摘要：AbstractAlaskan wildfires have major ecological, social, and economic consequences, but associated health impacts remain unexplored. We estimated cardiorespiratory morbidity associated with wildfire smoke (WFS) fine particulate matter with a diameter less than 2.5 μm (PM2.5) in three major population centers (Anchorage, Fairbanks, and the Matanuska‐Susitna Valley) during the 2015–2019 wildfire seasons. To estimate WFS PM2.5, we utilized data from ground‐based monitors and satellite‐based smoke plume estimates. We implemented time‐stratified case‐crossover analyses with single and distributed lag models to estimate the effect of WFS PM2.5on cardiorespiratory emergency department (ED) visits. On the day of exposure to WFS PM2.5, there was an increased odds of asthma‐related ED visits among 15–65 year olds (OR = 1.12, 95% CI = 1.08, 1.16), people >65 years (OR = 1.15, 95% CI = 1.01, 1.31), among Alaska Native people (OR = 1.16, 95% CI = 1.09, 1.23), and in Anchorage (OR = 1.10, 95% CI = 1.05, 1.15) and Fairbanks (OR = 1.12, 95% CI = 1.07, 1.17). There was an increased risk of heart failure related ED visits for Alaska Native people (Lag Day 5 OR = 1.13, 95% CI = 1.02, 1.25). We found evidence that rural populations may delay seeking care. As the frequency and magnitude of Alaskan wildfires continue to increase due to climate change, understanding the health impacts will be imperative. A nuanced understanding of the effects of WFS on specific demographic and geographic groups facilitates data‐driven public health interventions and fire management protocols that address these adverse health effects.Plain Language SummaryThe Alaskan wildfire season is getting longer, and large fires are becoming more common. We do not know how the smoke from these fires is affecting the health of Alaskans. In this study, we evaluated the associations between wildfire smoke exposure and cardiorespiratory visits to the ED in three major population centers where the majority of the Alaskan population lives: Anchorage, Fairbanks, and Matanuska‐Susitna Valley. We found that as the concentration of wildfire smoke increases, there are more likely to be visits to the ED for asthma, particularly among people older than 15 years of age, women, Alaska Native people, and people living in Anchorage and Fairbanks. Similarly, we found that Alaska Native people were more likely to visit the ED for cardiovascular issues than non‐Alaska Native people. Among people living in rural areas in the Matanuska‐Susitna Valley, we observed an initial decrease in cardiovascular ED visits on the day of exposure to wildfire smoke, but then these visits increased 2–3 days later. Understanding how wildfire smoke impacts specific demographic and geographic groups facilitates data‐driven public health interventions and fire management protocols that address these adverse health effects.Key PointsThe size and frequency of wildfires in Alaska are increasing, but there are no assessments of the direct health impacts of these eventsIn Alaska, wildfire smoke is positively associated with asthma emergency room visits, and this varies by age, sex, race, and geographyAlaska Native people had a higher risk of several cardiovascular outcomes during wildfire events
