Wildfire Smoke Linked to Increase in Mental Health ED Visits

TOPLINE:

Exposure to fine particulate matter (PM2.5) from the 2020 California wildfires was linked to an increase in mental health-related emergency department (ED) visits within 7 days of exposure, including increases of 8% for all-cause mental health, 15% for depression, and 29% for other mood-affective disorders, a new study showed.

METHODOLOGY:

• Data for nearly 87,000 ED visits related to mental health conditions by California residents (median age, 38 years; 53% men) from July 2020 through December 2020 were obtained from the Department of Health Care Access and Information.
• ED visits included those for all-cause mental disorders , psychoactive substance use disorders , non-mood psychotic disorders, anxiety, depression, and other mood-affective disorders.
• The investigators analyzed wildfire-specific PM2.5 exposure with up to 7-day lags based on participants’ residential zip codes.
• Covariate data included wildfire, climate, air pollution, population, and socioeconomic status, obtained from state and federal sources.

TAKEAWAY:

• A 10-μg/m³ increase in the wildfire-specific PM2.5 level was associated with increased ED visits for all-cause mental health conditions (cumulative relative risk [cRR], 1.08; 95% CI, 1.03-1.12), depression (cRR, 1.15; 95% CI, 1.02-1.30), and other mood-affective disorders (cRR, 1.29; 95% CI, 1.09-1.54).
• Women had an increased risk for ED visits due to depression up to 4 days post-exposure (cRR, 1.17; 95% CI, 1.03-1.32) and other mood-affective disorders up to 3 days post-exposure (cRR, 1.34; 95% CI, 1.11-1.62).
• Non-Hispanic Black individuals had an increased risk for ED visits due to other mood-affective disorders up to 5 days post-exposure (cRR, 2.35), whereas Hispanic individuals had an increased risk for ED visits due to depression up to 7 days post-exposure (cRR, 1.30).
• Young people (age, 15-24 years) showed increased ED visits for other mood-affective disorders up to 4 days post-exposure (cRR, 1.46).

IN PRACTICE:

“These findings suggest a potential link between wildfire-specific PM2.5 exposure and mental health outcomes; healthcare professionals and systems should prepare for a possible increase in demand for mental health–related emergency services during wildfire events,” the investigators wrote.

“We need to make sure everyone has access to mental health care during wildfire seasons, particularly the most vulnerable groups and particularly as wildfires become more frequent and severe as a result of climate change,” lead investigator Youn Soo Jung, PhD, Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, California, said in a press release.

SOURCE:

The study was published online on April 4 in JAMA Network Open.

LIMITATIONS:

ED visits may have been underestimated due to the COVID-19 pandemic. Excluding patients with both COVID-19 and mental health issues may have introduced bias. Limited data prevented the clear separation of wildfire smoke effects from evacuation effects. The use of retrospective billing data may have included coding errors. Additionally, data on individual-level exposure, lifestyle factors, and behavior changes were not available, and multiple comparisons were not adjusted for.

DISCLOSURES:

The study was funded by the National Heart, Lung, and Blood Institute; John Rock Endowment; Harvard T.H. Chan School of Public Health, Boston; and the Sean N Parker Center for Allergy and Asthma Research at Stanford University. Three of the 10 investigators reported having various ties with several sources. Full details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.