Climate change is increasing the frequency and intensity of extreme environmental exposures globally. In the US, the occurrence of extreme heat waves has increased by over 300% in the past 60 years, a trend that is predicted to accelerate in coming years. A hotter and drier climate has also fueled the incidence of wildfires across North America, leading to a rise in harmful wildfire smoke exposures. Outdoor workers are highly vulnerable to health risks of heat and wildfire smoke exposure, generally facing higher exposures as well as unique barriers to self-protection than the general population. Independently, wildfire smoke and extreme heat in occupational settings are associated with respiratory, cardiovascular and renal illnesses and disease. Concurrent smoke and heat events can amplify worker health risks and complicate approaches to self-protection. For example, N95 respirators can significantly reduce exposure to wildfire smoke but cause discomfort and increased body temperatures in hot weather.
Interventions to mitigate the impacts of wildfire smoke and heat on outdoor workers is urgently needed. Research relevant to such interventions has been conducted in the US and globally, spanning from observational studies that inform intervention development to full-scale effectiveness trials of interventions. Additional research on the barriers and facilitators of self-protective actions, especially for the most vulnerable workers, could facilitate the development and real-world implementation of acceptable, scalable, and effective interventions. Study designs centered on rapid research activities, collecting data immediately following extreme events, have several advantages that could bridge these knowledge gaps. Administering surveys quickly mitigates the risk of recall errors. Timely data collection also enables more precision regarding a specific event compared to conducting surveys, interviews or group discussions to collect information generalized over workers’ past experiences, which are likely highly heterogeneous. Further, rapid response research can provide unique insight into the specific time window of hypothetical intervention effects, for example, by illuminating barriers to self-protective barriers that interventions might modify. Additionally, time-sensitive data collection could support impactful research on policies that protect outdoor workers from wildfire smoke and heat exposures. Oregon and Washington state require employers to support outdoor worker health in times of significant risk due to wildfire smoke or heat. While these policies are evidence-based, future research evaluating the implementation of these rules is critical. For example, surveys collected from workers and supervisors after specific extreme heat events could provide key insight into heat and smoke rule implementation and potential methods to assist employers, supervisors, and workers in adhering to guidance.
Rapid response research can be challenging to conduct. To address challenges, our team developed a wildfire smoke protocol for rapid response (WiSPRR) for the national environmental influences on Child Health Outcomes (ECHO) Cohort, including a novel approach for automated near-real-time detection of wildfire smoke in US communities and validated surveys administered to impacted ECHO participants immediately after a smoke event. WiSPRR was successfully piloted in the 2025 wildfire season and is being scaled up to the entire ECHO Cohort (over 65,000 mother/child dyads nationwide) this season. Here, we propose to extend WiSPRR to support time-sensitive research on wildfire smoke and heat exposure events impacting outdoor workers in the PNW. The proposed work aligns with the National Occupational Research Agenda for Agriculture, Forestry and Fishing (AgFF) by targeting work-related illnesses caused by exposure to extreme heat and wildfire smoke, including a focus on vulnerable workers in the agricultural sector. The project addresses workplace issues highlighted by the National Institute of Occupational Safety and Health (NIOSH) Future of Work Initiative, including disaster response and extreme weather conditions.
Christine Loftus, PhD, MPH, MS, University of Washington. Rapid Identification of Extreme Exposures Impacting PNW Agricultural Workers: Novel Tools and Methods for Time-Sensitive Research and Intervention.