Five-Part Action Plan For Patients With Asthma, COPD Helps to Alleviate Wildfire-Related Health Risks

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According to research published in the Chronic Obstructive Pulmonary Disease Foundation’s journal, communities that are impacted by an increased wildfire activity and smoke can utilize a population health-based action plan to help alleviate health risks, notably for those who have asthma or chronic obstructive pulmonary disease (COPD). The perspective article introduces a 5-part Wildfire Population Health Approach initiated by the University of California, Davis Health (UCDH); however, the authors note that additional support is needed from health care professionals to implement this method in health systems.¹

“Air pollutants from wildfires negatively affect everyone and are particularly dangerous for those with respiratory diseases like COPD and asthma as the pollutants increase lung inflammation,” said study co-author Reshma Gupta, MD, MSHPM, chief of Population Health and Accountable Care at UCDH, in a news release. “This approach uses new technologies and population health methods to identify those at risk of wildfire smoke-induced health complications and to put interventions in place to mitigate the negative impact of poor air quality on the community.”¹

Multiple components of wildfire smoke can have negative or adverse impacts on the individual’s health, including particulate matter, carbon dioxide, water vapor, carbon monoxide, hydrocarbons, nitrogen oxides, and trace minerals. These components can irritate the eyes and respiratory tract and lead to cough, phlegm, wheezing, difficulty breathing, or exacerbate pre-existing health conditions such as cardiovascular conditions, as well as the respiratory and circulatory systems.²

According to the authors, the communities that are most vulnerable to wildfires or wildfire smoke are often from underserved areas that are impacted negatively by social determinants of health. Insufficient access to health care can further inhibit health care professionals’ visibility into the problem; therefore, the investigators urge that health systems must identify high-risk populations for adverse health outcomes.²

In the 5-item Wildfire Population Health Approach plan, the authors suggest that this approach can help health care professionals engage with community organizations and public health data to help clinically at-risk and underserved populations. The plan consists of the following 5 items: identify clinically at-risk and underserved patient populations using validated and condition-targeted registries; assemble multidisciplinary care teams (consisting of community organizations, environmental scientists, public health professionals, among others) to better understand the specific needs of the communities and patients; create custom analytics that use public health data to stratify wildfire risk; develop care pathways based on wildfire risk by risk of exposure, disease, and access to health care; and identify outcome measures that are personalized to interventions that will continue to improve efforts.²

“This population health-based approach not only helps us lessen the negative impact of wildfire smoke on those with COPD or asthma, but also increases our ability to identify those at high risk of developing these respiratory diseases,” said Gupta in the news release. “Much of the data we use in our approach comes from detailed air quality and wildfire maps throughout the US, so other health care teams across the county could adopt a similar strategy. Leveraging these data will allow us to help reduce the impact of poor air quality and improve the health of those in our community.”¹

The authors emphasize that in the coming years, there is an urgent need to better prepare health systems, health care professionals, and communities to better manage the health impacts and detrimental consequences that environmental events can have. With climate change and increasingly frequent wildfires threatening the health of communities, health systems can adapt to this by adopting the 5-plan approach or developing one of their own that is air quality-focused.²

“Over many years, we watched the increasingly frequent and significant impact of wildfires on the patients in our COPD clinic, including exacerbations and impaired access to medications. We wanted to do more than provide treatment after the fact,” said study co-author Brooks Kuhn, MD, co-director of UCDH’s Comprehensive COPD Clinic and medical director of UCDH’s Department of Respiratory Care, in the news release. “Through collaboration with our Population Health team, we built resources—and systems to deliver them at the right time—to support and educate high-risk patients, such as those with COPD and asthma, before and during wildfires, not after.”¹

References

1. COPD Foundation. People with COPD, asthma have higher risk of health problems from increased wildfire activity, smoke. News release. August 14, 2024. Accessed August 14, 2024. Email.

2. Kuhn BT, Gupta R. Improving wildfire readiness among patients with chronic obstructive pulmonary disease and asthma: applying a population health approach to climate change. Chronic Obstr Pulm Dis. 2024; 11(4): 427-435. doi: 10.15326/jcopdf.2024.0509