{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:50:26Z","timestamp":1787010626803,"version":"build-2736575974"},"posted":{"date-parts":[[2025,7,16]]},"group-title":"Public and Global Health","reference-count":66,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,7,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>\n                    Given the increasing wildfire activity in the US, assessment of the health impacts of wildfire-specific fine particulate matter (PM\n                    <jats:sub>2.5<\/jats:sub>\n                    ), a growing source of surface air pollution, and its relative toxicity compared to non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    is needed to support mitigation strategies.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>\n                    To investigate associations of long-term exposure of wildfire-specific and non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    with cardiopulmonary hospitalization risks.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design, Setting, and Participants<\/jats:title>\n                  <jats:p>\n                    We obtained over 89 million cardiopulmonary hospitalizations for residents across 20 US states from 2006 to 2019 from the State Inpatient Databases. We assigned estimated 2-year average concentrations of wildfire-specific and non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    to each hospitalization based on residential ZIP codes to characterize exposure levels. We used a self-controlled design, which is robust to unmeasured confounding, to assess the associations.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Exposures<\/jats:title>\n                  <jats:p>\n                    2-year moving average exposures to wildfire-specific and non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    from the year of hospitalization to the prior year.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main Outcomes and Measures<\/jats:title>\n                  <jats:p>The hospitalizations for cardiovascular (ischemic heart disease, cerebrovascular disease, heart failure, arrhythmia, other cardiovascular diseases) and pulmonary diseases (acute respiratory infections, pneumonia, chronic obstructive pulmonary disease [COPD], asthma, other respiratory diseases) were identified based on the first 3 diagnosis codes at discharge.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Wildfire-specific PM\n                    <jats:sub>2.5<\/jats:sub>\n                    had stronger effects than non-wildfire PM\n                    <jats:sub>2.5.<\/jats:sub>\n                    Specifically, each 1-\u00b5g\/m\n                    <jats:sup>3<\/jats:sup>\n                    increase in 2-year wildfire-specific PM\n                    <jats:sub>2.5<\/jats:sub>\n                    was significantly associated with increased hospitalization risks for all cardiopulmonary diseases, with relative risk ranging from 1.100 (95% CI: 1.091, 1.108) for heart failure to 1.160 (95% CI: 1.142, 1.178) for asthma. In comparison, a 1 \u00b5g\/m\n                    <jats:sup>3<\/jats:sup>\n                    increase in non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    was associated with increased hospitalization risks for all cardiopulmonary diseases, but with relative risks ranging from 1.047 (95% CI: 1.042, 1.051) for COPD to 1.085 (95% CI: 1.082, 1.088) for hypertension. Stronger effects of both wildfire-specific and non-wildfire PM\n                    <jats:sub>2.5<\/jats:sub>\n                    were observed among minorities, individuals with obesity or diabetes, and those living in metropolitan areas, those with fewer years of education, and more deprived communities.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    Long-term exposure to wildfire-specific PM\n                    <jats:sub>2.5<\/jats:sub>\n                    poses a greater risk of cardiopulmonary hospitalization than PM\n                    <jats:sub>2.5<\/jats:sub>\n                    from non-wildfire sources. Greater effort should be placed on wildfire management, with particular focus on strategies to reduce smoke in addition to traditional air quality control strategies.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Key point<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Questions<\/jats:title>\n                    <jats:p>Does long-term exposure to fine particulate matter from wildfire and non-wildfire sources affect the risk of cardiopulmonary hospitalization differently?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Based on over 89 million hospitalization records for the residents of 20 US states from 2006 to 2019, exposure to fine particulate matter from wildfire was associated with a greater risk of cardiopulmonary hospitalization, compared to those from non-wildfire sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Meaning<\/jats:title>\n                    <jats:p>Fine particulate matter from wildfire sources poses a greater health threat than those from non-wildfire sources; greater effort should be placed on wildfire management in addition to relying solely on traditional air quality control strategies.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.1101\/2025.07.15.25331618","type":"posted-content","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:05:32Z","timestamp":1752710732000},"source":"Crossref","is-referenced-by-count":1,"title":["Cardiopulmonary hospitalization risks from wildfire and non-wildfire PM\n                  <sub>2.5<\/sub>\n                  in 20 US states"],"prefix":"10.64898","author":[{"given":"Min","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghao","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdieh Danesh","family":"Yazdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind J.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel D.","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert O.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaguang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"issue":"3","key":"2025071804501063000_2025.07.15.25331618v1.1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/CM9.0000000000002218","article-title":"Ambient fine particulate matter and cardiopulmonary health risks in China","volume":"136","year":"2023","journal-title":"Chinese medical journal"},{"key":"2025071804501063000_2025.07.15.25331618v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076322"},{"key":"2025071804501063000_2025.07.15.25331618v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076939"},{"key":"2025071804501063000_2025.07.15.25331618v1.4","doi-asserted-by":"crossref","first-page":"100603","DOI":"10.1016\/j.envadv.2024.100603","article-title":"An update on adverse health effects from exposure to PM2.5","volume":"18","year":"2024","journal-title":"Environmental Advances"},{"issue":"1","key":"2025071804501063000_2025.07.15.25331618v1.5","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1038\/s43247-025-02314-0","article-title":"Anthropogenic climate change contributes to wildfire particulate matter and related mortality in the United States","volume":"6","year":"2025","journal-title":"Communications earth & environment"},{"key":"2025071804501063000_2025.07.15.25331618v1.6","doi-asserted-by":"crossref","unstructured":"Qiu M , Li J , Gould CF , et al. 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