{"doi":"10.1002/ppul.26835","title":"Wildfire smoke knowledge gaps: A survey of pediatric pulmonary providers in Washington State","abstract":"Evidence is accumulating linking wildfire smoke (WFS) exposure with multiple negative health consequences across the life course, including adverse respiratory, cardiovascular, and mental health effects.1 Children are particularly susceptible, as WFS exposure can increase their risk of asthma exacerbation and frequency of upper respiratory and lower respiratory tract infections.2 Early life may be a critical period of vulnerability to exposure, based on links between WFS exposure and increased respiratory emergency department visits which are stronger for younger compared to older children,2 and increased risk of preterm birth and low birth weight.3 Drier and hotter conditions due to climate change have resulted in increased numbers and size of wildfires, increased human WFS exposure, and disproportionate impacts on socially disadvantaged communities.4, 5 People living outside the traditionally fire-prone Western United States are increasingly affected, as evidenced by both the recent record-setting Canadian wildfires impacting air quality across the Eastern and Midwest United States and the unprecedented wildfires that devastated Hawaiian communities on Maui. Based on this increasing urgency, a 2021 American Thoracic Society workshop recognized the important role clinicians can play in communicating the risks and importance of preventing WFS exposure to patients and their families.1 However, this topic is not commonly included in pediatric pulmonology training curricula and few continuing medical education (CME) efforts address this important health concern. We sought to evaluate the experience and confidence of pediatric pulmonary providers in discussing WFS health risks and prevention strategies in Washington State to understand knowledge gaps and inform strategies to close them. We identified all practicing pediatric pulmonology physicians and fellows in Washington State, which included members of four institutions and one fellowship program (N = 37) located across the state. These individuals were sent e-mail invitations to participate and a link to the survey. On clicking the link, eligibility was verified, and eligible participants could then complete the survey via REDCap (File S1: Reference 1). Inclusion criteria included currently seeing children as a pediatric pulmonary physician or fellow in a clinical setting. The survey was available for completion between 26 May and 17 July 2023. This study was reviewed by the University of Washington Human Subjects Division and was determined to be exempt, and formal informed consent was not required. Survey questions included demographic information (years of experience and region of medical school, residency, and fellowship training), prior formal WFS instruction, and clinical experience with children affected by WFS (Table S1). We also assessed participants’ confidence related to specific WFS content areas. Finally, we asked for opinions on the importance of discussing WFS during clinical encounters. We used descriptive statistics to characterize demographics and response frequencies. Seven fellows and 21 practicing pediatric pulmonologists responded to the survey (total n = 28; response rate 76% of eligible individuals). Participants ranged from first-year fellows to pulmonologists with 15 or more years of experience (Table 1). Approximately half completed medical school in the Western United States; three-quarters completed residency and fellowship in the Western United States. The vast majority of participants had recent experience caring for children impacted by WFS (96%) and had counselled on how to protect against WFS (93%, Figure 1). However, few had formal WSF instruction (32%). None reported having received WFS-related instruction in medical school, and few recalled receiving it during pediatrics residency (11%), pediatric pulmonary fellowship (14%), or as a practicing physician (21%). Most participants indicated confidence in understanding the clinical impact of WF","journal":"Pediatric Pulmonology","year":2023,"id":379440,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9659,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":490644,"name":"Jonathan D. Cogen","orcid":"0000-0002-0382-6858","position":1,"is_corresponding":false},{"id":325491,"name":"Catherine J. Karr","orcid":"0000-0002-4683-2270","position":2,"is_corresponding":false},{"id":460758,"name":"Mary E. Crocker","orcid":"0000-0002-0587-1249","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":null,"created_at":"2026-07-19T01:16:52.622552Z","pmid":"38153213","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}