Analyzing the Distribution, Effectiveness, and Implementation of Wildfire Smoke Exposure Reduction Strategies on Respiratory Health

The objective of my proposal is to apply a novel, interdisciplinary approach with its combination of spatial analysis, implementation science, and exposure assessment to understand respiratory health and gaps in resource availability in the San Francisco Bay Area. My proposal builds on my past and current expertise in environmental engineering to use a systematic approach to assimilate across multiple data source to detect wildfire smoke risk changes due to exposure reduction strategies. I seek additional training to develop and apply innovative spatial and exposure analytical and qualitative methods to better characterize respiratory risk due to wildfire smoke exposure across all populations and identify specific factors influencing the success or implementation of strategies designed to increase community resilience. Due to evolving climate trends, environments in the western United States (U.S.) as well as more broadly across Canada have become drier and warmer resulting in more frequent and intense wildfire fire events. Year after year, wildfire smoke and particularly, wildfire-specific fine particulate matter (PM2.5) remain significant contributors to the air pollution burden on population health in the U.S. and beyond. While numerous guidance documents exist, especially in California, it unknown whether these strategies are adopted and enacted across communities and specifically in those most vulnerable to respiratory health outcomes. Historical patterns have led some communities to face higher risk for adverse respiratory outcomes and therefore these communities must be the public health priority when examining respiratory health effects of wildfire smoke and identifying effective risk reduction strategies. This proposal will advance the field of environmental health by applying spatial analysis to examine the distribution of risk reduction strategies and the factors driving these patterns (Aim 1); identifying individual, organizational, and societal factors that influence the presence of wildfire smoke risk reduction strategies using implementation research methods (Aim 2); and quantifying the impact of these strategies on the association between wildfire smoke and respiratory outcomes, with a focus on how effectiveness may vary based on community characteristics (Aim 3).The K99 training will enhance my research expertise through targeted coursework, mentorship, and active engagement in: (1) advanced spatial analysis; (2) implementation science and community-based participatory research; (3) quasi-experimental methods and epidemiology; and (4) career development. The skills gained through this award are essential to achieving my long-term goal of advancing multidisciplinary statistical and methodological approaches to quantify the respiratory health impacts of air pollution and exposure reduction strategies. This work will generate new scientific knowledge to improve understanding of respiratory health disparities and resource distribution, while equipping me with the expertise to plan and execute independent, innovative studies on the health effects of hazardous air pollutants using multi- dimensional analysis techniques. Project Number: 1K99ES038229-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Environmental Health Sciences (NIEHS) | Principal Investigator: Rebecca Sugrue | Institution: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, SAN FRANCISCO, CA | Award Amount: $117,747 | Activity Code: K99 | Study Section: Special Emphasis Panel[ZRG1 F12C-C (20)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11283300