Canadian wildfire pollution negatively impacted Eastern US residents’ lungs, heart
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Key takeaways:
- From June 6 to 8, 2023, the mean PM2.5 was 70.8 μg/m3, and from June 28 to 30, 2023, it was 55.8 μg/m3.
- Researchers observed heightened odds for cardiopulmonary encounters on these days in 2023 vs. 2018 + 2019.
Despite living far away from Canada, Maryland residents experienced more cardiopulmonary disease health concerns in June 2023 believed to be due to Canadian wildfire pollution, according to findings published in JAMA Network Open.
“Clinicians who have patients with heart and lung diseases should be aware of upcoming days with poor air quality and be able to take action to support their patients when they may feel more sick,” Mary E. Maldarelli, MD, a fellow in the division of pulmonary, critical care and sleep medicine at the University of Maryland School of Medicine, and Bradley Maron, MD, professor of medicine at University of Maryland School of Medicine and co-executive director of the University of Maryland Institute for Health Computing, told Healio in a statement.
“As climate change worsens, clinicians may need to be increasingly aware of distant major environmental events and that predicted air quality changes will negatively impact a wide number of patients,” they continued.
Maldarelli, Maron and colleagues analyzed University of Maryland Medical System data on cardiopulmonary diseases from June 2023, June 2018 and June 2019 to determine how exposure to smoke/pollution from the Canadian wildfires in 2023 impacted inpatient, ambulatory and ED cardiopulmonary clinical encounters.
To conduct this study, researchers assessed statewide air quality and identified hotspot days, which they defined as days where PM2.5 was higher than the 35 μg/m3 toxic National Ambient Air Quality Standard.
The 2023 hotspot days, which Maldarelli and Maron said were informed by the air quality analyses, included June 6 to 8 (mean PM2.5, 70.8 μg/m3) and June 28 to 30 (mean PM2.5, 55.8 μg/m3), according to the study.
During June 2023, 25.1% of encounters took place on hotspot days, and this was significantly greater than the 22.3% of encounters during June 2018 and 2019 that happened on matched hotspot days (P = .01).
When broken down by setting (inpatient, ambulatory and ED), this finding held true, with more of each encounter happening on hotspot days in 2023.
Based on the above data, researchers observed a significant heightened likelihood for cardiopulmonary encounters on hotspot days in June 2023 vs. June 2018 and 2019 (adjusted OR = 1.18; 95% CI, 1.03-1.34).
“We found that there was an increased risk of an encounter with the health care system for patients with heart and lung diseases on poor air quality days from wildfire smoke that had drifted over 2,000 miles from Canada,” Maldarelli and Maron told Healio.
Notably, patients with cardiac diseases such as hypertension faced an elevated likelihood for a clinical encounter on hotspot days in June 2023 vs. June 2018 and 2019 (aOR = 1.2; 95% CI, 1.01-1.42), according to the study.
“In our subgroup analysis, we found patients with cardiac disease were at an even greater increased risk for health care encounters,” Maldarelli and Maron told Healio. “This marks an important opportunity for physicians and health care providers to identify patients who may be affected by marked changes in air quality.”
When assessed against June 2018 and 2019, researchers found a smaller mean Area Deprivation Index score — representing greater socioeconomic advantage — among patients with cardiopulmonary encounters on hotspots days in June 2023 (39.1 vs. 41; P = .05).
“We were surprised that the patients who came to the hospital on poor air quality days were more likely to be socioeconomically advantaged than patients who came to the hospital on better air quality days,” Maldarelli and Maron told Healio. “It made us concerned that patients who may not have the same advantage were not able to get to clinical care, even though they may have needed it.”
Moving forward, Maldarelli and Maron plan to build on this topic and look into other areas to help patients in Maryland.
“We are looking forward to identifying new ways to meet the needs of our patients, including leveraging health informatics and our state-wide reach as an institution to find ways to deliver high quality health care to patients who may not have the ability to come see their doctor on poor air quality days,” Maldarelli and Maron told Healio.
“This study was an exciting opportunity to apply the big data research capabilities of University of Maryland’s Institute for Health Computing to a novel health problem for all patients in the state of Maryland,” Maldarelli and Maron added. “We anticipate continuing to produce high quality research on emerging health challenges and are eager to use novel informatics techniques to improve the health of Marylanders.”
Reference:
- Exposure to remote wildfire smoke drifting across the US linked to increased medical visits for heart and lung problems. https://www.medschool.umaryland.edu/news/2024/exposure-to-remote-wildfire-smoke-drifting-across-the-us-linked-to-increased-medical-visits-for-heart-and-lung-problems.html. Published Dec. 13, 2024. Accessed Dec. 16, 2024.
For more information:
Mary E. Maldarelli, MD, can be reached at mary.maldarelli@som.umaryland.edu.