176 The Asthma Mobile Health Study: Wildfires and Asthma Exacerbations, Just Blowing Smoke or is There a Correlation?

Abstract

Results: The median times for sham CT consent in phase 1 were 2 and 4 minutes. Of the 729 patients enrolled in phase 2, 647 (89%) underwent CT evaluation. Their median age was 52 years (IQR 32, 74); 54% were male; 95% had a blunt mechanism of trauma; 55% were admitted to the hospital; and 5% had a surgical procedure performed after CT. The median and mean TACCT were 11 min (IQR 7, 19) and 17 min (SD 20) respectively. The median GCS was 15 (IQR 14, 15). Of the 647 patients enrolled, 439 patients (67.9%; 95% confidence interval [CI] 64.2 -71.3%) met feasible consent criteria. Of the 208 patients who did not meet feasible consent criteria, 190 (91.4%; 95% CI 86.7 -94.5%) had a GCS less than 15 and 18 (8.7%; 95% CI 5.5 -13.3%) had a short TACCT.Conclusions: In this study of acute, adult trauma patients, consent for CT was feasible in over two-thirds of patients. When CT was not feasible, the primary reason was a GCS < 15. When considering efforts to increase shared decisionmaking between medical providers and acute trauma patients, informed consent for CT scans is a feasible option. Future studies may determine if providing such informed consent correlates with improvement in patient satisfaction and more efficient CT utilization.Acknowledgements: This work was made possible by R25MD006832 from the National Institute on Minority Health and Health Disparities. The viewpoints and opinions expressed here in no way reflect those held by this institution.

The Relationship Between Wildfires and Respiratory Health

“…The Gan et al (2020) study found results of The Relationship Between Wildfires and Respiratory Health (Krishna Kolen) elevated office visits with elevations of wildfire smoke PM2.5 exposures and that these exposures had stronger impacts on females and those in the 15-65year-old age category. The Gowda et al (2016aGowda et al ( , 2016b studies demonstrated a close correlation between wildfire-induced air quality changes and users reporting air quality as an asthma trigger. Further, Haikerwal et al (2015) showed positive associations between wildfire related PM2.5 exposures and emergency department attendances for asthma, again with increased risk found for adult women and in same day exposures to PM2.5.…”

“…By following the trends of results found in the literature review, it is expected that communities in the GPAZ would see increased emergency department admissions and hospitalizations for asthma and COPD during periods of increased fine particulate matter (PM2.5) in the air, which can be linked to the presence of wildfire smoke. Potential implications for respiratory outcomes due to elevated AQHI values based on the literature review suggest increased asthma hospitalizations and emergency department visits (Borchers Arrigada et al, 2019), elevated office visits (Gan et al, 2020), increased reporting of asthma triggers (Gowda et al, 2016a(Gowda et al, , 2016b, and increases in emergency department attendees for asthma on the same day of smoke exposure (Haikerwal et al, 2015).…”

“…Another area for future research could be the implementation of app software into the healthcare system and general population to assess how respiratory outcomes are impacted by poor air quality. The Asthma Mobile Health Study completed by Gowda et al (2016aGowda et al ( , 2016b was an example of how apps can be used to provide health data, and future research can demonstrate the use of apps as a way of sending real-time advisories to at-risk populations when adverse environmental conditions develop, such as sending AQHI data to users with asthma during extreme wildfire conditions to help individuals better prepare for an exacerbation. Apps can also be used to help healthcare facilities optimize allocation of resources and can be used to provide users with resources to help them in adverse environmental conditions (Gowda et al, 2016a(Gowda et al, , 2016b.…”

“…The theoretical framework drawn from the literature review emphasizes the measurement of exposure data. Numerous studies used fine particulate matter (PM2.5) as a basis for wildfire smoke concentrations (Borchers Arriagada et al, 2019;Gan et al, 2020;Gowda et al, 2016aGowda et al, , 2016bHaikerwal et al, 2015;Lipner et al, 2019;Yao et al, 2020). Other studies used AQHI and AQI data, which is derived from PM2.5 to determine wildfire smoke exposure (Yao et al, 2020;Gowda et al, 2016aGowda et al, , 2016b.…”

“…Numerous studies used fine particulate matter (PM2.5) as a basis for wildfire smoke concentrations (Borchers Arriagada et al, 2019;Gan et al, 2020;Gowda et al, 2016aGowda et al, , 2016bHaikerwal et al, 2015;Lipner et al, 2019;Yao et al, 2020). Other studies used AQHI and AQI data, which is derived from PM2.5 to determine wildfire smoke exposure (Yao et al, 2020;Gowda et al, 2016aGowda et al, , 2016b. Other methods such as satellite imagery data (Lipner et al, 2019;Mazdiyansi and AghaKouchhak, 2019;Gan et al, 2020) were used, however these studies are less common.…”