The U.S. health care system is ill-prepared to treat pregnant patients and their infants who have endured the impacts of wildfire smoke exposure, a new study finds.
Many residents of communities prone to the proliferation of wildfire smoke lack geographic access to the treatments they might need, according to the study, published in the American Public Health Association’s Medical Care journal.
“The smoke-plumes generated by wildfires can be transported over large distances and affect nearly every community in the U.S., even those far from fire activity,” the authors stated.
The researchers, from the University of Maryland and the Children’s Hospital of Philadelphia, warned that exposure to smoke during pregnancy “has been linked to adverse birth outcomes.”
“Impacts on pregnant people have been less well studied, but the pollutants carried by smoke increase hypertensive disorders of pregnancy, gestational diabetes, and cardiovascular events,” the scientists noted.
To identify the geographic bounds of wildfire smoke plumes, the researchers harnessed existing data from National Oceanic and Atmospheric Administration satellite sensors.
They then collected county-level information on demographics, number of births and locations of maternity care and neonatal units, as well as the availability of OB-GYN services and family practice physicians. The assessments also included measurements of fine particulate matter — PM 2.5 — that were attributable to wildfire smoke.
The scientists found that the average annual number of smoke days during the 2016 to 2020 study period ranged from 3.8 in low-risk counties to 15.3 in higher-risk regions.
Some of the most affected counties located on the West Coast had more than 35 such days each year, although the Northern Rockies and portions of the Midwest also had their fair share of elevated smoke days, the researchers found.
The average concentration of PM 2.5 in high-risk counties was more than double that of low-risk areas, according to the study.
Ultimately, the scientists determined that 7.3 million women of reproductive age lived in the high-risk counties during the study period, and nearly 460,500 infants were born to them.
They also found significant discrepancies in perinatal resource distribution according to regional smoke-risk categories.
For example, the data showed that the number of OB-GYN physicians per 10,000 births was 61 in low-risk counties, 33 in moderate-risk counties and zero in high-risk counties.
As for the median distance to the nearest maternity care hospital, the respective mileage was 8, 13 and 22. And when it came to the nearest neonatal care facility, those ranges grew to 34, 44 and 72 miles.
“Communities at high risk of smoke exposure appeared to be particularly constrained, beyond what their other characteristics would predict,” the authors stated.
Although the researchers said that certain at-home measures — such as installing air filters and sealing buildings — can help mitigate the effects of smoke exposure, they stressed that these actions are by no means sufficient.
“Millions of reproductive age women and their infants are being exposed and many will need timely treatment,” they said. “Policymakers and clinicians seeking to meet the challenges of climate change must consider these constraints in devising appropriate responses.”
