Cardiovascular and cerebrovascular emergency department visits associated with wildfire smoke exposure in California in 2015

Wettstein, ZS; Hoshiko, S; Fahimi, J; Harrison, RJ; Cascio, WE; Rappold, AG

HERO ID

5814276

Reference Type

Journal Article

Year

2018

Language

English

PMID

29643111

HERO ID 5814276
In Press No
Year 2018
Title Cardiovascular and cerebrovascular emergency department visits associated with wildfire smoke exposure in California in 2015
Authors Wettstein, ZS; Hoshiko, S; Fahimi, J; Harrison, RJ; Cascio, WE; Rappold, AG
Journal Journal of the American Heart Association
Volume 7
Issue 8
Page Numbers e007492
Abstract <strong>BACKGROUND: </strong>Wildfire smoke is known to exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent, despite biological plausibility.<br /><br /><strong>METHODS AND RESULTS: </strong>A population-based epidemiologic analysis was conducted for daily cardiovascular and cerebrovascular emergency department (ED) visits and wildfire smoke exposure in 2015 among adults in 8 California air basins. A quasi-Poisson regression model was used for zip code-level counts of ED visits, adjusting for heat index, day of week, seasonality, and population. Satellite-imaged smoke plumes were classified as light, medium, or dense based on model-estimated concentrations of fine particulate matter. Relative risk was determined for smoky days for lag days 0 to 4. Rates of ED visits by age- and sex-stratified groups were also examined. Rates of all-cause cardiovascular ED visits were elevated across all lags, with the greatest increase on dense smoke days and among those aged ≥65 years at lag 0 (relative risk 1.15, 95% confidence interval [1.09, 1.22]). All-cause cerebrovascular visits were associated with smoke, especially among those 65 years and older, (1.22 [1.00, 1.49], dense smoke, lag 1). Respiratory conditions were also increased, as anticipated (1.18 [1.08, 1.28], adults >65 years, dense smoke, lag 1). No association was found for the control condition, acute appendicitis. Elevated risks for individual diagnoses included myocardial infarction, ischemic heart disease, heart failure, dysrhythmia, pulmonary embolism, ischemic stroke, and transient ischemic attack.<br /><br /><strong>CONCLUSIONS: </strong>Analysis of an extensive wildfire season found smoke exposure to be associated with cardiovascular and cerebrovascular ED visits for all adults, particularly for those over aged 65 years.
Doi 10.1161/JAHA.117.007492
Pmid 29643111
Wosid WOS:000432332200008
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword heart failure; ischemic heart disease; particulate matter; stroke; wildfire
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