Affiliation:
1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California.
Abstract
Background
Increasing wildfire activity worldwide has led to exposure to poor air quality and numerous detrimental health impacts. This study hypothesized an association between exposure to poor air quality from wildfire smoke and adverse respiratory events under general anesthesia in pediatric patients.
Methods
This was a single-center retrospective double-cohort study examining two significant wildfire events in Northern California. Pediatric patients presenting for elective surgery during periods of unhealthy air quality were compared with those during periods of healthy air quality. The primary exposure, unhealthy air, was determined using local air quality sensors. The primary outcome was the occurrence of an adverse respiratory event under anesthesia. Secondary analysis included association with other known risk factors for adverse respiratory events.
Results
A total of 625 patients were included in the analysis. The overall risk of a respiratory complication was 42.4% (265 of 625). In children without a history of reactive airway disease, the risk of adverse respiratory events did not change during unhealthy air periods (102 of 253, 40.3%) compared with healthy air periods (95 of 226, 42.0%; relative risk 0.96 [0.77 to 1.19], P = 0.703). In children with a history of reactive airway disease, the risk of adverse respiratory events increased from 36.8% (25 of 68) during healthy air periods to 55.1% (43 of 78) during periods with unhealthy air (1.50 [1.04 to 2.17], P = 0.032). The effect of air quality on adverse respiratory events was significantly modified by reactive airways disease status (1.56 [1.02 to 2.40], P = 0.041).
Conclusions
Pediatric patients with underlying risk factors for respiratory complications under general anesthesia had a greater incidence of adverse respiratory events during periods of unhealthy air quality caused by wildfire smoke. In this vulnerable patient population, postponing elective anesthetics should be considered when air quality is poor.
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Anesthesiology and Pain Medicine
Reference43 articles.
1. Increasing western US forest wildfire activity: sensitivity to changes in the timing of spring;Westerling;Philos Trans R Soc Lond B Biol Sci,2016
2. The changing risk and burden of wildfire in the United States;Burke;Proc Natl Acad Sci U S A,2021
3. Wildfires wreaked havoc in 2021, CAMS tracked their impact
4. It’s not just the West. These places ae also on fire;The New York Times
5. Short-term acute exposure to wildfire smoke and lung function among Royal Canadian Mounted Police (RCMP) officers;Moitra;Int J Environ Res Public Health,2021
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献