Evidence map›Paper›PMID 41013892›Full record

ArticleHeadache2026

Association between wildfire smoke exposure and pediatric emergency department visits for headache.

Hannah F J Shapiro, Amy A Gelfand, Daniel J Shapiro, Holly Elser, Chen Chen, Joan A Casey

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Headache, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hannah F J ShapiroDepartment of Neurology, Child & Adolescent Headache Program, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-9987-2903
Amy A GelfandDepartment of Neurology, Child & Adolescent Headache Program, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-0911-7905
Daniel J ShapiroDepartment of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.
Holly ElserDepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-1781-904X
Chen ChenScripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA.
Joan A CaseyDepartment of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA.

Funding

the National Institute of Environmental Health Sciences, National Institutes of Health P30-ES030284
6 · The paper itself

Abstract

objectiveThe purpose of this study was to determine whether short-term exposure to wildfire smoke is associated with emergency department visits for headache in children and adolescents.

backgroundWildfires are becoming increasingly common and are associated with numerous adverse health outcomes. However, we currently do not know how wildfire smoke exposure affects children and adolescents with primary headache disorders. Headache disorders in youth are a major contributor to frequently missed school days and youth with headache disorders have high medical care utilization and total healthcare costs. Therefore, understanding factors that may contribute to headache exacerbations and potential increases in healthcare utilization is of particular interest.

methodsThis was a time-stratified case-crossover study linking daily health data from the California Department of Health Care Access and Information to daily ZIP code-level wildfire PM

resultsWe identified 206,230 unique emergency department encounters for primary headache disorders. Most visits were in female patients (61.4%) 15-19 years old (58.5%) who identified as Hispanic (48.8%) and lived in a very low-opportunity (37.7%) or low-opportunity (21.6%) neighborhood. The adjusted odds of an emergency department visit incrementally decreased per unit increase in wildfire-specific PM

conclusionChildren are less likely to seek care in the emergency department for primary headache in the days following exposure to wildfire smoke, suggesting that healthcare utilization changes during wildfires. Clinicians should ensure youth with headache disorders who experience worsening symptoms associated with air pollution are equipped with strategies to manage their headache disorder at home during days with wildfire smoke, including effective at-home acute headache medications.

Indexed as

Emergency Service, HospitalEnvironmental ExposureHeadacheParticulate MatterSmokeWildfiresAdolescentCaliforniaChildChild, PreschoolCross-Over StudiesEmergency Room VisitsFemaleHumansMaleYoung AdultParticulate MatterSmokeclimate changeemergency departmentenvironmental healthhealthcare utilizationpediatric headachewildfire smoke

Identifiers

PMID41013892
PMCPMC13142203

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.