Wildfire smoke exposure and cardiopulmonary hospitalizations among those over age 65 in the United States
Citation:
Deflorio-Barker, S., J. Crooks, J. Reyes, AND A. Rappold. Wildfire smoke exposure and cardiopulmonary hospitalizations among those over age 65 in the United States. International Society for Environmental Epidemiology, Sydney, New South Wales, AUSTRALIA, September 24 - 28, 2017.
Impact/Purpose:
The purpose of this study was to examine the relationship between wildland fire smoke and cardio-pulmonary hospital admissions among those 65 and over across the US.
Description:
Background: The health implications of excess PM2.5 due to wildland fire smoke are not well understood. Very few studies have assessed the effect of wildland fire smoke from multiple fires across the US. Methods: We estimated daily concentrations of PM2.5 due to wildland fire smoke across the entire US, using Community Multi-scale Air Quality data. We examined the relationship between wildland fire smoke and hospitalizations among Medicare recipients from 2008-2010. Daily counts of hospitalizations from the Center for Medicare and Medicaid Services were used to calculate the proportion of Medicare recipients from US counties who were hospitalized due to any cardiovascular or respiratory outcome, or due to asthma, bronchitis, or wheezing. The relationship between hospitalizations and wildland fire smoke was assessed using Poisson regression to estimate the marginal effect of PM2.5 exposure on wildland fire smoke days and non-wildland fire smoke days. To account for variation by county, the analysis was performed on each county individually, followed by a meta-analysis to obtain a summarized estimate of the effect of PM2.5 and hospitalizations, Results: A total of 6,103,970 hospital admissions were recorded during 2008-2010 among Medicare recipients, of which 1,151,565 (19%) occurred on wildland fire smoke days. Measured as percent change in hospitalizations per 10 µg of PM2.5, the marginal effect of asthma, bronchitis, and wheezing hospital admissions on smoke days was 1.4% (0.58, 2.20), and 3.1% (1.9, 4.3) for non-smoke days. For cardiovascular hospitalizations, the effect on smoke days was 1.1% (0.66, 1.6) and 3.9% (3.2, 4.6) on non-smoke days. Similarly, respiratory hospitalizations were 0.83% (0.34, 1.3) and 3.4% (2.6, 4.2) on smoke days and non-smoke days, respectively. Conclusions: Exposure to wildland fire smoke was associated with cardiovascular, all respiratory, and asthma, bronchitis, and wheezing hospitalizations among Medicare recipients. This abstract does not necessarily reflect EPA policy.