Prescribed Fires, Smoke Exposure, and Hospital Utilization Among Heart Failure Patients: ISEE NAC 2023

Abstract for submission to the 2023 ISEE North America Chapter conference Background and Aim: Prescribed fires are increasingly utilized, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire and heart failure (HF) patients’ hospital utilization. Methods: We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated prescribed fire occurrences within 1, 2, and 5 km of the patients’ primary residence with the number of hospital visits and 7- and 30-day readmissions for each patient. We also compared associations with those observed using zip code-level smoke density data, which captures more wildfire smoke exposure than prescribed fires. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regressions models were used for readmissions. All models were adjusted for age, sex, race, smoking status, and neighborhood socio-economic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). Results: Associations between prescribed fires and hospital visits were generally null with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke days at the zip code level was associated with both 7-day (8.6% increase; 95% CI = 1.5%, 16.1%) and 30-day readmissions (5.3%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.3%; 95% CI: -0.2%, 2.7%).  Conclusions: Area-level smoke exposure is positively associated with hospital utilization but not proximity to prescribed fire occurrences. This abstract does not necessarily reflect U.S.EPA policy.

Impact/Purpose

Abstract on association between prescribed fires and health outcomes in heart failure patients that is being submitted to the 2023 ISEE North America Chapter conference Results: Associations between prescribed fires and hospital visits were generally null with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke days at the zip code level was associated with both 7-day (8.6% increase; 95% CI = 1.5%, 16.1%) and 30-day readmissions (5.3%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.3%; 95% CI: -0.2%, 2.7%).  Conclusions: Area-level smoke exposure is positively associated with hospital utilization but not proximity to prescribed fire occurrences. This abstract does not necessarily reflect U.S.EPA policy.

Citation

Raab, H., J. Moyer, S. Afrin, F. Garcia-Menendez, AND C. Ward-Caviness. Prescribed Fires, Smoke Exposure, and Hospital Utilization Among Heart Failure Patients: ISEE NAC 2023. ISEE North American Chapter Meeting, Corvalis, OR, June 19 - 21, 2023.