Alexeeff Stacey E, Van Den Eeden Stephen K, Deosaransingh Kamala, Sidney Stephen, Liao Noelle S, Rana Jamal S
Division of Research Kaiser Permanente Northern California Pleasanton CA USA.
Department of Cardiology Kaiser Permanente Oakland Medical Center Oakland CA USA.
J Am Heart Assoc. 2025 Feb 18;14(4):e036264. doi: 10.1161/JAHA.124.036264. Epub 2025 Feb 5.
We examined the association between acute cardiovascular disease (CVD) events and wildfire air pollution in California in 2018.
The study included adult (≥18 years) members of Kaiser Permanente Northern California, an integrated health care system. Outcomes included CVD events (hospitalizations for acute myocardial infarction, heart failure, or stroke, and CVD death) and death from any cause. Fine particulate air pollution (particulate matter <2.5 microns in diameter; PM) exposure was assessed in categories (Good <12 μg/m, Moderate 12-34 μg/m, High ≥35 μg/m) and continuously. Poisson time series regression was used to model daily event rates during July 1 to December 31, 2018, using a spline to adjust for long-term time trends. We calculated rate ratios (RR) to estimate the association between wildfire air pollution and daily rate of CVD events and deaths.
Our study included 3.2 million adults with a total follow-up of 587.9 million person-days. High PM concentrations during the Mendocino Complex wildfire in July to August was associated with an increased rate of CVD events (RR, 1.231 [95% CI, 1.039-1.458]) and death (RR, 1.358 [95% CI, 1.128-1.635]) compared with Good PM concentrations. In contrast, there was no evidence of increased risk during the Camp wildfire in November (RR for CVD events, 0.966 [95% CI, 0.894-1.044]; RR for all-cause mortality, 0.985 [95% CI, 0.904-1.074] High versus Good PM concentrations).
There was some evidence of increased rates of CVD events and death during wildfires, but results were inconsistent. With ongoing climate change, large wildfires are a pressing public health concern and future work is needed to understand differences in health outcomes by wildfire.
我们研究了2018年加利福尼亚州急性心血管疾病（CVD）事件与野火空气污染之间的关联。
该研究纳入了北加利福尼亚州凯撒医疗集团（Kaiser Permanente）的成年（≥18岁）成员，这是一个综合医疗保健系统。结局包括CVD事件（急性心肌梗死、心力衰竭或中风住院以及CVD死亡）和任何原因导致的死亡。细颗粒物空气污染（直径<2.5微米的颗粒物；PM）暴露按类别（良好<12μg/m³、中等12 - 34μg/m³、高≥35μg/m³）以及连续方式进行评估。使用泊松时间序列回归对2018年7月1日至12月31日期间的每日事件发生率进行建模，使用样条来调整长期时间趋势。我们计算率比（RR）以估计野火空气污染与CVD事件和死亡的每日发生率之间的关联。
我们的研究纳入了320万成年人，总随访时间为5.879亿人日。7月至8月门多西诺复合大火期间的高PM浓度与CVD事件发生率增加（RR，1.231[95%CI，1.039 - 1.458]）和死亡（RR，1.358[95%CI，1.128 - 1.635]）相关，与良好的PM浓度相比。相比之下，11月坎普大火期间没有证据表明风险增加（CVD事件的RR，0.966[95%CI，0.894 - 1.044]；全因死亡率的RR，0.985[95%CI，0.904 - 1.074]，高PM浓度与良好PM浓度相比）。
有一些证据表明野火期间CVD事件和死亡率增加，但结果不一致。随着气候变化的持续，大型野火是一个紧迫的公共卫生问题，未来需要开展工作以了解不同野火导致的健康结局差异。
