Finding into death of Hoi-Sam Lau

Contributing factors

• thunderstorm asthma event with massive pollen concentration
• sensitisation to rye grass pollen
• suboptimal preventer medication use
• hay fever with seasonal asthma exacerbations
• delayed ambulance response due to unprecedented surge in demand
• possible exposure to Alternaria mould spores
• absence of asthma action plan
• no recent lung function testing
• allergic asthma inadequately managed in primary care

Coroner's recommendations

1. Further research into meteorological, biological and aerobiological factors contributing to thunderstorm asthma to improve prediction and forecasting
2. Continued verification and development of the thunderstorm asthma forecasting system
3. Continuation of public awareness campaigns about thunderstorm asthma, hay fever and preventative therapy
4. Further medical, allied health and community education encouraging hay fever sufferers to undergo allergy testing and develop management plans
5. When thunderstorm asthma warnings issued, public advised to remain indoors with windows shut and evaporative cooling turned off
6. Ongoing review of the effectiveness of new ambulance call-taking scripts and consideration of providing callers with estimated ambulance arrival times
7. Continued cooperation between ESTA, Ambulance Victoria, DHHS and Bureau of Meteorology on surge preparedness and response capabilities