Using Low-Cost Sensors to Assess Fine Particulate Matter Infiltration (PM2.5) during a Wildfire Smoke Episode at a Large Inpatient Healthcare Facility

Seasons of smoke and fire: preparing health systems for improved performance before, during, and after wildfires

Increased frequency, intensity, and duration of wildfires are intensifying exposure to direct and smoke-related hazards in many areas, leading to evacuation and smoke-related effects on health and health systems that can affect regions extending over thousands of kilometres. Effective preparation and response are currently hampered by inadequate training, continued siloing of disciplines, insufficient finance, and inadequate coordination between health systems and governance at municipal, regional, national, and international levels. This Review highlights the key health and health systems considerations before, during, and after wildfires, and outlines how a health system should respond to optimise population health outcomes now and into the future. The focus is on the implications of wildfires for air quality, mental health, and emergency management, with elements of international policy and finance also addressed. We discuss commonalities of existing climate-resilient health care and disaster management frameworks and integrate them into an approach that addresses issues of financing, leadership and governance, health workforce, health information systems, infrastructure, supply chain, technologies, community interaction and health-care delivery, before, during, and after a wildfire season. This Review is a practical briefing for leaders and health professionals facing severe wildfire seasons and a call to break down silos and join with other disciplines to proactively plan for and fund innovation and coordination in service of a healthier future.

Data Linkages for Wildfire Exposures and Human Health Studies: A Scoping Review

Wildfires are increasing in frequency and intensity, with significant consequences that impact human health. A scoping review was conducted to: (a) understand wildfire-related health effects, (b) identify and describe environmental exposure and health outcome data sources used to research the impacts of wildfire exposures on health, and (c) identify gaps and opportunities to leverage exposure and health data to advance research. A literature search was conducted in PubMed and a sample of 83 articles met inclusion criteria. A majority of studies focused on respiratory and cardiovascular outcomes. Hospital administrative data was the most common health data source, followed by government data sources and health surveys. Wildfire smoke, specifically fine particulate matter (PM2.5), was the most common exposure measure and was predominantly estimated from monitoring networks and satellite data. Health data were not available in real-time, and they lacked spatial and temporal coverage to study health outcomes with longer latency periods. Exposure data were often available in real-time and provided better temporal and spatial coverage but did not capture the complex mixture of hazardous wildfire smoke pollutants nor exposures associated with non-air pathways such as soil, household dust, food, and water. This scoping review of the specific health and exposure data sources used to underpin these studies provides a framework for the research community to understand: (a) the use and value of various environmental and health data sources, and (b) the opportunities for improving data collection, integration, and accessibility to help inform our understanding of wildfires and other environmental exposures.

Clearing the Air: Understanding the Impact of Wildfire Smoke on Asthma and COPD

Wildfires are a global natural phenomenon. In North America, wildfires have not only become more frequent, but also more severe and longer in duration, a trend ascribed to climate change combined with large fuel stores left from modern fire suppression. The intensification of wildfire activity has significant implications for planetary health and public health, as exposure to fine particulate matter (PM2.5) in wildfire smoke is linked to adverse health effects. This review focuses on respiratory morbidity from wildfire smoke exposure. Inhalation of wildfire PM2.5 causes lung injury via oxidative stress, local and systemic inflammation, airway epithelium compromise, and increased vulnerability to infection. Wildfire PM2.5 exposure results in exacerbations of pre-existing asthma and chronic obstructive pulmonary disease, with an escalation in healthcare utilization, including emergency department visits and hospitalizations. Wildfire smoke exposure may be associated with asthma onset, long-term impairment of lung function, and increased all-cause mortality. Children, older adults, occupationally-exposed groups, and possibly women are the most at risk from wildfire smoke. Future research is needed to clarify best practices for risk mitigation and wildfire management.

