Heaney Alexandra, Stowell Jennifer D, Liu Jia Coco, Basu Rupa, Marlier Miriam, Kinney Patrick
Division of Environmental Health Sciences School of Public Health University of California, Berkeley Berkeley CA USA.
Department of Environmental Health School of Public Health Boston University Boston MA USA.
Geohealth. 2022 Jun 3;6(6):e2021GH000578. doi: 10.1029/2021GH000578. eCollection 2022 Jun.
Increases in wildfire activity across the Western US pose a significant public health threat. While there is evidence that wildfire smoke is detrimental for respiratory health, the impacts on cardiovascular health remain unclear. This study evaluates the association between fine particulate matter (PM) from wildfire smoke and unscheduled cardiorespiratory hospital visits in California during the 2004-2009 wildfire seasons. We estimate daily mean wildfire-specific PM with Goddard Earth Observing System-Chem, a global three-dimensional model of atmospheric chemistry, with wildfire emissions estimates from the Global Fire Emissions Database. We defined a "smoke event day" as cumulative 0-1-day lag wildfire-specific PM ≥ 98th percentile of cumulative 0-1 lag day wildfire PM. Associations between exposure and outcomes are estimated using negative binomial regression. Results indicate that smoke event days are associated with a 3.3% (95% CI: [0.4%, 6.3%]) increase in visits for all respiratory diseases and a 10.3% (95% CI: [2.3%, 19.0%]) increase for asthma specifically. Stratifying by age, we found the largest effect for asthma among children ages 0-5 years. We observed no significant association between exposure and overall cardiovascular disease, but stratified analyses revealed increases in visits for all cardiovascular, ischemic heart disease, and heart failure among non-Hispanic white individuals and those older than 65 years. Further, we found a significant interaction between smoke event days and daily average temperature for all cardiovascular disease visits, suggesting that days with high wildfire PM concentrations and high temperatures may pose greater risk for cardiovascular disease. These results suggest substantial increases in adverse outcomes from wildfire smoke exposure and indicate the need for improved prevention strategies and adaptations to protect vulnerable populations.
美国西部野火活动的增加对公众健康构成了重大威胁。虽然有证据表明野火烟雾对呼吸系统健康有害，但对心血管健康的影响仍不明确。本研究评估了2004 - 2009年野火季节期间，加利福尼亚州野火烟雾中的细颗粒物（PM）与非计划心肺疾病住院就诊之间的关联。我们使用戈达德地球观测系统化学模型（一种全球大气化学三维模型）以及全球火灾排放数据库中的野火排放估算值，来估算每日平均特定野火PM。我们将“烟雾事件日”定义为累积0 - 1天滞后的特定野火PM≥累积0 - 1天滞后野火PM的第98百分位数。使用负二项回归估算暴露与结果之间的关联。结果表明，烟雾事件日与所有呼吸道疾病就诊人数增加3.3%（95%置信区间：[0.4%，6.3%]）以及哮喘就诊人数增加10.3%（95%置信区间：[2.3%，19.0%]）相关。按年龄分层后，我们发现0 - 5岁儿童中哮喘的影响最大。我们未观察到暴露与总体心血管疾病之间存在显著关联，但分层分析显示，非西班牙裔白人个体以及65岁以上人群中，所有心血管疾病、缺血性心脏病和心力衰竭的就诊人数有所增加。此外，我们发现所有心血管疾病就诊的烟雾事件日与日平均温度之间存在显著交互作用，这表明野火PM浓度高且温度高的日子可能对心血管疾病构成更大风险。这些结果表明野火烟雾暴露导致的不良后果大幅增加，并表明需要改进预防策略和适应性措施以保护弱势群体。
