In the summer of 2023, severe wildfires throughout Canada led to smoky skies and poor air quality on the East Coast of the United States and more doctor visits in Maryland.

“Everybody had very dark skies. New York turned orange for a little bit,” said Mary Maldarelli, MD, pulmonary critical care fellow at the University of Maryland School of Medicine (UMSOM). “But most importantly, my patients at the VA [Baltimore Veterans Affairs Medical Center] came in to me saying they were coughing quite a bit more and needed their albuterol more often, so they felt much sicker than they usually did when these wildfires occurred.”

With a background in climate science pulmonary critical care fellow, Maldarelli, was not surprised by the impact on her patients.

“So, I had the opportunity to meet with Dr. Brad Maron, who’s in charge of the Institute for Health Computing, and he was also interested in studying the wildfires as a cardiologist. Wildfires also affect cardiovascular disease, and he, of course, knows that. And so, together we said, ‘Why don’t we study these to see if we can help our patients?’ ” Maldarelli continued.

“So, we collaborated with a team at the Institute for Health Computing, which comprises a bunch of data scientists and visualization experts who helped us extract clinical data from the University of Maryland System. We also teamed up with University of Maryland, College Park environmental scientists, and they helped us understand what were the best days to study based on their environmental data of the smoke plumes.”

The data confirmed that the wildfire smoke caused an increase in cardiopulmonary patient visits across the University of Maryland Medical System.

“We looked at cardiac disease, respiratory disease, heart failure, and then all of those diseases together, and we found across the board that we saw more patients coming to see their doctors on days where there was a lot more wildfire smoke,” Maldarelli said. “We also started to look at kind of where did our patients come from? And it actually was not the same across the state of Maryland.

“There are pockets of Maryland where more people came in than others. And finally, we also wanted to look at: Who were the patients coming in? Are they people who have high socioeconomic status or a lower socioeconomic status? And we found that people who tended to be more socioeconomically advantaged trended to come in on those days.”

With more climate events expected in the future. Maldarelli says it may be beneficial to educate doctors and explore ways to help disadvantaged patients.

“How do we get them the help they need?” she said. “Do we need to partner with a pharmaceutical company to send out inhalers ahead of time? Do we need to make sure that they have visits already scheduled with us on those bad days, so they can already come see us? Do we need to do more telehealth? I think there are a lot of opportunities for growth to help meet our patients where they are.”