In the framework of climate change, the hazard caused by wildfires approaching the anthropic settlements is raising an increasing concern. Fatalities and relevant damage to properties were recently caused by wildfires affecting the Wildland-Urban and Wildland-Industrial Interfaces. Industrial sites storing large quantities of hazardous materials are vulnerable to interface fires, which have the potential to trigger specific cascading events such as Natech scenarios followed by domino effects. The present study aims at providing a methodology for the quantitative assessment of the vulnerability of industrial sites exposed to wildfires. The approach provides a novel framework for the identification and quantification of all the chains of failures that may occur due to wildfires or interface fires approaching industrial sites. The methodology accounts for the thermal radiation from fires in both primary Natech scenarios and cascading scenarios triggered by domino effects. The dynamic features of interface fires and the synergistic effects of multiple fires are also taken into account. The results of a case study demonstrated the importance of considering the dynamic behavior of wildfire, which strongly affects the vulnerability of industrial structures. The results also evidence the importance of emergency management and first response on the overall vulnerability figures.
Few studies have examined the relationship between exposure to natural hazards and suicide and self-harm in youth. We extend prior research by investigating the association between multiple disasters and the risks of self-harm and suicide longitudinally in a nationally representative longitudinal cohort of adolescents 14 to 15 years to 18-19 years of age. Natural disasters were identified through parental self-reports for the local area. Different types of multiple disaster exposures were investigated including compound disasters (two or more disasters occurring in the last 12 months), cascading disasters (a disaster that leads to another disaster in the subsequent wave) and consecutive disasters (multiple disasters within the last two years or over an eight-year period). Using 8,714 person-waves of data from 2,908 adolescents, findings from random effect models suggest that parental reports of fire or floods increase the risk of self-harm ideation, self-harm, and suicidal ideation. Compound disasters of fire/flood and drought were also associated with increased risk of suicidal thoughts. Cascading disasters of drought followed by fire/flood increased the risks of self-harm but recurrent consecutive droughts were associated with lower risks of suicidal ideation. Australian adolescents are exposed to high rates of natural disasters that increase the risk of self-harm and thoughts of self-harm and suicide. Climate change will increase risk of natural disaster exposure for all countries. Despite these increased risks, there was resilience to disaster exposure particularly in the case of recurrent drought suggesting that youth, families and communities may well develop protective strategies to support mental health.
As wildfire activity continues to increase throughout much of the western US, questions remain about how to effectively communicate wildfire smoke risk to harder-to-reach groups, including rural populations. Standard public health strategies rely largely on risk assessment and communication informed by available air quality data. However, rural populations can be difficult to reach through traditional communication channels and air quality monitoring to inform messaging can be absent or scarce. As efforts increase to expand air quality monitoring into rural regions, there is a need to identify and affirm the most effective content and communication channels for motivating protective action. We used a mental models approach to identify wildfire smoke risk information needs and preferred communication channels in three rural counties in northern Nevada. Participants revealed a substantial knowledge base with opportunities for enhancement related to the range of potential physical and mental health impacts, vulnerable groups, and exposure mitigation strategies. Preferred communication channels were varied but almost exclusively local. The mental models approach also uncovered important barriers to exposure mitigation as well as potential areas of future research. Insights gained from this study will be used to inform targeted wildfire smoke risk communication for rural Nevada counties and may serve to motivate similar studies in other rural regions. Identifying similarities and differences in information needs and preferred communication channels can help inform understanding of how and why to tailor wildfire smoke risk communication. Any new messaging developed from such studies should be evaluated to ensure its effectiveness.
Currently, more than half of the world’s human population lives in urban areas, which are increasingly affected by climate hazards. Little is known about how multi-hazard environments affect people, especially those living in urban areas in northern latitudes. This study surveyed homeowners in Anchorage and Fairbanks, USA, Alaska’s largest urban centers, to measure individual risk perceptions, mitigation response, and damages related to wildfire, surface ice hazards, and permafrost thaw. Up to one third of residents reported being affected by all three hazards, with surface ice hazards being the most widely distributed, related to an estimated $25 million in annual damages. Behavioral risk response, policy recommendations for rapidly changing urban environments, and the challenges to local governments in mitigation efforts are discussed.
