Introduction: Wildfires are an increasing global threat, exposing over 2 billion people annually to hazardous air quality. Children from low socioeconomic status (SES) regions often experience worse respiratory outcomes during wildfires compared to their higher SES peers. However, direct data on wildfire impacts remains limited. This study examines whether wildfires exacerbate respiratory health disparities compared to non-wildfire periods. Methods: A retrospective cohort study of 2,417 patients aged 0-29 years admitted to a quaternary Pediatric Intensive Care Unit for acute respiratory failure from 2016-2023 was conducted. Data were collected from Virtual Pediatric Systems, the Area Deprivation Index (ADI), Fire Information for Resource Management, and the Air Quality System, and merged using zip codes. The Wildfire cohort included children with a wildfire within 100 miles, confirmed by satellite, and PM2.5 levels in the 10 days before admission exceeding 1 standard deviation above the annual mean. Non-wildfire patients were all other respiratory failure admissions in the same period. SES was defined by ADI quintiles, with low and high SES representing the lowest and highest quintiles. Statistical analyses included Fisher’s exact test, Mann-Whitney U test, and logistic regression. Results: During wildfires, children from low SES backgrounds had a significantly higher risk of intubation than in non-wildfire times (29% vs. 13%, p = .003), a difference not observed in high SES children (8% vs. 10%, p = 0.49). Logistic regression showed that wildfire exposure and low SES together increased intubation odds (OR = 2.7, p = .04). Higher Pediatric Index of Mortality 3 (PIM3) scores also raised intubation risk (OR = 1.3, p < .001) while other investigated demographic factors did not. Conclusion: This study underscores the elevated respiratory risks for low-SES children during wildfires. Additional research and greater public health awareness can inform targeted interventions and disaster preparedness to protect these vulnerable populations as wildfire frequency increases.
Henning et al. (Sun,) studied this question.