Fundamentals of low-cost aerosol sensor design and operation

Most evaluations of low-cost aerosol sensors have focused on their measurement bias compared to regulatory monitors. Few evaluations have applied fundamental principles of aerosol science to increase our understanding of how such sensors work and could be improved. We examined the Plantower PMS5003 sensor's internal geometry, laser properties, photodiode responses, microprocessor output, flow rates, and response to mono- and poly-disperse aerosols. We developed a physics-based model of particle light scattering within the sensor, which we used to predict counting and sizing efficiency for 0.30 to 10 μm particles. We found that the PMS5003 counts single particle scattering events, acting like an imperfect optical particle counter, rather than a nephelometer. As particle flow is not focused into the core of the laser beam, >99% of particles that flow through the PMS5003 miss the laser, and those that intercept the laser usually miss the focal point and are subsequently undersized, resulting in erroneous size distribution data. Our model predictions of PMS5003 response to varying particle diameters, aerosol compositions, and relative humidity were consistent with laboratory data. Computational fluid dynamics simulations of the PurpleAir monitor housing showed that for wind-speeds less than 3 m s-1, fine and coarse particles were representatively aspired to the PMS5003 inlet. Our measurements and models explain why the PurpleAir overstates regulatory PM2.5 in some locations but not others; why the PurpleAir PM10 is unresponsive to windblown dust; and why it reports a similar particle size distribution for coarse particles as it does for smoke and ambient background aerosol.

Fine particulate matter infiltration at Western Montana residences during wildfire season

BACKGROUND/AIMS

Wildfire air pollution is a growing public health concern as wildfires increase in size, intensity, and duration in the United States. The public is often encouraged to stay indoors during wildfire smoke events to reduce exposure. However, there is limited information on how much wildfire smoke infiltrates indoors at residences and what household/behavioral characteristics contribute to higher infiltration. We assessed fine particulate matter (PM2.5) infiltration into Western Montana residences during wildfire season.

METHODS

We measured continuous outdoor and indoor PM2.5 concentrations from July-October 2022 at 20 residences in Western Montana during wildfire season using low-cost PM2.5 sensors. We used paired outdoor/indoor PM2.5 data from each household to calculate infiltration efficiency (Finf; range 0-1; higher values indicate more outdoor PM2.5 infiltration to the indoor environment) using previously validated methods. Analyses were conducted for all households combined and for various household subgroups.

RESULTS

Median (25th percentile, 75th percentile) daily outdoor PM2.5 at the households was 3.7 μg/m3 (2.1, 7.1) during the entire study period and 29.0 μg/m3 (19.0, 49.4) during a 2-week period in September impacted by wildfire smoke. Median daily indoor PM2.5 at the households was 2.5 μg/m3 (1.3, 5.5) overall and 10.4 μg/m3 (5.6, 21.0) during the wildfire period. Overall Finf was 0.34 (95 % Confidence Interval [95%CI]: 0.33, 0.35) with lower values during the wildfire period (0.32; 95%CI: 0.28, 0.36) versus non-wildfire period (0.39; 95%CI: 0.37, 0.42). Indoor PM2.5 concentrations and Finf varied substantially across household subgroups such as household income, age of the home, presence of air conditioning units, and use of portable air cleaners.

CONCLUSIONS

Indoor PM2.5 was substantially higher during wildfire-impacted periods versus the rest of the study. Indoor PM2.5 and Finf were highly variable across households. Our results highlight potentially modifiable behaviors and characteristics that can be used in targeted intervention strategies.

The application of portable air cleaners in spaces occupied by vulnerable people during wildfire events

In this study, PM2.5 concentrations were collected and documented during wildfire smoke impacted days using PurpleAir PA-II sensors at three different locations in a community located in the northwestern United States. Each location was comprised of three co-located sensors with one sensor positioned outdoors, one sensor indoors, and one sensor indoors with an air cleaner in the room. The relationship between both indoor and outdoor PM2.5 concentrations provided evidence on the effectiveness of sheltering indoors from wildfire smoke events with and without an air purification system.

Protecting Cardiovascular Health From Wildfire Smoke

Wildfire smoke is a rapidly growing threat to global cardiovascular health. We review the literature linking wildfire smoke exposures to cardiovascular effects. We find substantial evidence that short-term exposures are associated with key cardiovascular outcomes, including mortality, hospitalization, and acute coronary syndrome. Wildfire smoke exposures will continue to increase over the majority of Earth's surface. For example, the United States alone has experienced a 5-fold increase in annual area burned since 1972, with 82 million individuals estimated to be exposed to wildfire smoke by midcentury. The associated rise in excess morbidity and mortality constitutes a growing global public health crisis. Fortunately, the effect of wildfire smoke on cardiovascular health is modifiable at the individual and population levels through specific interventions. Health systems therefore have an opportunity to help safeguard patients from smoke exposures. We provide a roadmap of evidence-based interventions to reduce risk and protect cardiovascular health. Key interventions include preparing health systems for smoke events; identifying and educating vulnerable patients; reducing outdoor activities; creating cleaner air environments; using air filtration devices and personal respirators; and aggressive management of chronic diseases and traditional risk factors. Further research is needed to test the efficacy of interventions on reducing cardiovascular outcomes.

