| Abstrakt: |
In 2016, unprecedented intense wildfires burned over 150,000 acres in the southern Appalachian Mountains in the United States. Smoke from these fires greatly impacted the region and exposure to this smoke was significant. A bidirectional case‐crossover design was applied to assess the relationship between PM2.5 (a surrogate for wildfire smoke) exposure and respiratory‐ and cardiovascular‐related emergency department (ED) visits in Western North Carolina during these events. For 0‐, 3‐, and 7‐day lags, findings indicated a significant increase in the odds of being admitted to the ED for a respiratory (ORs: 1.055, 95% CI: 1.048–1.063; 1.083, 1.074–1.092; 1.066, 1.058–1.074; respectively) or cardiovascular event (ORs: 1.052, 95% CI: 1.045–1.060; 1.074, 1.066–1.081; 1.067, 1.060–1.075; respectively) for every 5 μg/m3 increase in PM2.5 over a chosen cutpoint of 20.4 μg/m3. For all endpoints assessed except for emphysema, there were statistically significant increases in odds from 5.1% to 8.3%. In general, this increase was most pronounced 3 days after exposure. Additionally, individuals aged 55+ generally experience higher odds of heart disease at the 3‐ and 7‐day lag points, and Black/African Americans generally experience higher odds of asthma at the 3‐day lag point. In general, larger fires and increased numbers of fires within counties resulted in higher health burden at same day exposure. In a secondary analysis, the odds of an ED visit increased by over 40% in several cases among people exposed to days above the Environmental Protection Agency 24‐hr PM2.5 standard of 35 μg/m3. Our findings provide new understanding on the health impacts of wildfires on rural populations in the southeastern US. Plain Language Summary: The 2016 wildfires in the southern Appalachian Mountains in the United States burned over 150,000 acres. The smoke released by these fires resulted in concentrations of air pollutants well above federal regulations. Exposure to this smoke may result in more visits to the emergency room (ER) for respiratory and cardiovascular illnesses such as asthma and heart disease. To learn how this smoke impacted the health of people living and working in western North Carolina, we looked at data from ERs for these health issues and compared it with increases in air pollution from these wildfires. We found significant increases in odds of visiting the ER up to 7 days after exposure to this smoke. We found that people over 55 years old and Black/African Americans were more likely than other groups to visit the ER for these reasons. We also found counties with more and larger wildfires also led to worse higher odds of these illnesses in some cases. This is the first study exploring how these fires impact how many people go to the ER for respiratory and cardiovascular problems. Key Points: PM2.5 concentrations were estimated for 16 counties in Western North Carolina before, during, and after the 2016 wildfires in the regionEmergency department respiratory and cardiovascular admissions showed a clear increase in odds with elevated wildfire smoke exposureOlder adults and Black/African Americans were more vulnerable. Larger fires and more fires per county were associated with higher health burden at same day of exposure. [ABSTRACT FROM AUTHOR] |
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