The relationship of respiratory and cardiovascular hospital admissions to the southern California wildfires of 2003

Occupational and Environmental Medicine - Tập 66 Số 3 - Trang 189-197 - 2009
Ralph J. Delfino1, Sean S. Brummel2, Jun Wu3,4, Hal S. Stern2, Bart Ostro5, Michael Lipsett6, Arthur Winer7, Donald Street8, L Zhang6, Thomas Tjoa3, Daniel L. Gillen2
1Epidemiology Department, School of Medicine, University of California, Irvine, 100 Theory Dr., Suite 100, Irvine, CA 92617-7555, USA
2Department of Statistics, School of Information and Computer Science, University of California, Irvine, California, USA
3Department of Epidemiology, School of Medicine, University of California, Irvine, California, USA
4Program in Public Health, University of California, Irvine, California, USA
5Air Pollution Epidemiology Section, California Office of Environmental Health Hazard Assessment, Oakland, California, USA
6Exposure Assessment Section, Environmental Health Investigations Branch, California Department of Health Services, Oakland, California, USA
7Department of Environmental Health Sciences, School of Public Health, University of California, Los Angeles, California, USA
8Independent consultant, Salem, Oregon, USA

Tóm tắt

Objective:There is limited information on the public health impact of wildfires. The relationship of cardiorespiratory hospital admissions (n = 40 856) to wildfire-related particulate matter (PM2.5) during catastrophic wildfires in southern California in October 2003 was evaluated.Methods:Zip code level PM2.5concentrations were estimated using spatial interpolations from measured PM2.5, light extinction, meteorological conditions, and smoke information from MODIS satellite images at 250 m resolution. Generalised estimating equations for Poisson data were used to assess the relationship between daily admissions and PM2.5, adjusted for weather, fungal spores (associated with asthma), weekend, zip code-level population and sociodemographics.Results:Associations of 2-day average PM2.5with respiratory admissions were stronger during than before or after the fires. Average increases of 70 μg/m3PM2.5during heavy smoke conditions compared with PM2.5in the pre-wildfire period were associated with 34% increases in asthma admissions. The strongest wildfire-related PM2.5associations were for people ages 65–99 years (10.1% increase per 10 μg/m3PM2.5, 95% CI 3.0% to 17.8%) and ages 0–4 years (8.3%, 95% CI 2.2% to 14.9%) followed by ages 20–64 years (4.1%, 95% CI −0.5% to 9.0%). There were no PM2.5–asthma associations in children ages 5–18 years, although their admission rates significantly increased after the fires. Per 10 μg/m3wildfire-related PM2.5, acute bronchitis admissions across all ages increased by 9.6% (95% CI 1.8% to 17.9%), chronic obstructive pulmonary disease admissions for ages 20–64 years by 6.9% (95% CI 0.9% to 13.1%), and pneumonia admissions for ages 5–18 years by 6.4% (95% CI −1.0% to 14.2%). Acute bronchitis and pneumonia admissions also increased after the fires. There was limited evidence of a small impact of wildfire-related PM2.5on cardiovascular admissions.Conclusions:Wildfire-related PM2.5led to increased respiratory hospital admissions, especially asthma, suggesting that better preventive measures are required to reduce morbidity among vulnerable populations.

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Occupational and Environmental Medicine

Tập 66 Số 3

189-197

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