Cardiovascular and Cerebrovascular Emergency Department Events Related to California Wildfires in 2015

摘要

Fine particulate matter (PM2.5) found in smoke can exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent. Methods: We conducted a time series analysis of adult cardiovascular and cerebrovascular events for the 2015 wildfire season in 8 California Air Basins. We used estimated fire-PM2.5 concentrations and satellite data from the Hazard Mapping System together with California statewide emergency department (ED) data at the ZIP code-level. Age- and gender-stratified population subsets were modeled with lags up to 5 days and models were adjusted for adjusted for seasonal trend, day of the week and heat index. Results: All-cause cardiovascular ED visits across all lags were elevated (RR of 1.07, 95%CI[1.05,1.09]), as were all-cause cerebrovascular (1.13 [1.05-1.21]), and all-cause respiratory visits (1.10 [1.08,1.12]). No significant association was found for the control condition of acute appendicitis (0.93 [0.81,1.06]). Elevated individual diagnoses included ischemic heart disease (1.09 [1.05,1.13]), heart failure (1.10 [1.06,1.14]), and dysrhythmia (1.14 [1.11,1.17]). Ischemic strokes were elevated up to 5 lag days for adults 65 years and older (1.21 [1.05,1.37]). Dose-dependent responses were observed for fire-PM2.5 and nearly all diagnosis categories, across all 5 lags. Conclusions: Wildfire PM2.5 elevated the risk of cardiovascular and cerebrovascular ED visits. This abstract does not necessarily reflect US EPA views and policies.