Nursing Research and Advocacy Promotes Health during Wildfire Smoke

Julie Postma, PhD, RN (See bio below)

My work in public/community/population health nursing has focused on research, representation and advocacy for people experiencing environmental health risks, especially among those with asthma. Witnessing the impact that wildfire smoke has had on the quality of life among people living in the Western U.S. prompted me to design and test innovations to minimize risk among those vulnerable to the damaging effects of breathing wildfire smoke.

Multiple sub-populations are at risk from harmful effects of breathing fine particulate matter (PM2.5). Our interdisciplinary team has focused on two: young adults with asthma and agricultural workers. While we know that breathing fine particulate matter can lead to emergency room admissions and hospitalizations related to respiratory and cardiovascular health effects, we know very little about the impact that air quality alerts have on human behavior to minimize exposure.

In a recent publication in Public Health Nursing, we report on a study exploring the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during the 2020 wildfire season. Sixty-seven young adults aged 18-26 were enrolled and randomized to one of three groups. Both intervention arms could access Smoke Sense Urbanova (Smoke Sense was developed by the EPA and duplicated for our study by our tech partner Urbanova), an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova-Plus arm also received air quality notifications, accessed preventive tips and a message board and used a mobile spirometer to monitor their forced expiratory volume in one second (FEV1) daily.  Although the app is not yet ready for “prime-time,” our successes in being funded by the National Institute of Nursing Research, recruiting through universities in the Western U.S., and retaining young adults in the study speaks to the urgency of identifying strategies to reduce risk and promote health amidst a changing climate.

Agricultural workers are facing unprecedented exposures to wildfire smoke. California, Oregon, and Washington have all passed emergency rules for workplace exposure to wildfire smoke. In general, the rules require employers to monitor PM2.5 daily and convert it to the air quality index for PM2.5, communicate the wildfire smoke hazard to employees, train employees and supervisors on ways to minimize risk, and, if feasible, control the hazard by relocating workers, providing an enclosed location with filtered air, changing work schedules, reducing work intensity, providing more rest periods, and using N95 masks. However, there are different thresholds for applying these levels of control across Western States. Ongoing advocacy with agricultural workers is critical for this essential workforce.

For more information:

Dr. Postma is Professor and Associate Dean for Research at the Washington State University College of Nursing.

She is a member of ACHNE, the Association of Community Health Nursing Educators: https://www.achne.org/

In ACHNE, she serves as the Member-at-Large for the Western region (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming).

She is also a member of the Editorial Board for the Public Health Nursing journal. In addition, she is a member of the American Public Health Association, Public Health Nursing section, and a member of the Washington State Nurses Association and American Nurses Association.

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