AAAAI: Protecting Patients With Asthma During Wildfire Season

In an interview with Pharmacy Times, Meghan Rebuli, PhD, assistant professor in the Division of Pediatric Allergy and Immunology at the University of North Carolina School of Medicine, discussed findings from her session, “Effects of Wildfires on Asthma Incidence and Morbidity,” presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting in Philadelphia, Pennsylvania.

Rebuli highlighted growing epidemiologic evidence linking wildfire smoke exposure to increased asthma-related morbidity, including higher rates of emergency department visits, greater use of respiratory medications, and worsening respiratory symptoms.

She noted that studies demonstrate that for every 10-µg/m³ increase in wildfire-related particulate matter (PM2.5), there is a measurable rise in asthma exacerbations and health care utilization. PM2.5 particles are extremely small—small enough to penetrate deep into the lower airways—raising particular concern for patients with underlying respiratory disease. Importantly, wildfire PM2.5 is not compositionally identical to traffic-related or ambient particulate matter. Combustion processes generate complex mixtures, including volatile organic compounds and polycyclic aromatic hydrocarbons, which may have additional airway-irritating and toxic properties.

Vulnerable populations include children, older adults, and individuals with preexisting asthma or chronic obstructive pulmonary disease. Emerging data suggest that even infants exposed within the first months of life may demonstrate earlier and increased respiratory medication use following wildfire events.

Rebuli emphasized mitigation strategies, including staying indoors, using air recirculation settings, minimizing indoor pollution sources, and creating HEPA-filtered clean rooms. However, medication preparedness remains critical.

For pharmacists, proactive outreach is essential. Ensuring patients maintain access to controller therapies, reinforcing appropriate rescue inhaler use, and encouraging early prescription refills ahead of wildfire events can reduce preventable exacerbations and health care utilization.