Wildfire smoke has always been recognized for worsening health issues like heart disease, lung illnesses, and asthma. However, recent research unveils that such smoke can negatively impact health even from thousands of miles away. A study from the University of Maryland Institute for Health Computing (UM-IHC) observed nearly a 20 percent increase in medical visits for heart and lung ailments during a six-day period in June 2023, when smoke from wildfires in Western Canada spread across the U.S., particularly affecting air quality in Baltimore and its vicinity.
The findings were published today in JAMA Network Open.
During the summer of 2023, severe wildfires in Canada produced a massive plume of smoke that traveled 2,000 miles to the East Coast of the United States, degrading air quality and resulting in many people seeking medical attention for breathing difficulties.
“Baltimore experienced very dark skies, and the smell of smoke was prevalent,” remarked Mary Maldarelli, MD, a pulmonary critical care fellow at the University of Maryland School of Medicine (UMSOM) and the study’s lead author. “More importantly, my patients reported increased coughing and a need for their medications more frequently, indicating they were feeling much worse than usual during the wildfire events.” Dr. Maldarelli is also training in Pulmonary and Critical Care Medicine at the University of Maryland Medical Center.
To investigate whether these smoky days resulted in measurable health impacts, she collaborated with data scientists and visualization experts at UM-IHC, who have access to almost 2 million anonymized patient records from the University of Maryland Medical System (UMMS).
The research team examined satellite imagery and data from the Environmental Protection Agency (EPA) to identify six “hotspot” days in June 2023 that showed high levels of air pollution from wildfire smoke in the Maryland area, all of which surpassed the EPA’s safe air quality standards across the state’s 23 counties.
They then analyzed anonymized electronic health records from UMMS, comparing visits for heart and lung conditions during June 2023 with similar data from June 2018 and June 2019. This included visits to emergency rooms, hospitalizations, and outpatient appointments.
“Our findings revealed that these hotspot days correlated with an 18 percent increase in the probability of patients seeking care for cardiopulmonary issues,” stated study co-author Bradley Maron, MD, a Professor of Medicine at UMSOM and Co-Executive Director of UM-IHC. “Additionally, there was a staggering 55 percent increase in outpatient visits for heart and lung concerns, particularly among older, non-smoking, and relatively affluent patients compared to those who typically visit their doctors on days with good air quality.”
This observation underscores the significance of healthcare access and suggests that economically disadvantaged individuals might not be receiving necessary medical attention during high-risk days characterized by wildfire smoke.
As climate-related events become more frequent, there is a pressing need for physicians to develop better strategies to assist vulnerable patients on such hazardous days.
“We have a unique opportunity to utilize UM-IHC’s capabilities to proactively pinpoint patients who are at the highest risk and offer them preemptive care,” noted UMSOM Dean Mark T. Gladwin, MD, who serves as the John Z. and Akiko K. Bowers Distinguished Professor and Vice President for Medical Affairs at the University of Maryland, Baltimore. “By providing telehealth options or other methods for accessing care, we could play a vital role in preventing cardiovascular issues on days when air pollution is exacerbated by smoke.”
Amir Sapkota, PhD, and Hyeonjin Song, PhD, from the University of Maryland School of Public Health, conducted the satellite and EPA analyses for this study. Co-authors included faculty from the University of Maryland, College Park, the University of Maryland School of Pharmacy, and the University of Maryland Medical System.
“The ability to access detailed clinical data and employ advanced analytic methodologies is crucial for the future of healthcare, positioning UMMS to be at the forefront of innovative medical practices that enhance patient care for years to come,” commented study co-author Warren D’Souza, PhD, Co-Director of UM-IHC and Senior Vice President/Chief Innovation Officer at UMMS.
The study received funding from Montgomery County, Maryland, and The University of Maryland Strategic Partnership: MPowering the State, which is a formal collaboration between the University of Maryland, College Park and the University of Maryland, Baltimore.
