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As climate change drives longer and more intense wildfire seasons, wildfire PM\n                      <jats:sub>2.5<\/jats:sub>\n                      may contribute to more frequent headaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Our study included adult Californian members (aged \u226518\u2009years) of a large de\u2010identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension\u2010type headache, migraine headache, cluster headache, and \u201cother\u201d primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire\u2010specific PM\n                      <jats:sub>2.5<\/jats:sub>\n                      to residential zip code and conducted a time\u2010stratified case\u2010crossover analysis considering 7\u2010day average PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentrations, first for primary headache disorders combined, and then by headache subtype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a05534\/13,623 [47.6%]) followed by \u201cother\u201d primary headache (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a06489\/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7\u2010day average wildfire PM\n                      <jats:sub>2.5<\/jats:sub>\n                      (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95\u20131.44 per 10\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      increase) and by subtype we observed increased odds of ED visits associated with 7\u2010day average wildfire PM\n                      <jats:sub>2.5<\/jats:sub>\n                      for tension\u2010type headache (OR 1.42, 95% CI 0.91\u20132.22), \u201cother\u201d primary headache (OR 1.40, 95% CI 0.96\u20132.05), and cluster headache (OR 1.29, 95% CI 0.71\u20132.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM\n                      <jats:sub>2.5<\/jats:sub>\n                      was associated with tension\u2010type headache (OR 1.29, 95% CI 1.03\u20131.62), but not migraine, cluster, or \u201cother\u201d primary headaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Although imprecise, these results suggest short\u2010term wildfire PM\n                      <jats:sub>2.5<\/jats:sub>\n                      exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache\u2010related healthcare needs in the wake of wildfires and on poor air quality days.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14442","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T07:05:31Z","timestamp":1674025531000},"page":"94-103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Wildfire smoke exposure and emergency department visits for headache: A case\u2010crossover analysis in California, 2006\u20132020"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1781-904X","authenticated-orcid":false,"given":"Holly","family":"Elser","sequence":"first","affiliation":[{"name":"Department of Neurology Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Population Health Sciences Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian T.","family":"Rowland","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences Columbia Mailman School of Public Health  New\u00a0York New York USA"},{"name":"PSE Healthy Energy  Oakland New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maksym S.","family":"Marek","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew V.","family":"Kiang","sequence":"additional","affiliation":[{"name":"Epidemiology and Population Health Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Shea","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences Columbia Mailman School of Public Health  New\u00a0York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Do","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences Columbia Mailman School of Public Health  New\u00a0York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"Benmarhnia","sequence":"additional","affiliation":[{"name":"Scripps Institution of Oceanography University of California, San Diego  La\u00a0Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L. 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