Effects of Wildfire Events on California Radiation Oncology Clinics and Patients

Abstract

PurposeThe impact of climate-driven events, such as wildfires, on healthcare delivery and cancer care is a growing concern. Patients with cancer undergoing radiotherapy are particularly vulnerable to treatment interruptions, which have a direct impact on survival. We report the results of a study characterizing the impact of wildfires on radiation oncology clinics and their patients. Methods and MaterialsA survey of California radiation oncologists was used to evaluate emergency preparedness and the impact of wildfires on the delivery of radiotherapy services between 2017-2022. Descriptive statistics and Pearson's chi-squared tests were performed to investigate potential relationships between provider characteristics, practice settings, and perceptions of the impact of wildfire events. California Department of Forestry and Fire Protection (CAL FIRE) data were employed to map the geographic distribution of wildfires to clinic locations. ResultsResponse rate was 12.3% (51/415 radiation oncologists), representing 25% of clinics (43/176) in 41% (24/58) of California counties. 61% (31/51) of respondents reported being impacted by a wildfire, two of which are rural clinics (100%, 2/2) and 29 are (59%, 29/49) metropolitan practices. Of these, 18% (9/51) reported a clinic closure, and 29% (15/51) reported staffing shortages. Respondents reported impacts on patients, including having to evacuate (55%, 28/51), cancel/reschedule treatments (53%, 27/51), and experiencing physical, mental, or financial hardship due to wildfires (45%, 23/51). Respondents described impacts on clinical operations, including being forced to transfer patients (24%, 12/51), transportation interruptions (37%, 19/51), regional/community evacuations (35%, 18/51), and physical/mental health impacts (27%, 14/51) on clinic personnel. Less than half of the respondents (47%, 24/51) reported their workplace had a wildfire emergency preparedness plan. Additionally, geographic analysis revealed that 100% (176/176) of clinics were located within 25 miles of a wildfire. ConclusionsThis study highlights the impact of wildfires on radiation oncology clinics and patients, and underscores the need for emergency preparedness planning to minimize the consequences of such disasters.