronchial and bronchoalveolar lavage samples. Although it was a small study, the authors suggest that )] TJ ET
BT 26.250 117.953 Td /F1 9.8 Tf  [(systemic and pulmonary inflammation in human subjects can result from exposure to wood smoke particles.)] TJ ET
BT 26.250 98.548 Td /F1 9.8 Tf  [(Firefighters are at particular risk of inhalation of wildfire smoke particles. In recognition of this, suitable filters need to be used in )] TJ ET
BT 26.250 86.643 Td /F1 9.8 Tf  [(breathing apparatus., such as the POVF \(particulate/organic vapour/formaldehyde\) filter )] TJ ET
0.267 0.267 0.267 rg
BT 407.212 88.151 Td /F4 8.7 Tf  [(37)] TJ ET
0.271 0.267 0.267 rg
BT 416.849 86.643 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 67.239 Td /F1 9.8 Tf  [(A crude extrapolated estimate from Finland suggested that high PM)] TJ ET
BT 317.804 65.174 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 329.851 67.239 Td /F1 9.8 Tf  [( levels following wildfires in 2002 caused additional total )] TJ ET
BT 26.250 55.334 Td /F1 9.8 Tf  [(mortality of 9-34 cases in a population of 3.4 million compared with what would normally be expected )] TJ ET
0.267 0.267 0.267 rg
BT 463.557 56.841 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 473.194 55.334 Td /F1 9.8 Tf  [(. High levels of PM)] TJ ET
BT 554.470 53.270 Td /F1 8.7 Tf  [(10)] TJ ET
BT 26.250 43.429 Td /F1 9.8 Tf  [(\(both urban and from bushfires\) were associated with a 1.8% increase in ED attendances in a study in Victoria \(carried out )] TJ ET
Q
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BT 291.710 19.825 Td /F1 11.0 Tf  [(6)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
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BT 26.250 767.476 Td /F1 9.8 Tf  [(during a bushfire season in 2003-2003\) )] TJ ET
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BT 198.591 768.983 Td /F4 8.7 Tf  [(39)] TJ ET
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BT 26.250 755.571 Td /F1 9.8 Tf  [(useful public health information, facilitating preparedness for increased pressure on health care services, and should be )] TJ ET
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BT 394.073 743.667 Td /F1 9.8 Tf  [( monitoring alone may not adequately )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(represent the adverse effects of air quality that may be caused by the PM)] TJ ET
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BT 26.250 695.159 Td /F4 12.0 Tf  [(Other Health Effects)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(Health effects of wildfires are wide ranging, and may result directly from both the thermal effects and smoke. Further health )] TJ ET
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BT 26.250 639.491 Td /F1 9.8 Tf  [(conditions to access healthcare facilities.)] TJ ET
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BT 26.250 569.372 Td /F1 9.8 Tf  [(Patients with COPD have been noted to be at increased risk as a result of air pollution. A study looking at symptoms of 21 local )] TJ ET
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BT 341.107 545.562 Td /F1 9.8 Tf  [( and carbon monoxide levels in the atmosphere )] TJ ET
BT 26.250 533.658 Td /F1 9.8 Tf  [(increased, thus illustrating the link between air pollution from wildfires and COPD exacerbation )] TJ ET
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BT 26.250 147.825 Td /F1 9.8 Tf  [(Despite frequent fires in Europe, very little literature exists on potential associated health effects. The vegetation fires which )] TJ ET
BT 26.250 135.920 Td /F1 9.8 Tf  [(surrounded Vilnius in Lithuania in 2002 caused increases in hospital attendances for respiratory conditions and asthma )] TJ ET
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0.271 0.267 0.267 rg
BT 304.675 88.301 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 68.896 Td /F1 9.8 Tf  [(Although these studies on the respiratory effects reported from wildfires have been undertaken, little data on the levels of )] TJ ET
BT 26.250 56.991 Td /F1 9.8 Tf  [(pollutant exposure has been documented reducing the ability to extrapolate this information to UK wildfires.)] TJ ET
Q
q
15.000 27.706 577.500 749.294 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(during a bushfire season in 2003-2003\) )] TJ ET
0.267 0.267 0.267 rg
BT 198.591 768.983 Td /F4 8.7 Tf  [(39)] TJ ET
0.271 0.267 0.267 rg
BT 208.228 767.476 Td /F1 9.8 Tf  [(. A system of monitoring air pollution during and after wildfire events may provide )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(useful public health information, facilitating preparedness for increased pressure on health care services, and should be )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(considered. It would be important to monitor PM)] TJ ET
BT 233.252 741.602 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 245.299 743.667 Td /F1 9.8 Tf  [( levels, not just PM)] TJ ET
BT 327.121 741.602 Td /F1 8.7 Tf  [(10)] TJ ET
BT 336.758 743.667 Td /F1 9.8 Tf  [( levels. PM)] TJ ET
BT 384.436 741.602 Td /F1 8.7 Tf  [(10)] TJ ET
BT 394.073 743.667 Td /F1 9.8 Tf  [( monitoring alone may not adequately )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(represent the adverse effects of air quality that may be caused by the PM)] TJ ET
BT 342.199 729.698 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 356.655 731.762 Td /F1 9.8 Tf  [(fraction )] TJ ET
0.267 0.267 0.267 rg
BT 391.336 733.269 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 400.973 731.762 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 695.159 Td /F4 12.0 Tf  [(Other Health Effects)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(Health effects of wildfires are wide ranging, and may result directly from both the thermal effects and smoke. Further health )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(implications include: psychological reactions to an extreme event, physical concerns such as trauma during evacuation, and )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(pressures on local resources, from increased demand on health services and inability of patients with chronic health care )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(conditions to access healthcare facilities.)] TJ ET
BT 26.250 620.086 Td /F4 9.8 Tf  [(Respiratory symptoms)] TJ ET
BT 26.250 600.681 Td /F1 9.8 Tf  [(Certain population groups are at particular risk of respiratory effects from bushfire smoke, including young children, those with )] TJ ET
BT 26.250 588.777 Td /F1 9.8 Tf  [(pre-existing cardiopulmonary conditions, and smokers )] TJ ET
0.267 0.267 0.267 rg
BT 261.956 590.284 Td /F4 8.7 Tf  [(40)] TJ ET
0.271 0.267 0.267 rg
BT 271.594 588.777 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 569.372 Td /F1 9.8 Tf  [(Patients with COPD have been noted to be at increased risk as a result of air pollution. A study looking at symptoms of 21 local )] TJ ET
BT 26.250 557.467 Td /F1 9.8 Tf  [(patients with COPD in the two months following the Denver wildfires of 2002 revealed that dyspnoea, cough, chest tightness, )] TJ ET
BT 26.250 545.562 Td /F1 9.8 Tf  [(wheeze and sputum production all increased on days when PM)] TJ ET
BT 299.377 543.498 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 311.423 545.562 Td /F1 9.8 Tf  [(, PM)] TJ ET
BT 331.469 543.498 Td /F1 8.7 Tf  [(10)] TJ ET
BT 341.107 545.562 Td /F1 9.8 Tf  [( and carbon monoxide levels in the atmosphere )] TJ ET
BT 26.250 533.658 Td /F1 9.8 Tf  [(increased, thus illustrating the link between air pollution from wildfires and COPD exacerbation )] TJ ET
0.267 0.267 0.267 rg
BT 435.906 535.165 Td /F4 8.7 Tf  [(41)] TJ ET
0.271 0.267 0.267 rg
BT 445.543 533.658 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 514.253 Td /F1 9.8 Tf  [(In a paediatric cohort study 32 children with a history of wheeze suffered adverse effects from increased PM)] TJ ET
BT 491.744 512.189 Td /F1 8.7 Tf  [(10)] TJ ET
BT 501.382 514.253 Td /F1 9.8 Tf  [( particles after )] TJ ET
BT 26.250 502.348 Td /F1 9.8 Tf  [(the 2009 Australian bushfires, although whilst symptoms of evening wet cough worsened, dry cough and wheeze did not )] TJ ET
0.267 0.267 0.267 rg
BT 547.592 503.855 Td /F4 8.7 Tf  [(42)] TJ ET
0.271 0.267 0.267 rg
BT 557.230 502.348 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 482.943 Td /F1 9.8 Tf  [(A study of 465 non-asthmatic teenagers affected by 2003 wildfires in Spain revealed that healthy patients with estimated smaller )] TJ ET
BT 26.250 471.039 Td /F1 9.8 Tf  [(airways who performed on the lowest quartile of lung function tests were more susceptible to the respiratory effects of wildfire )] TJ ET
BT 26.250 459.134 Td /F1 9.8 Tf  [(smoke )] TJ ET
0.267 0.267 0.267 rg
BT 57.674 460.641 Td /F4 8.7 Tf  [(43)] TJ ET
0.271 0.267 0.267 rg
BT 67.312 459.134 Td /F1 9.8 Tf  [(. Those with smaller airways and poorer pre- existing lung function were more vulnerable to smoke effects.)] TJ ET
BT 26.250 439.729 Td /F1 9.8 Tf  [(Data from the 1994 Sydney Bushfires show that there was no increase in acute asthma related admissions in central Sydney )] TJ ET
0.267 0.267 0.267 rg
BT 566.537 441.236 Td /F4 8.7 Tf  [(44)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 427.824 Td /F1 9.8 Tf  [(or Western Sydney )] TJ ET
0.267 0.267 0.267 rg
BT 111.865 429.332 Td /F4 8.7 Tf  [(45)] TJ ET
0.271 0.267 0.267 rg
BT 121.502 427.824 Td /F1 9.8 Tf  [( in the aftermath of the fires. This may not however reflect the true prevalence of asthma exacerbations, )] TJ ET
BT 26.250 415.920 Td /F1 9.8 Tf  [(as only the more severe cases would present to the ED. In the days following the 1987 Californian bushfire, there was a 40% )] TJ ET
BT 26.250 404.015 Td /F1 9.8 Tf  [(increase in ED attendances )] TJ ET
0.267 0.267 0.267 rg
BT 148.183 405.522 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 157.821 404.015 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 384.610 Td /F1 9.8 Tf  [(A cohort study from Darwin Australia shows that studies looking at hospital attendances alone may underestimate the )] TJ ET
BT 26.250 372.705 Td /F1 9.8 Tf  [(respiratory symptoms)] TJ ET
0.267 0.267 0.267 rg
BT 119.431 374.213 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 129.068 372.705 Td /F1 9.8 Tf  [(. In this study, 251 adults and children were asked to keep a record of their asthma symptoms during a )] TJ ET
BT 26.250 360.801 Td /F1 9.8 Tf  [(7 month bushfire period in 2004. During this time, PM)] TJ ET
BT 256.555 358.736 Td /F1 8.7 Tf  [(10)] TJ ET
BT 266.192 360.801 Td /F1 9.8 Tf  [( ranged from 2.6 � 43.3 �g m)] TJ ET
BT 391.928 364.689 Td /F1 8.7 Tf  [(?3)] TJ ET
BT 401.565 360.801 Td /F1 9.8 Tf  [(. High PM)] TJ ET
BT 444.368 358.736 Td /F1 8.7 Tf  [(10)] TJ ET
BT 454.005 360.801 Td /F1 9.8 Tf  [( levels were significantly )] TJ ET
BT 26.250 348.896 Td /F1 9.8 Tf  [(associated with an onset of asthma symptoms, use of oral steroid medication, the mean daily symptom count and the mean )] TJ ET
BT 26.250 336.991 Td /F1 9.8 Tf  [(daily dose of beta 2 agonists. However, there was no increase in the numbers of health care attendances or severe asthma )] TJ ET
BT 26.250 325.086 Td /F1 9.8 Tf  [(attacks)] TJ ET
BT 26.250 305.682 Td /F1 9.8 Tf  [(An increase in respiratory symptoms and deteriorating lung function was also seen in a study of findings reported by respiratory )] TJ ET
BT 26.250 293.777 Td /F1 9.8 Tf  [(physicians and governmental reports in Indonesia at the time of the Indonesian bushfires of 1997 )] TJ ET
0.267 0.267 0.267 rg
BT 446.807 295.284 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 456.444 293.777 Td /F1 9.8 Tf  [(. Worsening of respiratory )] TJ ET
BT 26.250 281.872 Td /F1 9.8 Tf  [(symptoms were seen during the same period in surrounding countries such as Malaysia )] TJ ET
0.267 0.267 0.267 rg
BT 407.728 283.379 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 417.366 281.872 Td /F1 9.8 Tf  [( and Singapore )] TJ ET
0.267 0.267 0.267 rg
BT 486.201 283.379 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 495.838 281.872 Td /F1 9.8 Tf  [(, illustrating the )] TJ ET
BT 26.250 269.967 Td /F1 9.8 Tf  [(ability of particulate matter and air pollution to spread widely. 94% of the air particles noted in Singapore in the haze following )] TJ ET
BT 26.250 258.063 Td /F1 9.8 Tf  [(the Indonesian fires were PM)] TJ ET
BT 152.512 255.998 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 164.559 258.063 Td /F1 9.8 Tf  [(, and emergency department attendances related to the haze increased although overall )] TJ ET
BT 26.250 246.158 Td /F1 9.8 Tf  [(hospital admissions due to respiratory effects did not)] TJ ET
0.267 0.267 0.267 rg
BT 253.308 247.665 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 262.945 246.158 Td /F1 9.8 Tf  [(. These effects were observed more than 500 km from the bushfires.)] TJ ET
BT 26.250 226.753 Td /F1 9.8 Tf  [(Delayed health effects may also occur: one study looking at health effects after the 2003 Canadian wildfires showed that there )] TJ ET
BT 26.250 214.848 Td /F1 9.8 Tf  [(was no increase in presentations to medical services for mental health or cardiovascular problems, but there was a peak in )] TJ ET
BT 26.250 202.944 Td /F1 9.8 Tf  [(respiratory consultations 5 weeks after the fires. This may be because of delayed respiratory health effects of wildfires smoke )] TJ ET
0.267 0.267 0.267 rg
BT 568.135 204.451 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 191.039 Td /F1 9.8 Tf  [(. In addition, long term exposure to particulate matter may increase susceptibility to infection possibly through an impairment of )] TJ ET
BT 26.250 179.134 Td /F1 9.8 Tf  [(respiratory clearance systems )] TJ ET
0.267 0.267 0.267 rg
BT 158.450 180.641 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 168.088 179.134 Td /F1 9.8 Tf  [(, thus helping to explain an increase in pneumonia and acute bronchiolitis seen after the 2003 )] TJ ET
BT 26.250 167.229 Td /F1 9.8 Tf  [(Californian wildfires.)] TJ ET
BT 26.250 147.825 Td /F1 9.8 Tf  [(Despite frequent fires in Europe, very little literature exists on potential associated health effects. The vegetation fires which )] TJ ET
BT 26.250 135.920 Td /F1 9.8 Tf  [(surrounded Vilnius in Lithuania in 2002 caused increases in hospital attendances for respiratory conditions and asthma )] TJ ET
0.267 0.267 0.267 rg
BT 541.079 137.427 Td /F4 8.7 Tf  [(53)] TJ ET
0.271 0.267 0.267 rg
BT 550.717 135.920 Td /F1 9.8 Tf  [(. )] TJ ET
BT 26.250 124.015 Td /F1 9.8 Tf  [(These peaked in September \(the fires started in early August\), possibly due to delayed respiratory effects or increased air )] TJ ET
BT 26.250 112.110 Td /F1 9.8 Tf  [(pollutant levels. High levels of ozone, PM)] TJ ET
BT 203.993 110.046 Td /F1 8.7 Tf  [(10)] TJ ET
BT 213.630 112.110 Td /F1 9.8 Tf  [(, nitrogen dioxide and carbon monoxide were noted in the atmosphere. Possible )] TJ ET
BT 26.250 100.206 Td /F1 9.8 Tf  [(recommendations may be to administer steroids more readily than usual for asthmatics, and recommend the avoidance of )] TJ ET
BT 26.250 88.301 Td /F1 9.8 Tf  [(outdoor activities for those vulnerable to respiratory pathology )] TJ ET
0.267 0.267 0.267 rg
BT 295.038 89.808 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 304.675 88.301 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 68.896 Td /F1 9.8 Tf  [(Although these studies on the respiratory effects reported from wildfires have been undertaken, little data on the levels of )] TJ ET
BT 26.250 56.991 Td /F1 9.8 Tf  [(pollutant exposure has been documented reducing the ability to extrapolate this information to UK wildfires.)] TJ ET
Q
q
15.000 27.706 577.500 749.294 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(during a bushfire season in 2003-2003\) )] TJ ET
0.267 0.267 0.267 rg
BT 198.591 768.983 Td /F4 8.7 Tf  [(39)] TJ ET
0.271 0.267 0.267 rg
BT 208.228 767.476 Td /F1 9.8 Tf  [(. A system of monitoring air pollution during and after wildfire events may provide )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(useful public health information, facilitating preparedness for increased pressure on health care services, and should be )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(considered. It would be important to monitor PM)] TJ ET
BT 233.252 741.602 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 245.299 743.667 Td /F1 9.8 Tf  [( levels, not just PM)] TJ ET
BT 327.121 741.602 Td /F1 8.7 Tf  [(10)] TJ ET
BT 336.758 743.667 Td /F1 9.8 Tf  [( levels. PM)] TJ ET
BT 384.436 741.602 Td /F1 8.7 Tf  [(10)] TJ ET
BT 394.073 743.667 Td /F1 9.8 Tf  [( monitoring alone may not adequately )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(represent the adverse effects of air quality that may be caused by the PM)] TJ ET
BT 342.199 729.698 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 356.655 731.762 Td /F1 9.8 Tf  [(fraction )] TJ ET
0.267 0.267 0.267 rg
BT 391.336 733.269 Td /F4 8.7 Tf  [(38)] TJ ET
0.271 0.267 0.267 rg
BT 400.973 731.762 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 695.159 Td /F4 12.0 Tf  [(Other Health Effects)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(Health effects of wildfires are wide ranging, and may result directly from both the thermal effects and smoke. Further health )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(implications include: psychological reactions to an extreme event, physical concerns such as trauma during evacuation, and )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(pressures on local resources, from increased demand on health services and inability of patients with chronic health care )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(conditions to access healthcare facilities.)] TJ ET
BT 26.250 620.086 Td /F4 9.8 Tf  [(Respiratory symptoms)] TJ ET
BT 26.250 600.681 Td /F1 9.8 Tf  [(Certain population groups are at particular risk of respiratory effects from bushfire smoke, including young children, those with )] TJ ET
BT 26.250 588.777 Td /F1 9.8 Tf  [(pre-existing cardiopulmonary conditions, and smokers )] TJ ET
0.267 0.267 0.267 rg
BT 261.956 590.284 Td /F4 8.7 Tf  [(40)] TJ ET
0.271 0.267 0.267 rg
BT 271.594 588.777 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 569.372 Td /F1 9.8 Tf  [(Patients with COPD have been noted to be at increased risk as a result of air pollution. A study looking at symptoms of 21 local )] TJ ET
BT 26.250 557.467 Td /F1 9.8 Tf  [(patients with COPD in the two months following the Denver wildfires of 2002 revealed that dyspnoea, cough, chest tightness, )] TJ ET
BT 26.250 545.562 Td /F1 9.8 Tf  [(wheeze and sputum production all increased on days when PM)] TJ ET
BT 299.377 543.498 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 311.423 545.562 Td /F1 9.8 Tf  [(, PM)] TJ ET
BT 331.469 543.498 Td /F1 8.7 Tf  [(10)] TJ ET
BT 341.107 545.562 Td /F1 9.8 Tf  [( and carbon monoxide levels in the atmosphere )] TJ ET
BT 26.250 533.658 Td /F1 9.8 Tf  [(increased, thus illustrating the link between air pollution from wildfires and COPD exacerbation )] TJ ET
0.267 0.267 0.267 rg
BT 435.906 535.165 Td /F4 8.7 Tf  [(41)] TJ ET
0.271 0.267 0.267 rg
BT 445.543 533.658 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 514.253 Td /F1 9.8 Tf  [(In a paediatric cohort study 32 children with a history of wheeze suffered adverse effects from increased PM)] TJ ET
BT 491.744 512.189 Td /F1 8.7 Tf  [(10)] TJ ET
BT 501.382 514.253 Td /F1 9.8 Tf  [( particles after )] TJ ET
BT 26.250 502.348 Td /F1 9.8 Tf  [(the 2009 Australian bushfires, although whilst symptoms of evening wet cough worsened, dry cough and wheeze did not )] TJ ET
0.267 0.267 0.267 rg
BT 547.592 503.855 Td /F4 8.7 Tf  [(42)] TJ ET
0.271 0.267 0.267 rg
BT 557.230 502.348 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 482.943 Td /F1 9.8 Tf  [(A study of 465 non-asthmatic teenagers affected by 2003 wildfires in Spain revealed that healthy patients with estimated smaller )] TJ ET
BT 26.250 471.039 Td /F1 9.8 Tf  [(airways who performed on the lowest quartile of lung function tests were more susceptible to the respiratory effects of wildfire )] TJ ET
BT 26.250 459.134 Td /F1 9.8 Tf  [(smoke )] TJ ET
0.267 0.267 0.267 rg
BT 57.674 460.641 Td /F4 8.7 Tf  [(43)] TJ ET
0.271 0.267 0.267 rg
BT 67.312 459.134 Td /F1 9.8 Tf  [(. Those with smaller airways and poorer pre- existing lung function were more vulnerable to smoke effects.)] TJ ET
BT 26.250 439.729 Td /F1 9.8 Tf  [(Data from the 1994 Sydney Bushfires show that there was no increase in acute asthma related admissions in central Sydney )] TJ ET
0.267 0.267 0.267 rg
BT 566.537 441.236 Td /F4 8.7 Tf  [(44)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 427.824 Td /F1 9.8 Tf  [(or Western Sydney )] TJ ET
0.267 0.267 0.267 rg
BT 111.865 429.332 Td /F4 8.7 Tf  [(45)] TJ ET
0.271 0.267 0.267 rg
BT 121.502 427.824 Td /F1 9.8 Tf  [( in the aftermath of the fires. This may not however reflect the true prevalence of asthma exacerbations, )] TJ ET
BT 26.250 415.920 Td /F1 9.8 Tf  [(as only the more severe cases would present to the ED. In the days following the 1987 Californian bushfire, there was a 40% )] TJ ET
BT 26.250 404.015 Td /F1 9.8 Tf  [(increase in ED attendances )] TJ ET
0.267 0.267 0.267 rg
BT 148.183 405.522 Td /F4 8.7 Tf  [(46)] TJ ET
0.271 0.267 0.267 rg
BT 157.821 404.015 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 384.610 Td /F1 9.8 Tf  [(A cohort study from Darwin Australia shows that studies looking at hospital attendances alone may underestimate the )] TJ ET
BT 26.250 372.705 Td /F1 9.8 Tf  [(respiratory symptoms)] TJ ET
0.267 0.267 0.267 rg
BT 119.431 374.213 Td /F4 8.7 Tf  [(47)] TJ ET
0.271 0.267 0.267 rg
BT 129.068 372.705 Td /F1 9.8 Tf  [(. In this study, 251 adults and children were asked to keep a record of their asthma symptoms during a )] TJ ET
BT 26.250 360.801 Td /F1 9.8 Tf  [(7 month bushfire period in 2004. During this time, PM)] TJ ET
BT 256.555 358.736 Td /F1 8.7 Tf  [(10)] TJ ET
BT 266.192 360.801 Td /F1 9.8 Tf  [( ranged from 2.6 � 43.3 �g m)] TJ ET
BT 391.928 364.689 Td /F1 8.7 Tf  [(?3)] TJ ET
BT 401.565 360.801 Td /F1 9.8 Tf  [(. High PM)] TJ ET
BT 444.368 358.736 Td /F1 8.7 Tf  [(10)] TJ ET
BT 454.005 360.801 Td /F1 9.8 Tf  [( levels were significantly )] TJ ET
BT 26.250 348.896 Td /F1 9.8 Tf  [(associated with an onset of asthma symptoms, use of oral steroid medication, the mean daily symptom count and the mean )] TJ ET
BT 26.250 336.991 Td /F1 9.8 Tf  [(daily dose of beta 2 agonists. However, there was no increase in the numbers of health care attendances or severe asthma )] TJ ET
BT 26.250 325.086 Td /F1 9.8 Tf  [(attacks)] TJ ET
BT 26.250 305.682 Td /F1 9.8 Tf  [(An increase in respiratory symptoms and deteriorating lung function was also seen in a study of findings reported by respiratory )] TJ ET
BT 26.250 293.777 Td /F1 9.8 Tf  [(physicians and governmental reports in Indonesia at the time of the Indonesian bushfires of 1997 )] TJ ET
0.267 0.267 0.267 rg
BT 446.807 295.284 Td /F4 8.7 Tf  [(48)] TJ ET
0.271 0.267 0.267 rg
BT 456.444 293.777 Td /F1 9.8 Tf  [(. Worsening of respiratory )] TJ ET
BT 26.250 281.872 Td /F1 9.8 Tf  [(symptoms were seen during the same period in surrounding countries such as Malaysia )] TJ ET
0.267 0.267 0.267 rg
BT 407.728 283.379 Td /F4 8.7 Tf  [(49)] TJ ET
0.271 0.267 0.267 rg
BT 417.366 281.872 Td /F1 9.8 Tf  [( and Singapore )] TJ ET
0.267 0.267 0.267 rg
BT 486.201 283.379 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 495.838 281.872 Td /F1 9.8 Tf  [(, illustrating the )] TJ ET
BT 26.250 269.967 Td /F1 9.8 Tf  [(ability of particulate matter and air pollution to spread widely. 94% of the air particles noted in Singapore in the haze following )] TJ ET
BT 26.250 258.063 Td /F1 9.8 Tf  [(the Indonesian fires were PM)] TJ ET
BT 152.512 255.998 Td /F1 8.7 Tf  [(2.5)] TJ ET
BT 164.559 258.063 Td /F1 9.8 Tf  [(, and emergency department attendances related to the haze increased although overall )] TJ ET
