CO-exposure to wildfire smoke and extreme heat:… (F31ES039535) – Project Grant to University Of Washington

Abstract: The united states (U.S.) is in a mental health crisis. Mental health services face a trifecta of challenges: rising demand, fewer available providers, and widening insurance coverage gaps. The mental health crisis is driven by many clinically relevant factors, including genetics, economic instability, affordable housing shortages, and sustained social isolation from the covid-19 pandemic. An understudied driver of adverse mental health is environmental exposures, particularly those from extreme weather events, such as wildfires and extreme heat, which are increasing in frequency and severity, especially in the western US. There is strong biological plausibility for the extreme weather-mental illness relationship, including wildfire smoke-induced oxidative stress in the brain and heat-induced neuroinflammation. Thus, IT is critical to understand the influence of wildfire smoke exposure and extreme heat, and their CO-occurrence, on clinical manifestations of mental illness and to develop prepared- ness measures across mental health care settings. As the least air-conditioned state in the U.S. With historically mild to moderate weather, washington state (WA) may be especially ILL-equipped to safeguard residents' mental health from these growing threats. A critical research GAP remains about (1) households' perceptions of and preparedness for wildfire smoke, extreme heat, and the associated mental health impacts, and (2) the associa- tion between short-term wildfire smoke and extreme heat exposure and acute care-seeking for adverse mental health in WA. This project will examine the effects of wildfire fine particulate matter (PM2.5) and extreme heat on both self-reported mental health in 2025 and mental health-related acute care visits in WA from 2016 to 2022. Our overarching hypothesis is that smoke and heat-related mental health perceptions and preparedness are shaped by household-level factors, with short-term exposure to wildfire PM2.5 and extreme heat, individually and in combination, increasing the risk of emergency department (ED) visits for all-cause and cause-specific mental health conditions. To test this hypothesis, we aim to (1) assess household perceptions, preparedness, and men- TAL health needs related to wildfire smoke and extreme heat risk in an overburdened community in eastern WA through a cross-sectional, rapid needs survey, (2) evaluate the association between short-term wildfire PM2.5 exposure and all-cause and cause-specific mental health ED visits, and (3) evaluate the association between short-term wildfire smoke and extreme heat CO-exposure and all-cause and cause-specific mental health ED visits. This proposed research incorporates a rigorous training plan, including academic and scientific support for the applicant's success in epidemiologic and causal inference methods, psychiatric outcome ascertainment and etiology, exposure assessment, survey design, community-engaged research, scientific writing, and profes- sional development. Research will be supported by an interdisciplinary team at the university of WA and WA state department of health. Collectively, this project will provide the necessary evidence to inform household and healthcare preparedness and response, safeguarding mental health from extreme weather events.

CO-exposure to wildfire smoke and extreme heat: impacts on psychiatric emergency department visits and community perceptions and preparedness in washington state

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