Cumulative Impacts of Diverse Land Uses in British Columbia, Canada: Application of the "EnviroScreen" Method

(1) Objectives: Cumulative impacts refer to the legacies of land use decisions on environmental, community and health values. New integrative impact assessment tools are required to assess cumulative impacts on diverse values to meet sustainability goals in the 21st century. In this contribution, the CalEnviroScreen methodology-a screening tool capable of merging environmental, socioeconomic and health data-is applied to Local Health Areas in British Columbia, Canada. (2) Methods: The CalEnviroScreen is a method that standardizes environmental, socioeconomic and health data to depict an indicator's percentile rank in the distribution of all units of analysis. The method combines indicators to measure four dimensions of pressure: environmental exposures, environmental effects, socioeconomic conditions, and sensitive populations (i.e., health outcomes). We create two versions of EnviroScreen: one following the CalEnviroScreen suite of indicators, and another that uses nuanced indicators to approximate the realities of industrial land uses present in British Columbia. BCEnviroScreen scores are plotted by race/ethnicity to understand potential racial inequities in cumulative exposures. (3) Results: The BCEnviroScreen has a greater likelihood of quantifying the cumulative impacts of diverse industries and land uses present across resource-dependent parts of the province, relative to the more urban-centric CalEnviroScreen indicator suite. Analyzing the distribution of BCEnviroScreen scores by race/ethnicity suggests that visible minority populations may be inequitably exposed to cumulative impacts in BC. (4) Conclusion: EnviroScreen tools hold significant potential to influence Canadian environmental health policy. This research demonstrates the applicability of the tool to British Columbia and other jurisdictions, illustrates how indicators can be tailored to better represent regional context, and shows how the tool can be used to screen for potential environmental health injustices.

Outdoor and indoor fine particulate matter at skilled nursing facilities in the western United States during wildfire and non-wildfire seasons

Wildfire activity is increasing in parts of the world where extreme drought and warming temperatures contribute to fireprone conditions, including the western United States. The elderly are among the most vulnerable, and those in long-term care with preexisting conditions have added risk for adverse health outcomes from wildfire smoke exposure. In this study, we report continuous co-located indoor and outdoor fine particulate matter (PM_2.5 ) measurements at four skilled nursing facilities in the western United States. Throughout the year 2020, over 8000 h of data were collected, which amounted to approximately 300 days of indoor and outdoor sampling at each facility. The highest indoor 24 h average PM_2.5 recorded at each facility was 43.6 µg/m³ , 103.2 µg/m³ , 35.4 µg/m³ , and 202.5 µg/m³ , and these peaks occurred during the wildfire season. The indoor-to-outdoor PM_2.5 ratio and calculated infiltration efficiencies indicated high variation in the impact of wildfire events on Indoor Air Quality between the four facilities. Notably, infiltration efficiency ranged from 0.22 to 0.76 across the four facilities. We propose that this variability is evidence that PM_2.5 infiltration may be impacted by modifiable building characteristics and human behavioral factors, and this should be addressed in future studies.

Development of IoT-Based Particulate Matter Monitoring System for Construction Sites

Particulate matters (PMs) generated on construction sites can pose serious health risks to field workers and residents living near construction sites. PMs are generated in a wide range of locations; therefore, they must be managed in real time at various locations within construction sites for practical management of the PMs. However, no such systems exist currently. Therefore, this study aims to develop a system that can manage PMs in real time at multiple locations in a construction site using the Internet of Things technology. Accordingly, measuring instrument, network, and program services were developed as system components, while considering the characteristics of construction sites, and the construction site PM monitoring system was developed by integrating these components. Finally, performance certification and field application tests were performed to verify the developed system. The construction site PM monitoring system (CPMS) achieved grade 1 for reproducibility, relative precision, and data acquisition rate, and grade 2 for accuracy and coefficient of determination. Thus, it received a performance certification of grade 2, in total. In particular, regarding accuracy, which is a shortcoming of the light-scattering method and represents the accuracy of measurements, the CPMS was found to have an accuracy of 74.2%.