Smoke exposure from a fertilizer plant fire is associated with cardiovascular and respiratory hospital encounters

While wildfire smoke is associated with adverse respiratory and cardiovascular health outcomes, industrial fires are less researched. Between January 31 and 6 February 2022, a fire burned at a North Carolina fertilizer company. We examined whether populations living within 25-miles of the fertilizer plant had increased health services utilization during the fire week and following week. Inpatient, outpatient and observation/emergency department (ED) encounters with diagnosis codes for cardiovascular and respiratory diseases and injuries at four medical centers were identified for the fire week and comparison weeks. Smoke exposure was estimated by ZIP code using a Hybrid Single-Particle Lagrangian Integrated Trajectory dispersion model and categorized (high, moderate, low, none). Negative binomial regression estimated associations between smoke exposure levels and counts of encounters in outpatient, inpatient, and ED/observation settings. High smoke exposure was associated with a 78% greater rate of respiratory encounters across all settings (IRR = 1.78, 95% CI 1.25-2.57) compared to no smoke exposure. Each additional day with any smoke exposure was associated with a 28% greater rate of respiratory encounters (IRR = 1.28, 95% CI 1.11-1.49). Populations exposed to industrial fire smoke may have increased healthcare utilization, potentially informing resource planning.