title: The respiratory health impact of a large urban fire.
abstract: OBJECTIVE
  In July 1988, a fire destroyed a huge supermarket warehouse in Richmond, Calif, sending smoke into residential neighborhoods for nearly a week. There was no organized public health response. To evaluate the respiratory health impact on the general population, a survey of emergency room visits and hospital admissions to the two acute-care hospitals serving the population downwind was conducted.
  
  
  METHODS
  Medical records of 489 patients meeting specified diagnostic criteria during the week of the fire and several reference periods were abstracted. Ratios of proportions for respiratory diagnoses (i.e., emergency room visits for a given diagnosis/total emergency room visits) were calculated, comparing the fire week with the reference periods, and 1988 mortality data for the area were reviewed.
  
  
  RESULTS
  Ratios of proportions for emergency room visits for asthma and all lower respiratory conditions increased significantly during the fire. Respiratory-related hospitalizations also increased. However, there was no observable increase in respiratory mortality.
  
  
  CONCLUSIONS
  This fire was found to have had a moderate impact on the respiratory health of local residents. Public health intervention is indicated to prevent respiratory morbidity when extended exposure to structural fire smoke is predictable.
authors.affiliation: California Office of Environmental Health Hazard Assessment, Berkeley.
authors.forename: M
authors.initials: M
authors.lastname: Lipsett
authors.forename: K
authors.initials: K
authors.lastname: Waller
authors.forename: D
authors.initials: D
authors.lastname: Shusterman
authors.forename: S
authors.initials: S
authors.lastname: Thollaug
authors.forename: W
authors.initials: W
authors.lastname: Brunner
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D001991:Bronchitis / Q000453:epidemiology / Q000209:etiology; D002140:California / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005390:Fires; D006760:Hospitalization; D006801:Humans; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D014504:Urban Health