Monitoring Emergency Department Visits for Health Effects of Wildfires Using Syndromic Surveillance in Oregon: An Example of How Regions Can Use Essence to Plan for Natural and Unplanned Disasters

BACKGROUND:   Oregon’s Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) provides near real-time data for public health professionals and hospitals to monitor what is happening in emergency departments across the state. Public health practitioners can use ESSENCE to provide information on Emergency Department (ED) visits to prepare for natural and unplanned disasters, including wildfires. To address the gap of knowledge regarding wildfire-related health effects, the present analysis uses ESSENCE as a tool to review retrospective data on wildfire-related ED visits. Data yielded from this analysis will inform hospitals and public health workers on mitigation strategies, risk communication and surge capacity planning for the upcoming wildfire season. 

METHODS:  We conducted a retrospective review of ED data, including chief complaints and discharge data, from Oregon hospitals in six regions during wild-fire related particulate matter (PM 2.5) in the summer of 2014. We used a combination of satellite air quality data and syndromic surveillance data to bring awareness of prevalent health issues during wildfires and exemplify utilization of ESSENCE. We obtained daily counts of ED visits from ESSENCE with date and time of admission, county of residence, zip code, gender, race, ethnicity, chief complaint and discharge ICD-9-CM codes. In the study presented here, we queried wildfire-related, eye, head, respiratory and cardiovascular ED visits. We extracted data on air quality from Oregon Department of Environmental Quality (DEQ). To assess the burden of wildfires, we conducted descriptive analysis on each specific region by counting number of visits, looking at proportions of wildfire related chief complaints out of the total number of emergency department visits. To gain an understanding of how air quality changed during the fires and if poor air quality occurred on days ED visits spiked, concentrations of fine particulate matter (PM 2.5) from smoke forecasting models were averaged to the regions before and after a wildfire.

RESULTS:   Initial results from the analysis of wildfire-related ED visits will be presented and analytic issues will be discussed. Any patterns viewed in the data will be shared with ESSENCE users to help with the preparation of the next wildfire season. 

CONCLUSIONS: This case study can be used as a tool for public health professionals in planning for wildfires and other natural disasters as well as a training tool for other potential data users. For example, data users can replicate the present ESSENCE analysis by making similar queries tailored to their own region.