Wildfire-specific PM2.5 and risk of ED visits for mental health, pregnancy, respiratory and cardiovascular outcomes: evidence from 2020 California wildfires
Abstract/Contents
- Abstract
- Beyond their immediate devastation, the 2020 wildfires in California increased the risk of exposure to fine particulate matter (PM2.5) at the population level to a broad region, which could have led to increased emergency department visits. However, studies to date have been on limited geographic areas and found inconsistent results. Additionally, the impact on mental health outcomes and pregnancy-complication in the aftermath of the fires is understudied. This is a retrospective, cross-sectional, ecological study conducted among people residing in California and presenting to California hospitals from July 1, 2020, to December 31, 2020. We studied patients who had an emergency department (ED) visit due to potentially PM2.5-related diseases (respiratory, cardiovascular, mental, and pregnancy-related) as identified by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Using a distributed non-linear lagged model, we investigated the immediate (day 0) and delayed (up to 4 days after exposures) association between 10 ug/m3 increases in wildfire-specific PM2.5 and ED visits after adjusting for COVID-19 co-occurrence. The effect of an increase in wildfire specific PM2.5 concentration per 10 ug/m3 over 4 lag days was statistically significantly associated with an increase in the number of ED visits for chronic lower respiratory conditions (cumulative relative risk (cRR)1.121 [95% CI 1.071-1.174]), asthma (cRR 1.154 [1.090-1.222]), and all combined respiratory conditions (cRR 1.026 [1.001-1.052]). The additional significant relationship was evident for COPD (lag 0-3: cRR 1.126 [0.949- 1.336]), all combined mental health conditions (lag 0-2: cRR 1.052 [1.017-1.089]), other mood affective disorders (lag 0-3: cRR 1.189 [1.035-1.364]), and all combined pregnancy-related conditions (lag0-4: cRR 1.035 [1.001-1.071]) when we examine with multiple exposure windows. Our subgroup analyses indicated that Medicaid enrollees, females, and adults (age 25-64) had higher risks for ED visits during wildfires. Mediation analyses showed that the percent excess risk of wildfire-specific PM2.5 on outcomes explained by COVID-19 was -7% for respiratory and -31% for pregnancy-related outcomes. After using wildfire-specific PM2.5 across the entire of California and controlling COVID-19, our results found that increases in wildfire-specific PM2.5 are more likely to increase the number of ED visits at the ZCTA-level. We found elevated associations with mental and pregnancy-related outcomes and confirmed previously reported associations with respiratory and cardiovascular outcomes. Each health outcome has different lag times of susceptibility to wildfire smoke exposure and varies by sociodemographic characteristics, including age, sex, race/ethnicity, and health insurance types.
Description
| Type of resource | text |
|---|---|
| Date modified | February 9, 2024 |
| Publication date | March 17, 2023 |
Creators/Contributors
| Author | Jung, Youn Soo |
|---|---|
| Thesis advisor | Nelson, Lorene |
| Thesis advisor | Nadeau, Kari |
Subjects
| Subject | Wildfires > Health aspects |
|---|---|
| Subject | Public health |
| Genre | Text |
| Genre | Thesis |
Bibliographic information
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- User agrees that, where applicable, content will not be used to identify or to otherwise infringe the privacy or confidentiality rights of individuals. Content distributed via the Stanford Digital Repository may be subject to additional license and use restrictions applied by the depositor.
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- This work is licensed under a Creative Commons Attribution 4.0 International license (CC BY).
Preferred citation
- Preferred citation
- Jung, Y. (2025). Wildfire-specific PM2.5 and risk of ED visits for mental health, pregnancy, respiratory and cardiovascular outcomes: evidence from 2020 California wildfires. Stanford Digital Repository. Available at https://purl.stanford.edu/vj832cf1556. https://doi.org/10.25740/vj832cf1556.
Collection
Epidemiology & Clinical Research Masters Theses
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- Contact
- younsoojungsun@gmail.com
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