{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:30:58Z","timestamp":1791469858841,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>As wildfires worldwide increase in severity and frequency, fine particulate matter (PM 2.5), generated as a component of wildfire smoke, increasingly impacts air quality. Children are particularly vulnerable to poor air quality in numerous ways, including inhalation of more air in proportion to their body size than adults. Though its adverse impacts on the lower airway are well demonstrated, the clinical effects of PM 2.5 on the pediatric upper airway are poorly understood and warrant investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2014 to 2023, patient presentations to a pediatric emergency department in Northern California during exposure periods of elevated PM 2.5 burden associated with nearby wildfires were identified. Patient diagnoses, presenting symptoms, and management were analyzed. Comparison group patients were evaluated during date\u2010matched control periods with confirmed normal air quality. Chi\u2010squared analyses determined significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During periods of increased wildfire\u2010generated PM 2.5 burden, a significantly greater proportion of pediatric patients presented to the emergency department with upper airway pathology compared to matched control periods of healthy air quality. Further, a significantly greater proportion of patients were diagnosed with croup during wildfires. Of patients presenting with upper airway pathology, a significantly greater proportion experienced dysphonia during wildfires and had a negative strep test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Wildfire\u2010generated PM 2.5 may contribute to increased rates of croup presentations, and PM 2.5 may disproportionately affect the larynx in the pediatric upper airway. Larger population\u2010based studies and preclinical models may clarify these clinical manifestations of a growing public health threat.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1191","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:54:58Z","timestamp":1741611298000},"page":"2072-2081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of Pediatric Acute Upper Airway Pathology During Local Wildfires and Increased PM 2.5 Burden"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0145-5942","authenticated-orcid":false,"given":"Patrick","family":"Kiessling","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-3068","authenticated-orcid":false,"given":"Kara","family":"Meister","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Lucille Packard Children's Hospital, Stanford Children's Health Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5352-7469","authenticated-orcid":false,"given":"Douglas","family":"Sidell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Lucille Packard Children's Hospital, Stanford Children's Health Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"O'Bryan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9841-0184","authenticated-orcid":false,"given":"Elizabeth","family":"Erickson\u2010DiRenzo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Lucille Packard Children's Hospital, Stanford Children's Health Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-227X","authenticated-orcid":false,"given":"Karthik","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford Health Care Stanford California USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Lucille Packard Children's Hospital, Stanford Children's Health Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61766-8"},{"key":"e_1_2_7_3_1","unstructured":"Air pollution from wildfires expected to surge as world warms. November 17 2022. Accessed August 16 2024.https:\/\/www.unep.org\/news-and-stories\/story\/air-pollution-wildfires-expected-surge-world-warms"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aab2356"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2021.347"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-052422-020909"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz114"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-21708-0"},{"key":"e_1_2_7_9_1","unstructured":"Particulate matter (PM2.5) trends. US EPA O. July 19 2016. Accessed August 16 2024.https:\/\/www.epa.gov\/air-trends\/particulate-matter-pm25-trends"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2017.08.102"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NURSE.0000839804.04081.c0"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atmosenv.2021.118210"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","unstructured":"FadaduRP SolomonG BalmesJR.Wildfires and human health.JAMA. Published online July 10 2024.doi:10.1001\/jama.2024.13600","DOI":"10.1001\/jama.2024.13600"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2021.12.004"},{"key":"e_1_2_7_15_1","unstructured":"OlomuP McLeanM.Pediatric airway anatomy.OpenAnesthesia. Accessed October 17 2024.https:\/\/www.openanesthesia.org\/keywords\/pediatric-airway-anatomy\/"},{"key":"e_1_2_7_16_1","first-page":"1","article-title":"PM2.5 exposure and asthma development: the key role of oxidative stress","volume":"2022","author":"Liu K","year":"2022","journal-title":"Oxid Med Cell Longevity"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-023-01057-9"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103739"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23250"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23328"},{"key":"e_1_2_7_21_1","unstructured":"BAAQMD. Accessed August 16 2024.https:\/\/www.baaqmd.gov\/en\/"},{"key":"e_1_2_7_22_1","unstructured":"AQI Basics | AirNow.gov. Accessed October 17 2024.https:\/\/www.airnow.gov\/aqi\/aqi-basics"},{"key":"e_1_2_7_23_1","unstructured":"California Department of Forestry and Fire Protection | CAL FIRE. Accessed August 16 2024.https:\/\/www.fire.ca.gov\/"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.6b06200"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004344"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201902-150OC"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-027128"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41370-020-00267-4"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.0179"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/08958370903571849"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2017.07.063"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011365"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-519OC"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X8100100304"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03117-0"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04190-y"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adj7264"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joclim.2021.100053"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-065504"},{"key":"e_1_2_7_40_1","unstructured":"Create a clean room to protect indoor air quality during a wildfire. US EPA O. December 12 2018. Accessed January 2 2025.https:\/\/www.epa.gov\/emergencies-iaq\/create-clean-room-protect-indoor-air-quality-during-wildfire"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12131"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1029\/2018GH000144"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:08:07Z","timestamp":1760965687000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/ohn.1191"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1191","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"assertion":[{"value":"2024-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}