BT 26.250 246.158 Td /F1 9.8 Tf  [(hospital admissions due to respiratory effects did not)] TJ ET
0.267 0.267 0.267 rg
BT 253.308 247.665 Td /F4 8.7 Tf  [(50)] TJ ET
0.271 0.267 0.267 rg
BT 262.945 246.158 Td /F1 9.8 Tf  [(. These effects were observed more than 500 km from the bushfires.)] TJ ET
BT 26.250 226.753 Td /F1 9.8 Tf  [(Delayed health effects may also occur: one study looking at health effects after the 2003 Canadian wildfires showed that there )] TJ ET
BT 26.250 214.848 Td /F1 9.8 Tf  [(was no increase in presentations to medical services for mental health or cardiovascular problems, but there was a peak in )] TJ ET
BT 26.250 202.944 Td /F1 9.8 Tf  [(respiratory consultations 5 weeks after the fires. This may be because of delayed respiratory health effects of wildfires smoke )] TJ ET
0.267 0.267 0.267 rg
BT 568.135 204.451 Td /F4 8.7 Tf  [(51)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 191.039 Td /F1 9.8 Tf  [(. In addition, long term exposure to particulate matter may increase susceptibility to infection possibly through an impairment of )] TJ ET
BT 26.250 179.134 Td /F1 9.8 Tf  [(respiratory clearance systems )] TJ ET
0.267 0.267 0.267 rg
BT 158.450 180.641 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 168.088 179.134 Td /F1 9.8 Tf  [(, thus helping to explain an increase in pneumonia and acute bronchiolitis seen after the 2003 )] TJ ET
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BT 292.298 301.127 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 301.936 299.619 Td /F1 9.8 Tf  [(, when a 6.1% increased rate admission for cardiovascular )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(complaints was seen following the fires, including an 11.3% increased rate of admission due to cardiac failure in comparison to )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(the air pollution levels reported before the wildfires started.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(After the Darwin wildfires, an increase in cardiovascular complications was seen in the Australian indigenous population only, )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(with a 3 day lag after raised bushfire smoke levels )] TJ ET
0.267 0.267 0.267 rg
BT 244.631 246.008 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 254.268 244.500 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 225.096 Td /F4 9.8 Tf  [(Ophthalmic effects)] TJ ET
BT 26.250 205.691 Td /F1 9.8 Tf  [(Eye irritation from air pollution has been noted, as well as reduced visibility as a result of ambient smoke )] TJ ET
0.267 0.267 0.267 rg
BT 477.636 207.198 Td /F4 8.7 Tf  [(57)] TJ ET
0.271 0.267 0.267 rg
BT 487.273 205.691 Td /F1 9.8 Tf  [(. Reduced visibility )] TJ ET
BT 26.250 193.786 Td /F1 9.8 Tf  [(from wildfire smoke has caused fatal road traffic collisions, so care must be taken when travelling around areas near wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 567.034 195.293 Td /F4 8.7 Tf  [(58)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 181.881 Td /F1 9.8 Tf  [(. The police and highway agencies have an important role in restricting access to at risk areas.)] TJ ET
BT 26.250 162.477 Td /F1 9.8 Tf  [(Corneal abrasions have also been reported; 13% of patients fire-related presentations to the emergency department the week )] TJ ET
BT 26.250 150.572 Td /F1 9.8 Tf  [(following Almeda County wildfires in California 1991 had corneal abrasions )] TJ ET
0.267 0.267 0.267 rg
BT 351.373 152.079 Td /F4 8.7 Tf  [(59)] TJ ET
0.271 0.267 0.267 rg
BT 361.011 150.572 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 131.167 Td /F4 9.8 Tf  [(Psychological effects)] TJ ET
BT 26.250 111.762 Td /F1 9.8 Tf  [(Overseas studies demonstrate that large wildfires can be devastating, destroying not only lives but livelihoods, homes and )] TJ ET
BT 26.250 99.858 Td /F1 9.8 Tf  [(communities. This is strikingly illustrated by Mcfarlane et al.)] TJ ET
0.267 0.267 0.267 rg
BT 281.983 101.365 Td /F4 8.7 Tf  [(60)] TJ ET
0.271 0.267 0.267 rg
BT 291.620 99.858 Td /F1 9.8 Tf  [(, who looked at the mental health impact of bushfires in an )] TJ ET
BT 26.250 87.953 Td /F1 9.8 Tf  [(Australian community. Twelve months after the fires, 42% of the population exposed to wildfires were classified as potential )] TJ ET
BT 26.250 76.048 Td /F1 9.8 Tf  [(psychiatric cases \(scored according to the General Health Questionnaire )] TJ ET
0.267 0.267 0.267 rg
BT 342.170 77.555 Td /F4 8.7 Tf  [(61)] TJ ET
0.271 0.267 0.267 rg
BT 351.807 76.048 Td /F1 9.8 Tf  [(\) � more than double that seen in the non-exposed )] TJ ET
BT 26.250 64.143 Td /F1 9.8 Tf  [(population.)] TJ ET
BT 26.250 44.739 Td /F1 9.8 Tf  [(A study of 357 patients who sought healthcare assistance \(therefore not a random sample of exposed persons\) after the 2003 )] TJ ET
Q
q
15.000 30.453 577.500 746.547 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F4 9.8 Tf  [(Burns)] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(An obvious risk to those in very close proximity to wildfires \(most likely those failing to vacate the fire area or fire fighters\) is that )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(of direct flame burns and thermal burns. Clinical management will be similar to that of a normal burns patient where there has )] TJ ET
BT 26.250 724.262 Td /F1 9.8 Tf  [(also bee inhalation of combustion products. Patients admitted to the ICU with burns after the Victoria Wildfires differed from )] TJ ET
BT 26.250 712.357 Td /F1 9.8 Tf  [(�usual� burns patients in that the degree of early multi-organ failures and the severity of inhalational burn were higher than )] TJ ET
BT 26.250 700.452 Td /F1 9.8 Tf  [(expected for the degree and percentage of burns )] TJ ET
0.267 0.267 0.267 rg
BT 240.340 701.960 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 249.978 700.452 Td /F1 9.8 Tf  [(. Another major factor is the number of casualties and potential demand on )] TJ ET
BT 26.250 688.548 Td /F1 9.8 Tf  [(healthcare resources, depending on the scale of the fire and its location in relation to urbanisation.)] TJ ET
BT 26.250 669.143 Td /F1 9.8 Tf  [(Severe burns require specialist multidisciplinary resources, which could become overwhelmed in the case of severe wildfire. )] TJ ET
BT 26.250 657.238 Td /F1 9.8 Tf  [(National burns disaster plans, such as the Australian Mass Casualty Burn Disaster Plan, instigated at the time of the �Black )] TJ ET
BT 26.250 645.333 Td /F1 9.8 Tf  [(Saturday� disaster in Victoria, Australia )] TJ ET
0.267 0.267 0.267 rg
BT 196.934 646.841 Td /F4 8.7 Tf  [(54)] TJ ET
0.271 0.267 0.267 rg
BT 206.571 645.333 Td /F1 9.8 Tf  [(, can help to mitigate against problems of overwhelmed resources.)] TJ ET
BT 26.250 625.929 Td /F1 9.8 Tf  [(In the 72 hours following the 2009 Victoria Wildfires, 17 patients presented to local EDs with burns of >10% of body surface )] TJ ET
BT 26.250 614.024 Td /F1 9.8 Tf  [(area \(BSA\) and another 129 with burns of <10% of BSA )] TJ ET
0.267 0.267 0.267 rg
BT 269.863 615.531 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 279.501 614.024 Td /F1 9.8 Tf  [(. 20 patients were managed at the specialist tertiary adult burns )] TJ ET
BT 26.250 602.119 Td /F1 9.8 Tf  [(centre, 19 of whom needed surgical procedures \(such as escharotomies or debridements\). The total theatre time for these )] TJ ET
BT 26.250 590.214 Td /F1 9.8 Tf  [(burns patients in the first 72 hours was 48.7 hours )] TJ ET
0.267 0.267 0.267 rg
BT 244.650 591.722 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 254.287 590.214 Td /F1 9.8 Tf  [(. This illustrates the extra impact on resources of a surge of burns patients; )] TJ ET
BT 26.250 578.310 Td /F1 9.8 Tf  [(even a small number of casualties can require significant resources.)] TJ ET
BT 26.250 558.905 Td /F1 9.8 Tf  [(If there are large numbers of burns presenting to hospital, careful triage is mandatory. Initial measures such as fluid )] TJ ET
BT 26.250 547.000 Td /F1 9.8 Tf  [(resuscitation, analgesia and covering affected areas with cling film can be instigated in the ED relatively easily even to larger )] TJ ET
BT 26.250 535.095 Td /F1 9.8 Tf  [(numbers of casualties. Such triage will avoid overloading specialist burns centres with the more minor burns that can be )] TJ ET
BT 26.250 523.191 Td /F1 9.8 Tf  [(effectively treated locally. The triage category for the more severely injured may also have to be adapted; for example, under )] TJ ET
BT 26.250 511.286 Td /F1 9.8 Tf  [(the Australian mass casualty burns disaster plan, the threshold of burns for admittance to the specialist burns centre )] TJ ET
BT 26.250 499.381 Td /F1 9.8 Tf  [(\(>20%BSA\) was revised to BSA >30% in order to avoid overwhelming specialist services )] TJ ET
0.267 0.267 0.267 rg
BT 412.058 500.888 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 421.695 499.381 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 479.976 Td /F4 9.8 Tf  [(Heat Induced Illness)] TJ ET
BT 26.250 460.572 Td /F1 9.8 Tf  [(Heat induced illness can be caused by working in hot and humid conditions and will be affected by proximity to the fire. The )] TJ ET
BT 26.250 448.667 Td /F1 9.8 Tf  [(extent of heat related illness will not be covered in full in this paper except to note that those directly involved with fire fighting )] TJ ET
BT 26.250 436.762 Td /F1 9.8 Tf  [(are particularly vulnerable.)] TJ ET
BT 26.250 417.357 Td /F1 9.8 Tf  [(Modern fire fighters� personal protective equipment \(PPE\) is comprised of tunics and leggings. The retention of heat within the )] TJ ET
BT 26.250 405.453 Td /F1 9.8 Tf  [(structural PPE can cause heat related illness, initially heat exhaustion leading to heat stroke. Careful design of wildfire PPE, rest )] TJ ET
BT 26.250 393.548 Td /F1 9.8 Tf  [(periods, adequate hydration and health awareness of those involved is extremely important )] TJ ET
0.267 0.267 0.267 rg
BT 421.856 395.055 Td /F4 8.7 Tf  [(55)] TJ ET
0.271 0.267 0.267 rg
BT 431.494 393.548 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 374.143 Td /F4 9.8 Tf  [(Cardiovascular effects)] TJ ET
BT 26.250 354.738 Td /F1 9.8 Tf  [(There was a slight increase in admissions to the ED with ischemic heart disease on days when there was air pollution from )] TJ ET
BT 26.250 342.834 Td /F1 9.8 Tf  [(Sydney wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 99.394 344.341 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 109.032 342.834 Td /F1 9.8 Tf  [(. Cardiovascular mortality rates also increased on days with high levels of bushfire smoke in a study of )] TJ ET
BT 26.250 330.929 Td /F1 9.8 Tf  [(Sydney air pollution between 1997 and 2004 \(OR 1.10 \(95%CI: 1.00�1.20\)\))] TJ ET
0.267 0.267 0.267 rg
BT 351.422 332.436 Td /F4 8.7 Tf  [(56)] TJ ET
0.271 0.267 0.267 rg
BT 361.060 330.929 Td /F1 9.8 Tf  [(. This may be secondary to high levels of PM)] TJ ET
BT 555.055 328.865 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 26.250 319.024 Td /F1 9.8 Tf  [(but further research needs to be carried out to establish this link.)] TJ ET
BT 26.250 299.619 Td /F1 9.8 Tf  [(A similar picture was seen after the 2003 Californian wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 292.298 301.127 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 301.936 299.619 Td /F1 9.8 Tf  [(, when a 6.1% increased rate admission for cardiovascular )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(complaints was seen following the fires, including an 11.3% increased rate of admission due to cardiac failure in comparison to )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(the air pollution levels reported before the wildfires started.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(After the Darwin wildfires, an increase in cardiovascular complications was seen in the Australian indigenous population only, )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(with a 3 day lag after raised bushfire smoke levels )] TJ ET
0.267 0.267 0.267 rg
BT 244.631 246.008 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 254.268 244.500 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 225.096 Td /F4 9.8 Tf  [(Ophthalmic effects)] TJ ET
BT 26.250 205.691 Td /F1 9.8 Tf  [(Eye irritation from air pollution has been noted, as well as reduced visibility as a result of ambient smoke )] TJ ET
0.267 0.267 0.267 rg
BT 477.636 207.198 Td /F4 8.7 Tf  [(57)] TJ ET
0.271 0.267 0.267 rg
BT 487.273 205.691 Td /F1 9.8 Tf  [(. Reduced visibility )] TJ ET
BT 26.250 193.786 Td /F1 9.8 Tf  [(from wildfire smoke has caused fatal road traffic collisions, so care must be taken when travelling around areas near wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 567.034 195.293 Td /F4 8.7 Tf  [(58)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 181.881 Td /F1 9.8 Tf  [(. The police and highway agencies have an important role in restricting access to at risk areas.)] TJ ET
BT 26.250 162.477 Td /F1 9.8 Tf  [(Corneal abrasions have also been reported; 13% of patients fire-related presentations to the emergency department the week )] TJ ET
BT 26.250 150.572 Td /F1 9.8 Tf  [(following Almeda County wildfires in California 1991 had corneal abrasions )] TJ ET
0.267 0.267 0.267 rg
BT 351.373 152.079 Td /F4 8.7 Tf  [(59)] TJ ET
0.271 0.267 0.267 rg
BT 361.011 150.572 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 131.167 Td /F4 9.8 Tf  [(Psychological effects)] TJ ET
BT 26.250 111.762 Td /F1 9.8 Tf  [(Overseas studies demonstrate that large wildfires can be devastating, destroying not only lives but livelihoods, homes and )] TJ ET
BT 26.250 99.858 Td /F1 9.8 Tf  [(communities. This is strikingly illustrated by Mcfarlane et al.)] TJ ET
0.267 0.267 0.267 rg
BT 281.983 101.365 Td /F4 8.7 Tf  [(60)] TJ ET
0.271 0.267 0.267 rg
BT 291.620 99.858 Td /F1 9.8 Tf  [(, who looked at the mental health impact of bushfires in an )] TJ ET
BT 26.250 87.953 Td /F1 9.8 Tf  [(Australian community. Twelve months after the fires, 42% of the population exposed to wildfires were classified as potential )] TJ ET
BT 26.250 76.048 Td /F1 9.8 Tf  [(psychiatric cases \(scored according to the General Health Questionnaire )] TJ ET
0.267 0.267 0.267 rg
BT 342.170 77.555 Td /F4 8.7 Tf  [(61)] TJ ET
0.271 0.267 0.267 rg
BT 351.807 76.048 Td /F1 9.8 Tf  [(\) � more than double that seen in the non-exposed )] TJ ET
BT 26.250 64.143 Td /F1 9.8 Tf  [(population.)] TJ ET
BT 26.250 44.739 Td /F1 9.8 Tf  [(A study of 357 patients who sought healthcare assistance \(therefore not a random sample of exposed persons\) after the 2003 )] TJ ET
Q
q
15.000 30.453 577.500 746.547 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F4 9.8 Tf  [(Burns)] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(An obvious risk to those in very close proximity to wildfires \(most likely those failing to vacate the fire area or fire fighters\) is that )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(of direct flame burns and thermal burns. Clinical management will be similar to that of a normal burns patient where there has )] TJ ET
BT 26.250 724.262 Td /F1 9.8 Tf  [(also bee inhalation of combustion products. Patients admitted to the ICU with burns after the Victoria Wildfires differed from )] TJ ET
BT 26.250 712.357 Td /F1 9.8 Tf  [(�usual� burns patients in that the degree of early multi-organ failures and the severity of inhalational burn were higher than )] TJ ET
BT 26.250 700.452 Td /F1 9.8 Tf  [(expected for the degree and percentage of burns )] TJ ET
0.267 0.267 0.267 rg
BT 240.340 701.960 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 249.978 700.452 Td /F1 9.8 Tf  [(. Another major factor is the number of casualties and potential demand on )] TJ ET
BT 26.250 688.548 Td /F1 9.8 Tf  [(healthcare resources, depending on the scale of the fire and its location in relation to urbanisation.)] TJ ET
BT 26.250 669.143 Td /F1 9.8 Tf  [(Severe burns require specialist multidisciplinary resources, which could become overwhelmed in the case of severe wildfire. )] TJ ET
BT 26.250 657.238 Td /F1 9.8 Tf  [(National burns disaster plans, such as the Australian Mass Casualty Burn Disaster Plan, instigated at the time of the �Black )] TJ ET
BT 26.250 645.333 Td /F1 9.8 Tf  [(Saturday� disaster in Victoria, Australia )] TJ ET
0.267 0.267 0.267 rg
BT 196.934 646.841 Td /F4 8.7 Tf  [(54)] TJ ET
0.271 0.267 0.267 rg
BT 206.571 645.333 Td /F1 9.8 Tf  [(, can help to mitigate against problems of overwhelmed resources.)] TJ ET
BT 26.250 625.929 Td /F1 9.8 Tf  [(In the 72 hours following the 2009 Victoria Wildfires, 17 patients presented to local EDs with burns of >10% of body surface )] TJ ET
BT 26.250 614.024 Td /F1 9.8 Tf  [(area \(BSA\) and another 129 with burns of <10% of BSA )] TJ ET
0.267 0.267 0.267 rg
BT 269.863 615.531 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 279.501 614.024 Td /F1 9.8 Tf  [(. 20 patients were managed at the specialist tertiary adult burns )] TJ ET
BT 26.250 602.119 Td /F1 9.8 Tf  [(centre, 19 of whom needed surgical procedures \(such as escharotomies or debridements\). The total theatre time for these )] TJ ET
BT 26.250 590.214 Td /F1 9.8 Tf  [(burns patients in the first 72 hours was 48.7 hours )] TJ ET
0.267 0.267 0.267 rg
BT 244.650 591.722 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 254.287 590.214 Td /F1 9.8 Tf  [(. This illustrates the extra impact on resources of a surge of burns patients; )] TJ ET
BT 26.250 578.310 Td /F1 9.8 Tf  [(even a small number of casualties can require significant resources.)] TJ ET
BT 26.250 558.905 Td /F1 9.8 Tf  [(If there are large numbers of burns presenting to hospital, careful triage is mandatory. Initial measures such as fluid )] TJ ET
BT 26.250 547.000 Td /F1 9.8 Tf  [(resuscitation, analgesia and covering affected areas with cling film can be instigated in the ED relatively easily even to larger )] TJ ET
BT 26.250 535.095 Td /F1 9.8 Tf  [(numbers of casualties. Such triage will avoid overloading specialist burns centres with the more minor burns that can be )] TJ ET
BT 26.250 523.191 Td /F1 9.8 Tf  [(effectively treated locally. The triage category for the more severely injured may also have to be adapted; for example, under )] TJ ET
BT 26.250 511.286 Td /F1 9.8 Tf  [(the Australian mass casualty burns disaster plan, the threshold of burns for admittance to the specialist burns centre )] TJ ET
BT 26.250 499.381 Td /F1 9.8 Tf  [(\(>20%BSA\) was revised to BSA >30% in order to avoid overwhelming specialist services )] TJ ET
0.267 0.267 0.267 rg
BT 412.058 500.888 Td /F4 8.7 Tf  [(14)] TJ ET
0.271 0.267 0.267 rg
BT 421.695 499.381 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 479.976 Td /F4 9.8 Tf  [(Heat Induced Illness)] TJ ET
BT 26.250 460.572 Td /F1 9.8 Tf  [(Heat induced illness can be caused by working in hot and humid conditions and will be affected by proximity to the fire. The )] TJ ET
BT 26.250 448.667 Td /F1 9.8 Tf  [(extent of heat related illness will not be covered in full in this paper except to note that those directly involved with fire fighting )] TJ ET
BT 26.250 436.762 Td /F1 9.8 Tf  [(are particularly vulnerable.)] TJ ET
BT 26.250 417.357 Td /F1 9.8 Tf  [(Modern fire fighters� personal protective equipment \(PPE\) is comprised of tunics and leggings. The retention of heat within the )] TJ ET
BT 26.250 405.453 Td /F1 9.8 Tf  [(structural PPE can cause heat related illness, initially heat exhaustion leading to heat stroke. Careful design of wildfire PPE, rest )] TJ ET
BT 26.250 393.548 Td /F1 9.8 Tf  [(periods, adequate hydration and health awareness of those involved is extremely important )] TJ ET
0.267 0.267 0.267 rg
BT 421.856 395.055 Td /F4 8.7 Tf  [(55)] TJ ET
0.271 0.267 0.267 rg
BT 431.494 393.548 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 374.143 Td /F4 9.8 Tf  [(Cardiovascular effects)] TJ ET
BT 26.250 354.738 Td /F1 9.8 Tf  [(There was a slight increase in admissions to the ED with ischemic heart disease on days when there was air pollution from )] TJ ET
BT 26.250 342.834 Td /F1 9.8 Tf  [(Sydney wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 99.394 344.341 Td /F4 8.7 Tf  [(31)] TJ ET
0.271 0.267 0.267 rg
BT 109.032 342.834 Td /F1 9.8 Tf  [(. Cardiovascular mortality rates also increased on days with high levels of bushfire smoke in a study of )] TJ ET
BT 26.250 330.929 Td /F1 9.8 Tf  [(Sydney air pollution between 1997 and 2004 \(OR 1.10 \(95%CI: 1.00�1.20\)\))] TJ ET
0.267 0.267 0.267 rg
BT 351.422 332.436 Td /F4 8.7 Tf  [(56)] TJ ET
0.271 0.267 0.267 rg
BT 361.060 330.929 Td /F1 9.8 Tf  [(. This may be secondary to high levels of PM)] TJ ET
BT 555.055 328.865 Td /F1 8.7 Tf  [(2.5 )] TJ ET
BT 26.250 319.024 Td /F1 9.8 Tf  [(but further research needs to be carried out to establish this link.)] TJ ET
BT 26.250 299.619 Td /F1 9.8 Tf  [(A similar picture was seen after the 2003 Californian wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 292.298 301.127 Td /F4 8.7 Tf  [(52)] TJ ET
0.271 0.267 0.267 rg
BT 301.936 299.619 Td /F1 9.8 Tf  [(, when a 6.1% increased rate admission for cardiovascular )] TJ ET
BT 26.250 287.715 Td /F1 9.8 Tf  [(complaints was seen following the fires, including an 11.3% increased rate of admission due to cardiac failure in comparison to )] TJ ET
BT 26.250 275.810 Td /F1 9.8 Tf  [(the air pollution levels reported before the wildfires started.)] TJ ET
BT 26.250 256.405 Td /F1 9.8 Tf  [(After the Darwin wildfires, an increase in cardiovascular complications was seen in the Australian indigenous population only, )] TJ ET
BT 26.250 244.500 Td /F1 9.8 Tf  [(with a 3 day lag after raised bushfire smoke levels )] TJ ET
0.267 0.267 0.267 rg
BT 244.631 246.008 Td /F4 8.7 Tf  [(34)] TJ ET
0.271 0.267 0.267 rg
BT 254.268 244.500 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 225.096 Td /F4 9.8 Tf  [(Ophthalmic effects)] TJ ET
BT 26.250 205.691 Td /F1 9.8 Tf  [(Eye irritation from air pollution has been noted, as well as reduced visibility as a result of ambient smoke )] TJ ET
0.267 0.267 0.267 rg
BT 477.636 207.198 Td /F4 8.7 Tf  [(57)] TJ ET
0.271 0.267 0.267 rg
BT 487.273 205.691 Td /F1 9.8 Tf  [(. Reduced visibility )] TJ ET
BT 26.250 193.786 Td /F1 9.8 Tf  [(from wildfire smoke has caused fatal road traffic collisions, so care must be taken when travelling around areas near wildfires )] TJ ET
0.267 0.267 0.267 rg
BT 567.034 195.293 Td /F4 8.7 Tf  [(58)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 181.881 Td /F1 9.8 Tf  [(. The police and highway agencies have an important role in restricting access to at risk areas.)] TJ ET
BT 26.250 162.477 Td /F1 9.8 Tf  [(Corneal abrasions have also been reported; 13% of patients fire-related presentations to the emergency department the week )] TJ ET
BT 26.250 150.572 Td /F1 9.8 Tf  [(following Almeda County wildfires in California 1991 had corneal abrasions )] TJ ET
0.267 0.267 0.267 rg
BT 351.373 152.079 Td /F4 8.7 Tf  [(59)] TJ ET
0.271 0.267 0.267 rg
BT 361.011 150.572 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 131.167 Td /F4 9.8 Tf  [(Psychological effects)] TJ ET
BT 26.250 111.762 Td /F1 9.8 Tf  [(Overseas studies demonstrate that large wildfires can be devastating, destroying not only lives but livelihoods, homes and )] TJ ET
BT 26.250 99.858 Td /F1 9.8 Tf  [(communities. This is strikingly illustrated by Mcfarlane et al.)] TJ ET
0.267 0.267 0.267 rg
BT 281.983 101.365 Td /F4 8.7 Tf  [(60)] TJ ET
0.271 0.267 0.267 rg
BT 291.620 99.858 Td /F1 9.8 Tf  [(, who looked at the mental health impact of bushfires in an )] TJ ET
BT 26.250 87.953 Td /F1 9.8 Tf  [(Australian community. Twelve months after the fires, 42% of the population exposed to wildfires were classified as potential )] TJ ET
BT 26.250 76.048 Td /F1 9.8 Tf  [(psychiatric cases \(scored according to the General Health Questionnaire )] TJ ET
0.267 0.267 0.267 rg
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BT 239.765 58.499 Td /F4 8.7 Tf  [(77)] TJ ET
