Impacts of Wildfire Smoke and Air Pollution on a Pediatric Population with Asthma: A Population-Based Study.

Wildfires are increasing yearly in number and severity as a part of the evolving climate crisis. These fires are a significant source of air pollution, a common driver of flares in cardiorespiratory disease, including asthma, which is the most common chronic disease of childhood. Poorly controlled asthma leads to significant societal costs through morbidity, mortality, lost school and work time and healthcare utilization. This retrospective cohort study set in Calgary, Canada evaluates the relationship between asthma exacerbations during wildfire smoke events and equivalent low-pollution periods in a pediatric asthma population. Air pollution was based on daily average levels of PM2.5. Wildfire smoke events were determined by combining information from provincial databases and local monitors. Exposures were assumed using postal codes in the health record at the time of emergency department visits. Provincial claims data identified 27,501 asthma exacerbations in 57,375 children with asthma between 2010 to 2021. Wildfire smoke days demonstrated an increase in asthma exacerbations over the baseline (incidence rate ratio: 1.13; 95% CI: 1.02-1.24); this was not seen with air pollution in general. Increased rates of asthma exacerbations were also noted yearly in September. Asthma exacerbations were significantly decreased during periods of COVID-19 healthcare precautions.

Health Impact Assessment of PM2.5 attributable mortality from the September 2020 Washington State Wildfire Smoke Episode.

Major wildfires that started in the summer of 2020 along the west coast of the U.S. have made PM2.5 concentrations in cities in this region rank among the highest in the world. Regions of Washington were impacted by active wildfires in the state, and by aged wood smoke transported from fires in Oregon and California. This study aims to assess the population health impact of increased PM2.5 concentrations attributable to the wildfire. Average daily PM2.5 concentrations for each county before and during the 2020 Washington wildfire episode were obtained from the Washington Department of Ecology. Utilizing previously established associations of short-term mortality for PM2.5, we estimated excess mortality for Washington attributable to the increased PM2.5 levels. On average, PM2.5 concentrations increased 91.7 µg/m3 during the wildfire episode. Each week of wildfire smoke exposures was estimated to result in 87.6 (95% CI: 70.9, 103.1) cases of increased all-cause mortality, 19.1 (95% CI: 10.0, 28.2) increased cardiovascular disease deaths, and 9.4 (95% CI: 5.1, 13.5) increased respiratory disease deaths. Because wildfire smoke episodes are likely to continue impacting the Pacific Northwest in future years, continued preparedness and mitigations to reduce exposures to wildfire smoke are necessary to avoid this excess health burden.