The short-term respiratory health effects of recurrent landfill fires: A time-series analysis, Havering, UK (2018–2023)

Objectives This study assessed the short-term respiratory health effects associated with recurrent fire incidents at Arnold's Field, a former landfill site in the London Borough of Havering, among residents living in close proximity. Study design An epidemiological time-series analysis was conducted using residents’ healthcare utilisation data (N = 23,656), local air quality measurements, meteorological variables, and fire incident records from January 2018 to September 2023. Methods Poisson regression models were used to assess associations between fire days and daily counts of respiratory healthcare activity, including general practice (GP) attendances and prescriptions, accident and emergency (A&E) attendances, and hospital admissions. Models were adjusted for air pollution, weather, seasonality, and COVID 19 lockdown periods. Results There were 99 fire days during the study period. GP attendances for patients with existing chronic respiratory illness were significantly higher on fire days as compared to non-fire days (RR = 1.35, 95% CI: 1.01–1.80), equivalent to 35% rise in rate of attendance. No significant associations were observed for GP attendances with general respiratory symptoms, GP prescriptions, A&E attendances or hospital admissions. Daily average and maximum PM 2 . 5 concentrations were not associated with significant changes in healthcare utilisation. Conclusions This study provides the first fine-scale UK evidence of short-term respiratory health effects associated with landfill fires. Recurrent fires were linked to increased GP consultations among individuals with chronic respiratory conditions, underscoring their heightened vulnerability to acute smoke exposure. While no clear effects were observed in the general population, the findings highlight the need for strengthened local air-quality monitoring, greater emphasis on peak exposures and susceptible groups in health-risk assessments, and targeted public health responses. Further research should examine a broader range of pollutants and assess the longer-term health implications of repeated smoke exposure.