Short-Term Health Outcomes of the Weaver Fertilizer Plant Fire on the Surrounding Community

Objectives: To assess differences in health care utilization, mortality, and incidence of health conditions nearly 2 years after a fertilizer plant fire near a residential area. Design: We performed a longitudinal cohort study. Participants: Residents who lived within a 1-mile radius of the fertilizer plant (exposed cohort, N = 2546) were compared to 2 matched control cohorts based on neighborhood (N = 10 043) or participant-level (N = 10 001) characteristics. Setting: We extracted electronic health record data from January 31, 2020, to November 21, 2023, comprising the “pre” time period from January 31, 2020, to January 31, 2022, and the “post” time period from February 1, 2022, to November 21, 2023. Main Outcome Measures: Outcomes included health care utilization (number of outpatient clinic visits, ED visits, and hospitalizations in the pre- and postfire periods), mortality (measured for each participant in each cohort in the postperiod only), and incidence of health conditions (development of asthma, cancer, chronic heart disease, diabetes, migraines, nausea, and neurocognitive disorders in the postperiod). Results: Health care utilization was highest among the cohort that was exposed to the fire in pre- and postfire periods and decreased over time for all cohorts. There were no significant differences between cohorts with respect to mortality or incidence of health conditions. Conclusions: We did not identify statistically significantly differences in health outcomes among the exposed, compared to neighborhood- and participant-level matched cohorts. Policymakers and funders should have mechanisms available for rapid funding opportunities for disaster evaluation to follow cohorts and assess long-term health effects.