title: Immediate health effects of an urban wildfire.
abstract: To document the immediate health effects of the urban wildfire that swept through parts of Alameda County, California, on October 20 and 21, 1991, we conducted a retrospective review of emergency department and coroner's records. Nine hospitals (6 local and 3 outlying) were surveyed for the week beginning October 20, 1991. Coroner's reports were reviewed for 25 identified fire-related deaths. A total of 241 fire-related emergency encounters, including 44 inpatient admissions, were recorded for 227 persons. Nearly a fourth of emergency department patients were seen for work-related injuries, more than half of which occurred among professional firefighters. Smoke-related disorders constituted more than half of all emergency department cases; of these, 61% had documented bronchospasm. Major trauma and burns contributed 1% and 4% of principal diagnoses, respectively; these were exceeded in number by corneal abrasions (13%), other medical problems (8%), and minor trauma (7%), among other diagnoses. All coroner's cases involved extensive burns, many with documented smoke inhalation injury. While the Oakland-Berkeley fire storm resulted in a high case-fatality ratio among major burn cases (25/31), those who survived the initial fire storm did well clinically. Among emergency department patients, medical (particularly smoke-related) disorders outnumbered traumatic presentations by a ratio of more than 2 to 1.
authors.affiliation: California Office of Environmental Health Hazard Assessment, Alta Bates Hospital Burn Center, Berkeley.
authors.forename: D
authors.initials: D
authors.lastname: Shusterman
authors.forename: J Z
authors.initials: JZ
authors.lastname: Kaplan
authors.forename: C
authors.initials: C
authors.lastname: Canabarro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001986:Bronchial Spasm / Q000453:epidemiology; D002056:Burns / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D002263:Carboxyhemoglobin / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004190:Disasters; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004813:Epidemiology; D005260:Female; D005390:Fires; D006262:Health; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009784:Occupational Diseases / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015208:Smoke Inhalation Injury / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology
chemical_list: D002263:Carboxyhemoglobin