Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities

The threats to human health from wildfires and wildfire smoke (WFS) in the United States (US) are increasing due to continued climate change. A growing body of literature has documented important adverse health effects of WFS exposure, but there is insufficient evidence regarding how risk related to...

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Main Authors: Jennifer D Stowell, Ian Sue Wing, Yasmin Romitti, Patrick L Kinney, Gregory A Wellenius
Format: Article
Language:English
Published: IOP Publishing 2024-01-01
Series:Environmental Research: Health
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Online Access:https://doi.org/10.1088/2752-5309/ad976d
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author Jennifer D Stowell
Ian Sue Wing
Yasmin Romitti
Patrick L Kinney
Gregory A Wellenius
author_facet Jennifer D Stowell
Ian Sue Wing
Yasmin Romitti
Patrick L Kinney
Gregory A Wellenius
author_sort Jennifer D Stowell
collection DOAJ
description The threats to human health from wildfires and wildfire smoke (WFS) in the United States (US) are increasing due to continued climate change. A growing body of literature has documented important adverse health effects of WFS exposure, but there is insufficient evidence regarding how risk related to WFS exposure varies across individual or community level characteristics. To address this evidence gap, we utilized a large nationwide database of healthcare utilization claims for emergency department (ED) visits in California across multiple wildfire seasons (May through November, 2012–2019) and quantified the health impacts of fine particulate matter <2.5 μ m (PM _2.5 ) air pollution attributable to WFS, overall and among subgroups of the population. We aggregated daily counts of ED visits to the level of the Zip Code Tabulation Area (ZCTA) and used a time-stratified case-crossover design and distributed lag non-linear models to estimate the association between WFS and relative risk of ED visits. We further assessed how the association with WFS varied across subgroups defined by age, race, social vulnerability, and residential air conditioning (AC) prevalence. Over a 7 day period, PM _2.5 from WFS was associated with elevated risk of ED visits for all causes (1.04% (0.32%, 1.71%)), non-accidental causes (2.93% (2.16%, 3.70%)), and respiratory disease (15.17% (12.86%, 17.52%)), but not with ED visits for cardiovascular diseases (1.06% (−1.88%, 4.08%)). Analysis across subgroups revealed potential differences in susceptibility by age, race, and AC prevalence, but not across subgroups defined by ZCTA-level Social Vulnerability Index scores. These results suggest that PM _2.5 from WFS is associated with higher rates of all cause, non-accidental, and respiratory ED visits with important heterogeneity across certain subgroups. Notably, lower availability of residential AC was associated with higher health risks related to wildfire activity.
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spelling doaj-art-68ad4169caac4a0fad4d3847e2f0170d2024-12-11T08:40:07ZengIOP PublishingEnvironmental Research: Health2752-53092024-01-013101500210.1088/2752-5309/ad976dEmergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communitiesJennifer D Stowell0https://orcid.org/0000-0001-6879-7149Ian Sue Wing1https://orcid.org/0000-0003-1177-3589Yasmin Romitti2Patrick L Kinney3Gregory A Wellenius4Department of Environmental Health, Boston University School of Public Health , Boston, MA, United States of America; Center for Climate and Health, Boston University , Boston, MA, United States of AmericaCenter for Climate and Health, Boston University , Boston, MA, United States of America; Department of Earth & Environment, Boston University , Boston, MA, United States of AmericaCenter for Climate and Health, Boston University , Boston, MA, United States of America; Department of Earth & Environment, Boston University , Boston, MA, United States of America; Health Effects Institute , Boston, MA, United States of AmericaDepartment of Environmental Health, Boston University School of Public Health , Boston, MA, United States of America; Center for Climate and Health, Boston University , Boston, MA, United States of AmericaDepartment of Environmental Health, Boston University School of Public Health , Boston, MA, United States of America; Center for Climate and Health, Boston University , Boston, MA, United States of AmericaThe threats to human health from wildfires and wildfire smoke (WFS) in the United States (US) are increasing due to continued climate change. A growing body of literature has documented important adverse health effects of WFS exposure, but there is insufficient evidence regarding how risk related to WFS exposure varies across individual or community level characteristics. To address this evidence gap, we utilized a large nationwide database of healthcare utilization claims for emergency department (ED) visits in California across multiple wildfire seasons (May through November, 2012–2019) and quantified the health impacts of fine particulate matter <2.5 μ m (PM _2.5 ) air pollution attributable to WFS, overall and among subgroups of the population. We aggregated daily counts of ED visits to the level of the Zip Code Tabulation Area (ZCTA) and used a time-stratified case-crossover design and distributed lag non-linear models to estimate the association between WFS and relative risk of ED visits. We further assessed how the association with WFS varied across subgroups defined by age, race, social vulnerability, and residential air conditioning (AC) prevalence. Over a 7 day period, PM _2.5 from WFS was associated with elevated risk of ED visits for all causes (1.04% (0.32%, 1.71%)), non-accidental causes (2.93% (2.16%, 3.70%)), and respiratory disease (15.17% (12.86%, 17.52%)), but not with ED visits for cardiovascular diseases (1.06% (−1.88%, 4.08%)). Analysis across subgroups revealed potential differences in susceptibility by age, race, and AC prevalence, but not across subgroups defined by ZCTA-level Social Vulnerability Index scores. These results suggest that PM _2.5 from WFS is associated with higher rates of all cause, non-accidental, and respiratory ED visits with important heterogeneity across certain subgroups. Notably, lower availability of residential AC was associated with higher health risks related to wildfire activity.https://doi.org/10.1088/2752-5309/ad976dwildfireclimateemergency departmentrespiratorycardiovascularvulnerability
spellingShingle Jennifer D Stowell
Ian Sue Wing
Yasmin Romitti
Patrick L Kinney
Gregory A Wellenius
Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
Environmental Research: Health
wildfire
climate
emergency department
respiratory
cardiovascular
vulnerability
title Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
title_full Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
title_fullStr Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
title_full_unstemmed Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
title_short Emergency department visits in California associated with wildfire PM2.5: differing risk across individuals and communities
title_sort emergency department visits in california associated with wildfire pm2 5 differing risk across individuals and communities
topic wildfire
climate
emergency department
respiratory
cardiovascular
vulnerability
url https://doi.org/10.1088/2752-5309/ad976d
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