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The association between wildfire smoke exposure and asthma-specific medical care utilization in Oregon during the 2013 wildfire season


Wildfire smoke (WFS) increases the risk of respiratory hospitalizations. We evaluated the association between WFS and asthma healthcare utilization (AHCU) during the 2013 wildfire season in Oregon. WFS particulate matter ≤ 2.5 μm in diameter (PM2.5) was estimated using a blended model of in situ monitoring, chemical transport models, and satellite-based data. Asthma claims and place of service were identified from Oregon All Payer All Claims data from 1 May 2013 to 30 September 2013. The association with WFS PM2.5 was evaluated using time-stratified case-crossover designs. The maximum WFS PM2.5 concentration during the study period was 172 µg/m3. A 10 µg/m3 increase in WFS increased risk in asthma diagnosis at emergency departments (odds ratio [OR]: 1.089, 95% confidence interval [CI]: 1.043–1.136), office visit (OR: 1.050, 95% CI: 1.038–1.063), and outpatient visits (OR: 1.065, 95% CI: 1.029–1.103); an association was observed with asthma rescue inhaler medication fills (OR: 1.077, 95% CI: 1.065–1.088). WFS increased the risk for asthma morbidity during the 2013 wildfire season in Oregon. Communities impacted by WFS could see increases in AHCU for tertiary, secondary, and primary care.

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Fig. 1: Number of smoke-impacted days where WFS PM2.5 > 15 µg/m3 in Oregon State counties from 1 May 2013 to 30 September 2013.
Fig. 2: Same-day association between a 10 μg/m3 increase in WFS PM2.5 and risk for AHCU event by strata, adjusting for temperature.
Fig. 3
Fig. 4


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Funding for this study was provided by the National Aeronautics and Space Administration grant number NNX15AF35G and the A.J. Kauvar Foundation. The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Correspondence to Sheryl Magzamen.

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Gan, R.W., Liu, J., Ford, B. et al. The association between wildfire smoke exposure and asthma-specific medical care utilization in Oregon during the 2013 wildfire season. J Expo Sci Environ Epidemiol 30, 618–628 (2020).

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  • Epidemiology
  • Population-based studies
  • Exposure modeling

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