Mott Joshua A, Meyer Pamela, Mannino David, Redd Stephen C, Smith Eva M, Gotway-Crawford Carol, Chase Emmett
Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Mailstop E-17, Atlanta, GA 30333, USA.
West J Med. 2002 May;176(3):157-62. doi: 10.1136/ewjm.176.3.157.
To assess the health effects of exposure to smoke from the fifth largest US wildfire of 1999 and to evaluate whether participation in interventions to reduce smoke exposure prevented adverse lower respiratory tract health effects among residents of the Hoopa Valley National Indian Reservation in northwestern California.
Observational study: epidemiologists from the Centers for Disease Control and Prevention retrospectively reviewed medical records at the local medical center and conducted survey interviews of reservation residents.
Humboldt County, California.
Interviews were completed with 289 of 385 residents, representing 26% of the households on the reservation. Of the 289 participants, 92 (31.8%) had preexisting cardiopulmonary conditions.
During the weeks of the forest fire, medical visits for respiratory illnesses increased by 217 visits (from 417 to 634 visits, or by 52%) over the previous year. Survey results indicated that although 181 (62.6%) of 289 participants reported worsening lower respiratory tract symptoms, those with preexisting cardiopulmonary conditions reported more symptoms before, during, and after the smoke episode. An increased duration of the use of high-efficiency particulate air cleaners and the recollection of public service announcements were associated with a reduced odds of reporting adverse health effects of the lower respiratory tract. No protective effects were observed for duration of mask use or evacuation.
Timely actions undertaken by the clinical staff of the local medical center appeared beneficial to the respiratory health of the community. Future programs that reduce economic barriers to evacuation during smoke episodes may also improve intervention participation rates and decrease smoke exposures. Although promising, the effectiveness of these and other interventions need to be confirmed in a prospective community intervention trial.
评估暴露于1999年美国第五大野火产生的烟雾对健康的影响，并评估参与减少烟雾暴露的干预措施是否能预防加利福尼亚州西北部胡帕谷印第安人保留地居民的下呼吸道健康不良影响。
观察性研究：疾病控制与预防中心的流行病学家回顾了当地医疗中心的病历，并对保留地居民进行了调查访谈。
加利福尼亚州洪堡县。
对385名居民中的289人进行了访谈，占保留地家庭的26%。在289名参与者中，92人（31.8%）有既往心肺疾病。
在森林火灾发生的几周内，呼吸系统疾病的就诊次数比上一年增加了217次（从417次增至634次，增幅为52%）。调查结果表明，虽然289名参与者中有181人（62.6%）报告下呼吸道症状恶化，但有既往心肺疾病的人在烟雾事件之前、期间和之后报告的症状更多。高效空气过滤器使用时间的增加以及对公共服务公告的回忆与报告下呼吸道不良健康影响的几率降低有关。未观察到使用口罩或疏散时间的保护作用。
当地医疗中心临床工作人员采取的及时行动似乎对社区的呼吸健康有益。未来减少烟雾事件期间疏散经济障碍的项目也可能提高干预参与率并减少烟雾暴露。尽管前景乐观，但这些及其他干预措施的有效性需要在前瞻性社区干预试验中得到证实。
