ArticleProceedings of the National Academy of Sciences of the United States of America2023
Emergency department visits respond nonlinearly to wildfire smoke.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 61 citations in OpenAlex.
- Québec Wildfires and Respiratory Emergency Department Visits in Charlottesville, Virginia.EcoHealth · 2026Article
- Wearable measured physiological stress and activity patterns changes after 2025 Los Angeles wildfire among older adults: findings from a pilot prospective cohort study.Environmental research, health : ERH · 2026Article
- Primary care, weather, and the missed opportunity for savings.Health affairs scholar · 2026Article
- Two-way fixed effects models in air pollution epidemiology: a proposed framework for model specifications and recommendations for future studies.American journal of epidemiology · 2026Article
- Associations between wildland fire smoke PMEnvironmental health : a global access science source · 2026Article
- Workplace Exposures May Mask Wildfire Smoke-Related Exposure Inequities and Mortality.Environmental science & technology letters · 2026Article
- Weather information improves a predictive model of emergency department arrivals.Internal and emergency medicine · 2026Article
- Impact of air pollution on exacerbations of respiratory and cardiovascular diseases for the intensivist: a narrative review.Intensive care medicine experimental · 2026Review
- Behavioral responses to wildfire smoke: Insights from smartphone location data.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- The effect of wildfire air pollution on local hospital admissions in New York.Environmental research communications · 2026Article
- Growing impacts of fire smoke on ozone pollution and associated mortality burden in the United States.Science advances · 2026Article
- Association between wildfire smoke exposure and pediatric emergency department visits for headache.Headache · 2026Article
- Valuing wildfire smoke-related mortality benefits from climate mitigation.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- US Emergency Department Use and Operations Amid Natural Disasters: A Narrative Review.The western journal of emergency medicine · 2026Review
- Prenatal Exposure to Wildfire and Autism in Children.Environmental science & technology · 2026Article
- Health Impact Analysis of Wildfire Smoke-PMGeoHealth · 2026Article
- Wildfire-Specific PMGeoHealth · 2026Article
- Two and a half decades of United States wildfire burn zone disaster data, 2000-2025.Scientific data · 2025Article
- Human Sputum Microbiome Composition and Sputum Inflammatory Cell Profiles Are Altered with Controlled Wood Smoke Exposure as a Model for Wildfire Smoke.American journal of respiratory and critical care medicine · 2025Article
- Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Air pollution negatively affects a range of health outcomes. Wildfire smoke is an increasingly important contributor to air pollution, yet wildfire smoke events are highly salient and could induce behavioral responses that alter health impacts. We combine geolocated data covering all emergency department (ED) visits to nonfederal hospitals in California from 2006 to 2017 with spatially resolved estimates of daily wildfire smoke PM[Formula: see text] concentrations and quantify how smoke events affect ED visits. Total ED visits respond nonlinearly to smoke concentrations. Relative to a day with no smoke, total visits increase by 1 to 1.5% in the week following low or moderate smoke days but decline by 6 to 9% following extreme smoke days. Reductions persist for at least a month. Declines at extreme levels are driven by diagnoses not thought to be acutely impacted by pollution, including accidental injuries and several nonurgent symptoms, and declines come disproportionately from less-insured populations. In contrast, health outcomes with the strongest physiological link to short-term air pollution increase dramatically in the week following an extreme smoke day: We estimate that ED visits for asthma, COPD, and cough all increase by 30 to 110%. Data from internet searches, vehicle traffic sensors, and park visits indicate behavioral changes on high smoke days consistent with declines in healthcare utilization. Because low and moderate smoke days vastly outweigh high smoke days, we estimate that smoke was responsible for an average of 3,010 (95% CI: 1,760-4,380) additional ED visits per year 2006 to 2017. Given the increasing intensity of wildfire smoke events, behavioral mediation is likely to play a growing role in determining total smoke impacts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.