SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic
Objectives To determine healthcare service utilisation for cardiorespiratory presentations and outpatient salbutamol dispensation associated with 2.5 months of severe, unabating wildfire smoke in Canada’s high subarctic.Design A retrospective cohort study using hospital, clinic, pharmacy and environ...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/2/e037029.full |
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| author | Warren Dodd Caren Rose Courtney Howard Katherine Kohle Craig Scott Patrick Scott Ashlee Cunsolo James Orbinski |
| author_facet | Warren Dodd Caren Rose Courtney Howard Katherine Kohle Craig Scott Patrick Scott Ashlee Cunsolo James Orbinski |
| author_sort | Warren Dodd |
| collection | DOAJ |
| description | Objectives To determine healthcare service utilisation for cardiorespiratory presentations and outpatient salbutamol dispensation associated with 2.5 months of severe, unabating wildfire smoke in Canada’s high subarctic.Design A retrospective cohort study using hospital, clinic, pharmacy and environmental data analysed using Poisson regression.Setting Territorial referral hospital and clinics in Yellowknife, Northwest Territories, Canada.Participants Individuals from Yellowknife and surrounding communities presenting for care between 2012 and 2015.Main outcome measures Emergency room (ER) presentations, hospital admissions and clinic visits for cardiorespiratory events, and outpatient salbutamol prescriptionsResults The median 24-hour mean particulate matter (PM2.5) was fivefold higher in the summer of 2014 compared with 2012, 2013 and 2015 (median=30.8 µg/m3), with the mean peaking at 320.3 µg/m3. A 10 µg/m3 increase in PM2.5 was associated with an increase in asthma-related (incidence rate ratio (IRR) (95% CI): 1.11 (1.07, 1.14)) and pneumonia-related ER visits (IRR (95% CI): 1.06 (1.02, 1.10)), as well as an increase in chronic obstructive pulmonary disease hospitalisations (IRR (95% CI): 1.11 (1.02, 1.20). Compared with 2012 and 2013, salbutamol dispensations in 2014 increased by 48%; clinic visits for asthma, pneumonia and cough increased; ER visits for asthma doubled, with the highest rate in females, in adults aged ≥40 years and in Dene people, while pneumonia increased by 57%, with higher rates in males, in individualsaged <40 years and in Inuit people. Cardiac variables were unchanged.Conclusions Severe wildfires in 2014 resulted in extended poor air quality associated with increases in health resource utilization; some impacts were seen disproportionately among vulnerable populations, such as children and Indigenous individuals. Public health advisories asking people to stay inside were inadequately protective, with compliance possibly impacted by the prolonged exposure. Future research should investigate use of at-home air filtration systems, clean-air shelters and public health messaging which addresses mental health and supports physical activity. |
| format | Article |
| id | doaj-art-e101ca32811b424cb627a0507e6c007f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e101ca32811b424cb627a0507e6c007f2024-11-19T01:30:09ZengBMJ Publishing GroupBMJ Open2044-60552021-02-0111210.1136/bmjopen-2020-037029SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarcticWarren Dodd0Caren Rose1Courtney Howard2Katherine Kohle3Craig Scott4Patrick Scott5Ashlee Cunsolo6James Orbinski73 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, CanadaSchool of Population and Public Health, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada1 Cumming School of Medicine, University of Calgary, Yellowknife, Northwest Territories, Canada4 Northwest Territories Health and Social Services, Yellowknife, Northwest Territories, Canada5 Climate Change Initiatives, Ecology North, Yellowknife, Northwest Territories, Canada6 Jordanstone College of Art and Design, University of Dundee, Dundee, UK7 Labrador Institute, Memorial University of Newfoundland, Saint John`s, Newfoundland, Canada8 Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, CanadaObjectives To determine healthcare service utilisation for cardiorespiratory presentations and outpatient salbutamol dispensation associated with 2.5 months of severe, unabating wildfire smoke in Canada’s high subarctic.Design A retrospective cohort study using hospital, clinic, pharmacy and environmental data analysed using Poisson regression.Setting Territorial referral hospital and clinics in Yellowknife, Northwest Territories, Canada.Participants Individuals from Yellowknife and surrounding communities presenting for care between 2012 and 2015.Main outcome measures Emergency room (ER) presentations, hospital admissions and clinic visits for cardiorespiratory events, and outpatient salbutamol prescriptionsResults The median 24-hour mean particulate matter (PM2.5) was fivefold higher in the summer of 2014 compared with 2012, 2013 and 2015 (median=30.8 µg/m3), with the mean peaking at 320.3 µg/m3. A 10 µg/m3 increase in PM2.5 was associated with an increase in asthma-related (incidence rate ratio (IRR) (95% CI): 1.11 (1.07, 1.14)) and pneumonia-related ER visits (IRR (95% CI): 1.06 (1.02, 1.10)), as well as an increase in chronic obstructive pulmonary disease hospitalisations (IRR (95% CI): 1.11 (1.02, 1.20). Compared with 2012 and 2013, salbutamol dispensations in 2014 increased by 48%; clinic visits for asthma, pneumonia and cough increased; ER visits for asthma doubled, with the highest rate in females, in adults aged ≥40 years and in Dene people, while pneumonia increased by 57%, with higher rates in males, in individualsaged <40 years and in Inuit people. Cardiac variables were unchanged.Conclusions Severe wildfires in 2014 resulted in extended poor air quality associated with increases in health resource utilization; some impacts were seen disproportionately among vulnerable populations, such as children and Indigenous individuals. Public health advisories asking people to stay inside were inadequately protective, with compliance possibly impacted by the prolonged exposure. Future research should investigate use of at-home air filtration systems, clean-air shelters and public health messaging which addresses mental health and supports physical activity.https://bmjopen.bmj.com/content/11/2/e037029.full |
| spellingShingle | Warren Dodd Caren Rose Courtney Howard Katherine Kohle Craig Scott Patrick Scott Ashlee Cunsolo James Orbinski SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic BMJ Open |
| title | SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic |
| title_full | SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic |
| title_fullStr | SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic |
| title_full_unstemmed | SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic |
| title_short | SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada’s high subarctic |
| title_sort | sos summer of smoke a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in canada s high subarctic |
| url | https://bmjopen.bmj.com/content/11/2/e037029.full |
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