title: Forecast-based interventions can reduce the health and economic burden of wildfires.
abstract: We simulated public health forecast-based interventions during a wildfire smoke episode in rural North Carolina to show the potential for use of modeled smoke forecasts toward reducing the health burden and showed a significant economic benefit of reducing exposures. Daily and county wide intervention advisories were designed to occur when fine particulate matter (PM2.5) from smoke, forecasted 24 or 48 h in advance, was expected to exceed a predetermined threshold. Three different thresholds were considered in simulations, each with three different levels of adherence to the advisories. Interventions were simulated in the adult population susceptible to health exacerbations related to the chronic conditions of asthma and congestive heart failure. Associations between Emergency Department (ED) visits for these conditions and daily PM2.5 concentrations under each intervention were evaluated. Triggering interventions at lower PM2.5 thresholds (≤ 20 μg/m(3)) with good compliance yielded the greatest risk reduction. At the highest threshold levels (50 μg/m(3)) interventions were ineffective in reducing health risks at any level of compliance. The economic benefit of effective interventions exceeded $1 M in excess ED visits for asthma and heart failure, $2 M in loss of productivity, $100 K in respiratory conditions in children, and $42 million due to excess mortality.
authors.affiliation: Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency , MB 58B, 109 TW Alexander Drive, Research Triangle Park, North Carolina 27711, United States.
authors.forename: Ana G
authors.initials: AG
authors.lastname: Rappold
authors.forename: Neal L
authors.initials: NL
authors.lastname: Fann
authors.forename: James
authors.initials: J
authors.lastname: Crooks
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.forename: Wayne E
authors.initials: WE
authors.lastname: Cascio
authors.forename: Robert B
authors.initials: RB
authors.lastname: Devlin
authors.forename: David
authors.initials: D
authors.lastname: Diaz-Sanchez
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis* / Q000633:toxicity; D002648:Child; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital; D005260:Female; D005390:Fires; D005544:Forecasting; D006333:Heart Failure / Q000139:chemically induced / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D009657:North Carolina; D052638:Particulate Matter / Q000032:analysis* / Q000633:toxicity; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D012306:Risk; D012424:Rural Population; D012906:Smoke / Q000009:adverse effects / Q000032:analysis
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D012906:Smoke