0.271 0.267 0.267 rg
BT 249.403 56.991 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 37.587 Td /F1 9.8 Tf  [(After the Russian wildfires in 2010, concern was raised that up to 4% re � suspension of radioactively contaminated \(from )] TJ ET
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q
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BT 26.250 767.476 Td /F1 9.8 Tf  [(Californian wildfires also gives a dramatic picture, with 33% showing symptoms of major depression and 24% showing )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(symptoms of Post Traumatic Stress Disorder )] TJ ET
0.267 0.267 0.267 rg
BT 222.381 757.079 Td /F4 8.7 Tf  [(62)] TJ ET
0.271 0.267 0.267 rg
BT 232.018 755.571 Td /F1 9.8 Tf  [(. Property damage and physical injury during the fires were significantly � )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(associated with psychopathology. This suggests that screening people who present for emergency relief centres in the )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(aftermath of a wildfire may be of help to identify people who are particularly likely to suffer from psychopathology.)] TJ ET
BT 26.250 712.357 Td /F1 9.8 Tf  [(A cross sectional case control study )] TJ ET
0.267 0.267 0.267 rg
BT 183.937 713.864 Td /F4 8.7 Tf  [(63)] TJ ET
0.271 0.267 0.267 rg
BT 193.574 712.357 Td /F1 9.8 Tf  [( looked at those affected by the Greek wildfires of 2007. Increased symptoms of )] TJ ET
BT 26.250 700.452 Td /F1 9.8 Tf  [(somatisation, depression, anxiety, hostility, and paranoia were found in those who were victims of the fire compared with )] TJ ET
BT 26.250 688.548 Td /F1 9.8 Tf  [(controls. Another study of 30 adults 6 weeks post exposure to wildfires showed increased levels of posttraumatic stress, )] TJ ET
BT 26.250 676.643 Td /F1 9.8 Tf  [(depression, and anxiety symptoms )] TJ ET
0.267 0.267 0.267 rg
BT 179.062 678.150 Td /F4 8.7 Tf  [(64)] TJ ET
0.271 0.267 0.267 rg
BT 188.699 676.643 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 657.238 Td /F1 9.8 Tf  [(There is strong psychological link between local populations and their geographical surroundings, which assume great cultural, )] TJ ET
BT 26.250 645.333 Td /F1 9.8 Tf  [(social and personal significance. The devastating effects of a wildfire on physical surroundings can translate to psychological )] TJ ET
BT 26.250 633.429 Td /F1 9.8 Tf  [(distress )] TJ ET
0.267 0.267 0.267 rg
BT 62.549 634.936 Td /F4 8.7 Tf  [(65)] TJ ET
0.271 0.267 0.267 rg
BT 72.187 633.429 Td /F1 9.8 Tf  [(. Immense efforts to preserve buildings of importance to the community were made by Greek firefighters in the )] TJ ET
BT 26.250 621.524 Td /F1 9.8 Tf  [(August 2007 fires who saved the temples of Ancient Olympia \(home of the Olympic Games\). A study of the mental health of )] TJ ET
BT 26.250 609.619 Td /F1 9.8 Tf  [(these firefighters noted that 19 of 102 had post-traumatic stress disorder as defined by ICD-10 )] TJ ET
0.267 0.267 0.267 rg
BT 434.863 611.126 Td /F4 8.7 Tf  [(66)] TJ ET
0.271 0.267 0.267 rg
BT 444.500 609.619 Td /F1 9.8 Tf  [(. The authors note that early )] TJ ET
BT 26.250 597.714 Td /F1 9.8 Tf  [(detection of post traumatic stress may help to mitigate against post disaster psychiatric morbidity.)] TJ ET
BT 26.250 578.310 Td /F1 9.8 Tf  [(Increased smoking and anxiolytic use has been observed after wildfire exposure. 2063 adolescents and young adults were )] TJ ET
BT 26.250 566.405 Td /F1 9.8 Tf  [(assessed to see whether exposure to a traumatic event, in this case the 2003 Australian wildfires, increased tobacco smoking )] TJ ET
0.267 0.267 0.267 rg
BT 570.329 567.912 Td /F4 8.7 Tf  [(67)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 554.500 Td /F1 9.8 Tf  [(. Exposure to traumatic events during the disaster, independent of PTSD symptoms, was a predictor of increased tobacco use )] TJ ET
BT 26.250 542.595 Td /F1 9.8 Tf  [(\(OR 1.12, 95%CI 1.03-1.21\). Increased consumption of anxiolytics was noted in men after exposure to the 2006 wildfires in )] TJ ET
BT 26.250 530.691 Td /F1 9.8 Tf  [(Northern Spain )] TJ ET
0.267 0.267 0.267 rg
BT 94.529 532.198 Td /F4 8.7 Tf  [(68)] TJ ET
0.271 0.267 0.267 rg
BT 104.167 530.691 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 511.286 Td /F1 9.8 Tf  [(The nature of the media coverage following a wildfire can make a difference to the population�s psychological health. Vicarious )] TJ ET
BT 26.250 499.381 Td /F1 9.8 Tf  [(traumatisation � i.e. symptoms suggestive of post-traumatic stress disorder in patients who themselves have not been exposed )] TJ ET
BT 26.250 487.476 Td /F1 9.8 Tf  [(to the tragedy directly but only through exposure to the media has also been noted following the 2001 New South Wales )] TJ ET
BT 26.250 475.572 Td /F1 9.8 Tf  [(bushfires )] TJ ET
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BT 68.516 477.079 Td /F4 8.7 Tf  [(69)] TJ ET
0.271 0.267 0.267 rg
BT 78.154 475.572 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 456.167 Td /F1 9.8 Tf  [(Studies of rescue workers show that psychological effects can be both delayed and in some cases beneficial. 469 firefighters )] TJ ET
BT 26.250 444.262 Td /F1 9.8 Tf  [(were followed up for 25 months after exposure to a bushfire )] TJ ET
0.267 0.267 0.267 rg
BT 285.834 445.769 Td /F4 8.7 Tf  [(61)] TJ ET
0.271 0.267 0.267 rg
BT 295.471 448.150 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 297.881 445.769 Td /F4 8.7 Tf  [(70)] TJ ET
0.271 0.267 0.267 rg
BT 307.518 444.262 Td /F1 9.8 Tf  [(. Delayed and chronic psychiatric morbidity was more )] TJ ET
BT 26.250 432.357 Td /F1 9.8 Tf  [(prevalent than acute morbidity, and severity of morbidity was linked to the firefighters� losses and extent of exposure. Those )] TJ ET
BT 26.250 420.453 Td /F1 9.8 Tf  [(involved in the recovery may show some beneficial as well as detrimental psychological effects, since team building and )] TJ ET
BT 26.250 408.548 Td /F1 9.8 Tf  [(working together have been described )] TJ ET
0.267 0.267 0.267 rg
BT 194.252 410.055 Td /F4 8.7 Tf  [(71)] TJ ET
0.271 0.267 0.267 rg
BT 203.890 408.548 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 389.143 Td /F1 9.8 Tf  [(Paediatric Psychological Morbidity)] TJ ET
BT 26.250 369.738 Td /F1 9.8 Tf  [(Many studies have focused primarily on paediatric psychiatric morbidity in relation to wildfires. Younger children are at )] TJ ET
BT 26.250 357.834 Td /F1 9.8 Tf  [(especially high risk of PTSD symptoms, as are children who perceive their own lives to be at risk or experience ongoing loss or )] TJ ET
BT 26.250 345.929 Td /F1 9.8 Tf  [(disruption )] TJ ET
0.267 0.267 0.267 rg
BT 71.227 347.436 Td /F4 8.7 Tf  [(72)] TJ ET
0.271 0.267 0.267 rg
BT 80.864 345.929 Td /F1 9.8 Tf  [(. This was identified in a follow up study of 155 8-18 year olds exposed to the Canberra wildfires in 2005, leading )] TJ ET
BT 26.250 334.024 Td /F1 9.8 Tf  [(the authors to advise that identifying and supporting younger patients and those who are experiencing ongoing disruption may )] TJ ET
BT 26.250 322.119 Td /F1 9.8 Tf  [(help to mitigate against their development of PTSD symptoms.)] TJ ET
BT 26.250 302.715 Td /F1 9.8 Tf  [(Risk factors for depressive illness were assessed in a study of 2379 school children exposed to wildfires in Australia who were )] TJ ET
BT 26.250 290.810 Td /F1 9.8 Tf  [(followed up for 6 months after the event )] TJ ET
0.267 0.267 0.267 rg
BT 200.219 292.317 Td /F4 8.7 Tf  [(73)] TJ ET
0.271 0.267 0.267 rg
BT 209.857 290.810 Td /F1 9.8 Tf  [(. Factors contributing to psychiatric morbidity \(as measured by increased emotional )] TJ ET
BT 26.250 278.905 Td /F1 9.8 Tf  [(stress and anxiety\) included evacuation and experience. These factors were also predictive for ongoing emotional distress, as )] TJ ET
BT 26.250 267.000 Td /F1 9.8 Tf  [(was a perceived threat to self or parents.)] TJ ET
BT 26.250 247.596 Td /F1 9.8 Tf  [(Continuation of psychological morbidity in to adulthood may be of concern, as illustrated by a cohort of 806 children who had )] TJ ET
BT 26.250 235.691 Td /F1 9.8 Tf  [(been exposed to bushfires in Australia in 1983 who were followed up for 20 years )] TJ ET
0.267 0.267 0.267 rg
BT 379.590 237.198 Td /F4 8.7 Tf  [(74)] TJ ET
0.271 0.267 0.267 rg
BT 389.227 235.691 Td /F1 9.8 Tf  [(. Results suggested that although the )] TJ ET
BT 26.250 223.786 Td /F1 9.8 Tf  [(impact of the bushfires on overall adult psychiatric morbidity was small, after 20 years, seventy-five per cent of the bushfire-)] TJ ET
BT 26.250 211.881 Td /F1 9.8 Tf  [(exposed group reported some degree of distress in relation to the bushfire exposure.)] TJ ET
BT 26.250 192.477 Td /F1 9.8 Tf  [(A longitudinal study of children after Australian bushfires indicated that the mother�s psychological reaction to the disaster had a )] TJ ET
BT 26.250 180.572 Td /F1 9.8 Tf  [(greater impact on the child�s psychiatric morbidity than the child�s own exposure to the disaster. Thus targeting mothers when )] TJ ET
BT 26.250 168.667 Td /F1 9.8 Tf  [(offering psychological support may be worthwhile )] TJ ET
0.267 0.267 0.267 rg
BT 241.374 170.174 Td /F4 8.7 Tf  [(75)] TJ ET
0.271 0.267 0.267 rg
BT 251.011 168.667 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 132.065 Td /F4 12.0 Tf  [(Water and Land Pollution)] TJ ET
BT 26.250 112.110 Td /F1 9.8 Tf  [(Examination of potential water contamination in areas surrounding the Lithuanian fires of summer 2002 show that in the autumn )] TJ ET
BT 26.250 100.206 Td /F1 9.8 Tf  [(of that year there was a substantial \(60-81%\) increase in heavy metal \(copper, lead and zinc\) levels in surrounding rivers )] TJ ET
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BT 548.626 101.713 Td /F4 8.7 Tf  [(76)] TJ ET
0.271 0.267 0.267 rg
BT 558.263 100.206 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 80.801 Td /F1 9.8 Tf  [(Ash debris following the Californian wildfires of 2007 was found to contain high levels of heavy metals, including arsenic, )] TJ ET
BT 26.250 68.896 Td /F1 9.8 Tf  [(cadmium, copper, and lead. A national clean up campaign was organised because of concerns that exposure to high levels of )] TJ ET
BT 26.250 56.991 Td /F1 9.8 Tf  [(such metals could cause long term health effects )] TJ ET
0.267 0.267 0.267 rg
BT 239.765 58.499 Td /F4 8.7 Tf  [(77)] TJ ET
0.271 0.267 0.267 rg
BT 249.403 56.991 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 37.587 Td /F1 9.8 Tf  [(After the Russian wildfires in 2010, concern was raised that up to 4% re � suspension of radioactively contaminated \(from )] TJ ET
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q
15.000 23.301 577.500 753.699 re W n
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BT 26.250 767.476 Td /F1 9.8 Tf  [(Californian wildfires also gives a dramatic picture, with 33% showing symptoms of major depression and 24% showing )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(symptoms of Post Traumatic Stress Disorder )] TJ ET
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BT 222.381 757.079 Td /F4 8.7 Tf  [(62)] TJ ET
0.271 0.267 0.267 rg
BT 232.018 755.571 Td /F1 9.8 Tf  [(. Property damage and physical injury during the fires were significantly � )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(associated with psychopathology. This suggests that screening people who present for emergency relief centres in the )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(aftermath of a wildfire may be of help to identify people who are particularly likely to suffer from psychopathology.)] TJ ET
BT 26.250 712.357 Td /F1 9.8 Tf  [(A cross sectional case control study )] TJ ET
0.267 0.267 0.267 rg
BT 183.937 713.864 Td /F4 8.7 Tf  [(63)] TJ ET
0.271 0.267 0.267 rg
BT 193.574 712.357 Td /F1 9.8 Tf  [( looked at those affected by the Greek wildfires of 2007. Increased symptoms of )] TJ ET
BT 26.250 700.452 Td /F1 9.8 Tf  [(somatisation, depression, anxiety, hostility, and paranoia were found in those who were victims of the fire compared with )] TJ ET
BT 26.250 688.548 Td /F1 9.8 Tf  [(controls. Another study of 30 adults 6 weeks post exposure to wildfires showed increased levels of posttraumatic stress, )] TJ ET
BT 26.250 676.643 Td /F1 9.8 Tf  [(depression, and anxiety symptoms )] TJ ET
0.267 0.267 0.267 rg
BT 179.062 678.150 Td /F4 8.7 Tf  [(64)] TJ ET
0.271 0.267 0.267 rg
BT 188.699 676.643 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 657.238 Td /F1 9.8 Tf  [(There is strong psychological link between local populations and their geographical surroundings, which assume great cultural, )] TJ ET
BT 26.250 645.333 Td /F1 9.8 Tf  [(social and personal significance. The devastating effects of a wildfire on physical surroundings can translate to psychological )] TJ ET
BT 26.250 633.429 Td /F1 9.8 Tf  [(distress )] TJ ET
0.267 0.267 0.267 rg
BT 62.549 634.936 Td /F4 8.7 Tf  [(65)] TJ ET
0.271 0.267 0.267 rg
BT 72.187 633.429 Td /F1 9.8 Tf  [(. Immense efforts to preserve buildings of importance to the community were made by Greek firefighters in the )] TJ ET
BT 26.250 621.524 Td /F1 9.8 Tf  [(August 2007 fires who saved the temples of Ancient Olympia \(home of the Olympic Games\). A study of the mental health of )] TJ ET
BT 26.250 609.619 Td /F1 9.8 Tf  [(these firefighters noted that 19 of 102 had post-traumatic stress disorder as defined by ICD-10 )] TJ ET
0.267 0.267 0.267 rg
BT 434.863 611.126 Td /F4 8.7 Tf  [(66)] TJ ET
0.271 0.267 0.267 rg
BT 444.500 609.619 Td /F1 9.8 Tf  [(. The authors note that early )] TJ ET
BT 26.250 597.714 Td /F1 9.8 Tf  [(detection of post traumatic stress may help to mitigate against post disaster psychiatric morbidity.)] TJ ET
BT 26.250 578.310 Td /F1 9.8 Tf  [(Increased smoking and anxiolytic use has been observed after wildfire exposure. 2063 adolescents and young adults were )] TJ ET
BT 26.250 566.405 Td /F1 9.8 Tf  [(assessed to see whether exposure to a traumatic event, in this case the 2003 Australian wildfires, increased tobacco smoking )] TJ ET
0.267 0.267 0.267 rg
BT 570.329 567.912 Td /F4 8.7 Tf  [(67)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 554.500 Td /F1 9.8 Tf  [(. Exposure to traumatic events during the disaster, independent of PTSD symptoms, was a predictor of increased tobacco use )] TJ ET
BT 26.250 542.595 Td /F1 9.8 Tf  [(\(OR 1.12, 95%CI 1.03-1.21\). Increased consumption of anxiolytics was noted in men after exposure to the 2006 wildfires in )] TJ ET
BT 26.250 530.691 Td /F1 9.8 Tf  [(Northern Spain )] TJ ET
0.267 0.267 0.267 rg
BT 94.529 532.198 Td /F4 8.7 Tf  [(68)] TJ ET
0.271 0.267 0.267 rg
BT 104.167 530.691 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 511.286 Td /F1 9.8 Tf  [(The nature of the media coverage following a wildfire can make a difference to the population�s psychological health. Vicarious )] TJ ET
BT 26.250 499.381 Td /F1 9.8 Tf  [(traumatisation � i.e. symptoms suggestive of post-traumatic stress disorder in patients who themselves have not been exposed )] TJ ET
BT 26.250 487.476 Td /F1 9.8 Tf  [(to the tragedy directly but only through exposure to the media has also been noted following the 2001 New South Wales )] TJ ET
BT 26.250 475.572 Td /F1 9.8 Tf  [(bushfires )] TJ ET
0.267 0.267 0.267 rg
BT 68.516 477.079 Td /F4 8.7 Tf  [(69)] TJ ET
0.271 0.267 0.267 rg
BT 78.154 475.572 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 456.167 Td /F1 9.8 Tf  [(Studies of rescue workers show that psychological effects can be both delayed and in some cases beneficial. 469 firefighters )] TJ ET
BT 26.250 444.262 Td /F1 9.8 Tf  [(were followed up for 25 months after exposure to a bushfire )] TJ ET
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BT 285.834 445.769 Td /F4 8.7 Tf  [(61)] TJ ET
0.271 0.267 0.267 rg
BT 295.471 448.150 Td /F1 8.7 Tf  [(,)] TJ ET
0.267 0.267 0.267 rg
BT 297.881 445.769 Td /F4 8.7 Tf  [(70)] TJ ET
0.271 0.267 0.267 rg
BT 307.518 444.262 Td /F1 9.8 Tf  [(. Delayed and chronic psychiatric morbidity was more )] TJ ET
BT 26.250 432.357 Td /F1 9.8 Tf  [(prevalent than acute morbidity, and severity of morbidity was linked to the firefighters� losses and extent of exposure. Those )] TJ ET
BT 26.250 420.453 Td /F1 9.8 Tf  [(involved in the recovery may show some beneficial as well as detrimental psychological effects, since team building and )] TJ ET
BT 26.250 408.548 Td /F1 9.8 Tf  [(working together have been described )] TJ ET
0.267 0.267 0.267 rg
BT 194.252 410.055 Td /F4 8.7 Tf  [(71)] TJ ET
0.271 0.267 0.267 rg
BT 203.890 408.548 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 389.143 Td /F1 9.8 Tf  [(Paediatric Psychological Morbidity)] TJ ET
BT 26.250 369.738 Td /F1 9.8 Tf  [(Many studies have focused primarily on paediatric psychiatric morbidity in relation to wildfires. Younger children are at )] TJ ET
BT 26.250 357.834 Td /F1 9.8 Tf  [(especially high risk of PTSD symptoms, as are children who perceive their own lives to be at risk or experience ongoing loss or )] TJ ET
BT 26.250 345.929 Td /F1 9.8 Tf  [(disruption )] TJ ET
0.267 0.267 0.267 rg
BT 71.227 347.436 Td /F4 8.7 Tf  [(72)] TJ ET
0.271 0.267 0.267 rg
BT 80.864 345.929 Td /F1 9.8 Tf  [(. This was identified in a follow up study of 155 8-18 year olds exposed to the Canberra wildfires in 2005, leading )] TJ ET
BT 26.250 334.024 Td /F1 9.8 Tf  [(the authors to advise that identifying and supporting younger patients and those who are experiencing ongoing disruption may )] TJ ET
BT 26.250 322.119 Td /F1 9.8 Tf  [(help to mitigate against their development of PTSD symptoms.)] TJ ET
BT 26.250 302.715 Td /F1 9.8 Tf  [(Risk factors for depressive illness were assessed in a study of 2379 school children exposed to wildfires in Australia who were )] TJ ET
BT 26.250 290.810 Td /F1 9.8 Tf  [(followed up for 6 months after the event )] TJ ET
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BT 200.219 292.317 Td /F4 8.7 Tf  [(73)] TJ ET
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BT 209.857 290.810 Td /F1 9.8 Tf  [(. Factors contributing to psychiatric morbidity \(as measured by increased emotional )] TJ ET
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BT 26.250 267.000 Td /F1 9.8 Tf  [(was a perceived threat to self or parents.)] TJ ET
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BT 26.250 168.667 Td /F1 9.8 Tf  [(offering psychological support may be worthwhile )] TJ ET
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0.271 0.267 0.267 rg
BT 251.011 168.667 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 132.065 Td /F4 12.0 Tf  [(Water and Land Pollution)] TJ ET
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BT 548.626 101.713 Td /F4 8.7 Tf  [(76)] TJ ET
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BT 558.263 100.206 Td /F1 9.8 Tf  [(.)] TJ ET
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BT 26.250 767.476 Td /F1 9.8 Tf  [(Chernobyl\) soil could occur in areas affected by wildfire. Increased levels of caesium, strontium and plutonium occurred )] TJ ET
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BT 26.250 687.110 Td /F1 9.8 Tf  [(itself. Two hospitals were in the direct line of the 2003 San Diego Wildfire, and had to prepare for complete evacuation of the )] TJ ET
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40.154 171.490 40.337 171.934 40.337 172.381 c f
BT 45.750 169.413 Td /F1 9.8 Tf  [(Emergency service centres,)] TJ ET
40.337 156.726 m 
40.337 157.173 40.154 157.617 39.838 157.933 c
39.522 158.249 39.078 158.432 38.631 158.432 c
38.185 158.432 37.741 158.249 37.425 157.933 c
37.109 157.617 36.925 157.173 36.925 156.726 c
36.925 156.280 37.109 155.836 37.425 155.520 c
37.741 155.204 38.185 155.020 38.631 155.020 c
39.078 155.020 39.522 155.204 39.838 155.520 c
40.154 155.836 40.337 156.280 40.337 156.726 c f
BT 45.750 153.759 Td /F1 9.8 Tf  [(Transport infrastructure \(road, rail, air and inland waterways etc.\))] TJ ET
40.337 141.071 m 
40.337 141.518 40.154 141.962 39.838 142.278 c
39.522 142.594 39.078 142.778 38.631 142.778 c
38.185 142.778 37.741 142.594 37.425 142.278 c
37.109 141.962 36.925 141.518 36.925 141.071 c
36.925 140.625 37.109 140.181 37.425 139.865 c
37.741 139.549 38.185 139.365 38.631 139.365 c
39.078 139.365 39.522 139.549 39.838 139.865 c
40.154 140.181 40.337 140.625 40.337 141.071 c f
BT 45.750 138.104 Td /F1 9.8 Tf  [(Utility infrastructure \(generation and movement of; water and sewage, gas, electricity, fuel, communications etc.\))] TJ ET
40.337 125.417 m 
40.337 125.863 40.154 126.307 39.838 126.623 c
39.522 126.939 39.078 127.123 38.631 127.123 c
38.185 127.123 37.741 126.939 37.425 126.623 c
37.109 126.307 36.925 125.863 36.925 125.417 c
36.925 124.970 37.109 124.526 37.425 124.210 c
37.741 123.894 38.185 123.710 38.631 123.710 c
39.078 123.710 39.522 123.894 39.838 124.210 c
40.154 124.526 40.337 124.970 40.337 125.417 c f
BT 45.750 122.449 Td /F1 9.8 Tf  [(Other National and critical infrastructure facilities, structures and properties identified on National and Community Risk )] TJ ET
BT 45.750 110.544 Td /F1 9.8 Tf  [(Registers)] TJ ET
BT 26.250 87.390 Td /F1 9.8 Tf  [(Developments, facilities, structures and properties that adjoin high risk habitats, land uses and/or landscapes are within the )] TJ ET
BT 26.250 75.485 Td /F1 9.8 Tf  [(�Urban / Rural Interface�. Where wildfire could be a risk to human life it must be mitigated within the Local Authority�s Local )] TJ ET
BT 26.250 63.580 Td /F1 9.8 Tf  [(Development Framework and agreed by the appropriate agencies and authorities.)] TJ ET
Q
q
15.000 16.547 577.500 760.453 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(Chernobyl\) soil could occur in areas affected by wildfire. Increased levels of caesium, strontium and plutonium occurred )] TJ ET
0.267 0.267 0.267 rg
BT 543.195 768.983 Td /F4 8.7 Tf  [(78)] TJ ET
0.271 0.267 0.267 rg
BT 552.832 767.476 Td /F1 9.8 Tf  [(. )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(However the associated health risk to the firefighters and the general public was thought to be negligible.)] TJ ET
BT 26.250 718.969 Td /F4 12.0 Tf  [(Resources and Access)] TJ ET
BT 26.250 699.015 Td /F1 9.8 Tf  [(Access and egress routes to local hospitals may be blocked by traffic congestion as people leave the wildfire area or by the fire )] TJ ET
BT 26.250 687.110 Td /F1 9.8 Tf  [(itself. Two hospitals were in the direct line of the 2003 San Diego Wildfire, and had to prepare for complete evacuation of the )] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(hospital at very short notice )] TJ ET
0.267 0.267 0.267 rg
BT 147.637 676.712 Td /F4 8.7 Tf  [(79)] TJ ET
0.271 0.267 0.267 rg
BT 157.275 675.205 Td /F1 9.8 Tf  [(. Healthcare workers in these hospitals suffered adverse health consequences from ash and )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(smoke in the hospital ventilation system. Some were forced to decide between responding to the hospitals� calls for more )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(assistance and the need to evacuate their own homes.)] TJ ET
BT 26.250 631.991 Td /F1 9.8 Tf  [(Difficulty in accessing commodities including food and regular medication can have a significant impact, particularly on patients )] TJ ET
BT 26.250 620.086 Td /F1 9.8 Tf  [(with chronic health conditions who may be unable to collect their normal medication or attend medical appointments. The )] TJ ET
BT 26.250 608.181 Td /F1 9.8 Tf  [(elderly, the isolated, and those with chronic health problems will be particularly vulnerable. The US document �Wildfire Smoke, a )] TJ ET
BT 26.250 596.277 Td /F1 9.8 Tf  [(guide for public health officials� advises that patients have at least a 5 day stock of medication available, as well as several )] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(day�s worth of non-perishable food )] TJ ET
0.267 0.267 0.267 rg
BT 177.989 585.879 Td /F4 8.7 Tf  [(80)] TJ ET
0.271 0.267 0.267 rg
