title: Wildland forest fire smoke: health effects and intervention evaluation, Hoopa, California, 1999.
abstract: OBJECTIVE
  To assess the health effects of exposure to smoke from the fifth largest US wildfire of 1999 and to evaluate whether participation in interventions to reduce smoke exposure prevented adverse lower respiratory tract health effects among residents of the Hoopa Valley National Indian Reservation in northwestern California.
  
  
  METHODS
  Observational study: epidemiologists from the Centers for Disease Control and Prevention retrospectively reviewed medical records at the local medical center and conducted survey interviews of reservation residents.
  
  
  METHODS
  Humboldt County, California.
  
  
  METHODS
  Interviews were completed with 289 of 385 residents, representing 26% of the households on the reservation. Of the 289 participants, 92 (31.8%) had preexisting cardiopulmonary conditions.
  
  
  RESULTS
  During the weeks of the forest fire, medical visits for respiratory illnesses increased by 217 visits (from 417 to 634 visits, or by 52%) over the previous year. Survey results indicated that although 181 (62.6%) of 289 participants reported worsening lower respiratory tract symptoms, those with preexisting cardiopulmonary conditions reported more symptoms before, during, and after the smoke episode. An increased duration of the use of high-efficiency particulate air cleaners and the recollection of public service announcements were associated with a reduced odds of reporting adverse health effects of the lower respiratory tract. No protective effects were observed for duration of mask use or evacuation.
  
  
  CONCLUSIONS
  Timely actions undertaken by the clinical staff of the local medical center appeared beneficial to the respiratory health of the community. Future programs that reduce economic barriers to evacuation during smoke episodes may also improve intervention participation rates and decrease smoke exposures. Although promising, the effectiveness of these and other interventions need to be confirmed in a prospective community intervention trial.
authors.affiliation: Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Mailstop E-17, Atlanta, GA 30333, USA. zud9@cdc.gov
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Mott
authors.forename: Pamela
authors.initials: P
authors.lastname: Meyer
authors.forename: David
authors.initials: D
authors.lastname: Mannino
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Redd
authors.forename: Eva M
authors.initials: EM
authors.lastname: Smith
authors.forename: Carol
authors.initials: C
authors.lastname: Gotway-Crawford
authors.forename: Emmett
authors.initials: E
authors.lastname: Chase
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects; D002140:California; D005260:Female; D005390:Fires; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012906:Smoke / Q000009:adverse effects*
chemical_list: D012906:Smoke