Mortality in US Hemodialysis Patients Following Exposure to Wildfire Smoke.

Journal of the American Society of Nephrology : JASN
Yuzhi XiAna G Rappold

Abstract

Wildfires are increasingly a significant source of fine particulate matter (PM2.5), which has been linked to adverse health effects and increased mortality. ESKD patients are potentially susceptible to this environmental stressor. We conducted a retrospective time-series analysis of the association between daily exposure to wildfire PM2.5 and mortality in 253 counties near a major wildfire between 2008 and 2012. Using quasi-Poisson regression models, we estimated rate ratios (RRs) for all-cause mortality on the day of exposure and up to 30 days following exposure, adjusted for background PM2.5, day of week, seasonality, and heat. We stratified the analysis by causes of death (cardiac, vascular, infectious, or other) and place of death (clinical or nonclinical setting) for differential PM2.5 exposure and outcome classification. We found 48,454 deaths matched to the 253 counties. A 10-μg/m3 increase in wildfire PM2.5 associated with a 4% increase in all-cause mortality on the same day (RR, 1.04; 95% confidence interval [95% CI], 1.01 to 1.07) and 7% increase cumulatively over 30 days following exposure (RR, 1.07; 95% CI, 1.01 to 1.12). Risk was elevated following exposure for deaths occurring in nonclinical settings (RR, 1.07; 95...Continue Reading

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Citations

Apr 3, 2021·The Science of the Total Environment·Angeliki KaranasiouXavier Querol
Aug 28, 2021·Environmental Science and Pollution Research International·Yue ChenHai-Feng Pan

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