BT 187.627 584.372 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 564.967 Td /F1 9.8 Tf  [(As homes can be caught up in wildfires, it is imperative that access routes for inhabitants are as safe as possible, and well )] TJ ET
BT 26.250 553.062 Td /F1 9.8 Tf  [(signposted, especially in rural areas, so that emergency services can find them easily if needed. A leaflet published by the )] TJ ET
BT 26.250 541.158 Td /F1 9.8 Tf  [(Scottish Wildfire forum highlights this point, advising clear signage to rural properties )] TJ ET
0.267 0.267 0.267 rg
BT 393.094 542.665 Td /F4 8.7 Tf  [(81)] TJ ET
0.271 0.267 0.267 rg
BT 402.731 541.158 Td /F1 9.8 Tf  [(. Power supplies may be disrupted, )] TJ ET
BT 26.250 529.253 Td /F1 9.8 Tf  [(compounding effects on the local population. There is also a risk of electrocution from fallen power lines arcing because of )] TJ ET
BT 26.250 517.348 Td /F1 9.8 Tf  [(water and smoke.)] TJ ET
BT 26.250 480.746 Td /F4 12.0 Tf  [(Communication)] TJ ET
BT 26.250 460.791 Td /F1 9.8 Tf  [(A Global Early Warning System for Wildland Fire has been proposed )] TJ ET
0.267 0.267 0.267 rg
BT 325.361 462.299 Td /F4 8.7 Tf  [(82)] TJ ET
0.271 0.267 0.267 rg
BT 334.998 460.791 Td /F1 9.8 Tf  [(. Spanish systems of satellite surveillance have been )] TJ ET
BT 26.250 448.887 Td /F1 9.8 Tf  [(trialled with success, and may be worth developing elsewhere )] TJ ET
0.267 0.267 0.267 rg
BT 295.565 450.394 Td /F4 8.7 Tf  [(83)] TJ ET
0.271 0.267 0.267 rg
BT 305.202 448.887 Td /F1 9.8 Tf  [(. Safety measures to the public faced with a wildfire threat can )] TJ ET
BT 26.250 436.982 Td /F1 9.8 Tf  [(be issued.)] TJ ET
BT 26.250 417.577 Td /F1 9.8 Tf  [(An example of such a public health message is the �Ready, Set, Go� campaign in Texas )] TJ ET
0.267 0.267 0.267 rg
BT 408.840 419.084 Td /F4 8.7 Tf  [(84)] TJ ET
0.271 0.267 0.267 rg
BT 418.477 417.577 Td /F1 9.8 Tf  [(:)] TJ ET
0.271 0.267 0.267 RG
40.337 401.140 m 
40.337 401.587 40.154 402.031 39.838 402.347 c
39.522 402.662 39.078 402.846 38.631 402.846 c
38.185 402.846 37.741 402.662 37.425 402.347 c
37.109 402.031 36.925 401.587 36.925 401.140 c
36.925 400.693 37.109 400.249 37.425 399.933 c
37.741 399.618 38.185 399.434 38.631 399.434 c
39.078 399.434 39.522 399.618 39.838 399.933 c
40.154 400.249 40.337 400.693 40.337 401.140 c f
BT 45.750 398.172 Td /F1 9.8 Tf  [(Be ready for a fire threat)] TJ ET
40.337 385.485 m 
40.337 385.932 40.154 386.376 39.838 386.692 c
39.522 387.008 39.078 387.192 38.631 387.192 c
38.185 387.192 37.741 387.008 37.425 386.692 c
37.109 386.376 36.925 385.932 36.925 385.485 c
36.925 385.039 37.109 384.595 37.425 384.279 c
37.741 383.963 38.185 383.779 38.631 383.779 c
39.078 383.779 39.522 383.963 39.838 384.279 c
40.154 384.595 40.337 385.039 40.337 385.485 c f
BT 45.750 382.518 Td /F1 9.8 Tf  [(Have situational awareness if a fire threat occurs and be �set� to leave if you need to)] TJ ET
40.337 369.831 m 
40.337 370.277 40.154 370.721 39.838 371.037 c
39.522 371.353 39.078 371.537 38.631 371.537 c
38.185 371.537 37.741 371.353 37.425 371.037 c
37.109 370.721 36.925 370.277 36.925 369.831 c
36.925 369.384 37.109 368.940 37.425 368.624 c
37.741 368.308 38.185 368.124 38.631 368.124 c
39.078 368.124 39.522 368.308 39.838 368.624 c
40.154 368.940 40.337 369.384 40.337 369.831 c f
BT 45.750 366.863 Td /F1 9.8 Tf  [(Go early � leave at risk areas early)] TJ ET
BT 26.250 343.708 Td /F1 9.8 Tf  [(The UK government�s advice )] TJ ET
0.267 0.267 0.267 rg
BT 154.131 345.215 Td /F4 8.7 Tf  [(85)] TJ ET
0.271 0.267 0.267 rg
BT 163.768 343.708 Td /F1 9.8 Tf  [( to �Go in, stay in, tune in�, although aimed at general emergencies, may be useful to prevent )] TJ ET
BT 26.250 331.803 Td /F1 9.8 Tf  [(exposure to air pollution from fire smoke, as sheltering can reduce exposure )] TJ ET
0.267 0.267 0.267 rg
BT 356.804 333.311 Td /F4 8.7 Tf  [(86)] TJ ET
0.271 0.267 0.267 rg
BT 366.442 331.803 Td /F1 9.8 Tf  [(. Obviously this is less advisable for those who )] TJ ET
BT 26.250 319.899 Td /F1 9.8 Tf  [(are in the direct path of the fire, who may need to evacuate.)] TJ ET
BT 26.250 283.296 Td /F4 12.0 Tf  [(Development Planning)] TJ ET
BT 26.250 263.342 Td /F1 9.8 Tf  [(In the UK the new National Planning Policy Framework )] TJ ET
0.267 0.267 0.267 rg
BT 265.759 264.849 Td /F4 8.7 Tf  [(87)] TJ ET
0.271 0.267 0.267 rg
BT 275.396 263.342 Td /F1 9.8 Tf  [( provides scope to improve wildfire resilience in new and existing )] TJ ET
BT 26.250 251.437 Td /F1 9.8 Tf  [(developments under both natural hazard and climate change \(mitigation and adaptation\) policies. This will include:)] TJ ET
40.337 235.000 m 
40.337 235.447 40.154 235.891 39.838 236.207 c
39.522 236.522 39.078 236.706 38.631 236.706 c
38.185 236.706 37.741 236.522 37.425 236.207 c
37.109 235.891 36.925 235.447 36.925 235.000 c
36.925 234.553 37.109 234.109 37.425 233.793 c
37.741 233.478 38.185 233.294 38.631 233.294 c
39.078 233.294 39.522 233.478 39.838 233.793 c
40.154 234.109 40.337 234.553 40.337 235.000 c f
BT 45.750 232.032 Td /F1 9.8 Tf  [(Residential, commercial and industrial properties,)] TJ ET
40.337 219.345 m 
40.337 219.792 40.154 220.236 39.838 220.552 c
39.522 220.868 39.078 221.052 38.631 221.052 c
38.185 221.052 37.741 220.868 37.425 220.552 c
37.109 220.236 36.925 219.792 36.925 219.345 c
36.925 218.899 37.109 218.455 37.425 218.139 c
37.741 217.823 38.185 217.639 38.631 217.639 c
39.078 217.639 39.522 217.823 39.838 218.139 c
40.154 218.455 40.337 218.899 40.337 219.345 c f
BT 45.750 216.378 Td /F1 9.8 Tf  [(Nursing / care homes,)] TJ ET
40.337 203.691 m 
40.337 204.137 40.154 204.581 39.838 204.897 c
39.522 205.213 39.078 205.397 38.631 205.397 c
38.185 205.397 37.741 205.213 37.425 204.897 c
37.109 204.581 36.925 204.137 36.925 203.691 c
36.925 203.244 37.109 202.800 37.425 202.484 c
37.741 202.168 38.185 201.984 38.631 201.984 c
39.078 201.984 39.522 202.168 39.838 202.484 c
40.154 202.800 40.337 203.244 40.337 203.691 c f
BT 45.750 200.723 Td /F1 9.8 Tf  [(Health care facilities \(hospitals, care centres\),)] TJ ET
40.337 188.036 m 
40.337 188.482 40.154 188.926 39.838 189.242 c
39.522 189.558 39.078 189.742 38.631 189.742 c
38.185 189.742 37.741 189.558 37.425 189.242 c
37.109 188.926 36.925 188.482 36.925 188.036 c
36.925 187.589 37.109 187.145 37.425 186.829 c
37.741 186.513 38.185 186.329 38.631 186.329 c
39.078 186.329 39.522 186.513 39.838 186.829 c
40.154 187.145 40.337 187.589 40.337 188.036 c f
BT 45.750 185.068 Td /F1 9.8 Tf  [(Schools and other educational facilities,)] TJ ET
40.337 172.381 m 
40.337 172.828 40.154 173.272 39.838 173.588 c
39.522 173.903 39.078 174.087 38.631 174.087 c
38.185 174.087 37.741 173.903 37.425 173.588 c
37.109 173.272 36.925 172.828 36.925 172.381 c
36.925 171.934 37.109 171.490 37.425 171.174 c
37.741 170.859 38.185 170.675 38.631 170.675 c
39.078 170.675 39.522 170.859 39.838 171.174 c
40.154 171.490 40.337 171.934 40.337 172.381 c f
BT 45.750 169.413 Td /F1 9.8 Tf  [(Emergency service centres,)] TJ ET
40.337 156.726 m 
40.337 157.173 40.154 157.617 39.838 157.933 c
39.522 158.249 39.078 158.432 38.631 158.432 c
38.185 158.432 37.741 158.249 37.425 157.933 c
37.109 157.617 36.925 157.173 36.925 156.726 c
36.925 156.280 37.109 155.836 37.425 155.520 c
37.741 155.204 38.185 155.020 38.631 155.020 c
39.078 155.020 39.522 155.204 39.838 155.520 c
40.154 155.836 40.337 156.280 40.337 156.726 c f
BT 45.750 153.759 Td /F1 9.8 Tf  [(Transport infrastructure \(road, rail, air and inland waterways etc.\))] TJ ET
40.337 141.071 m 
40.337 141.518 40.154 141.962 39.838 142.278 c
39.522 142.594 39.078 142.778 38.631 142.778 c
38.185 142.778 37.741 142.594 37.425 142.278 c
37.109 141.962 36.925 141.518 36.925 141.071 c
36.925 140.625 37.109 140.181 37.425 139.865 c
37.741 139.549 38.185 139.365 38.631 139.365 c
39.078 139.365 39.522 139.549 39.838 139.865 c
40.154 140.181 40.337 140.625 40.337 141.071 c f
BT 45.750 138.104 Td /F1 9.8 Tf  [(Utility infrastructure \(generation and movement of; water and sewage, gas, electricity, fuel, communications etc.\))] TJ ET
40.337 125.417 m 
40.337 125.863 40.154 126.307 39.838 126.623 c
39.522 126.939 39.078 127.123 38.631 127.123 c
38.185 127.123 37.741 126.939 37.425 126.623 c
37.109 126.307 36.925 125.863 36.925 125.417 c
36.925 124.970 37.109 124.526 37.425 124.210 c
37.741 123.894 38.185 123.710 38.631 123.710 c
39.078 123.710 39.522 123.894 39.838 124.210 c
40.154 124.526 40.337 124.970 40.337 125.417 c f
BT 45.750 122.449 Td /F1 9.8 Tf  [(Other National and critical infrastructure facilities, structures and properties identified on National and Community Risk )] TJ ET
BT 45.750 110.544 Td /F1 9.8 Tf  [(Registers)] TJ ET
BT 26.250 87.390 Td /F1 9.8 Tf  [(Developments, facilities, structures and properties that adjoin high risk habitats, land uses and/or landscapes are within the )] TJ ET
BT 26.250 75.485 Td /F1 9.8 Tf  [(�Urban / Rural Interface�. Where wildfire could be a risk to human life it must be mitigated within the Local Authority�s Local )] TJ ET
BT 26.250 63.580 Td /F1 9.8 Tf  [(Development Framework and agreed by the appropriate agencies and authorities.)] TJ ET
Q
q
15.000 16.547 577.500 760.453 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(Chernobyl\) soil could occur in areas affected by wildfire. Increased levels of caesium, strontium and plutonium occurred )] TJ ET
0.267 0.267 0.267 rg
BT 543.195 768.983 Td /F4 8.7 Tf  [(78)] TJ ET
0.271 0.267 0.267 rg
BT 552.832 767.476 Td /F1 9.8 Tf  [(. )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(However the associated health risk to the firefighters and the general public was thought to be negligible.)] TJ ET
BT 26.250 718.969 Td /F4 12.0 Tf  [(Resources and Access)] TJ ET
BT 26.250 699.015 Td /F1 9.8 Tf  [(Access and egress routes to local hospitals may be blocked by traffic congestion as people leave the wildfire area or by the fire )] TJ ET
BT 26.250 687.110 Td /F1 9.8 Tf  [(itself. Two hospitals were in the direct line of the 2003 San Diego Wildfire, and had to prepare for complete evacuation of the )] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(hospital at very short notice )] TJ ET
0.267 0.267 0.267 rg
BT 147.637 676.712 Td /F4 8.7 Tf  [(79)] TJ ET
0.271 0.267 0.267 rg
BT 157.275 675.205 Td /F1 9.8 Tf  [(. Healthcare workers in these hospitals suffered adverse health consequences from ash and )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(smoke in the hospital ventilation system. Some were forced to decide between responding to the hospitals� calls for more )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(assistance and the need to evacuate their own homes.)] TJ ET
BT 26.250 631.991 Td /F1 9.8 Tf  [(Difficulty in accessing commodities including food and regular medication can have a significant impact, particularly on patients )] TJ ET
BT 26.250 620.086 Td /F1 9.8 Tf  [(with chronic health conditions who may be unable to collect their normal medication or attend medical appointments. The )] TJ ET
BT 26.250 608.181 Td /F1 9.8 Tf  [(elderly, the isolated, and those with chronic health problems will be particularly vulnerable. The US document �Wildfire Smoke, a )] TJ ET
BT 26.250 596.277 Td /F1 9.8 Tf  [(guide for public health officials� advises that patients have at least a 5 day stock of medication available, as well as several )] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(day�s worth of non-perishable food )] TJ ET
0.267 0.267 0.267 rg
BT 177.989 585.879 Td /F4 8.7 Tf  [(80)] TJ ET
0.271 0.267 0.267 rg
BT 187.627 584.372 Td /F1 9.8 Tf  [(.)] TJ ET
BT 26.250 564.967 Td /F1 9.8 Tf  [(As homes can be caught up in wildfires, it is imperative that access routes for inhabitants are as safe as possible, and well )] TJ ET
BT 26.250 553.062 Td /F1 9.8 Tf  [(signposted, especially in rural areas, so that emergency services can find them easily if needed. A leaflet published by the )] TJ ET
BT 26.250 541.158 Td /F1 9.8 Tf  [(Scottish Wildfire forum highlights this point, advising clear signage to rural properties )] TJ ET
0.267 0.267 0.267 rg
BT 393.094 542.665 Td /F4 8.7 Tf  [(81)] TJ ET
0.271 0.267 0.267 rg
BT 402.731 541.158 Td /F1 9.8 Tf  [(. Power supplies may be disrupted, )] TJ ET
BT 26.250 529.253 Td /F1 9.8 Tf  [(compounding effects on the local population. There is also a risk of electrocution from fallen power lines arcing because of )] TJ ET
BT 26.250 517.348 Td /F1 9.8 Tf  [(water and smoke.)] TJ ET
BT 26.250 480.746 Td /F4 12.0 Tf  [(Communication)] TJ ET
BT 26.250 460.791 Td /F1 9.8 Tf  [(A Global Early Warning System for Wildland Fire has been proposed )] TJ ET
0.267 0.267 0.267 rg
BT 325.361 462.299 Td /F4 8.7 Tf  [(82)] TJ ET
0.271 0.267 0.267 rg
BT 334.998 460.791 Td /F1 9.8 Tf  [(. Spanish systems of satellite surveillance have been )] TJ ET
BT 26.250 448.887 Td /F1 9.8 Tf  [(trialled with success, and may be worth developing elsewhere )] TJ ET
0.267 0.267 0.267 rg
BT 295.565 450.394 Td /F4 8.7 Tf  [(83)] TJ ET
0.271 0.267 0.267 rg
BT 305.202 448.887 Td /F1 9.8 Tf  [(. Safety measures to the public faced with a wildfire threat can )] TJ ET
BT 26.250 436.982 Td /F1 9.8 Tf  [(be issued.)] TJ ET
BT 26.250 417.577 Td /F1 9.8 Tf  [(An example of such a public health message is the �Ready, Set, Go� campaign in Texas )] TJ ET
0.267 0.267 0.267 rg
BT 408.840 419.084 Td /F4 8.7 Tf  [(84)] TJ ET
0.271 0.267 0.267 rg
BT 418.477 417.577 Td /F1 9.8 Tf  [(:)] TJ ET
0.271 0.267 0.267 RG
40.337 401.140 m 
40.337 401.587 40.154 402.031 39.838 402.347 c
39.522 402.662 39.078 402.846 38.631 402.846 c
38.185 402.846 37.741 402.662 37.425 402.347 c
37.109 402.031 36.925 401.587 36.925 401.140 c
36.925 400.693 37.109 400.249 37.425 399.933 c
37.741 399.618 38.185 399.434 38.631 399.434 c
39.078 399.434 39.522 399.618 39.838 399.933 c
40.154 400.249 40.337 400.693 40.337 401.140 c f
BT 45.750 398.172 Td /F1 9.8 Tf  [(Be ready for a fire threat)] TJ ET
40.337 385.485 m 
40.337 385.932 40.154 386.376 39.838 386.692 c
39.522 387.008 39.078 387.192 38.631 387.192 c
38.185 387.192 37.741 387.008 37.425 386.692 c
37.109 386.376 36.925 385.932 36.925 385.485 c
36.925 385.039 37.109 384.595 37.425 384.279 c
37.741 383.963 38.185 383.779 38.631 383.779 c
39.078 383.779 39.522 383.963 39.838 384.279 c
40.154 384.595 40.337 385.039 40.337 385.485 c f
BT 45.750 382.518 Td /F1 9.8 Tf  [(Have situational awareness if a fire threat occurs and be �set� to leave if you need to)] TJ ET
40.337 369.831 m 
40.337 370.277 40.154 370.721 39.838 371.037 c
39.522 371.353 39.078 371.537 38.631 371.537 c
38.185 371.537 37.741 371.353 37.425 371.037 c
37.109 370.721 36.925 370.277 36.925 369.831 c
36.925 369.384 37.109 368.940 37.425 368.624 c
37.741 368.308 38.185 368.124 38.631 368.124 c
39.078 368.124 39.522 368.308 39.838 368.624 c
40.154 368.940 40.337 369.384 40.337 369.831 c f
BT 45.750 366.863 Td /F1 9.8 Tf  [(Go early � leave at risk areas early)] TJ ET
BT 26.250 343.708 Td /F1 9.8 Tf  [(The UK government�s advice )] TJ ET
0.267 0.267 0.267 rg
BT 154.131 345.215 Td /F4 8.7 Tf  [(85)] TJ ET
0.271 0.267 0.267 rg
BT 163.768 343.708 Td /F1 9.8 Tf  [( to �Go in, stay in, tune in�, although aimed at general emergencies, may be useful to prevent )] TJ ET
BT 26.250 331.803 Td /F1 9.8 Tf  [(exposure to air pollution from fire smoke, as sheltering can reduce exposure )] TJ ET
0.267 0.267 0.267 rg
BT 356.804 333.311 Td /F4 8.7 Tf  [(86)] TJ ET
0.271 0.267 0.267 rg
BT 366.442 331.803 Td /F1 9.8 Tf  [(. Obviously this is less advisable for those who )] TJ ET
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BT 26.250 283.296 Td /F4 12.0 Tf  [(Development Planning)] TJ ET
BT 26.250 263.342 Td /F1 9.8 Tf  [(In the UK the new National Planning Policy Framework )] TJ ET
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BT 26.250 251.437 Td /F1 9.8 Tf  [(developments under both natural hazard and climate change \(mitigation and adaptation\) policies. This will include:)] TJ ET
40.337 235.000 m 
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40.337 219.345 m 
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40.337 203.691 m 
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38.185 205.397 37.741 205.213 37.425 204.897 c
37.109 204.581 36.925 204.137 36.925 203.691 c
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40.337 188.036 m 
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40.337 172.381 m 
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40.337 156.726 m 
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40.337 141.071 m 
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40.337 125.417 m 
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BT 45.750 122.449 Td /F1 9.8 Tf  [(Other National and critical infrastructure facilities, structures and properties identified on National and Community Risk )] TJ ET
BT 45.750 110.544 Td /F1 9.8 Tf  [(Registers)] TJ ET
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BT 26.250 750.278 Td /F4 12.0 Tf  [(Summary of pointers to good practice)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(This study identifies the main health protection issues to be considered in the event of wildfire. It points to evidence based )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(actions in response to acute events and ways to prepare for a potential increase in wildfires uedue to climate change. The )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(issues highlighted below can be used as guidance in formulating plans to mitigate against risk to health from wildfires.)] TJ ET
BT 26.250 687.110 Td /F1 9.8 Tf  [(Respiratory health impacts)] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(Emergency services and GPs should be prepared for increasing numbers of patients attending with )] TJ ET
BT 456.527 667.705 Td /F4 9.8 Tf  [(respiratory symptoms.)] TJ ET
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40.337 651.268 m 
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36.925 650.821 37.109 650.377 37.425 650.061 c
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40.154 650.377 40.337 650.821 40.337 651.268 c f
BT 45.750 648.300 Td /F1 9.8 Tf  [(Those with chronic respiratory illness may experience a worsening in their respiratory symptoms.)] TJ ET
40.337 635.613 m 
40.337 636.060 40.154 636.504 39.838 636.820 c
39.522 637.136 39.078 637.319 38.631 637.319 c
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BT 45.750 632.646 Td /F1 9.8 Tf  [(There may be an increased incidence of mild respiratory symptoms amongst previously healthy individuals, which may )] TJ ET
BT 45.750 620.741 Td /F1 9.8 Tf  [(require some medical treatment.)] TJ ET
40.337 608.054 m 
40.337 608.500 40.154 608.944 39.838 609.260 c
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40.154 607.163 40.337 607.607 40.337 608.054 c f
BT 45.750 605.086 Td /F1 9.8 Tf  [(Increased doses of anti-inflammatory and bronchodilator medication may be required. Stocks of drugs should be sufficient )] TJ ET
BT 45.750 593.181 Td /F1 9.8 Tf  [(to accommodate for this.)] TJ ET
BT 26.250 570.027 Td /F1 9.8 Tf  [(Minimising exposure to smoke)] TJ ET
BT 26.250 550.622 Td /F1 9.8 Tf  [(Considering the potential toxicity of wood fire smoke, it is advisable to )] TJ ET
BT 328.627 550.622 Td /F4 9.8 Tf  [(minimise exposure:)] TJ ET
40.337 534.185 m 
40.337 534.631 40.154 535.075 39.838 535.391 c
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38.185 535.891 37.741 535.707 37.425 535.391 c
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BT 45.750 531.217 Td /F1 9.8 Tf  [(Air quality reports should be checked. These may have the potential to be used in conjunction with syndromic surveillance )] TJ ET
BT 45.750 519.312 Td /F1 9.8 Tf  [(to understand health effects and their link with air pollution.)] TJ ET
40.337 506.625 m 
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BT 45.750 503.658 Td /F1 9.8 Tf  [(Indoor air should be kept as unpolluted as possible by keeping windows and doors closed and shutting off external )] TJ ET
BT 45.750 491.753 Td /F1 9.8 Tf  [(ventilation.)] TJ ET
BT 26.250 468.598 Td /F1 9.8 Tf  [(Other Systemic Health Effects)] TJ ET
40.337 452.161 m 
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BT 45.750 449.193 Td /F4 9.8 Tf  [(Burns )] TJ ET
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59.837 436.506 m 
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BT 65.250 433.539 Td /F1 9.8 Tf  [(In severe fires systems should be in place to cope with increased pressure on resources needed to manage burns )] TJ ET
BT 65.250 421.634 Td /F1 9.8 Tf  [(patients)] TJ ET
0.39 w 1 J 1 j
59.837 408.947 m 
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BT 65.250 405.979 Td /F1 9.8 Tf  [(Careful triage and judicious use of specialist burns services is needed)] TJ ET
40.337 389.542 m 
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40.337 373.887 m 
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BT 45.750 370.920 Td /F4 9.8 Tf  [(Psychological effects )] TJ ET
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0.39 w 1 J 1 j
59.837 358.233 m 
59.837 358.679 59.654 359.123 59.338 359.439 c
59.022 359.755 58.578 359.939 58.131 359.939 c
57.685 359.939 57.241 359.755 56.925 359.439 c
56.609 359.123 56.425 358.679 56.425 358.233 c
56.425 357.786 56.609 357.342 56.925 357.026 c
57.241 356.710 57.685 356.526 58.131 356.526 c
58.578 356.526 59.022 356.710 59.338 357.026 c
59.654 357.342 59.837 357.786 59.837 358.233 c s
BT 65.250 355.265 Td /F1 9.8 Tf  [(Support should be available to vulnerable groups)] TJ ET
0.39 w 1 J 1 j
59.837 342.578 m 
59.837 343.024 59.654 343.468 59.338 343.784 c
59.022 344.100 58.578 344.284 58.131 344.284 c
57.685 344.284 57.241 344.100 56.925 343.784 c
56.609 343.468 56.425 343.024 56.425 342.578 c
56.425 342.131 56.609 341.687 56.925 341.371 c
57.241 341.055 57.685 340.872 58.131 340.872 c
58.578 340.872 59.022 341.055 59.338 341.371 c
59.654 341.687 59.837 342.131 59.837 342.578 c s
BT 65.250 339.610 Td /F1 9.8 Tf  [(Responsible media reporting of events is important)] TJ ET
BT 26.250 312.705 Td /F1 9.8 Tf  [(Access and Egress)] TJ ET
BT 26.250 293.301 Td /F4 9.8 Tf  [(Access )] TJ ET
BT 63.105 293.301 Td /F1 9.8 Tf  [(to homes, health care facilities and resources may be impeded.)] TJ ET
40.337 276.864 m 
40.337 277.310 40.154 277.754 39.838 278.070 c
39.522 278.386 39.078 278.570 38.631 278.570 c
38.185 278.570 37.741 278.386 37.425 278.070 c
37.109 277.754 36.925 277.310 36.925 276.864 c
36.925 276.417 37.109 275.973 37.425 275.657 c
37.741 275.341 38.185 275.157 38.631 275.157 c
39.078 275.157 39.522 275.341 39.838 275.657 c
40.154 275.973 40.337 276.417 40.337 276.864 c f
BT 45.750 273.896 Td /F1 9.8 Tf  [(Systems should be in place to ensure delivery of medication and provisions to those who need them, especially vulnerable )] TJ ET
BT 45.750 261.991 Td /F1 9.8 Tf  [(groups. )] TJ ET
0.39 w 1 J 1 j
59.837 249.304 m 
59.837 249.751 59.654 250.195 59.338 250.511 c
59.022 250.826 58.578 251.010 58.131 251.010 c
57.685 251.010 57.241 250.826 56.925 250.511 c
56.609 250.195 56.425 249.751 56.425 249.304 c
56.425 248.857 56.609 248.413 56.925 248.097 c
57.241 247.782 57.685 247.598 58.131 247.598 c
58.578 247.598 59.022 247.782 59.338 248.097 c
59.654 248.413 59.837 248.857 59.837 249.304 c s
BT 65.250 246.336 Td /F1 9.8 Tf  [(People living in areas prone to wildfires may be advised to keep a stock of 5 day�s worth of non perishable provisions )] TJ ET
BT 65.250 234.432 Td /F1 9.8 Tf  [(and medications.)] TJ ET
40.337 217.995 m 
40.337 218.441 40.154 218.885 39.838 219.201 c
39.522 219.517 39.078 219.701 38.631 219.701 c
38.185 219.701 37.741 219.517 37.425 219.201 c
37.109 218.885 36.925 218.441 36.925 217.995 c
36.925 217.548 37.109 217.104 37.425 216.788 c
37.741 216.472 38.185 216.288 38.631 216.288 c
39.078 216.288 39.522 216.472 39.838 216.788 c
40.154 217.104 40.337 217.548 40.337 217.995 c f
