Wildfire smoke puts heat on hospital admissions

Cities downwind of active wildfires — or bushfires — experience poor air quality that can cause significant spikes in respiratory-related emergency department presentations and hospital admissions, according to Jamie Ranse, an expert in health and disaster management based at Griffith University in Gold Coast, Australia. Monitoring air-quality alerts during wildfire season could help hospitals better plan for sudden surges, he says.

During the 2019-2020 bushfire crisis, for example, which blazed across unprecedented areas of the country’s south-east, Australia’s capital, Canberra, recorded the worst air quality levels in the world for several days running. “I was visiting family in Canberra at the time, and we were stuck indoors for days because of the smoke,” Ranse recalls.

A subsequent study showed that respiratory illness admissions at one of the city’s two major hospitals increased by an average of 1.25 patients per day over a two-month period compared to the year before¹. “That’s a significant increase,” Ranse explains. “It’s roughly 75 extra people that the hospital had to find beds for.”

Overall, the 2019-2020 Australian bushfires were estimated to have caused more than 2,000 hospitalizations for respiratory problems.

“With increases in wildfire events predicted due to the impacts of climate change, hospitals should be monitoring for these types of occurrences,” Ranse says.

Disruption, rather than disaster

Ranse is an emergency department nurse turned global healthcare expert, who consulted for the World Health Organization during the pandemic on social distancing measures for mass gatherings.

He is currently focused on strengthening the functioning of healthcare operations during what are dubbed ‘disruptive events’, which range from international mass gatherings to wildfires. “When a disruptive event comes along — whether planned, such as hosting an Olympic Games, or unplanned such as an extreme weather event or disaster — my research looks at ways that we can try to maintain normal patient outcomes and operational capacity,” he explains.

The results of Ranse’s Canberra study suggest that daily respiratory-related emergency department patient presentations peaked on days of poor air quality, and gradually returned to normal over the next few days ¹.

“If health services know there’s a bad air-quality day coming, hospitals could make changes based on air-quality monitoring to try and protect themselves from the impact — whether those changes be laying on more staff, sourcing more respiratory related medications, or even altering internal processes,” Ranse says.