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Background and purpose We describe a novel, interprofessional, experiential training involving pharmacy students in response to a health emergency in rural Montana (MT). Educational activity and setting Fourth-year pharmacy students on clinical rotations were recruited to participate in screening events assessing effects of wildfire smoke in Seeley Lake, MT. Students were required to fulfill at least two hours of supplementary training in addition to education on human research guidelines. Students assisted with patient surveys (demographics, health, and respiratory), physiological testing with biomedical researchers, blood pressure and medication counseling, and spirometry specialists. Findings At least 20 pharmacy students have participated in this project in addition to nursing (n = 8), public health (n = 1), and social work (n = 1) students. In initial and subsequent screenings, students worked alongside a team of biomedical researchers and faculty from the University of Montana. An initial cohort of 95 patients was recruited. Summary This unique experiential training opportunity has afforded pharmacy students access to rural community patient interaction and exposure to and performance of a variety of tests in response to an environmental health emergency. Furthermore, it enabled health professionals and researchers to assess individual and overall community health following an extreme wildfire smoke event, providing the groundwork for utilization of pharmacy students in healthcare responses to public health emergencies.

Background: Extreme wildfire events are becoming more common and while the immediate risks to susceptible populations (i.e. elderly, asthmatics) are appreciated, the long-term health effects are not known. Historically, wildfire smoke exposure studies have consisted almost exclusively of retroactive health reports, including emergency department visits, hospital admissions, provider visits with emphasis on specific ICD codes. In 2017, the Seeley Lake, MT area experienced unprecedented levels of wildfire smoke from July 31 to September 18, with a daily average of 220.9 mg/m3. The aim of this study was to provide health assessments in the community as temporally close to the fires as possible and evaluate potential adverse health effects with multiple visits over two years. Additionally, the members of the community of Thompson Falls, MT were evaluated in 2018 as a comparison, due to their Northern Rockies location and 5-fold less smoke exposure during the same time period.Methods: Using the IPHARM (Improving Health Among Rural Montanans) infrastructure and experience to perform mobile health screenings, the Seeley Lake community was visited following the fires. The study resulted in the recruitment of a cohort (n=95, average age: 63 years), for a rapid response screening activity shortly following the wildland fire event, and two follow-up visits in 2018 and 2019. Results: The community experienced 35 of 49 days with >150 mg/m3 of PM2.5 which fell within the range of the Environmental Protection Agency designation of “very unhealthy”. Analysis of spirometry data found a significant decrease in lung function (FEV1/FVC ratio: forced expiratory volume in first second/forced vital capacity) and a more than doubling of participants that fell below the lower limit of normal (13.2% in 2017 to 41.7% in 2018) one year following the wildfire event, and remained decreased two years (35.9%) post exposure. In addition, observed FEV1 was significantly lower than predicted values. Conclusion: These findings suggest that wildfire smoke can have long-lasting effects on human health. As wildfires continue to increase both here and globally, understanding the health implications is vital to understanding the respiratory impacts of these events as well as developing public health strategies to mitigate the effects.