BT 45.750 215.027 Td /F1 9.8 Tf  [(Measures to maximise safety of routes to and from vulnerable areas should be in place.)] TJ ET
40.337 202.340 m 
40.337 202.786 40.154 203.230 39.838 203.546 c
39.522 203.862 39.078 204.046 38.631 204.046 c
38.185 204.046 37.741 203.862 37.425 203.546 c
37.109 203.230 36.925 202.786 36.925 202.340 c
36.925 201.893 37.109 201.449 37.425 201.133 c
37.741 200.817 38.185 200.634 38.631 200.634 c
39.078 200.634 39.522 200.817 39.838 201.133 c
40.154 201.449 40.337 201.893 40.337 202.340 c f
BT 45.750 199.372 Td /F1 9.8 Tf  [(Housing and evacuation routes in rural areas should be clearly signposted.)] TJ ET
BT 26.250 176.217 Td /F1 9.8 Tf  [(Water and Land Pollution)] TJ ET
BT 26.250 156.813 Td /F1 9.8 Tf  [(Water and land near the fire site may become polluted by substances present in wildfire ash.)] TJ ET
40.337 140.376 m 
40.337 140.822 40.154 141.266 39.838 141.582 c
39.522 141.898 39.078 142.082 38.631 142.082 c
38.185 142.082 37.741 141.898 37.425 141.582 c
37.109 141.266 36.925 140.822 36.925 140.376 c
36.925 139.929 37.109 139.485 37.425 139.169 c
37.741 138.853 38.185 138.669 38.631 138.669 c
39.078 138.669 39.522 138.853 39.838 139.169 c
40.154 139.485 40.337 139.929 40.337 140.376 c f
BT 45.750 137.408 Td /F1 9.8 Tf  [(An assessment of land and water pollution with remediation may be necessary.)] TJ ET
40.337 124.721 m 
40.337 125.167 40.154 125.611 39.838 125.927 c
39.522 126.243 39.078 126.427 38.631 126.427 c
38.185 126.427 37.741 126.243 37.425 125.927 c
37.109 125.611 36.925 125.167 36.925 124.721 c
36.925 124.274 37.109 123.830 37.425 123.514 c
37.741 123.198 38.185 123.015 38.631 123.015 c
39.078 123.015 39.522 123.198 39.838 123.514 c
40.154 123.830 40.337 124.274 40.337 124.721 c f
BT 45.750 121.753 Td /F1 9.8 Tf  [(Local authorities will be responsible for cleaning � up operations in conjunction with the Environment Agency)] TJ ET
BT 26.250 98.598 Td /F1 9.8 Tf  [(Visibility)] TJ ET
BT 26.250 79.194 Td /F4 9.8 Tf  [(Visibility)] TJ ET
BT 66.352 79.194 Td /F1 9.8 Tf  [( can be problematic)] TJ ET
Q
q
15.000 30.503 577.500 746.497 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Summary of pointers to good practice)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(This study identifies the main health protection issues to be considered in the event of wildfire. It points to evidence based )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(actions in response to acute events and ways to prepare for a potential increase in wildfires uedue to climate change. The )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(issues highlighted below can be used as guidance in formulating plans to mitigate against risk to health from wildfires.)] TJ ET
BT 26.250 687.110 Td /F1 9.8 Tf  [(Respiratory health impacts)] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(Emergency services and GPs should be prepared for increasing numbers of patients attending with )] TJ ET
BT 456.527 667.705 Td /F4 9.8 Tf  [(respiratory symptoms.)] TJ ET
0.271 0.267 0.267 RG
40.337 651.268 m 
40.337 651.715 40.154 652.159 39.838 652.475 c
39.522 652.790 39.078 652.974 38.631 652.974 c
38.185 652.974 37.741 652.790 37.425 652.475 c
37.109 652.159 36.925 651.715 36.925 651.268 c
36.925 650.821 37.109 650.377 37.425 650.061 c
37.741 649.746 38.185 649.562 38.631 649.562 c
39.078 649.562 39.522 649.746 39.838 650.061 c
40.154 650.377 40.337 650.821 40.337 651.268 c f
BT 45.750 648.300 Td /F1 9.8 Tf  [(Those with chronic respiratory illness may experience a worsening in their respiratory symptoms.)] TJ ET
40.337 635.613 m 
40.337 636.060 40.154 636.504 39.838 636.820 c
39.522 637.136 39.078 637.319 38.631 637.319 c
38.185 637.319 37.741 637.136 37.425 636.820 c
37.109 636.504 36.925 636.060 36.925 635.613 c
36.925 635.167 37.109 634.723 37.425 634.407 c
37.741 634.091 38.185 633.907 38.631 633.907 c
39.078 633.907 39.522 634.091 39.838 634.407 c
40.154 634.723 40.337 635.167 40.337 635.613 c f
BT 45.750 632.646 Td /F1 9.8 Tf  [(There may be an increased incidence of mild respiratory symptoms amongst previously healthy individuals, which may )] TJ ET
BT 45.750 620.741 Td /F1 9.8 Tf  [(require some medical treatment.)] TJ ET
40.337 608.054 m 
40.337 608.500 40.154 608.944 39.838 609.260 c
39.522 609.576 39.078 609.760 38.631 609.760 c
38.185 609.760 37.741 609.576 37.425 609.260 c
37.109 608.944 36.925 608.500 36.925 608.054 c
36.925 607.607 37.109 607.163 37.425 606.847 c
37.741 606.531 38.185 606.348 38.631 606.348 c
39.078 606.348 39.522 606.531 39.838 606.847 c
40.154 607.163 40.337 607.607 40.337 608.054 c f
BT 45.750 605.086 Td /F1 9.8 Tf  [(Increased doses of anti-inflammatory and bronchodilator medication may be required. Stocks of drugs should be sufficient )] TJ ET
BT 45.750 593.181 Td /F1 9.8 Tf  [(to accommodate for this.)] TJ ET
BT 26.250 570.027 Td /F1 9.8 Tf  [(Minimising exposure to smoke)] TJ ET
BT 26.250 550.622 Td /F1 9.8 Tf  [(Considering the potential toxicity of wood fire smoke, it is advisable to )] TJ ET
BT 328.627 550.622 Td /F4 9.8 Tf  [(minimise exposure:)] TJ ET
40.337 534.185 m 
40.337 534.631 40.154 535.075 39.838 535.391 c
39.522 535.707 39.078 535.891 38.631 535.891 c
38.185 535.891 37.741 535.707 37.425 535.391 c
37.109 535.075 36.925 534.631 36.925 534.185 c
36.925 533.738 37.109 533.294 37.425 532.978 c
37.741 532.662 38.185 532.479 38.631 532.479 c
39.078 532.479 39.522 532.662 39.838 532.978 c
40.154 533.294 40.337 533.738 40.337 534.185 c f
BT 45.750 531.217 Td /F1 9.8 Tf  [(Air quality reports should be checked. These may have the potential to be used in conjunction with syndromic surveillance )] TJ ET
BT 45.750 519.312 Td /F1 9.8 Tf  [(to understand health effects and their link with air pollution.)] TJ ET
40.337 506.625 m 
40.337 507.072 40.154 507.516 39.838 507.832 c
39.522 508.148 39.078 508.332 38.631 508.332 c
38.185 508.332 37.741 508.148 37.425 507.832 c
37.109 507.516 36.925 507.072 36.925 506.625 c
36.925 506.179 37.109 505.735 37.425 505.419 c
37.741 505.103 38.185 504.919 38.631 504.919 c
39.078 504.919 39.522 505.103 39.838 505.419 c
40.154 505.735 40.337 506.179 40.337 506.625 c f
BT 45.750 503.658 Td /F1 9.8 Tf  [(Indoor air should be kept as unpolluted as possible by keeping windows and doors closed and shutting off external )] TJ ET
BT 45.750 491.753 Td /F1 9.8 Tf  [(ventilation.)] TJ ET
BT 26.250 468.598 Td /F1 9.8 Tf  [(Other Systemic Health Effects)] TJ ET
40.337 452.161 m 
40.337 452.608 40.154 453.052 39.838 453.368 c
39.522 453.683 39.078 453.867 38.631 453.867 c
38.185 453.867 37.741 453.683 37.425 453.368 c
37.109 453.052 36.925 452.608 36.925 452.161 c
36.925 451.714 37.109 451.270 37.425 450.954 c
37.741 450.639 38.185 450.455 38.631 450.455 c
39.078 450.455 39.522 450.639 39.838 450.954 c
40.154 451.270 40.337 451.714 40.337 452.161 c f
BT 45.750 449.193 Td /F4 9.8 Tf  [(Burns )] TJ ET
BT 76.628 449.193 Td /F1 9.8 Tf  [(may pose a significant problem. )] TJ ET
0.39 w 1 J 1 j
59.837 436.506 m 
59.837 436.953 59.654 437.397 59.338 437.713 c
59.022 438.029 58.578 438.213 58.131 438.213 c
57.685 438.213 57.241 438.029 56.925 437.713 c
56.609 437.397 56.425 436.953 56.425 436.506 c
56.425 436.060 56.609 435.616 56.925 435.300 c
57.241 434.984 57.685 434.800 58.131 434.800 c
58.578 434.800 59.022 434.984 59.338 435.300 c
59.654 435.616 59.837 436.060 59.837 436.506 c s
BT 65.250 433.539 Td /F1 9.8 Tf  [(In severe fires systems should be in place to cope with increased pressure on resources needed to manage burns )] TJ ET
BT 65.250 421.634 Td /F1 9.8 Tf  [(patients)] TJ ET
0.39 w 1 J 1 j
59.837 408.947 m 
59.837 409.393 59.654 409.837 59.338 410.153 c
59.022 410.469 58.578 410.653 58.131 410.653 c
57.685 410.653 57.241 410.469 56.925 410.153 c
56.609 409.837 56.425 409.393 56.425 408.947 c
56.425 408.500 56.609 408.056 56.925 407.740 c
57.241 407.424 57.685 407.241 58.131 407.241 c
58.578 407.241 59.022 407.424 59.338 407.740 c
59.654 408.056 59.837 408.500 59.837 408.947 c s
BT 65.250 405.979 Td /F1 9.8 Tf  [(Careful triage and judicious use of specialist burns services is needed)] TJ ET
40.337 389.542 m 
40.337 389.989 40.154 390.433 39.838 390.749 c
39.522 391.064 39.078 391.248 38.631 391.248 c
38.185 391.248 37.741 391.064 37.425 390.749 c
37.109 390.433 36.925 389.989 36.925 389.542 c
36.925 389.095 37.109 388.651 37.425 388.335 c
37.741 388.020 38.185 387.836 38.631 387.836 c
39.078 387.836 39.522 388.020 39.838 388.335 c
40.154 388.651 40.337 389.095 40.337 389.542 c f
BT 45.750 386.574 Td /F4 9.8 Tf  [(Cardiovascular morbidity )] TJ ET
BT 166.036 386.574 Td /F1 9.8 Tf  [(may increase � Emergency Departments and GPs should be aware of this.)] TJ ET
40.337 373.887 m 
40.337 374.334 40.154 374.778 39.838 375.094 c
39.522 375.410 39.078 375.594 38.631 375.594 c
38.185 375.594 37.741 375.410 37.425 375.094 c
37.109 374.778 36.925 374.334 36.925 373.887 c
36.925 373.441 37.109 372.997 37.425 372.681 c
37.741 372.365 38.185 372.181 38.631 372.181 c
39.078 372.181 39.522 372.365 39.838 372.681 c
40.154 372.997 40.337 373.441 40.337 373.887 c f
BT 45.750 370.920 Td /F4 9.8 Tf  [(Psychological effects )] TJ ET
BT 148.164 370.920 Td /F1 9.8 Tf  [(may be significant. )] TJ ET
0.39 w 1 J 1 j
59.837 358.233 m 
59.837 358.679 59.654 359.123 59.338 359.439 c
59.022 359.755 58.578 359.939 58.131 359.939 c
57.685 359.939 57.241 359.755 56.925 359.439 c
56.609 359.123 56.425 358.679 56.425 358.233 c
56.425 357.786 56.609 357.342 56.925 357.026 c
57.241 356.710 57.685 356.526 58.131 356.526 c
58.578 356.526 59.022 356.710 59.338 357.026 c
59.654 357.342 59.837 357.786 59.837 358.233 c s
BT 65.250 355.265 Td /F1 9.8 Tf  [(Support should be available to vulnerable groups)] TJ ET
0.39 w 1 J 1 j
59.837 342.578 m 
59.837 343.024 59.654 343.468 59.338 343.784 c
59.022 344.100 58.578 344.284 58.131 344.284 c
57.685 344.284 57.241 344.100 56.925 343.784 c
56.609 343.468 56.425 343.024 56.425 342.578 c
56.425 342.131 56.609 341.687 56.925 341.371 c
57.241 341.055 57.685 340.872 58.131 340.872 c
58.578 340.872 59.022 341.055 59.338 341.371 c
59.654 341.687 59.837 342.131 59.837 342.578 c s
BT 65.250 339.610 Td /F1 9.8 Tf  [(Responsible media reporting of events is important)] TJ ET
BT 26.250 312.705 Td /F1 9.8 Tf  [(Access and Egress)] TJ ET
BT 26.250 293.301 Td /F4 9.8 Tf  [(Access )] TJ ET
BT 63.105 293.301 Td /F1 9.8 Tf  [(to homes, health care facilities and resources may be impeded.)] TJ ET
40.337 276.864 m 
40.337 277.310 40.154 277.754 39.838 278.070 c
39.522 278.386 39.078 278.570 38.631 278.570 c
38.185 278.570 37.741 278.386 37.425 278.070 c
37.109 277.754 36.925 277.310 36.925 276.864 c
36.925 276.417 37.109 275.973 37.425 275.657 c
37.741 275.341 38.185 275.157 38.631 275.157 c
39.078 275.157 39.522 275.341 39.838 275.657 c
40.154 275.973 40.337 276.417 40.337 276.864 c f
BT 45.750 273.896 Td /F1 9.8 Tf  [(Systems should be in place to ensure delivery of medication and provisions to those who need them, especially vulnerable )] TJ ET
BT 45.750 261.991 Td /F1 9.8 Tf  [(groups. )] TJ ET
0.39 w 1 J 1 j
59.837 249.304 m 
59.837 249.751 59.654 250.195 59.338 250.511 c
59.022 250.826 58.578 251.010 58.131 251.010 c
57.685 251.010 57.241 250.826 56.925 250.511 c
56.609 250.195 56.425 249.751 56.425 249.304 c
56.425 248.857 56.609 248.413 56.925 248.097 c
57.241 247.782 57.685 247.598 58.131 247.598 c
58.578 247.598 59.022 247.782 59.338 248.097 c
59.654 248.413 59.837 248.857 59.837 249.304 c s
BT 65.250 246.336 Td /F1 9.8 Tf  [(People living in areas prone to wildfires may be advised to keep a stock of 5 day�s worth of non perishable provisions )] TJ ET
BT 65.250 234.432 Td /F1 9.8 Tf  [(and medications.)] TJ ET
40.337 217.995 m 
40.337 218.441 40.154 218.885 39.838 219.201 c
39.522 219.517 39.078 219.701 38.631 219.701 c
38.185 219.701 37.741 219.517 37.425 219.201 c
37.109 218.885 36.925 218.441 36.925 217.995 c
36.925 217.548 37.109 217.104 37.425 216.788 c
37.741 216.472 38.185 216.288 38.631 216.288 c
39.078 216.288 39.522 216.472 39.838 216.788 c
40.154 217.104 40.337 217.548 40.337 217.995 c f
BT 45.750 215.027 Td /F1 9.8 Tf  [(Measures to maximise safety of routes to and from vulnerable areas should be in place.)] TJ ET
40.337 202.340 m 
40.337 202.786 40.154 203.230 39.838 203.546 c
39.522 203.862 39.078 204.046 38.631 204.046 c
38.185 204.046 37.741 203.862 37.425 203.546 c
37.109 203.230 36.925 202.786 36.925 202.340 c
36.925 201.893 37.109 201.449 37.425 201.133 c
37.741 200.817 38.185 200.634 38.631 200.634 c
39.078 200.634 39.522 200.817 39.838 201.133 c
40.154 201.449 40.337 201.893 40.337 202.340 c f
BT 45.750 199.372 Td /F1 9.8 Tf  [(Housing and evacuation routes in rural areas should be clearly signposted.)] TJ ET
BT 26.250 176.217 Td /F1 9.8 Tf  [(Water and Land Pollution)] TJ ET
BT 26.250 156.813 Td /F1 9.8 Tf  [(Water and land near the fire site may become polluted by substances present in wildfire ash.)] TJ ET
40.337 140.376 m 
40.337 140.822 40.154 141.266 39.838 141.582 c
39.522 141.898 39.078 142.082 38.631 142.082 c
38.185 142.082 37.741 141.898 37.425 141.582 c
37.109 141.266 36.925 140.822 36.925 140.376 c
36.925 139.929 37.109 139.485 37.425 139.169 c
37.741 138.853 38.185 138.669 38.631 138.669 c
39.078 138.669 39.522 138.853 39.838 139.169 c
40.154 139.485 40.337 139.929 40.337 140.376 c f
BT 45.750 137.408 Td /F1 9.8 Tf  [(An assessment of land and water pollution with remediation may be necessary.)] TJ ET
40.337 124.721 m 
40.337 125.167 40.154 125.611 39.838 125.927 c
39.522 126.243 39.078 126.427 38.631 126.427 c
38.185 126.427 37.741 126.243 37.425 125.927 c
37.109 125.611 36.925 125.167 36.925 124.721 c
36.925 124.274 37.109 123.830 37.425 123.514 c
37.741 123.198 38.185 123.015 38.631 123.015 c
39.078 123.015 39.522 123.198 39.838 123.514 c
40.154 123.830 40.337 124.274 40.337 124.721 c f
BT 45.750 121.753 Td /F1 9.8 Tf  [(Local authorities will be responsible for cleaning � up operations in conjunction with the Environment Agency)] TJ ET
BT 26.250 98.598 Td /F1 9.8 Tf  [(Visibility)] TJ ET
BT 26.250 79.194 Td /F4 9.8 Tf  [(Visibility)] TJ ET
BT 66.352 79.194 Td /F1 9.8 Tf  [( can be problematic)] TJ ET
Q
q
15.000 30.503 577.500 746.497 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Summary of pointers to good practice)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(This study identifies the main health protection issues to be considered in the event of wildfire. It points to evidence based )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(actions in response to acute events and ways to prepare for a potential increase in wildfires uedue to climate change. The )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(issues highlighted below can be used as guidance in formulating plans to mitigate against risk to health from wildfires.)] TJ ET
BT 26.250 687.110 Td /F1 9.8 Tf  [(Respiratory health impacts)] TJ ET
BT 26.250 667.705 Td /F1 9.8 Tf  [(Emergency services and GPs should be prepared for increasing numbers of patients attending with )] TJ ET
BT 456.527 667.705 Td /F4 9.8 Tf  [(respiratory symptoms.)] TJ ET
0.271 0.267 0.267 RG
40.337 651.268 m 
40.337 651.715 40.154 652.159 39.838 652.475 c
39.522 652.790 39.078 652.974 38.631 652.974 c
38.185 652.974 37.741 652.790 37.425 652.475 c
37.109 652.159 36.925 651.715 36.925 651.268 c
36.925 650.821 37.109 650.377 37.425 650.061 c
37.741 649.746 38.185 649.562 38.631 649.562 c
39.078 649.562 39.522 649.746 39.838 650.061 c
40.154 650.377 40.337 650.821 40.337 651.268 c f
BT 45.750 648.300 Td /F1 9.8 Tf  [(Those with chronic respiratory illness may experience a worsening in their respiratory symptoms.)] TJ ET
40.337 635.613 m 
40.337 636.060 40.154 636.504 39.838 636.820 c
39.522 637.136 39.078 637.319 38.631 637.319 c
38.185 637.319 37.741 637.136 37.425 636.820 c
37.109 636.504 36.925 636.060 36.925 635.613 c
36.925 635.167 37.109 634.723 37.425 634.407 c
37.741 634.091 38.185 633.907 38.631 633.907 c
39.078 633.907 39.522 634.091 39.838 634.407 c
40.154 634.723 40.337 635.167 40.337 635.613 c f
BT 45.750 632.646 Td /F1 9.8 Tf  [(There may be an increased incidence of mild respiratory symptoms amongst previously healthy individuals, which may )] TJ ET
BT 45.750 620.741 Td /F1 9.8 Tf  [(require some medical treatment.)] TJ ET
40.337 608.054 m 
40.337 608.500 40.154 608.944 39.838 609.260 c
39.522 609.576 39.078 609.760 38.631 609.760 c
38.185 609.760 37.741 609.576 37.425 609.260 c
37.109 608.944 36.925 608.500 36.925 608.054 c
36.925 607.607 37.109 607.163 37.425 606.847 c
37.741 606.531 38.185 606.348 38.631 606.348 c
39.078 606.348 39.522 606.531 39.838 606.847 c
40.154 607.163 40.337 607.607 40.337 608.054 c f
BT 45.750 605.086 Td /F1 9.8 Tf  [(Increased doses of anti-inflammatory and bronchodilator medication may be required. Stocks of drugs should be sufficient )] TJ ET
BT 45.750 593.181 Td /F1 9.8 Tf  [(to accommodate for this.)] TJ ET
BT 26.250 570.027 Td /F1 9.8 Tf  [(Minimising exposure to smoke)] TJ ET
BT 26.250 550.622 Td /F1 9.8 Tf  [(Considering the potential toxicity of wood fire smoke, it is advisable to )] TJ ET
BT 328.627 550.622 Td /F4 9.8 Tf  [(minimise exposure:)] TJ ET
40.337 534.185 m 
40.337 534.631 40.154 535.075 39.838 535.391 c
39.522 535.707 39.078 535.891 38.631 535.891 c
38.185 535.891 37.741 535.707 37.425 535.391 c
37.109 535.075 36.925 534.631 36.925 534.185 c
36.925 533.738 37.109 533.294 37.425 532.978 c
37.741 532.662 38.185 532.479 38.631 532.479 c
39.078 532.479 39.522 532.662 39.838 532.978 c
40.154 533.294 40.337 533.738 40.337 534.185 c f
BT 45.750 531.217 Td /F1 9.8 Tf  [(Air quality reports should be checked. These may have the potential to be used in conjunction with syndromic surveillance )] TJ ET
BT 45.750 519.312 Td /F1 9.8 Tf  [(to understand health effects and their link with air pollution.)] TJ ET
40.337 506.625 m 
40.337 507.072 40.154 507.516 39.838 507.832 c
39.522 508.148 39.078 508.332 38.631 508.332 c
38.185 508.332 37.741 508.148 37.425 507.832 c
37.109 507.516 36.925 507.072 36.925 506.625 c
36.925 506.179 37.109 505.735 37.425 505.419 c
37.741 505.103 38.185 504.919 38.631 504.919 c
39.078 504.919 39.522 505.103 39.838 505.419 c
40.154 505.735 40.337 506.179 40.337 506.625 c f
BT 45.750 503.658 Td /F1 9.8 Tf  [(Indoor air should be kept as unpolluted as possible by keeping windows and doors closed and shutting off external )] TJ ET
BT 45.750 491.753 Td /F1 9.8 Tf  [(ventilation.)] TJ ET
BT 26.250 468.598 Td /F1 9.8 Tf  [(Other Systemic Health Effects)] TJ ET
40.337 452.161 m 
40.337 452.608 40.154 453.052 39.838 453.368 c
39.522 453.683 39.078 453.867 38.631 453.867 c
38.185 453.867 37.741 453.683 37.425 453.368 c
37.109 453.052 36.925 452.608 36.925 452.161 c
36.925 451.714 37.109 451.270 37.425 450.954 c
37.741 450.639 38.185 450.455 38.631 450.455 c
39.078 450.455 39.522 450.639 39.838 450.954 c
40.154 451.270 40.337 451.714 40.337 452.161 c f
BT 45.750 449.193 Td /F4 9.8 Tf  [(Burns )] TJ ET
BT 76.628 449.193 Td /F1 9.8 Tf  [(may pose a significant problem. )] TJ ET
0.39 w 1 J 1 j
59.837 436.506 m 
59.837 436.953 59.654 437.397 59.338 437.713 c
59.022 438.029 58.578 438.213 58.131 438.213 c
57.685 438.213 57.241 438.029 56.925 437.713 c
56.609 437.397 56.425 436.953 56.425 436.506 c
56.425 436.060 56.609 435.616 56.925 435.300 c
57.241 434.984 57.685 434.800 58.131 434.800 c
58.578 434.800 59.022 434.984 59.338 435.300 c
59.654 435.616 59.837 436.060 59.837 436.506 c s
BT 65.250 433.539 Td /F1 9.8 Tf  [(In severe fires systems should be in place to cope with increased pressure on resources needed to manage burns )] TJ ET
BT 65.250 421.634 Td /F1 9.8 Tf  [(patients)] TJ ET
0.39 w 1 J 1 j
59.837 408.947 m 
59.837 409.393 59.654 409.837 59.338 410.153 c
59.022 410.469 58.578 410.653 58.131 410.653 c
57.685 410.653 57.241 410.469 56.925 410.153 c
56.609 409.837 56.425 409.393 56.425 408.947 c
56.425 408.500 56.609 408.056 56.925 407.740 c
57.241 407.424 57.685 407.241 58.131 407.241 c
58.578 407.241 59.022 407.424 59.338 407.740 c
59.654 408.056 59.837 408.500 59.837 408.947 c s
BT 65.250 405.979 Td /F1 9.8 Tf  [(Careful triage and judicious use of specialist burns services is needed)] TJ ET
40.337 389.542 m 
40.337 389.989 40.154 390.433 39.838 390.749 c
39.522 391.064 39.078 391.248 38.631 391.248 c
38.185 391.248 37.741 391.064 37.425 390.749 c
37.109 390.433 36.925 389.989 36.925 389.542 c
36.925 389.095 37.109 388.651 37.425 388.335 c
37.741 388.020 38.185 387.836 38.631 387.836 c
39.078 387.836 39.522 388.020 39.838 388.335 c
40.154 388.651 40.337 389.095 40.337 389.542 c f
BT 45.750 386.574 Td /F4 9.8 Tf  [(Cardiovascular morbidity )] TJ ET
BT 166.036 386.574 Td /F1 9.8 Tf  [(may increase � Emergency Departments and GPs should be aware of this.)] TJ ET
40.337 373.887 m 
40.337 374.334 40.154 374.778 39.838 375.094 c
39.522 375.410 39.078 375.594 38.631 375.594 c
38.185 375.594 37.741 375.410 37.425 375.094 c
37.109 374.778 36.925 374.334 36.925 373.887 c
36.925 373.441 37.109 372.997 37.425 372.681 c
37.741 372.365 38.185 372.181 38.631 372.181 c
39.078 372.181 39.522 372.365 39.838 372.681 c
40.154 372.997 40.337 373.441 40.337 373.887 c f
BT 45.750 370.920 Td /F4 9.8 Tf  [(Psychological effects )] TJ ET
BT 148.164 370.920 Td /F1 9.8 Tf  [(may be significant. )] TJ ET
0.39 w 1 J 1 j
59.837 358.233 m 
59.837 358.679 59.654 359.123 59.338 359.439 c
59.022 359.755 58.578 359.939 58.131 359.939 c
57.685 359.939 57.241 359.755 56.925 359.439 c
56.609 359.123 56.425 358.679 56.425 358.233 c
56.425 357.786 56.609 357.342 56.925 357.026 c
57.241 356.710 57.685 356.526 58.131 356.526 c
58.578 356.526 59.022 356.710 59.338 357.026 c
59.654 357.342 59.837 357.786 59.837 358.233 c s
BT 65.250 355.265 Td /F1 9.8 Tf  [(Support should be available to vulnerable groups)] TJ ET
0.39 w 1 J 1 j
59.837 342.578 m 
59.837 343.024 59.654 343.468 59.338 343.784 c
59.022 344.100 58.578 344.284 58.131 344.284 c
57.685 344.284 57.241 344.100 56.925 343.784 c
56.609 343.468 56.425 343.024 56.425 342.578 c
56.425 342.131 56.609 341.687 56.925 341.371 c
57.241 341.055 57.685 340.872 58.131 340.872 c
58.578 340.872 59.022 341.055 59.338 341.371 c
59.654 341.687 59.837 342.131 59.837 342.578 c s
BT 65.250 339.610 Td /F1 9.8 Tf  [(Responsible media reporting of events is important)] TJ ET
BT 26.250 312.705 Td /F1 9.8 Tf  [(Access and Egress)] TJ ET
BT 26.250 293.301 Td /F4 9.8 Tf  [(Access )] TJ ET
BT 63.105 293.301 Td /F1 9.8 Tf  [(to homes, health care facilities and resources may be impeded.)] TJ ET
40.337 276.864 m 
40.337 277.310 40.154 277.754 39.838 278.070 c
39.522 278.386 39.078 278.570 38.631 278.570 c
38.185 278.570 37.741 278.386 37.425 278.070 c
37.109 277.754 36.925 277.310 36.925 276.864 c
36.925 276.417 37.109 275.973 37.425 275.657 c
37.741 275.341 38.185 275.157 38.631 275.157 c
39.078 275.157 39.522 275.341 39.838 275.657 c
40.154 275.973 40.337 276.417 40.337 276.864 c f
BT 45.750 273.896 Td /F1 9.8 Tf  [(Systems should be in place to ensure delivery of medication and provisions to those who need them, especially vulnerable )] TJ ET
BT 45.750 261.991 Td /F1 9.8 Tf  [(groups. )] TJ ET
0.39 w 1 J 1 j
59.837 249.304 m 
59.837 249.751 59.654 250.195 59.338 250.511 c
59.022 250.826 58.578 251.010 58.131 251.010 c
57.685 251.010 57.241 250.826 56.925 250.511 c
56.609 250.195 56.425 249.751 56.425 249.304 c
56.425 248.857 56.609 248.413 56.925 248.097 c
57.241 247.782 57.685 247.598 58.131 247.598 c
58.578 247.598 59.022 247.782 59.338 248.097 c
59.654 248.413 59.837 248.857 59.837 249.304 c s
BT 65.250 246.336 Td /F1 9.8 Tf  [(People living in areas prone to wildfires may be advised to keep a stock of 5 day�s worth of non perishable provisions )] TJ ET
BT 65.250 234.432 Td /F1 9.8 Tf  [(and medications.)] TJ ET
40.337 217.995 m 
40.337 218.441 40.154 218.885 39.838 219.201 c
39.522 219.517 39.078 219.701 38.631 219.701 c
38.185 219.701 37.741 219.517 37.425 219.201 c
37.109 218.885 36.925 218.441 36.925 217.995 c
