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The 2007 San Diego Wildfire Impact on the Emergency Department of the University of California, San Diego Hospital System

Published online by Cambridge University Press:  28 June 2012

Craig I. Schranz ,
Edward M. Castillo  and
Gary M. Vilke
Craig I. Schranz*
Affiliation:
Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California, USA
Edward M. Castillo
Affiliation:
University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, California, USA
Gary M. Vilke
Affiliation:
University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, California, USA
*
Department of Emergency Medicine, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, Virginia 23708, USA, E-mail: schranzc@yahoo.com
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Abstract

Introduction:

In October 2007, San Diego County experienced a severe firestorm resulting in the burning of more than 368,000 acres, the destruction of more than 1,700 homes, and the evacuation of more than 500,000 people.

Hypothesis:

The goal of this study was to assess the impact of the 2007 San Diego Wildfires, and the acute change in air quality that followed, on the patient volume and types of complaints in the emergency department.

Method:

A retrospective review was performed of a database of all patients presenting to the Emergency Departments of University of California, San Diego (UCSD) hospitals for a six-day period both before (14–19 October 2007) and after (21–26 October 2007) the start of the 2007 firestorm. Charts were abstracted for data, including demographics, chief complaints, past medical history, fire-related injuries and disposition status. As a measure of pollution, levels of 2.5 micron Particulate Matter (PM 2.5) also were calculated from data provided by the San Diego Air Pollution Control District.

Results:

Emergency department volume decreased by 5.8% for the period following the fire. A rapid rise in PM2.5 levels coincided with the onset of the fires. The admission rate was higher in the period following the fires (19.8% vs. 15.2%) from the baseline period. Additionally, the Left Without Being Seen (LWBS) rate doubled to 4.6% from 2.3%. There was a statistically significant increase in patients presenting with a chief complaint of shortness of breath (6.5% vs. 4.2% p = 0.028) and smoke exposure (1.1% vs. 0% p = 0.001) following the fires. Patients with significant cardiac or pulmonary histories were no more likely to present to the emergency department during the fires.

Conclusions:

Despite the decreased volume, the admission and LWBS rate did increase following the onset of the firestorm. The cause of this increase is unclear. Despite a sudden decline in air quality, patients with significant cardiac and pulmonary morbidity did not vary their emergency department utilization rate. Based on the experience at UCSD, it appears that significant wildfires like that seen in 2007, only may marginally affect emergency department operations, and may not require significant changes to normal staffing levels.

Keywords

air pollutiondisasteremergency departmentfirefirestorm
Type
Case Study
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 5 , October 2010 , pp. 472 - 476
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1.California Department of Forestry and Fire Protection. Available at http://cdfdata.fire.ca.gov/incidents/incidents_archived?archive_year=2007. Accessed 24 August 2009.Google Scholar
2.Reza, HG, Leovy, J, Pham, A: “Scale of the fires' disruption on display at San Diego stadium,” LA Times 24 October 2007. Available at http://www.latimes.com/news/local/la-me-evacuate24oct24,0,627804.story?page=1&coll=la-headlines-california. Accessed 24 August 2009.Google Scholar
3.San Diego Air Pollution Control District. Available at http://www.sdapcd.org/info/info.html. Accessed 10 November 2008.Google Scholar
4.United States Environmental Protection Agency: National Ambient Air Quality Standards. Available at http://www.epa.gov/air/criteria.html. Accessed 24 August 2009.Google Scholar
5.Hsu, EB, Grabowski, JG, Chotani, RA, Winslow, JA, Alves, DW, VanRooyen, MJ: Effects on local emergency departments of large-scale urban chemical fire with hazardous materials spill. Prehosp Disaster Med 2002;17(4):196–201.CrossRefGoogle ScholarPubMed
6.Upshur, R, James, ML, Richardson, E, Brunton, G, Hunter, W, Chamber, L: Short-term adverse health effects in a community exposed to a large polyvinylchloride plastics fire. Arch Environ Health 2001;56(3):264–270.CrossRefGoogle Scholar
7.Smith, MA, Jalaludin, B, Byles, JE, Lim, L, Leeder, SR: Asthma presentations to emergency departments in western Sydney during the January 1994 bush-fires. Int J Epidemiol 1996;25(6):1227–1236.CrossRefGoogle Scholar
8.Vilke, GM, Smith, AM, Stepanski, BM, Ray, LU, Murrin, PA, Chan, TC: Impact of the San Diego County firestorm on emergency medical services. Prehosp Disaster Med 2006;21(5)353–358.CrossRefGoogle Scholar
9.Wang, HC, Yousef, E: Air quality and pediatric asthma-related emergencies. J Asthma 2007;44(10):839–841.CrossRefGoogle ScholarPubMed
10.Brito, F, Gimeno, F, Martinez, C, Tobias, A, Suarez, L, Guerra, F, Borja, J, Alonso, A: Air pollution and seasonal asthma during the pollen season. A cohort study in Puertollano and Ciudad Real (Spain). Allergy 2007;62(10):1152–1157.CrossRefGoogle Scholar
11.Braga, AL, Pereira, LA, Procopio, M, DeAndre, PA, Saldiva, PH: Association between air pollution and respiratory and cardiovascular diseases in Itabira, Minas Gerais State, Brazil. Cad Saude Publica 2007;Suppl 4:S570–S578.CrossRefGoogle Scholar
12.Ulirsch, GV, Ball, LM, Kaye, W, Shy, CM, Lee, CV, Crawford-Brown, D, Symons, M, Holloway, T: Effect of particulate matter air pollution on hospital admissions and medical visits for lung and heart disease in two southeast Idaho cities. J Expo Sci Environ Epidemiol 2007;17(5):478–487.CrossRefGoogle ScholarPubMed
13.National Aeronautics and Space Administration: Moderate Resolution Imaging Spectroradiometer. Available at http://rapidfire.sci.gsfc.nasa.gov/subsets/index.php?subset=AERONET_La_Jolla.2007297. Accessed 24 August 2009.Google Scholar