Immediate health effects of an urban wildfire

West J Med. 1993 Feb;158(2):133-8.


To document the immediate health effects of the urban wildfire that swept through parts of Alameda County, California, on October 20 and 21, 1991, we conducted a retrospective review of emergency department and coroner's records. Nine hospitals (6 local and 3 outlying) were surveyed for the week beginning October 20, 1991. Coroner's reports were reviewed for 25 identified fire-related deaths. A total of 241 fire-related emergency encounters, including 44 inpatient admissions, were recorded for 227 persons. Nearly a fourth of emergency department patients were seen for work-related injuries, more than half of which occurred among professional firefighters. Smoke-related disorders constituted more than half of all emergency department cases; of these, 61% had documented bronchospasm. Major trauma and burns contributed 1% and 4% of principal diagnoses, respectively; these were exceeded in number by corneal abrasions (13%), other medical problems (8%), and minor trauma (7%), among other diagnoses. All coroner's cases involved extensive burns, many with documented smoke inhalation injury. While the Oakland-Berkeley fire storm resulted in a high case-fatality ratio among major burn cases (25/31), those who survived the initial fire storm did well clinically. Among emergency department patients, medical (particularly smoke-related) disorders outnumbered traumatic presentations by a ratio of more than 2 to 1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchial Spasm / epidemiology
  • Burns / epidemiology
  • California / epidemiology
  • Carboxyhemoglobin / analysis
  • Child
  • Child, Preschool
  • Disasters*
  • Emergency Service, Hospital / statistics & numerical data
  • Epidemiology*
  • Female
  • Fires*
  • Health*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Mortality
  • Occupational Diseases / epidemiology
  • Patient Admission / statistics & numerical data
  • Retrospective Studies
  • Smoke Inhalation Injury / epidemiology
  • Urban Population
  • Wounds and Injuries / epidemiology


  • Carboxyhemoglobin