36.925 217.548 37.109 217.104 37.425 216.788 c
37.741 216.472 38.185 216.288 38.631 216.288 c
39.078 216.288 39.522 216.472 39.838 216.788 c
40.154 217.104 40.337 217.548 40.337 217.995 c f
BT 45.750 215.027 Td /F1 9.8 Tf  [(Measures to maximise safety of routes to and from vulnerable areas should be in place.)] TJ ET
40.337 202.340 m 
40.337 202.786 40.154 203.230 39.838 203.546 c
39.522 203.862 39.078 204.046 38.631 204.046 c
38.185 204.046 37.741 203.862 37.425 203.546 c
37.109 203.230 36.925 202.786 36.925 202.340 c
36.925 201.893 37.109 201.449 37.425 201.133 c
37.741 200.817 38.185 200.634 38.631 200.634 c
39.078 200.634 39.522 200.817 39.838 201.133 c
40.154 201.449 40.337 201.893 40.337 202.340 c f
BT 45.750 199.372 Td /F1 9.8 Tf  [(Housing and evacuation routes in rural areas should be clearly signposted.)] TJ ET
BT 26.250 176.217 Td /F1 9.8 Tf  [(Water and Land Pollution)] TJ ET
BT 26.250 156.813 Td /F1 9.8 Tf  [(Water and land near the fire site may become polluted by substances present in wildfire ash.)] TJ ET
40.337 140.376 m 
40.337 140.822 40.154 141.266 39.838 141.582 c
39.522 141.898 39.078 142.082 38.631 142.082 c
38.185 142.082 37.741 141.898 37.425 141.582 c
37.109 141.266 36.925 140.822 36.925 140.376 c
36.925 139.929 37.109 139.485 37.425 139.169 c
37.741 138.853 38.185 138.669 38.631 138.669 c
39.078 138.669 39.522 138.853 39.838 139.169 c
40.154 139.485 40.337 139.929 40.337 140.376 c f
BT 45.750 137.408 Td /F1 9.8 Tf  [(An assessment of land and water pollution with remediation may be necessary.)] TJ ET
40.337 124.721 m 
40.337 125.167 40.154 125.611 39.838 125.927 c
39.522 126.243 39.078 126.427 38.631 126.427 c
38.185 126.427 37.741 126.243 37.425 125.927 c
37.109 125.611 36.925 125.167 36.925 124.721 c
36.925 124.274 37.109 123.830 37.425 123.514 c
37.741 123.198 38.185 123.015 38.631 123.015 c
39.078 123.015 39.522 123.198 39.838 123.514 c
40.154 123.830 40.337 124.274 40.337 124.721 c f
BT 45.750 121.753 Td /F1 9.8 Tf  [(Local authorities will be responsible for cleaning � up operations in conjunction with the Environment Agency)] TJ ET
BT 26.250 98.598 Td /F1 9.8 Tf  [(Visibility)] TJ ET
BT 26.250 79.194 Td /F4 9.8 Tf  [(Visibility)] TJ ET
BT 66.352 79.194 Td /F1 9.8 Tf  [( can be problematic)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(11)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
0.39 w 1 J 1 j
Q
endstream
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0.271 0.267 0.267 rg
0.271 0.267 0.267 RG
0.39 w 1 J 1 j
q
15.000 115.755 577.500 661.245 re W n
0.271 0.267 0.267 rg
0.271 0.267 0.267 RG
40.337 770.444 m 
40.337 770.890 40.154 771.334 39.838 771.650 c
39.522 771.966 39.078 772.150 38.631 772.150 c
38.185 772.150 37.741 771.966 37.425 771.650 c
37.109 771.334 36.925 770.890 36.925 770.444 c
36.925 769.997 37.109 769.553 37.425 769.237 c
37.741 768.921 38.185 768.738 38.631 768.738 c
39.078 768.738 39.522 768.921 39.838 769.237 c
40.154 769.553 40.337 769.997 40.337 770.444 c f
BT 45.750 767.476 Td /F1 9.8 Tf  [(Road users should be made aware of the potential for low visibility when driving)] TJ ET
40.337 754.789 m 
40.337 755.236 40.154 755.680 39.838 755.996 c
39.522 756.311 39.078 756.495 38.631 756.495 c
38.185 756.495 37.741 756.311 37.425 755.996 c
37.109 755.680 36.925 755.236 36.925 754.789 c
36.925 754.342 37.109 753.898 37.425 753.582 c
37.741 753.267 38.185 753.083 38.631 753.083 c
39.078 753.083 39.522 753.267 39.838 753.582 c
40.154 753.898 40.337 754.342 40.337 754.789 c f
BT 45.750 751.821 Td /F1 9.8 Tf  [(Anyone presenting with eye irritation should be screened for corneal abrasion)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Communication)] TJ ET
BT 26.250 709.262 Td /F4 9.8 Tf  [(Good communication)] TJ ET
BT 126.470 709.262 Td /F1 9.8 Tf  [( is vital)] TJ ET
40.337 692.825 m 
40.337 693.271 40.154 693.715 39.838 694.031 c
39.522 694.347 39.078 694.531 38.631 694.531 c
38.185 694.531 37.741 694.347 37.425 694.031 c
37.109 693.715 36.925 693.271 36.925 692.825 c
36.925 692.378 37.109 691.934 37.425 691.618 c
37.741 691.302 38.185 691.119 38.631 691.119 c
39.078 691.119 39.522 691.302 39.838 691.618 c
40.154 691.934 40.337 692.378 40.337 692.825 c f
BT 45.750 689.857 Td /F1 9.8 Tf  [(Public health information should be clear and as accurate as possible)] TJ ET
40.337 677.170 m 
40.337 677.617 40.154 678.061 39.838 678.377 c
39.522 678.692 39.078 678.876 38.631 678.876 c
38.185 678.876 37.741 678.692 37.425 678.377 c
37.109 678.061 36.925 677.617 36.925 677.170 c
36.925 676.723 37.109 676.279 37.425 675.963 c
37.741 675.648 38.185 675.464 38.631 675.464 c
39.078 675.464 39.522 675.648 39.838 675.963 c
40.154 676.279 40.337 676.723 40.337 677.170 c f
BT 45.750 674.202 Td /F1 9.8 Tf  [(An )] TJ ET
BT 60.385 674.202 Td /F4 9.8 Tf  [(early warning system )] TJ ET
BT 162.262 674.202 Td /F1 9.8 Tf  [(should be in place to allow communities to prepare for wildfires and, if necessary, evacuate )] TJ ET
BT 45.750 662.298 Td /F1 9.8 Tf  [(threatened areas )] TJ ET
0.39 w 1 J 1 j
59.837 649.611 m 
59.837 650.057 59.654 650.501 59.338 650.817 c
59.022 651.133 58.578 651.317 58.131 651.317 c
57.685 651.317 57.241 651.133 56.925 650.817 c
56.609 650.501 56.425 650.057 56.425 649.611 c
56.425 649.164 56.609 648.720 56.925 648.404 c
57.241 648.088 57.685 647.904 58.131 647.904 c
58.578 647.904 59.022 648.088 59.338 648.404 c
59.654 648.720 59.837 649.164 59.837 649.611 c s
BT 65.250 646.643 Td /F1 9.8 Tf  [(This may be enhanced using satellite data as has been used in Spain)] TJ ET
0.39 w 1 J 1 j
59.837 633.956 m 
59.837 634.402 59.654 634.846 59.338 635.162 c
59.022 635.478 58.578 635.662 58.131 635.662 c
57.685 635.662 57.241 635.478 56.925 635.162 c
56.609 634.846 56.425 634.402 56.425 633.956 c
56.425 633.509 56.609 633.065 56.925 632.749 c
57.241 632.433 57.685 632.250 58.131 632.250 c
58.578 632.250 59.022 632.433 59.338 632.749 c
59.654 633.065 59.837 633.509 59.837 633.956 c s
BT 65.250 630.988 Td /F1 9.8 Tf  [(Early surveillance and models for fire prediction would also be useful)] TJ ET
40.337 614.551 m 
40.337 614.998 40.154 615.442 39.838 615.758 c
39.522 616.073 39.078 616.257 38.631 616.257 c
38.185 616.257 37.741 616.073 37.425 615.758 c
37.109 615.442 36.925 614.998 36.925 614.551 c
36.925 614.104 37.109 613.660 37.425 613.344 c
37.741 613.029 38.185 612.845 38.631 612.845 c
39.078 612.845 39.522 613.029 39.838 613.344 c
40.154 613.660 40.337 614.104 40.337 614.551 c f
BT 45.750 611.583 Td /F1 9.8 Tf  [(People with pre-existing health conditions should be made aware of the potential adverse health impact of wildfire smoke. )] TJ ET
BT 45.750 599.679 Td /F1 9.8 Tf  [(For example asthma sufferers could be advised to increase their medication if they are likely to be exposed to smoke.)] TJ ET
BT 26.250 559.326 Td /F4 12.0 Tf  [(Areas for Further Work)] TJ ET
BT 26.250 539.372 Td /F1 9.8 Tf  [(Relatively little work has been published regarding health effects of wildfires, in the UK despite their frequency although more )] TJ ET
BT 26.250 527.467 Td /F1 9.8 Tf  [(has been published for events abroad.)] TJ ET
BT 26.250 508.062 Td /F1 9.8 Tf  [(Studies focusing particularly on air pollution from wildfires within the UK could be of use, as pollution from UK fires may vary )] TJ ET
BT 26.250 496.158 Td /F1 9.8 Tf  [(from that found elsewhere in the world.)] TJ ET
BT 26.250 476.753 Td /F1 9.8 Tf  [(Health care workers treating casualties from wildfires should be encouraged to publish case studies of health effects to increase )] TJ ET
BT 26.250 464.848 Td /F1 9.8 Tf  [(the evidence base available to the international medical community dealing with wildfires. Long term longitudinal studies looking )] TJ ET
BT 26.250 452.943 Td /F1 9.8 Tf  [(at health effects in populations exposed to wildfires are needed as this will help to determine the level of pollution causing )] TJ ET
BT 26.250 441.039 Td /F1 9.8 Tf  [(adverse health effects.)] TJ ET
BT 26.250 404.436 Td /F4 12.0 Tf  [(Conclusion)] TJ ET
BT 26.250 384.482 Td /F1 9.8 Tf  [(Wildfires can cause significant health effects both in the population in the immediate vicinity and in those further from the fire )] TJ ET
BT 26.250 372.577 Td /F1 9.8 Tf  [(\(predominantly from the effects of air pollution\). Simple public health advice can help to mitigate risk to health. With an )] TJ ET
BT 26.250 360.672 Td /F1 9.8 Tf  [(increasing risk of wildfire in the UK, health care workers such as general practitioners, respiratory and emergency physicians )] TJ ET
BT 26.250 348.768 Td /F1 9.8 Tf  [(need to understand more about the health risks of wildfires.)] TJ ET
BT 26.250 329.363 Td /F1 9.8 Tf  [(More research is needed to evaluate long term health effects from exposure to wildfires, and careful identification and follow up )] TJ ET
BT 26.250 317.458 Td /F1 9.8 Tf  [(of those exposed could help in this process. The better our preparedness for wildfires in the UK, the more we can do to mitigate )] TJ ET
BT 26.250 305.553 Td /F1 9.8 Tf  [(against their adverse health effects.)] TJ ET
BT 26.250 268.951 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 248.997 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 212.394 Td /F4 12.0 Tf  [(Acknowledgements)] TJ ET
BT 26.250 192.440 Td /F1 9.8 Tf  [(Many thanks to Adrienne Dunne for her assistance in reviewing the toxicology of wood smoke.)] TJ ET
BT 26.250 163.337 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 126.185 Td /F4 12.0 Tf  [(Glossary)] TJ ET
Q
q
15.000 115.755 577.500 661.245 re W n
0.271 0.267 0.267 rg
0.271 0.267 0.267 RG
40.337 770.444 m 
40.337 770.890 40.154 771.334 39.838 771.650 c
39.522 771.966 39.078 772.150 38.631 772.150 c
38.185 772.150 37.741 771.966 37.425 771.650 c
37.109 771.334 36.925 770.890 36.925 770.444 c
36.925 769.997 37.109 769.553 37.425 769.237 c
37.741 768.921 38.185 768.738 38.631 768.738 c
39.078 768.738 39.522 768.921 39.838 769.237 c
40.154 769.553 40.337 769.997 40.337 770.444 c f
BT 45.750 767.476 Td /F1 9.8 Tf  [(Road users should be made aware of the potential for low visibility when driving)] TJ ET
40.337 754.789 m 
40.337 755.236 40.154 755.680 39.838 755.996 c
39.522 756.311 39.078 756.495 38.631 756.495 c
38.185 756.495 37.741 756.311 37.425 755.996 c
37.109 755.680 36.925 755.236 36.925 754.789 c
36.925 754.342 37.109 753.898 37.425 753.582 c
37.741 753.267 38.185 753.083 38.631 753.083 c
39.078 753.083 39.522 753.267 39.838 753.582 c
40.154 753.898 40.337 754.342 40.337 754.789 c f
BT 45.750 751.821 Td /F1 9.8 Tf  [(Anyone presenting with eye irritation should be screened for corneal abrasion)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Communication)] TJ ET
BT 26.250 709.262 Td /F4 9.8 Tf  [(Good communication)] TJ ET
BT 126.470 709.262 Td /F1 9.8 Tf  [( is vital)] TJ ET
40.337 692.825 m 
40.337 693.271 40.154 693.715 39.838 694.031 c
39.522 694.347 39.078 694.531 38.631 694.531 c
38.185 694.531 37.741 694.347 37.425 694.031 c
37.109 693.715 36.925 693.271 36.925 692.825 c
36.925 692.378 37.109 691.934 37.425 691.618 c
37.741 691.302 38.185 691.119 38.631 691.119 c
39.078 691.119 39.522 691.302 39.838 691.618 c
40.154 691.934 40.337 692.378 40.337 692.825 c f
BT 45.750 689.857 Td /F1 9.8 Tf  [(Public health information should be clear and as accurate as possible)] TJ ET
40.337 677.170 m 
40.337 677.617 40.154 678.061 39.838 678.377 c
39.522 678.692 39.078 678.876 38.631 678.876 c
38.185 678.876 37.741 678.692 37.425 678.377 c
37.109 678.061 36.925 677.617 36.925 677.170 c
36.925 676.723 37.109 676.279 37.425 675.963 c
37.741 675.648 38.185 675.464 38.631 675.464 c
39.078 675.464 39.522 675.648 39.838 675.963 c
40.154 676.279 40.337 676.723 40.337 677.170 c f
BT 45.750 674.202 Td /F1 9.8 Tf  [(An )] TJ ET
BT 60.385 674.202 Td /F4 9.8 Tf  [(early warning system )] TJ ET
BT 162.262 674.202 Td /F1 9.8 Tf  [(should be in place to allow communities to prepare for wildfires and, if necessary, evacuate )] TJ ET
BT 45.750 662.298 Td /F1 9.8 Tf  [(threatened areas )] TJ ET
0.39 w 1 J 1 j
59.837 649.611 m 
59.837 650.057 59.654 650.501 59.338 650.817 c
59.022 651.133 58.578 651.317 58.131 651.317 c
57.685 651.317 57.241 651.133 56.925 650.817 c
56.609 650.501 56.425 650.057 56.425 649.611 c
56.425 649.164 56.609 648.720 56.925 648.404 c
57.241 648.088 57.685 647.904 58.131 647.904 c
58.578 647.904 59.022 648.088 59.338 648.404 c
59.654 648.720 59.837 649.164 59.837 649.611 c s
BT 65.250 646.643 Td /F1 9.8 Tf  [(This may be enhanced using satellite data as has been used in Spain)] TJ ET
0.39 w 1 J 1 j
59.837 633.956 m 
59.837 634.402 59.654 634.846 59.338 635.162 c
59.022 635.478 58.578 635.662 58.131 635.662 c
57.685 635.662 57.241 635.478 56.925 635.162 c
56.609 634.846 56.425 634.402 56.425 633.956 c
56.425 633.509 56.609 633.065 56.925 632.749 c
57.241 632.433 57.685 632.250 58.131 632.250 c
58.578 632.250 59.022 632.433 59.338 632.749 c
59.654 633.065 59.837 633.509 59.837 633.956 c s
BT 65.250 630.988 Td /F1 9.8 Tf  [(Early surveillance and models for fire prediction would also be useful)] TJ ET
40.337 614.551 m 
40.337 614.998 40.154 615.442 39.838 615.758 c
39.522 616.073 39.078 616.257 38.631 616.257 c
38.185 616.257 37.741 616.073 37.425 615.758 c
37.109 615.442 36.925 614.998 36.925 614.551 c
36.925 614.104 37.109 613.660 37.425 613.344 c
37.741 613.029 38.185 612.845 38.631 612.845 c
39.078 612.845 39.522 613.029 39.838 613.344 c
40.154 613.660 40.337 614.104 40.337 614.551 c f
BT 45.750 611.583 Td /F1 9.8 Tf  [(People with pre-existing health conditions should be made aware of the potential adverse health impact of wildfire smoke. )] TJ ET
BT 45.750 599.679 Td /F1 9.8 Tf  [(For example asthma sufferers could be advised to increase their medication if they are likely to be exposed to smoke.)] TJ ET
BT 26.250 559.326 Td /F4 12.0 Tf  [(Areas for Further Work)] TJ ET
BT 26.250 539.372 Td /F1 9.8 Tf  [(Relatively little work has been published regarding health effects of wildfires, in the UK despite their frequency although more )] TJ ET
BT 26.250 527.467 Td /F1 9.8 Tf  [(has been published for events abroad.)] TJ ET
BT 26.250 508.062 Td /F1 9.8 Tf  [(Studies focusing particularly on air pollution from wildfires within the UK could be of use, as pollution from UK fires may vary )] TJ ET
BT 26.250 496.158 Td /F1 9.8 Tf  [(from that found elsewhere in the world.)] TJ ET
BT 26.250 476.753 Td /F1 9.8 Tf  [(Health care workers treating casualties from wildfires should be encouraged to publish case studies of health effects to increase )] TJ ET
BT 26.250 464.848 Td /F1 9.8 Tf  [(the evidence base available to the international medical community dealing with wildfires. Long term longitudinal studies looking )] TJ ET
BT 26.250 452.943 Td /F1 9.8 Tf  [(at health effects in populations exposed to wildfires are needed as this will help to determine the level of pollution causing )] TJ ET
BT 26.250 441.039 Td /F1 9.8 Tf  [(adverse health effects.)] TJ ET
BT 26.250 404.436 Td /F4 12.0 Tf  [(Conclusion)] TJ ET
BT 26.250 384.482 Td /F1 9.8 Tf  [(Wildfires can cause significant health effects both in the population in the immediate vicinity and in those further from the fire )] TJ ET
BT 26.250 372.577 Td /F1 9.8 Tf  [(\(predominantly from the effects of air pollution\). Simple public health advice can help to mitigate risk to health. With an )] TJ ET
BT 26.250 360.672 Td /F1 9.8 Tf  [(increasing risk of wildfire in the UK, health care workers such as general practitioners, respiratory and emergency physicians )] TJ ET
BT 26.250 348.768 Td /F1 9.8 Tf  [(need to understand more about the health risks of wildfires.)] TJ ET
BT 26.250 329.363 Td /F1 9.8 Tf  [(More research is needed to evaluate long term health effects from exposure to wildfires, and careful identification and follow up )] TJ ET
BT 26.250 317.458 Td /F1 9.8 Tf  [(of those exposed could help in this process. The better our preparedness for wildfires in the UK, the more we can do to mitigate )] TJ ET
BT 26.250 305.553 Td /F1 9.8 Tf  [(against their adverse health effects.)] TJ ET
BT 26.250 268.951 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 248.997 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 212.394 Td /F4 12.0 Tf  [(Acknowledgements)] TJ ET
BT 26.250 192.440 Td /F1 9.8 Tf  [(Many thanks to Adrienne Dunne for her assistance in reviewing the toxicology of wood smoke.)] TJ ET
BT 26.250 163.337 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 126.185 Td /F4 12.0 Tf  [(Glossary)] TJ ET
Q
q
15.000 115.755 577.500 661.245 re W n
0.271 0.267 0.267 rg
0.271 0.267 0.267 RG
40.337 770.444 m 
40.337 770.890 40.154 771.334 39.838 771.650 c
39.522 771.966 39.078 772.150 38.631 772.150 c
38.185 772.150 37.741 771.966 37.425 771.650 c
37.109 771.334 36.925 770.890 36.925 770.444 c
36.925 769.997 37.109 769.553 37.425 769.237 c
37.741 768.921 38.185 768.738 38.631 768.738 c
39.078 768.738 39.522 768.921 39.838 769.237 c
40.154 769.553 40.337 769.997 40.337 770.444 c f
BT 45.750 767.476 Td /F1 9.8 Tf  [(Road users should be made aware of the potential for low visibility when driving)] TJ ET
40.337 754.789 m 
40.337 755.236 40.154 755.680 39.838 755.996 c
39.522 756.311 39.078 756.495 38.631 756.495 c
38.185 756.495 37.741 756.311 37.425 755.996 c
37.109 755.680 36.925 755.236 36.925 754.789 c
36.925 754.342 37.109 753.898 37.425 753.582 c
37.741 753.267 38.185 753.083 38.631 753.083 c
39.078 753.083 39.522 753.267 39.838 753.582 c
40.154 753.898 40.337 754.342 40.337 754.789 c f
BT 45.750 751.821 Td /F1 9.8 Tf  [(Anyone presenting with eye irritation should be screened for corneal abrasion)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(Communication)] TJ ET
BT 26.250 709.262 Td /F4 9.8 Tf  [(Good communication)] TJ ET
BT 126.470 709.262 Td /F1 9.8 Tf  [( is vital)] TJ ET
40.337 692.825 m 
40.337 693.271 40.154 693.715 39.838 694.031 c
39.522 694.347 39.078 694.531 38.631 694.531 c
38.185 694.531 37.741 694.347 37.425 694.031 c
37.109 693.715 36.925 693.271 36.925 692.825 c
36.925 692.378 37.109 691.934 37.425 691.618 c
37.741 691.302 38.185 691.119 38.631 691.119 c
39.078 691.119 39.522 691.302 39.838 691.618 c
40.154 691.934 40.337 692.378 40.337 692.825 c f
BT 45.750 689.857 Td /F1 9.8 Tf  [(Public health information should be clear and as accurate as possible)] TJ ET
40.337 677.170 m 
40.337 677.617 40.154 678.061 39.838 678.377 c
39.522 678.692 39.078 678.876 38.631 678.876 c
38.185 678.876 37.741 678.692 37.425 678.377 c
37.109 678.061 36.925 677.617 36.925 677.170 c
36.925 676.723 37.109 676.279 37.425 675.963 c
37.741 675.648 38.185 675.464 38.631 675.464 c
39.078 675.464 39.522 675.648 39.838 675.963 c
40.154 676.279 40.337 676.723 40.337 677.170 c f
BT 45.750 674.202 Td /F1 9.8 Tf  [(An )] TJ ET
BT 60.385 674.202 Td /F4 9.8 Tf  [(early warning system )] TJ ET
BT 162.262 674.202 Td /F1 9.8 Tf  [(should be in place to allow communities to prepare for wildfires and, if necessary, evacuate )] TJ ET
BT 45.750 662.298 Td /F1 9.8 Tf  [(threatened areas )] TJ ET
0.39 w 1 J 1 j
59.837 649.611 m 
59.837 650.057 59.654 650.501 59.338 650.817 c
59.022 651.133 58.578 651.317 58.131 651.317 c
57.685 651.317 57.241 651.133 56.925 650.817 c
56.609 650.501 56.425 650.057 56.425 649.611 c
56.425 649.164 56.609 648.720 56.925 648.404 c
57.241 648.088 57.685 647.904 58.131 647.904 c
58.578 647.904 59.022 648.088 59.338 648.404 c
59.654 648.720 59.837 649.164 59.837 649.611 c s
BT 65.250 646.643 Td /F1 9.8 Tf  [(This may be enhanced using satellite data as has been used in Spain)] TJ ET
0.39 w 1 J 1 j
59.837 633.956 m 
59.837 634.402 59.654 634.846 59.338 635.162 c
59.022 635.478 58.578 635.662 58.131 635.662 c
57.685 635.662 57.241 635.478 56.925 635.162 c
56.609 634.846 56.425 634.402 56.425 633.956 c
56.425 633.509 56.609 633.065 56.925 632.749 c
57.241 632.433 57.685 632.250 58.131 632.250 c
58.578 632.250 59.022 632.433 59.338 632.749 c
59.654 633.065 59.837 633.509 59.837 633.956 c s
BT 65.250 630.988 Td /F1 9.8 Tf  [(Early surveillance and models for fire prediction would also be useful)] TJ ET
40.337 614.551 m 
40.337 614.998 40.154 615.442 39.838 615.758 c
39.522 616.073 39.078 616.257 38.631 616.257 c
38.185 616.257 37.741 616.073 37.425 615.758 c
37.109 615.442 36.925 614.998 36.925 614.551 c
36.925 614.104 37.109 613.660 37.425 613.344 c
37.741 613.029 38.185 612.845 38.631 612.845 c
39.078 612.845 39.522 613.029 39.838 613.344 c
40.154 613.660 40.337 614.104 40.337 614.551 c f
BT 45.750 611.583 Td /F1 9.8 Tf  [(People with pre-existing health conditions should be made aware of the potential adverse health impact of wildfire smoke. )] TJ ET
BT 45.750 599.679 Td /F1 9.8 Tf  [(For example asthma sufferers could be advised to increase their medication if they are likely to be exposed to smoke.)] TJ ET
BT 26.250 559.326 Td /F4 12.0 Tf  [(Areas for Further Work)] TJ ET
BT 26.250 539.372 Td /F1 9.8 Tf  [(Relatively little work has been published regarding health effects of wildfires, in the UK despite their frequency although more )] TJ ET
BT 26.250 527.467 Td /F1 9.8 Tf  [(has been published for events abroad.)] TJ ET
BT 26.250 508.062 Td /F1 9.8 Tf  [(Studies focusing particularly on air pollution from wildfires within the UK could be of use, as pollution from UK fires may vary )] TJ ET
BT 26.250 496.158 Td /F1 9.8 Tf  [(from that found elsewhere in the world.)] TJ ET
BT 26.250 476.753 Td /F1 9.8 Tf  [(Health care workers treating casualties from wildfires should be encouraged to publish case studies of health effects to increase )] TJ ET
BT 26.250 464.848 Td /F1 9.8 Tf  [(the evidence base available to the international medical community dealing with wildfires. Long term longitudinal studies looking )] TJ ET
BT 26.250 452.943 Td /F1 9.8 Tf  [(at health effects in populations exposed to wildfires are needed as this will help to determine the level of pollution causing )] TJ ET
BT 26.250 441.039 Td /F1 9.8 Tf  [(adverse health effects.)] TJ ET
BT 26.250 404.436 Td /F4 12.0 Tf  [(Conclusion)] TJ ET
BT 26.250 384.482 Td /F1 9.8 Tf  [(Wildfires can cause significant health effects both in the population in the immediate vicinity and in those further from the fire )] TJ ET
BT 26.250 372.577 Td /F1 9.8 Tf  [(\(predominantly from the effects of air pollution\). Simple public health advice can help to mitigate risk to health. With an )] TJ ET
BT 26.250 360.672 Td /F1 9.8 Tf  [(increasing risk of wildfire in the UK, health care workers such as general practitioners, respiratory and emergency physicians )] TJ ET
BT 26.250 348.768 Td /F1 9.8 Tf  [(need to understand more about the health risks of wildfires.)] TJ ET
BT 26.250 329.363 Td /F1 9.8 Tf  [(More research is needed to evaluate long term health effects from exposure to wildfires, and careful identification and follow up )] TJ ET
BT 26.250 317.458 Td /F1 9.8 Tf  [(of those exposed could help in this process. The better our preparedness for wildfires in the UK, the more we can do to mitigate )] TJ ET
BT 26.250 305.553 Td /F1 9.8 Tf  [(against their adverse health effects.)] TJ ET
BT 26.250 268.951 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 248.997 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 212.394 Td /F4 12.0 Tf  [(Acknowledgements)] TJ ET
BT 26.250 192.440 Td /F1 9.8 Tf  [(Many thanks to Adrienne Dunne for her assistance in reviewing the toxicology of wood smoke.)] TJ ET
BT 26.250 163.337 Td /F4 12.0 Tf  [(APPENDIX 1)] TJ ET
BT 26.250 126.185 Td /F4 12.0 Tf  [(Glossary)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(12)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
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BT 31.875 766.020 Td /F1 9.8 Tf  [(�BSA)] TJ ET
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BT 31.875 750.139 Td /F1 9.8 Tf  [(�CCRA)] TJ ET
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BT 132.979 750.139 Td /F1 9.8 Tf  [(UK Climate Change Risk Assessment 2012)] TJ ET
0.267 0.267 0.267 rg
26.625 744.112 101.854 0.750 re f
