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Abstract: TH-OR50

Exposure to Wildfire-Related Particulate Matter and Risk of Hospitalization and Mortality Among Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Song, Hyeonjin, The University of Maryland, College Park, Maryland, United States
  • Sieck, Nicole E., The University of Maryland, College Park, Maryland, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Maddux, Franklin W., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
  • Ellicott, Evan A., The University of Maryland, College Park, Maryland, United States
  • Sapkota, Amir, The University of Maryland, College Park, Maryland, United States
Background

Ongoing climate change is contributing to increases in frequency and severity of wildfires and the length of wildfire season. Wildfires are major sources of air pollution including fine particulate matter (aerodynamic diameter < 2.5 microns; PM2.5) that may disproportionately impact vulnerable populations such as hemodialysis patients. We investigated the effect of wildfire-related PM2.5 on hospitalization and mortality risk among hemodialysis patients.

Methods

We analyzed health records of 79,963 hemodialysis patients who received in-center hemodialysis treatment at 191 Fresenius Kidney Care clinics in Washington, Oregon, and California during 2005-2018. We estimated wildfire-related PM2.5 for each of the clinics using satellite-derived smoke polygons (Hazard Mapping System) and ground-based PM2.5 monitors (Air Quality System operated by Environmental Protection Agency). We conducted a time-stratified case-crossover analysis with a conditional Poisson model to investigate the association between exposure to wildfire-related PM2.5 and risk of hospitalization and mortality among hemodialysis patients.

Results

The daily wildfire-related PM2.5 concentration during the study period ranged from 0 to 551.3µg/m3 with the average of 0.7µg/m3 (SD=5.7µg/m3). A 10µg/m3 increase in wildfire-related PM2.5 was associated with 1% higher risk of all-cause hospitalization (RR: 1.01, 95% CI: 0.99, 1.02), and 4% higher risk of all-cause mortality (RR: 1.04, 95% CI: 1.02, 1.06).

Conclusion

We observed positive associations between increases in wildfire-related PM2.5 concentration and risk of all-cause hospitalization and mortality. Our findings highlight the need for targeted intervention, including early warnings, timely relocation of patients during wildfire events or improved air filtration systems to mitigate the adverse health effects of wildfire-related air pollution.