2017 San Diego wildfire increased pediatric respiratory ED visits

During a 2017 wildfire, San Diego hospitals observed an increase in ED visits for breathing problems among children, according to a study published in the Annals of the American Thoracic Society.

From Dec. 7 to 16, 2017, the modestly sized Lilac fire, which was driven by the Santa Ana winds, burned 4,100 acres in San Diego County.

“We conducted this study because wildfires are becoming increasingly common in California,” Sydney Leibel, MD, MPH, a pediatric allergist/immunologist at Rady Children’s Hospital in San Diego and an assistant professor of pediatrics at UC San Diego School of Medicine, said in a press release. “While there is significant data on the respiratory effects of these wildfires in adults, we wanted to investigate the health effects of wildfire smoke in the vulnerable pediatric population.”

Using 2011-2017 data from electronic medical records from Rady Children’s Hospital ED and urgent care clinics and information on fine particulate matter pollution in the area, Leibel and colleagues compared health care utilization among children in San Diego before and after the Lilac fire.

The researchers found that the fire was associated with 16 more visits to the Rady Children’s Hospital ED for respiratory complaints, such as difficulty breathing, wheezing, respiratory distress, asthma or cough, among children younger than 19 years.

Children younger than 12 years were particularly affected, according to the data. Specifically, those aged 6 to 12 years experienced the greatest relative increase in daily respiratory ED visits, with an additional 3.4 excess visits per day, and those aged 0 to 5 years had the greatest absolute number of excess daily respiratory ED visits, with 7.3 excess visits per day.

Similar trends were observed regarding respiratory visits to urgent care centers, the researchers noted.

Results also showed that the top five ZIP codes in San Diego County with the greatest changes in pediatric ED visits for respiratory problems were located downwind of the fire, which was expected based on the Santa Ana winds pattern.

In an analysis of fine particulate pollution during the same period, the researchers estimated that there was an average daily increase of 5.6 µg/m³ across all ZIP codes in San Diego that was attributable to the smoke from the wildfire.

“Our findings suggest that public health efforts focused on protecting young children with early warning systems and mitigation efforts downwind of Santa Ana wind-driven wildfires may decrease the impact of these destructive wildfires in the future,” Leibel said in the release. – by Melissa Foster

Disclosures: The authors report receiving support from the University of California Office of the President Multi-campus Research Programs and Initiatives grant and from the National Oceanic and Atmospheric Administration via the Regional Integrated Sciences and Assessments California Nevada Applications Program.