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BT 31.875 734.258 Td /F1 9.8 Tf  [(�CO)] TJ ET
0.267 0.267 0.267 rg
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580.125 680.344 0.750 64.519 re f
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BT 132.979 734.258 Td /F1 9.8 Tf  [(Carbon Monoxide)] TJ ET
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BT 31.875 670.489 Td /F1 9.8 Tf  [(�ED)] TJ ET
0.267 0.267 0.267 rg
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580.125 664.462 0.750 16.631 re f
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BT 132.979 670.489 Td /F1 9.8 Tf  [(Emergency Department)] TJ ET
0.267 0.267 0.267 rg
26.625 664.462 101.854 0.750 re f
26.625 648.581 0.750 16.631 re f
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BT 31.875 654.608 Td /F1 9.8 Tf  [(�ICU)] TJ ET
0.267 0.267 0.267 rg
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580.125 648.581 0.750 16.631 re f
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BT 132.979 654.608 Td /F1 9.8 Tf  [(Intensive Care Unit)] TJ ET
0.267 0.267 0.267 rg
26.625 648.581 101.854 0.750 re f
26.625 632.700 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.726 Td /F1 9.8 Tf  [(�PM 10)] TJ ET
0.267 0.267 0.267 rg
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127.729 632.700 0.750 16.631 re f
580.125 632.700 0.750 16.631 re f
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BT 132.979 638.726 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 10 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
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26.625 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.845 Td /F1 9.8 Tf  [(�PM 2.5)] TJ ET
0.267 0.267 0.267 rg
127.729 632.700 453.146 0.750 re f
127.729 616.819 0.750 16.631 re f
580.125 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 622.845 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 2.5 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
26.625 616.819 101.854 0.750 re f
26.625 600.938 101.854 0.750 re f
26.625 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.964 Td /F1 9.8 Tf  [(�WBC)] TJ ET
0.267 0.267 0.267 rg
127.729 616.819 453.146 0.750 re f
127.729 600.938 453.146 0.750 re f
127.729 600.938 0.750 16.631 re f
580.125 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 606.964 Td /F1 9.8 Tf  [(White Blood Cell)] TJ ET
BT 26.250 528.841 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 491.689 Td /F4 12.0 Tf  [(Prisma Checklist)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 471.735 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 435.132 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 407.678 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 407.678 Td /F1 9.8 Tf  [(In Pictures; Chile battles wildfires. 2012 [cited 2012 Jan 25])] TJ ET
0.267 0.267 0.267 rg
BT 26.250 399.192 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 380.642 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 380.642 Td /F1 9.8 Tf  [(BBC. Australia fires leave trail of devastation. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 372.156 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 353.606 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 353.606 Td /F1 9.8 Tf  [(Californian Department of Forestry and Fire Protection.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 345.120 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 326.570 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 326.570 Td /F1 9.8 Tf  [(EEA. Mapping the impacts of natural hazards and technological accidents in Europe. 2010)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 318.084 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 299.534 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 299.534 Td /F1 9.8 Tf  [(Effects of climate change on fire and rescue services in the UK. Fire Research Technical Report 1/2006. London: DCLG; )] TJ ET
BT 26.250 287.629 Td /F1 9.8 Tf  [(2006 Jan.)] TJ ET
BT 26.250 268.224 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 268.224 Td /F1 9.8 Tf  [(Department for Communities and Local Government Fire Statistics Great Britain, 2010-11. DLCG, London, 2011.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 259.739 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 241.188 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 241.188 Td /F1 9.8 Tf  [(DEFRA. Summary of the Key Findings from the UK Climate Change Risk Assessment 2012. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 232.702 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 214.152 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 214.152 Td /F1 9.8 Tf  [(Moffat AJ, Morison JIL, Nicoll B, Bain V. Climate Change Risk Assessment for the Forestry Sector.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 205.666 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 187.116 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 187.116 Td /F1 9.8 Tf  [(1993 - 1994, December - January, North Coast , Hunter and Sydney bushfire. 2007 [cited 2012 Jan 6].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 178.630 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 160.080 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 160.080 Td /F1 9.8 Tf  [(The Asian Forest Fires of 1997-1998. 2011 [cited 2011 Jan 20].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 151.594 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 133.044 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 133.044 Td /F1 9.8 Tf  [(Glover D, Jessup T. Indonesia's Fires and Haze: The Cost of Catastrophe. Singapore: International Development Research )] TJ ET
BT 26.250 121.140 Td /F1 9.8 Tf  [(Centre; 2002.)] TJ ET
BT 26.250 101.735 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 101.735 Td /F1 9.8 Tf  [(Filmon G. Firestorm 2003 provincial review. Victoria, British Columbia.: Province of British Columbia; 2003.)] TJ ET
BT 26.250 82.330 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 82.330 Td /F1 9.8 Tf  [(October 2007 California Wildfires. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 73.844 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 55.294 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 55.294 Td /F1 9.8 Tf  [(Cameron PA, Mitra B, Fitzgerald M, Scheinkestel CD, Stripp A, Batey C, et al. Black Saturday: the immediate impact of the )] TJ ET
Q
q
15.000 41.008 577.500 735.992 re W n
q
26.250 777.000 555.000 0.000 re W n
Q
1.000 1.000 1.000 rg
26.250 600.562 555.000 176.437 re f
0.267 0.267 0.267 rg
26.625 775.875 101.854 0.750 re f
26.625 759.994 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 766.020 Td /F1 9.8 Tf  [(�BSA)] TJ ET
0.267 0.267 0.267 rg
127.729 775.875 453.146 0.750 re f
127.729 759.994 0.750 16.631 re f
580.125 759.994 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 766.020 Td /F1 9.8 Tf  [(Body Surface Area)] TJ ET
0.267 0.267 0.267 rg
26.625 759.994 101.854 0.750 re f
26.625 744.112 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 750.139 Td /F1 9.8 Tf  [(�CCRA)] TJ ET
0.267 0.267 0.267 rg
127.729 759.994 453.146 0.750 re f
127.729 744.112 0.750 16.631 re f
580.125 744.112 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 750.139 Td /F1 9.8 Tf  [(UK Climate Change Risk Assessment 2012)] TJ ET
0.267 0.267 0.267 rg
26.625 744.112 101.854 0.750 re f
26.625 680.344 0.750 64.519 re f
0.271 0.267 0.267 rg
BT 31.875 734.258 Td /F1 9.8 Tf  [(�CO)] TJ ET
0.267 0.267 0.267 rg
127.729 744.112 453.146 0.750 re f
127.729 680.344 0.750 64.519 re f
580.125 680.344 0.750 64.519 re f
0.271 0.267 0.267 rg
BT 132.979 734.258 Td /F1 9.8 Tf  [(Carbon Monoxide)] TJ ET
0.267 0.267 0.267 rg
26.625 680.344 101.854 0.750 re f
26.625 664.462 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 670.489 Td /F1 9.8 Tf  [(�ED)] TJ ET
0.267 0.267 0.267 rg
127.729 680.344 453.146 0.750 re f
127.729 664.462 0.750 16.631 re f
580.125 664.462 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 670.489 Td /F1 9.8 Tf  [(Emergency Department)] TJ ET
0.267 0.267 0.267 rg
26.625 664.462 101.854 0.750 re f
26.625 648.581 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 654.608 Td /F1 9.8 Tf  [(�ICU)] TJ ET
0.267 0.267 0.267 rg
127.729 664.462 453.146 0.750 re f
127.729 648.581 0.750 16.631 re f
580.125 648.581 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 654.608 Td /F1 9.8 Tf  [(Intensive Care Unit)] TJ ET
0.267 0.267 0.267 rg
26.625 648.581 101.854 0.750 re f
26.625 632.700 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.726 Td /F1 9.8 Tf  [(�PM 10)] TJ ET
0.267 0.267 0.267 rg
127.729 648.581 453.146 0.750 re f
127.729 632.700 0.750 16.631 re f
580.125 632.700 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 638.726 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 10 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
26.625 632.700 101.854 0.750 re f
26.625 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.845 Td /F1 9.8 Tf  [(�PM 2.5)] TJ ET
0.267 0.267 0.267 rg
127.729 632.700 453.146 0.750 re f
127.729 616.819 0.750 16.631 re f
580.125 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 622.845 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 2.5 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
26.625 616.819 101.854 0.750 re f
26.625 600.938 101.854 0.750 re f
26.625 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.964 Td /F1 9.8 Tf  [(�WBC)] TJ ET
0.267 0.267 0.267 rg
127.729 616.819 453.146 0.750 re f
127.729 600.938 453.146 0.750 re f
127.729 600.938 0.750 16.631 re f
580.125 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 606.964 Td /F1 9.8 Tf  [(White Blood Cell)] TJ ET
BT 26.250 528.841 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 491.689 Td /F4 12.0 Tf  [(Prisma Checklist)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 471.735 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 435.132 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 407.678 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 407.678 Td /F1 9.8 Tf  [(In Pictures; Chile battles wildfires. 2012 [cited 2012 Jan 25])] TJ ET
0.267 0.267 0.267 rg
BT 26.250 399.192 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 380.642 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 380.642 Td /F1 9.8 Tf  [(BBC. Australia fires leave trail of devastation. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 372.156 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 353.606 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 353.606 Td /F1 9.8 Tf  [(Californian Department of Forestry and Fire Protection.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 345.120 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 326.570 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 326.570 Td /F1 9.8 Tf  [(EEA. Mapping the impacts of natural hazards and technological accidents in Europe. 2010)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 318.084 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 299.534 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 299.534 Td /F1 9.8 Tf  [(Effects of climate change on fire and rescue services in the UK. Fire Research Technical Report 1/2006. London: DCLG; )] TJ ET
BT 26.250 287.629 Td /F1 9.8 Tf  [(2006 Jan.)] TJ ET
BT 26.250 268.224 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 268.224 Td /F1 9.8 Tf  [(Department for Communities and Local Government Fire Statistics Great Britain, 2010-11. DLCG, London, 2011.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 259.739 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 241.188 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 241.188 Td /F1 9.8 Tf  [(DEFRA. Summary of the Key Findings from the UK Climate Change Risk Assessment 2012. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 232.702 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 214.152 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 214.152 Td /F1 9.8 Tf  [(Moffat AJ, Morison JIL, Nicoll B, Bain V. Climate Change Risk Assessment for the Forestry Sector.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 205.666 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 187.116 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 187.116 Td /F1 9.8 Tf  [(1993 - 1994, December - January, North Coast , Hunter and Sydney bushfire. 2007 [cited 2012 Jan 6].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 178.630 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 160.080 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 160.080 Td /F1 9.8 Tf  [(The Asian Forest Fires of 1997-1998. 2011 [cited 2011 Jan 20].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 151.594 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 133.044 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 133.044 Td /F1 9.8 Tf  [(Glover D, Jessup T. Indonesia's Fires and Haze: The Cost of Catastrophe. Singapore: International Development Research )] TJ ET
BT 26.250 121.140 Td /F1 9.8 Tf  [(Centre; 2002.)] TJ ET
BT 26.250 101.735 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 101.735 Td /F1 9.8 Tf  [(Filmon G. Firestorm 2003 provincial review. Victoria, British Columbia.: Province of British Columbia; 2003.)] TJ ET
BT 26.250 82.330 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 82.330 Td /F1 9.8 Tf  [(October 2007 California Wildfires. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 73.844 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 55.294 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 55.294 Td /F1 9.8 Tf  [(Cameron PA, Mitra B, Fitzgerald M, Scheinkestel CD, Stripp A, Batey C, et al. Black Saturday: the immediate impact of the )] TJ ET
Q
q
15.000 41.008 577.500 735.992 re W n
q
26.250 777.000 555.000 0.000 re W n
Q
1.000 1.000 1.000 rg
26.250 600.562 555.000 176.437 re f
0.267 0.267 0.267 rg
26.625 775.875 101.854 0.750 re f
26.625 759.994 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 766.020 Td /F1 9.8 Tf  [(�BSA)] TJ ET
0.267 0.267 0.267 rg
127.729 775.875 453.146 0.750 re f
127.729 759.994 0.750 16.631 re f
580.125 759.994 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 766.020 Td /F1 9.8 Tf  [(Body Surface Area)] TJ ET
0.267 0.267 0.267 rg
26.625 759.994 101.854 0.750 re f
26.625 744.112 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 750.139 Td /F1 9.8 Tf  [(�CCRA)] TJ ET
0.267 0.267 0.267 rg
127.729 759.994 453.146 0.750 re f
127.729 744.112 0.750 16.631 re f
580.125 744.112 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 750.139 Td /F1 9.8 Tf  [(UK Climate Change Risk Assessment 2012)] TJ ET
0.267 0.267 0.267 rg
26.625 744.112 101.854 0.750 re f
26.625 680.344 0.750 64.519 re f
0.271 0.267 0.267 rg
BT 31.875 734.258 Td /F1 9.8 Tf  [(�CO)] TJ ET
0.267 0.267 0.267 rg
127.729 744.112 453.146 0.750 re f
127.729 680.344 0.750 64.519 re f
580.125 680.344 0.750 64.519 re f
0.271 0.267 0.267 rg
BT 132.979 734.258 Td /F1 9.8 Tf  [(Carbon Monoxide)] TJ ET
0.267 0.267 0.267 rg
26.625 680.344 101.854 0.750 re f
26.625 664.462 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 670.489 Td /F1 9.8 Tf  [(�ED)] TJ ET
0.267 0.267 0.267 rg
127.729 680.344 453.146 0.750 re f
127.729 664.462 0.750 16.631 re f
580.125 664.462 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 670.489 Td /F1 9.8 Tf  [(Emergency Department)] TJ ET
0.267 0.267 0.267 rg
26.625 664.462 101.854 0.750 re f
26.625 648.581 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 654.608 Td /F1 9.8 Tf  [(�ICU)] TJ ET
0.267 0.267 0.267 rg
127.729 664.462 453.146 0.750 re f
127.729 648.581 0.750 16.631 re f
580.125 648.581 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 654.608 Td /F1 9.8 Tf  [(Intensive Care Unit)] TJ ET
0.267 0.267 0.267 rg
26.625 648.581 101.854 0.750 re f
26.625 632.700 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 638.726 Td /F1 9.8 Tf  [(�PM 10)] TJ ET
0.267 0.267 0.267 rg
127.729 648.581 453.146 0.750 re f
127.729 632.700 0.750 16.631 re f
580.125 632.700 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 638.726 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 10 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
26.625 632.700 101.854 0.750 re f
26.625 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 622.845 Td /F1 9.8 Tf  [(�PM 2.5)] TJ ET
0.267 0.267 0.267 rg
127.729 632.700 453.146 0.750 re f
127.729 616.819 0.750 16.631 re f
580.125 616.819 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 622.845 Td /F1 9.8 Tf  [(Particulate Matter with a diameter of 2.5 micrometer or less)] TJ ET
0.267 0.267 0.267 rg
26.625 616.819 101.854 0.750 re f
26.625 600.938 101.854 0.750 re f
26.625 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 31.875 606.964 Td /F1 9.8 Tf  [(�WBC)] TJ ET
0.267 0.267 0.267 rg
127.729 616.819 453.146 0.750 re f
127.729 600.938 453.146 0.750 re f
127.729 600.938 0.750 16.631 re f
580.125 600.938 0.750 16.631 re f
0.271 0.267 0.267 rg
BT 132.979 606.964 Td /F1 9.8 Tf  [(White Blood Cell)] TJ ET
BT 26.250 528.841 Td /F4 12.0 Tf  [(APPENDIX 2)] TJ ET
BT 26.250 491.689 Td /F4 12.0 Tf  [(Prisma Checklist)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 471.735 Td /F1 9.8 Tf  [(Download PDF)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 435.132 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 407.678 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 407.678 Td /F1 9.8 Tf  [(In Pictures; Chile battles wildfires. 2012 [cited 2012 Jan 25])] TJ ET
0.267 0.267 0.267 rg
BT 26.250 399.192 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 380.642 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 380.642 Td /F1 9.8 Tf  [(BBC. Australia fires leave trail of devastation. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 372.156 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 353.606 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 353.606 Td /F1 9.8 Tf  [(Californian Department of Forestry and Fire Protection.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 345.120 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 326.570 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 326.570 Td /F1 9.8 Tf  [(EEA. Mapping the impacts of natural hazards and technological accidents in Europe. 2010)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 318.084 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 299.534 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 299.534 Td /F1 9.8 Tf  [(Effects of climate change on fire and rescue services in the UK. Fire Research Technical Report 1/2006. London: DCLG; )] TJ ET
BT 26.250 287.629 Td /F1 9.8 Tf  [(2006 Jan.)] TJ ET
BT 26.250 268.224 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 268.224 Td /F1 9.8 Tf  [(Department for Communities and Local Government Fire Statistics Great Britain, 2010-11. DLCG, London, 2011.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 259.739 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 241.188 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 241.188 Td /F1 9.8 Tf  [(DEFRA. Summary of the Key Findings from the UK Climate Change Risk Assessment 2012. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 232.702 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 214.152 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 214.152 Td /F1 9.8 Tf  [(Moffat AJ, Morison JIL, Nicoll B, Bain V. Climate Change Risk Assessment for the Forestry Sector.)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 205.666 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 187.116 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 187.116 Td /F1 9.8 Tf  [(1993 - 1994, December - January, North Coast , Hunter and Sydney bushfire. 2007 [cited 2012 Jan 6].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 178.630 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 160.080 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 160.080 Td /F1 9.8 Tf  [(The Asian Forest Fires of 1997-1998. 2011 [cited 2011 Jan 20].)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 151.594 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 133.044 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 133.044 Td /F1 9.8 Tf  [(Glover D, Jessup T. Indonesia's Fires and Haze: The Cost of Catastrophe. Singapore: International Development Research )] TJ ET
BT 26.250 121.140 Td /F1 9.8 Tf  [(Centre; 2002.)] TJ ET
BT 26.250 101.735 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 101.735 Td /F1 9.8 Tf  [(Filmon G. Firestorm 2003 provincial review. Victoria, British Columbia.: Province of British Columbia; 2003.)] TJ ET
BT 26.250 82.330 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 82.330 Td /F1 9.8 Tf  [(October 2007 California Wildfires. 2011)] TJ ET
0.267 0.267 0.267 rg
BT 26.250 73.844 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 55.294 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 55.294 Td /F1 9.8 Tf  [(Cameron PA, Mitra B, Fitzgerald M, Scheinkestel CD, Stripp A, Batey C, et al. Black Saturday: the immediate impact of the )] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(13)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Disasters)] TJ ET
0.39 w 1 J 1 j
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BT 43.553 310.523 Td /F1 9.8 Tf  [(Health guidelines for vegetation fire events. World Health Organisation; UNEP; WMO; Institute of Environmental )] TJ ET
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BT 43.553 247.904 Td /F1 9.8 Tf  [(Tan WC, Qiu D, Liam BL, Ng TP, Lee SH, Van Eeden SF, et al. The human bone marrow response to acute air pollution )] TJ ET
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BT 43.553 216.594 Td /F1 9.8 Tf  [(Morgan G, Sheppeard V, Khalaj B, Ayyar A, Lincoln D, Jalaludin B, et al. Effects of Bushfire Smoke on Daily Mortality and )] TJ ET
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BT 43.553 185.285 Td /F1 9.8 Tf  [(Dennekamp M, Abramson MJ. The effects of bushfire smoke on respiratory health. [Review]. Respirology 2011 )] TJ ET
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BT 43.553 153.975 Td /F1 9.8 Tf  [(Johnston FH, Kavanagh AM, Bowman DM, Scott RK. Exposure to bushfire smoke and asthma: an ecological study. Med J )] TJ ET
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BT 43.553 122.666 Td /F1 9.8 Tf  [(Johnston F, Bailie R, Pilotto L, Hanigan I. Ambient biomass smoke and cardio-respiratory hospital admissions in Darwin, )] TJ ET
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BT 43.553 91.356 Td /F1 9.8 Tf  [(Jalava PI, Salonen RO, H�linen AI, Penttinen P, Pennanen AS, Sillanp�� M, et al. In vitro inflammatory and cytotoxic effects )] TJ ET
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BT 43.553 48.142 Td /F1 9.8 Tf  [(Ghio AJ, Soukup JM, Case M, Dailey LA, Richards J, Berntsen J, et al. Exposure to wood smoke particles produces )] TJ ET
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BT 26.250 579.680 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
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BT 26.250 561.130 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 561.130 Td /F1 9.8 Tf  [(Fowler C. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review. Journal of Ecological )] TJ ET
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BT 43.553 529.821 Td /F1 9.8 Tf  [(Morton, D., Rowland, C., Wood, C., Meek, L., Marston, C., Smith, G., Simpson, I.C. 2011. Final report for LCM2007 - the )] TJ ET
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BT 26.250 506.011 Td /F1 9.8 Tf  [(C03259\).)] TJ ET
BT 26.250 486.606 Td /F1 9.8 Tf  [(23.)] TJ ET
BT 43.553 486.606 Td /F1 9.8 Tf  [(World Health Organisation. VEGETATION FIRES - Technical Hazard Sheet - Natural disaster profiles. 2012 [cited 2012 Jan )] TJ ET
BT 26.250 474.702 Td /F1 9.8 Tf  [(19]. )] TJ ET
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BT 26.250 466.216 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 447.666 Td /F1 9.8 Tf  [(24.)] TJ ET
