South Coast hospitals saw double the average number of emergency presentations for breathing difficulties in the first week of the new year - as the bushfire emergency hit its peak.
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From December 30 to January 5, there were 100 presentations to emergency departments for asthma and breathing difficulties across the Illawarra Shoalhaven Local Health District.
That compares to a five-year average of 54 presentations for these conditions in that time period, says the region's public health director Curtis Gregory.
In that week too, Milton Ulladulla Hospital - the local hospital for many towns and villages under direct threat from the Currowan fire - received a dozen presentations specifically for smoke inhalation.
That compared to a five-year average of two such presentations.
The heat of that week also contributed to 12 emergency department presentations across the district - with eight of those presenting to the Milton Ulladulla Hospital.
Usually the district would see just one ED presentation for heat-related illness during that week.
Mr Gregory said it was a reminder for South Coast residents - particularly asthmatics, the elderly and those with chronic conditions - to continue to monitor air quality and temperatures.
While milder conditions are expected in the coming week, more than 80 bushfires are still burning across the state and temperatures are expected to heat up again on Tuesday.
"One of the unusual things about the last couple of months is that poor air quality and smoke haze have been so persistent and ongoing," Mr Gregory said.
"Rather than just one-off days of poor air quality, we are seeing a pattern of several consecutive days of poor to hazardous air quality.
"So there's a cumulative effect, especially for those with pre-existing conditions, as they haven't had much of an opportunity to recover and get respite from it."
Rather than just one-off days of poor air quality, we are seeing a pattern of several consecutive days of poor to hazardous air quality.
- ISLHD public health director Curtis Gregory
Mr Gregory said the local health district had a number of initiatives in place to deal with the increased demand.
"This includes temporarily transferring some patients away from high risk zones to free up capacity in hospitals like Milton Ulladulla," he said.
The district was also working with the primary health sector - with GPs and medical centres - to ensure those with respiratory conditions had action plans in place.
In areas hit by bushfires like the South Coast, NSW Health has also arranged for pharmacies to issue certain medicines without prescription and distribute free P2/ N95 face masks.
"These masks filter out the very fine particles present in bushfire smoke but to work most effectively, they need to be fitted properly to form a tight seal around the face," Mr Gregory said.
"They're useful for those who have to work outside, or who have to return to check on their properties.
"However they're not suitable for everyone - asthmatics for instance may find it more strenuous to breathe through them and should check with their GPs."
The best advice was still to stay inside as much as possible on smoky days, with windows and doors closed.
For more information, and a list of where the P2 face masks are available locally, visit www.health.nsw.gov.au/environment/factsheets/Pages/face-mask.aspx#p2lhds-is.
This story first appeared on the Illawarra Mercury.