Lipsett M, Waller K, Shusterman D, Thollaug S, Brunner W
California Office of Environmental Health Hazard Assessment, Berkeley.
Am J Public Health. 1994 Mar;84(3):434-8. doi: 10.2105/ajph.84.3.434.
In July 1988, a fire destroyed a huge supermarket warehouse in Richmond, Calif, sending smoke into residential neighborhoods for nearly a week. There was no organized public health response. To evaluate the respiratory health impact on the general population, a survey of emergency room visits and hospital admissions to the two acute-care hospitals serving the population downwind was conducted.
Medical records of 489 patients meeting specified diagnostic criteria during the week of the fire and several reference periods were abstracted. Ratios of proportions for respiratory diagnoses (i.e., emergency room visits for a given diagnosis/total emergency room visits) were calculated, comparing the fire week with the reference periods, and 1988 mortality data for the area were reviewed.
Ratios of proportions for emergency room visits for asthma and all lower respiratory conditions increased significantly during the fire. Respiratory-related hospitalizations also increased. However, there was no observable increase in respiratory mortality.
This fire was found to have had a moderate impact on the respiratory health of local residents. Public health intervention is indicated to prevent respiratory morbidity when extended exposure to structural fire smoke is predictable.
1988年7月，一场大火摧毁了加利福尼亚州里士满的一个大型超市仓库，浓烟飘入居民区近一周时间。当时没有有组织的公共卫生应对措施。为评估火灾对普通人群呼吸道健康的影响，对为火灾下风方向人群服务的两家急症医院的急诊就诊和住院情况进行了调查。
提取了火灾发生当周及几个参照期内符合特定诊断标准的489名患者的病历。计算了呼吸道诊断的比例比（即特定诊断的急诊就诊次数/总急诊就诊次数），将火灾当周与参照期进行比较，并查阅了该地区1988年的死亡率数据。
火灾期间，哮喘和所有下呼吸道疾病的急诊就诊比例比显著增加。呼吸道相关住院人数也有所增加。然而，呼吸道死亡率没有明显上升。
发现这场火灾对当地居民的呼吸道健康有中度影响。当预计会长期接触建筑物火灾烟雾时，建议采取公共卫生干预措施以预防呼吸道疾病。