BT 43.553 447.666 Td /F1 9.8 Tf  [(Johnson F, Hanighan I, Henderson S, Morgan G, Bowman D. Extreme air pollution events from bushfires and dust storms )] TJ ET
BT 26.250 435.761 Td /F1 9.8 Tf  [(and their association with mortality in Sydney, Australia 1994�2007. Environmental Health 2011 May 6.)] TJ ET
BT 26.250 416.356 Td /F1 9.8 Tf  [(25.)] TJ ET
BT 43.553 416.356 Td /F1 9.8 Tf  [(Boman BC, Forsberg AB, Jarvholm BG. Adverse health effects from ambient air pollution in relation to residential wood )] TJ ET
BT 26.250 404.451 Td /F1 9.8 Tf  [(combustion in modern society. Scand J Work Environ Health 2003 Aug;29\(4\):251-60.)] TJ ET
BT 26.250 385.047 Td /F1 9.8 Tf  [(26.)] TJ ET
BT 43.553 385.047 Td /F1 9.8 Tf  [(Hanninen OO, Salonen RO, Koistinen K, Lanki T, Barregard L, Jantunen M. Population exposure to fine particles and )] TJ ET
BT 26.250 373.142 Td /F1 9.8 Tf  [(estimated excess mortality in Finland from an East European wildfire episode. J Expos Sci Environ Epidemiol 2008 Jun )] TJ ET
BT 26.250 361.237 Td /F1 9.8 Tf  [(4;19\(4\):414-22.)] TJ ET
BT 26.250 341.832 Td /F1 9.8 Tf  [(27.)] TJ ET
BT 43.553 341.832 Td /F1 9.8 Tf  [(Naeher LP, Brauer M, Lipsett M, Zelikoff JT, Simpson CD, Koenig JQ, et al. Woodsmoke Health Effects: A Review. )] TJ ET
BT 26.250 329.928 Td /F1 9.8 Tf  [(Inhalation Toxicology 2007 Jan 1;19\(1\):67-106.)] TJ ET
BT 26.250 310.523 Td /F1 9.8 Tf  [(28.)] TJ ET
BT 43.553 310.523 Td /F1 9.8 Tf  [(Health guidelines for vegetation fire events. World Health Organisation; UNEP; WMO; Institute of Environmental )] TJ ET
BT 26.250 298.618 Td /F1 9.8 Tf  [(Epidemiology; 1999.)] TJ ET
BT 26.250 279.213 Td /F1 9.8 Tf  [(29.)] TJ ET
BT 43.553 279.213 Td /F1 9.8 Tf  [(Wakefield JC. A Toxicological Review of Products of Combustion. Health Protection Agency Chemical Hazards and Poisons )] TJ ET
BT 26.250 267.309 Td /F1 9.8 Tf  [(Division Report HPA-CHaPD-004, 2012.)] TJ ET
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BT 43.553 247.904 Td /F1 9.8 Tf  [(Tan WC, Qiu D, Liam BL, Ng TP, Lee SH, Van Eeden SF, et al. The human bone marrow response to acute air pollution )] TJ ET
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BT 43.553 216.594 Td /F1 9.8 Tf  [(Morgan G, Sheppeard V, Khalaj B, Ayyar A, Lincoln D, Jalaludin B, et al. Effects of Bushfire Smoke on Daily Mortality and )] TJ ET
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BT 43.553 185.285 Td /F1 9.8 Tf  [(Dennekamp M, Abramson MJ. The effects of bushfire smoke on respiratory health. [Review]. Respirology 2011 )] TJ ET
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BT 26.250 153.975 Td /F1 9.8 Tf  [(33.)] TJ ET
BT 43.553 153.975 Td /F1 9.8 Tf  [(Johnston FH, Kavanagh AM, Bowman DM, Scott RK. Exposure to bushfire smoke and asthma: an ecological study. Med J )] TJ ET
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BT 43.553 48.142 Td /F1 9.8 Tf  [(Ghio AJ, Soukup JM, Case M, Dailey LA, Richards J, Berntsen J, et al. Exposure to wood smoke particles produces )] TJ ET
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BT 26.250 661.643 Td /F1 9.8 Tf  [(2002-2003 bushfire season, Victoria, Australia. [Article]. Respirology 2009 Jan;14\(1\):69-75.)] TJ ET
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BT 43.553 642.238 Td /F1 9.8 Tf  [(Fowler C. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review. Journal of Ecological )] TJ ET
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BT 43.553 536.405 Td /F1 9.8 Tf  [(Mirabelli MC, Kunzli N, Avol E, Gilliland FD, Gauderman WJ, McConnell R, et al. Respiratory Symptoms Following Wildfire )] TJ ET
BT 26.250 524.500 Td /F1 9.8 Tf  [(Smoke Exposure: Airway Size as a Susceptibility Factor. [Article]. Epidemiology 2009 May;20\(3\):451-9.)] TJ ET
BT 26.250 505.095 Td /F1 9.8 Tf  [(44.)] TJ ET
BT 43.553 505.095 Td /F1 9.8 Tf  [(Cooper CW, Mira M, Danforth M, Abraham K, Fasher B, Bolton P. Acute exacerbations of asthma and bushfires. Lancet )] TJ ET
BT 26.250 493.191 Td /F1 9.8 Tf  [(1994 Jun;343\(8911\):1509.1;25\(6\):1227-36.)] TJ ET
BT 26.250 473.786 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 473.786 Td /F1 9.8 Tf  [(Smith MA, Jalaludin B, Byles JE, Lim L, Leeder SR. Asthma Presentations to Emergency Departments in Western Sydney )] TJ ET
BT 26.250 461.881 Td /F1 9.8 Tf  [(during the January 1994 Bushfires. International Journal of Epidemiology 1996 Dec 1;25\(6\):1227-36.)] TJ ET
BT 26.250 442.476 Td /F1 9.8 Tf  [(46.)] TJ ET
BT 43.553 442.476 Td /F1 9.8 Tf  [(Duclos P, Sanderson LM, Lipsett M. The 1987 Forest Fire Disaster in California: Assessment of Emergency Room Visits. )] TJ ET
BT 26.250 430.572 Td /F1 9.8 Tf  [(Archives of Environmental Health: An International Journal 1990 Jun 6;45:53-8.)] TJ ET
BT 26.250 411.167 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 411.167 Td /F1 9.8 Tf  [(Johnston FH, Webby RJ, Pilotto LS, Bailie RS, Parry DL, Halpin SJ. Vegetation fires, particulate air pollution and asthma: A )] TJ ET
BT 26.250 399.262 Td /F1 9.8 Tf  [(panel study in the Australian monsoon tropics. International Journal of Environmental Health Research 2006 Dec 1;16\(6\):391-)] TJ ET
BT 26.250 387.357 Td /F1 9.8 Tf  [(404.)] TJ ET
BT 26.250 367.953 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 367.953 Td /F1 9.8 Tf  [(Aditama TY. Impact of haze from forest fire to respiratory health: Indonesian experience. Respirology 2000;5\(2\):169-74.)] TJ ET
BT 26.250 348.548 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 348.548 Td /F1 9.8 Tf  [(Sastry N. Forest fires, air pollution, and mortality in Southeast Asia. Demography 2002 Feb 1;39\(1\):1-23.)] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 329.143 Td /F1 9.8 Tf  [(Emmanuel SC. Impact to lung health of haze from forest fires: The Singapore experience. Respirology 2000;5\(2\):175-82.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(51.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Moore D, Copes R, Fisk R, Joy R, Chan K, Brauer M. Population health effects of air quality changes due to forest fires in )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(British Columbia in 2003 : Estimates from physician-visit billing data. Canadian Journal of Public Health 97, 105-108. 2006.)] TJ ET
BT 26.250 278.429 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 278.429 Td /F1 9.8 Tf  [(Delfino RJ, Brummel S, Wu J, Stern H, Ostro B, Lipsett M, et al. The relationship of respiratory and cardiovascular hospital )] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(admissions to the southern California wildfires of 2003. [Article]. Occupational & Environmental Medicine 2009 Mar;66\(3\):189-97.)] TJ ET
BT 26.250 247.119 Td /F1 9.8 Tf  [(53.)] TJ ET
BT 43.553 247.119 Td /F1 9.8 Tf  [(Ovadnevaite J, Kvietkus K, Marsalka A. 2002 summer fires in Lithuania: Impact on the Vilnius city air quality and the )] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(inhabitants health. Science of The Total Environment 2006 Mar 1;356\(1-3\):11-21.)] TJ ET
BT 26.250 215.810 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 215.810 Td /F1 9.8 Tf  [(Seifman M, Ek EW, Menezes H, Rozen WM, Whitaker IS, Cleland HJ. Bushfire Disaster Burn Casualty Management: The )] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(Australian �Black Saturday� Bushfire Experience. Annals of Plastic Surgery 2011;67\(5\).)] TJ ET
BT 26.250 184.500 Td /F1 9.8 Tf  [(55.)] TJ ET
BT 43.553 184.500 Td /F1 9.8 Tf  [(Heat Induced Illnesses. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 176.015 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 157.464 Td /F1 9.8 Tf  [(56.)] TJ ET
BT 43.553 157.464 Td /F1 9.8 Tf  [(Johnson F, Hanighan I, Henderson S, Morgan G, Bowman D. Extreme air pollution events from bushfires and dust storms )] TJ ET
BT 26.250 145.560 Td /F1 9.8 Tf  [(and their association with mortality in Sydney, Australia 1994�2007. Environmental Health 2011 May 6.)] TJ ET
BT 26.250 126.155 Td /F1 9.8 Tf  [(57.)] TJ ET
BT 43.553 126.155 Td /F1 9.8 Tf  [(Hanninen OO, Salonen RO, Koistinen K, Lanki T, Barregard L, Jantunen M. Population exposure to fine particles and )] TJ ET
BT 26.250 114.250 Td /F1 9.8 Tf  [(estimated excess mortality in Finland from an East European wildfire episode. Journal of Exposure Science & Environmental )] TJ ET
BT 26.250 102.345 Td /F1 9.8 Tf  [(Epidemiology 2009 May;19\(4\):414-22.)] TJ ET
BT 26.250 82.941 Td /F1 9.8 Tf  [(58.)] TJ ET
BT 43.553 82.941 Td /F1 9.8 Tf  [(At least ten dead in crashes on Florida highway amid heavy smoke. 2012 [cited 2012 Jan 31])] TJ ET
0.267 0.267 0.267 rg
BT 26.250 74.455 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 55.905 Td /F1 9.8 Tf  [(59.)] TJ ET
BT 43.553 55.905 Td /F1 9.8 Tf  [(Shusterman D, Kaplan JZ, Canabarro C. Immediate health effects of an urban wildfire. Western Journal of Medicine 158[2], )] TJ ET
BT 26.250 44.000 Td /F1 9.8 Tf  [(133-138. 1993.)] TJ ET
Q
q
15.000 34.119 577.500 742.881 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(inflammation in healthy volunteers. Occupational and Environmental Medicine 2011 Jun 30.)] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(37.)] TJ ET
BT 43.553 748.071 Td /F1 9.8 Tf  [(De Vos AJBM, Cook AM, Devine BB, Thompson PJM, Weinstein PPMMBF. Effect of Protective Filters on Fire Fighter )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Respiratory Health During Simulated Bushfire Smoke Exposure. [Article]. American Journal Of Industrial Medicine 2006 )] TJ ET
BT 26.250 724.262 Td /F1 9.8 Tf  [(Sep;49\(9\):740-50.)] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(38.)] TJ ET
BT 43.553 704.857 Td /F1 9.8 Tf  [(Hanninen O, Salonen RO, Lanki T, Koistinen K, Jantunen M, Anttila P. Population Risk and Exposure-Response from )] TJ ET
BT 26.250 692.952 Td /F1 9.8 Tf  [(Exposures to Long-Range Transported Wildfire Smoke. [Abstract]. Epidemiology 2007 Sep;18\(5\):S191.)] TJ ET
BT 26.250 673.548 Td /F1 9.8 Tf  [(39.)] TJ ET
BT 43.553 673.548 Td /F1 9.8 Tf  [(Tham R, Erbas B, Akram M, Dennekam A, Abramson MJ. The impact of smoke on respiratory hospital outcomes during the )] TJ ET
BT 26.250 661.643 Td /F1 9.8 Tf  [(2002-2003 bushfire season, Victoria, Australia. [Article]. Respirology 2009 Jan;14\(1\):69-75.)] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(40.)] TJ ET
BT 43.553 642.238 Td /F1 9.8 Tf  [(Fowler C. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review. Journal of Ecological )] TJ ET
BT 26.250 630.333 Td /F1 9.8 Tf  [(Anthropology 2003 Jan 1;7:39-63.)] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(41.)] TJ ET
BT 43.553 610.929 Td /F1 9.8 Tf  [(Sutherland ERMM, Make BJM, Vedal SM, Zhang LP, Dutton SJM, Murphy JRP, et al. Wildfire smoke and respiratory )] TJ ET
BT 26.250 599.024 Td /F1 9.8 Tf  [(symptoms in patients with chronic obstructive pulmonary disease. [Letter]. Journal of Allergy & Clinical Immunology 2005 )] TJ ET
BT 26.250 587.119 Td /F1 9.8 Tf  [(Feb;115\(2\):420-2.)] TJ ET
BT 26.250 567.714 Td /F1 9.8 Tf  [(42.)] TJ ET
BT 43.553 567.714 Td /F1 9.8 Tf  [(Jalaludin B, Morgan G, O'Toole B, Leeder S. Acute effects of bushfires on respiratory symptoms in children with wheeze, )] TJ ET
BT 26.250 555.810 Td /F1 9.8 Tf  [(Sydney, Australia: Isee-548. [Abstract]. Epidemiology 2003 Sep;14\(5\):S107-S108.)] TJ ET
BT 26.250 536.405 Td /F1 9.8 Tf  [(43.)] TJ ET
BT 43.553 536.405 Td /F1 9.8 Tf  [(Mirabelli MC, Kunzli N, Avol E, Gilliland FD, Gauderman WJ, McConnell R, et al. Respiratory Symptoms Following Wildfire )] TJ ET
BT 26.250 524.500 Td /F1 9.8 Tf  [(Smoke Exposure: Airway Size as a Susceptibility Factor. [Article]. Epidemiology 2009 May;20\(3\):451-9.)] TJ ET
BT 26.250 505.095 Td /F1 9.8 Tf  [(44.)] TJ ET
BT 43.553 505.095 Td /F1 9.8 Tf  [(Cooper CW, Mira M, Danforth M, Abraham K, Fasher B, Bolton P. Acute exacerbations of asthma and bushfires. Lancet )] TJ ET
BT 26.250 493.191 Td /F1 9.8 Tf  [(1994 Jun;343\(8911\):1509.1;25\(6\):1227-36.)] TJ ET
BT 26.250 473.786 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 473.786 Td /F1 9.8 Tf  [(Smith MA, Jalaludin B, Byles JE, Lim L, Leeder SR. Asthma Presentations to Emergency Departments in Western Sydney )] TJ ET
BT 26.250 461.881 Td /F1 9.8 Tf  [(during the January 1994 Bushfires. International Journal of Epidemiology 1996 Dec 1;25\(6\):1227-36.)] TJ ET
BT 26.250 442.476 Td /F1 9.8 Tf  [(46.)] TJ ET
BT 43.553 442.476 Td /F1 9.8 Tf  [(Duclos P, Sanderson LM, Lipsett M. The 1987 Forest Fire Disaster in California: Assessment of Emergency Room Visits. )] TJ ET
BT 26.250 430.572 Td /F1 9.8 Tf  [(Archives of Environmental Health: An International Journal 1990 Jun 6;45:53-8.)] TJ ET
BT 26.250 411.167 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 411.167 Td /F1 9.8 Tf  [(Johnston FH, Webby RJ, Pilotto LS, Bailie RS, Parry DL, Halpin SJ. Vegetation fires, particulate air pollution and asthma: A )] TJ ET
BT 26.250 399.262 Td /F1 9.8 Tf  [(panel study in the Australian monsoon tropics. International Journal of Environmental Health Research 2006 Dec 1;16\(6\):391-)] TJ ET
BT 26.250 387.357 Td /F1 9.8 Tf  [(404.)] TJ ET
BT 26.250 367.953 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 367.953 Td /F1 9.8 Tf  [(Aditama TY. Impact of haze from forest fire to respiratory health: Indonesian experience. Respirology 2000;5\(2\):169-74.)] TJ ET
BT 26.250 348.548 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 348.548 Td /F1 9.8 Tf  [(Sastry N. Forest fires, air pollution, and mortality in Southeast Asia. Demography 2002 Feb 1;39\(1\):1-23.)] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 329.143 Td /F1 9.8 Tf  [(Emmanuel SC. Impact to lung health of haze from forest fires: The Singapore experience. Respirology 2000;5\(2\):175-82.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(51.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Moore D, Copes R, Fisk R, Joy R, Chan K, Brauer M. Population health effects of air quality changes due to forest fires in )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(British Columbia in 2003 : Estimates from physician-visit billing data. Canadian Journal of Public Health 97, 105-108. 2006.)] TJ ET
BT 26.250 278.429 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 278.429 Td /F1 9.8 Tf  [(Delfino RJ, Brummel S, Wu J, Stern H, Ostro B, Lipsett M, et al. The relationship of respiratory and cardiovascular hospital )] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(admissions to the southern California wildfires of 2003. [Article]. Occupational & Environmental Medicine 2009 Mar;66\(3\):189-97.)] TJ ET
BT 26.250 247.119 Td /F1 9.8 Tf  [(53.)] TJ ET
BT 43.553 247.119 Td /F1 9.8 Tf  [(Ovadnevaite J, Kvietkus K, Marsalka A. 2002 summer fires in Lithuania: Impact on the Vilnius city air quality and the )] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(inhabitants health. Science of The Total Environment 2006 Mar 1;356\(1-3\):11-21.)] TJ ET
BT 26.250 215.810 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 215.810 Td /F1 9.8 Tf  [(Seifman M, Ek EW, Menezes H, Rozen WM, Whitaker IS, Cleland HJ. Bushfire Disaster Burn Casualty Management: The )] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(Australian �Black Saturday� Bushfire Experience. Annals of Plastic Surgery 2011;67\(5\).)] TJ ET
BT 26.250 184.500 Td /F1 9.8 Tf  [(55.)] TJ ET
BT 43.553 184.500 Td /F1 9.8 Tf  [(Heat Induced Illnesses. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 176.015 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 157.464 Td /F1 9.8 Tf  [(56.)] TJ ET
BT 43.553 157.464 Td /F1 9.8 Tf  [(Johnson F, Hanighan I, Henderson S, Morgan G, Bowman D. Extreme air pollution events from bushfires and dust storms )] TJ ET
BT 26.250 145.560 Td /F1 9.8 Tf  [(and their association with mortality in Sydney, Australia 1994�2007. Environmental Health 2011 May 6.)] TJ ET
BT 26.250 126.155 Td /F1 9.8 Tf  [(57.)] TJ ET
BT 43.553 126.155 Td /F1 9.8 Tf  [(Hanninen OO, Salonen RO, Koistinen K, Lanki T, Barregard L, Jantunen M. Population exposure to fine particles and )] TJ ET
BT 26.250 114.250 Td /F1 9.8 Tf  [(estimated excess mortality in Finland from an East European wildfire episode. Journal of Exposure Science & Environmental )] TJ ET
BT 26.250 102.345 Td /F1 9.8 Tf  [(Epidemiology 2009 May;19\(4\):414-22.)] TJ ET
BT 26.250 82.941 Td /F1 9.8 Tf  [(58.)] TJ ET
BT 43.553 82.941 Td /F1 9.8 Tf  [(At least ten dead in crashes on Florida highway amid heavy smoke. 2012 [cited 2012 Jan 31])] TJ ET
0.267 0.267 0.267 rg
BT 26.250 74.455 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 55.905 Td /F1 9.8 Tf  [(59.)] TJ ET
BT 43.553 55.905 Td /F1 9.8 Tf  [(Shusterman D, Kaplan JZ, Canabarro C. Immediate health effects of an urban wildfire. Western Journal of Medicine 158[2], )] TJ ET
BT 26.250 44.000 Td /F1 9.8 Tf  [(133-138. 1993.)] TJ ET
Q
q
15.000 34.119 577.500 742.881 re W n
0.271 0.267 0.267 rg
BT 26.250 767.476 Td /F1 9.8 Tf  [(inflammation in healthy volunteers. Occupational and Environmental Medicine 2011 Jun 30.)] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(37.)] TJ ET
BT 43.553 748.071 Td /F1 9.8 Tf  [(De Vos AJBM, Cook AM, Devine BB, Thompson PJM, Weinstein PPMMBF. Effect of Protective Filters on Fire Fighter )] TJ ET
BT 26.250 736.167 Td /F1 9.8 Tf  [(Respiratory Health During Simulated Bushfire Smoke Exposure. [Article]. American Journal Of Industrial Medicine 2006 )] TJ ET
BT 26.250 724.262 Td /F1 9.8 Tf  [(Sep;49\(9\):740-50.)] TJ ET
BT 26.250 704.857 Td /F1 9.8 Tf  [(38.)] TJ ET
BT 43.553 704.857 Td /F1 9.8 Tf  [(Hanninen O, Salonen RO, Lanki T, Koistinen K, Jantunen M, Anttila P. Population Risk and Exposure-Response from )] TJ ET
BT 26.250 692.952 Td /F1 9.8 Tf  [(Exposures to Long-Range Transported Wildfire Smoke. [Abstract]. Epidemiology 2007 Sep;18\(5\):S191.)] TJ ET
BT 26.250 673.548 Td /F1 9.8 Tf  [(39.)] TJ ET
BT 43.553 673.548 Td /F1 9.8 Tf  [(Tham R, Erbas B, Akram M, Dennekam A, Abramson MJ. The impact of smoke on respiratory hospital outcomes during the )] TJ ET
BT 26.250 661.643 Td /F1 9.8 Tf  [(2002-2003 bushfire season, Victoria, Australia. [Article]. Respirology 2009 Jan;14\(1\):69-75.)] TJ ET
BT 26.250 642.238 Td /F1 9.8 Tf  [(40.)] TJ ET
BT 43.553 642.238 Td /F1 9.8 Tf  [(Fowler C. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review. Journal of Ecological )] TJ ET
BT 26.250 630.333 Td /F1 9.8 Tf  [(Anthropology 2003 Jan 1;7:39-63.)] TJ ET
BT 26.250 610.929 Td /F1 9.8 Tf  [(41.)] TJ ET
BT 43.553 610.929 Td /F1 9.8 Tf  [(Sutherland ERMM, Make BJM, Vedal SM, Zhang LP, Dutton SJM, Murphy JRP, et al. Wildfire smoke and respiratory )] TJ ET
BT 26.250 599.024 Td /F1 9.8 Tf  [(symptoms in patients with chronic obstructive pulmonary disease. [Letter]. Journal of Allergy & Clinical Immunology 2005 )] TJ ET
BT 26.250 587.119 Td /F1 9.8 Tf  [(Feb;115\(2\):420-2.)] TJ ET
BT 26.250 567.714 Td /F1 9.8 Tf  [(42.)] TJ ET
BT 43.553 567.714 Td /F1 9.8 Tf  [(Jalaludin B, Morgan G, O'Toole B, Leeder S. Acute effects of bushfires on respiratory symptoms in children with wheeze, )] TJ ET
BT 26.250 555.810 Td /F1 9.8 Tf  [(Sydney, Australia: Isee-548. [Abstract]. Epidemiology 2003 Sep;14\(5\):S107-S108.)] TJ ET
BT 26.250 536.405 Td /F1 9.8 Tf  [(43.)] TJ ET
BT 43.553 536.405 Td /F1 9.8 Tf  [(Mirabelli MC, Kunzli N, Avol E, Gilliland FD, Gauderman WJ, McConnell R, et al. Respiratory Symptoms Following Wildfire )] TJ ET
BT 26.250 524.500 Td /F1 9.8 Tf  [(Smoke Exposure: Airway Size as a Susceptibility Factor. [Article]. Epidemiology 2009 May;20\(3\):451-9.)] TJ ET
BT 26.250 505.095 Td /F1 9.8 Tf  [(44.)] TJ ET
BT 43.553 505.095 Td /F1 9.8 Tf  [(Cooper CW, Mira M, Danforth M, Abraham K, Fasher B, Bolton P. Acute exacerbations of asthma and bushfires. Lancet )] TJ ET
BT 26.250 493.191 Td /F1 9.8 Tf  [(1994 Jun;343\(8911\):1509.1;25\(6\):1227-36.)] TJ ET
BT 26.250 473.786 Td /F1 9.8 Tf  [(45.)] TJ ET
BT 43.553 473.786 Td /F1 9.8 Tf  [(Smith MA, Jalaludin B, Byles JE, Lim L, Leeder SR. Asthma Presentations to Emergency Departments in Western Sydney )] TJ ET
BT 26.250 461.881 Td /F1 9.8 Tf  [(during the January 1994 Bushfires. International Journal of Epidemiology 1996 Dec 1;25\(6\):1227-36.)] TJ ET
BT 26.250 442.476 Td /F1 9.8 Tf  [(46.)] TJ ET
BT 43.553 442.476 Td /F1 9.8 Tf  [(Duclos P, Sanderson LM, Lipsett M. The 1987 Forest Fire Disaster in California: Assessment of Emergency Room Visits. )] TJ ET
BT 26.250 430.572 Td /F1 9.8 Tf  [(Archives of Environmental Health: An International Journal 1990 Jun 6;45:53-8.)] TJ ET
BT 26.250 411.167 Td /F1 9.8 Tf  [(47.)] TJ ET
BT 43.553 411.167 Td /F1 9.8 Tf  [(Johnston FH, Webby RJ, Pilotto LS, Bailie RS, Parry DL, Halpin SJ. Vegetation fires, particulate air pollution and asthma: A )] TJ ET
BT 26.250 399.262 Td /F1 9.8 Tf  [(panel study in the Australian monsoon tropics. International Journal of Environmental Health Research 2006 Dec 1;16\(6\):391-)] TJ ET
BT 26.250 387.357 Td /F1 9.8 Tf  [(404.)] TJ ET
BT 26.250 367.953 Td /F1 9.8 Tf  [(48.)] TJ ET
BT 43.553 367.953 Td /F1 9.8 Tf  [(Aditama TY. Impact of haze from forest fire to respiratory health: Indonesian experience. Respirology 2000;5\(2\):169-74.)] TJ ET
BT 26.250 348.548 Td /F1 9.8 Tf  [(49.)] TJ ET
BT 43.553 348.548 Td /F1 9.8 Tf  [(Sastry N. Forest fires, air pollution, and mortality in Southeast Asia. Demography 2002 Feb 1;39\(1\):1-23.)] TJ ET
BT 26.250 329.143 Td /F1 9.8 Tf  [(50.)] TJ ET
BT 43.553 329.143 Td /F1 9.8 Tf  [(Emmanuel SC. Impact to lung health of haze from forest fires: The Singapore experience. Respirology 2000;5\(2\):175-82.)] TJ ET
BT 26.250 309.738 Td /F1 9.8 Tf  [(51.)] TJ ET
BT 43.553 309.738 Td /F1 9.8 Tf  [(Moore D, Copes R, Fisk R, Joy R, Chan K, Brauer M. Population health effects of air quality changes due to forest fires in )] TJ ET
BT 26.250 297.834 Td /F1 9.8 Tf  [(British Columbia in 2003 : Estimates from physician-visit billing data. Canadian Journal of Public Health 97, 105-108. 2006.)] TJ ET
BT 26.250 278.429 Td /F1 9.8 Tf  [(52.)] TJ ET
BT 43.553 278.429 Td /F1 9.8 Tf  [(Delfino RJ, Brummel S, Wu J, Stern H, Ostro B, Lipsett M, et al. The relationship of respiratory and cardiovascular hospital )] TJ ET
BT 26.250 266.524 Td /F1 9.8 Tf  [(admissions to the southern California wildfires of 2003. [Article]. Occupational & Environmental Medicine 2009 Mar;66\(3\):189-97.)] TJ ET
BT 26.250 247.119 Td /F1 9.8 Tf  [(53.)] TJ ET
BT 43.553 247.119 Td /F1 9.8 Tf  [(Ovadnevaite J, Kvietkus K, Marsalka A. 2002 summer fires in Lithuania: Impact on the Vilnius city air quality and the )] TJ ET
BT 26.250 235.215 Td /F1 9.8 Tf  [(inhabitants health. Science of The Total Environment 2006 Mar 1;356\(1-3\):11-21.)] TJ ET
BT 26.250 215.810 Td /F1 9.8 Tf  [(54.)] TJ ET
BT 43.553 215.810 Td /F1 9.8 Tf  [(Seifman M, Ek EW, Menezes H, Rozen WM, Whitaker IS, Cleland HJ. Bushfire Disaster Burn Casualty Management: The )] TJ ET
BT 26.250 203.905 Td /F1 9.8 Tf  [(Australian �Black Saturday� Bushfire Experience. Annals of Plastic Surgery 2011;67\(5\).)] TJ ET
BT 26.250 184.500 Td /F1 9.8 Tf  [(55.)] TJ ET
BT 43.553 184.500 Td /F1 9.8 Tf  [(Heat Induced Illnesses. )] TJ ET
0.267 0.267 0.267 rg
BT 26.250 176.015 Td /F1 7.5 Tf  [(REFERENCE LINK)] TJ ET
0.271 0.267 0.267 rg
BT 26.250 157.464 Td /F1 9.8 Tf  [(56.)] TJ ET
BT 43.553 157.464 Td /F1 9.8 Tf  [(Johnson F, Hanighan I, Henderson S, Morgan G, Bowman D. Extreme air pollution events from bushfires and dust storms )] TJ ET
BT 26.250 145.560 Td /F1 9.8 Tf  [(and their association with mortality in Sydney, Australia 1994�2007. Environmental Health 2011 May 6.)] TJ ET
BT 26.250 126.155 Td /F1 9.8 Tf  [(57.)] TJ ET
BT 43.553 126.155 Td /F1 9.8 Tf  [(Hanninen OO, Salonen RO, Koistinen K, Lanki T, Barregard L, Jantunen M. Population exposure to fine particles and )] TJ ET
BT 26.250 114.250 Td /F1 9.8 Tf  [(estimated excess mortality in Finland from an East European wildfire episode. Journal of Exposure Science & Environmental )] TJ ET
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