Wildfire Smoke Exposure During Pregnancy: Consensus-Building to Co-Create a Community-Engaged Study
This research article details a community-engaged study designed to investigate the impact of wildfire smoke exposure during pregnancy on infant health in Klamath County, Oregon, an area with high rates of infant mortality and low birth weight.
College of Health researcher(s)
Abstract
Relative to other Oregon counties, Klamath County experiences worse air quality due to wildfire smoke, as well as elevated rates of infant mortality and low birthweight. Klamath County Public Health (KCPH) raised concerns that wildfire smoke is a contributor to poor infant health. Thus, we built a multidisciplinary team and designed a community-engaged research (CEnR) project to capture community and individual-level exposure to wildfire smoke contaminants, alongside perinatal health outcomes. Through partnerships, we identified 24 individuals across academic, public health, and community organizations that met five times over three months to develop a study design. We initially used a modified Delphi method, but adjusted our approach to find multidisciplinary areas of agreement across a highly diverse team. Our team used structured meetings, surveys, and iterative feedback to build consensus on a study design. KCPH and our community partners reviewed and approved all proposed activities to ensure community input was integrated. The resultant study, trialed in Klamath County, included the use of environmental, residential, and personal samplers and health surveys with a cohort of pregnant individuals during the wildfire season. We discuss the advantages and challenges of building a multidisciplinary CEnR study in a rural county disproportionately impacted by wildfire smoke and infant mortality.
Wildfire Smoke and Pregnancy: Klamath County Study FAQs
What are the main concerns regarding infant health in Klamath County?
Klamath County has faced consistently higher rates of infant mortality and low birth weight compared to the Oregon state average. From 1995 to 2021, the infant mortality rate in Klamath County averaged 7.7 deaths per 1000 live births, exceeding Oregon's average of 5.2. Similarly, the rate of low birth weight infants in Klamath County has remained higher than the state average, with an average of 8.5% from 2009 to 2021, compared to Oregon's 6.5%.
How does wildfire smoke impact air quality in Klamath County?
Klamath County experiences worse air quality due to wildfire smoke than any other county in Oregon. From 2015 to 2022, there were 117 days with an Air Quality Index (AQI) exceeding 100, categorized as "unhealthy for sensitive groups." This translates to an average of 14.6 days per year with unhealthy air quality, primarily attributed to wildfires.
Why is there a concern about wildfire smoke exposure during pregnancy?
Preliminary research suggests a link between prenatal exposure to wildfire smoke and adverse birth outcomes like preterm birth and low birth weight. These conditions can lead to serious health complications for infants, including increased infant mortality risk, developmental disabilities, and chronic health issues like obesity and diabetes.
What is the purpose of the community-engaged research project in Klamath County?
The project aims to understand the relationship between wildfire smoke exposure during pregnancy and perinatal health outcomes in Klamath County. This involves collecting data on individual and community-level exposure to wildfire smoke contaminants and assessing its impact on various health endpoints.
How did the research team ensure community engagement in the study design?
A multidisciplinary team of 28 individuals from academic, public health, and community organizations collaborated on the study design. This included using surveys, structured meetings, and iterative feedback mechanisms to achieve consensus on the study elements, ensuring that community input was integrated into all aspects of the research.
What pollutants are being measured in the study and how is data being collected?
The study focuses on measuring exposure to PM2.5, carbon monoxide, polycyclic aromatic hydrocarbons (PAHs), and other volatile organic compounds found in wildfire smoke. Data collection involves using personal and environmental samplers, including silicone wristbands worn by participants and air monitors placed in their homes and at state-level air monitoring stations.
What health outcomes are being investigated in the study?
The study primarily examines perinatal health outcomes, with a specific focus on infant mortality and low birth weight. Other health metrics collected include respiratory health data from daily health surveys completed by participants, health history information collected at enrollment, and infant health data obtained shortly after birth.
What were some of the key challenges and lessons learned from this research project?
Challenges included:
- Low survey response rates due to community partners' concerns about scientific jargon and limited expertise
- Inconsistent meeting attendance due to busy schedules
- The need to balance scientific rigor with community priorities
The team adapted by shifting from a structured Delphi method to a more informal, qualitative approach for gathering feedback. Key lessons learned emphasized the importance of incorporating community perspectives, using clear and accessible communication, and allowing sufficient time for comprehensive team engagement.