Increase in Pediatric Respiratory Visits associated with Wildfires in San Diego County

Abstract

There is significant data that demonstrates increased ER visits and hospitalizations for cardiopulmonary causes during wildfire outbreaks. This utilization correlates with increased PM 2.5 and other airborne pollutants and has been demonstrated to affect vulnerable populations such as those with asthma. All Emergency Room and Urgent Care visits from 2011 to 2017 were collected from Rady Children’s Hospital. Specific data fields collected included date of visit, date of birth, zip code of residence, insurance type, language, respiratory/non- respiratory visit, and diagnosis. Air pollution data was provided by San Diego Air Pollution Control Division from the Camp Pendleton monitor from 2014 to 2017. Specific dates of interest included May 12-23, 2014 and December 6-16, 2017. A distinct and intense peak for PM 2.5 can be seen in May of 2014 consistent with the timing of the Bernardo fire. The majority of patients where younger, age 0-6 (70%) and had Medi-Cal insurance (74%).There was a significant deviation for respiratory visits for the May 2014 fires. By age group, there is a stronger signal for respiratory visits during the May 2014 fire for kids aged 0-6. To our knowledge this is one of the first studies to link an increase in pediatric urgent care and emergency room visits associated with wildfire-linked PM 2.5. Natural disasters such as wildfires are expected to increase in frequency and intensity in the future. Climate change will disproportionately affect young children, magnifying existing disparities. As these conditions compound and wild fires become more frequent, it is important for those at risk to be prepared.