We review current knowledge on the trends and drivers of global wildfire activity, advances in the measurement of wildfire smoke exposure, and evidence on the health effects of this exposure. We describe methodological issues in estimating the causal effects of wildfire smoke exposures on health and quantify their importance, emphasizing the role of nonlinear and lagged effects. We conduct a systematic review and meta-analysis of the health effects of wildfire smoke exposure, finding positive impacts on all-cause mortality and respiratory hospitalizations but less consistent evidence on cardiovascular morbidity. We conclude by highlighting priority areas for future research, including leveraging recently developed spatially and temporally resolved wildfire-specific ambient air pollution data to improve estimates of the health effects of wildfire smoke exposure.
OBJECTIVE: Agricultural producers face a wide array of stress triggers, shocks, and long-term pressures such as drought, flooding, fire, government policies, financial insecurity, and physical injuries. Extant research has revealed that mental health stigma, lack of access to care in rural areas, and negative coping responses (alcohol abuse, suicide, prescription drugs use) exacerbate the challenge of producer responses to short and long-term adversity. Resilience, the traits, processes, and capacities of producers to adapt and transform their approach to farming or ranching, when necessary, in response to stress triggers or long-term pressures, has received less research attention, particularly in the Western United States. The purpose of the study was to apply an interactionist occupational resilience theoretical perspective to the investigation of contextual factors contributing to resilience in Western United States agricultural producers. METHODS: Qualitative interviews (45 to 90 minutes) were conducted with agricultural producers (n=51) from Western states and territories. Applied thematic analysis with a phenomenological lens was utilized to analyze interview transcriptions. First and second level coding were conducted to derive themes. RESULTS: The analysis revealed that resilience is based upon the interactions between traits of producers and the context of agriculture. Four themes were generated (Agricultural Life, External Stressors, Traits and Adaptations, and Supports and Resources), supported by subthemes. The themes and subthemes are depicted in an agricultural producer resiliency model. The findings shed light on the equivocal role of neighbors in providing support for each other and the double-edged sword of co-working with family. CONCLUSIONS: The findings underscore that social capital is an important mechanism for supporting farmers and ranchers, as those with stronger social resources are more resilient. We recommend more funding to tailor stress and mental health programming to the specifics of agriculture, integration of behavioral health in primary care as a mechanism to increase access to care, and more intentional technical assistance for farmers and ranchers on strategic planning and problem solving.
Wildland fire smoke risks are not uniformly distributed across people and places, and the most vulnerable communities are often disproportionately impacted. This study develops a county level community health vulnerability index (CHVI) for the Contiguous United States (CONUS) using three major vulnerability components: adaptive capacity, sensitivity, and exposure at the national and regional level. We first calculated sensitivity and adaptive capacity sub-indices using nine sensitivity and twenty adaptive capacity variables. These sub-indices were then combined with an exposure sub-index, which is based on the Community Multiscale Air Quality data (2008-2018), to develop CHVI. Finally, we conducted several analyses with the derived indices to: 1) explore associations between the level of fine particulate matter from wildland fires (fire-PM(2.5)) and the sub-indices/CHVI; 2) measure the impact of fire-PM(2.5) on the increase in the annual number of days with 12-35 μg/m(3) (moderate) and >35 μg/m(3) (at or above unhealthy for sensitive groups) based on the US EPA Air Quality Index categories, and 3) calculate population size in different deciles of the sub-indices/CHVI. This study has three main findings. First, we showed that the counties with higher daily fire-PM(2.5) concentration tend to have lower adaptive capacity and higher sensitivity and vulnerability. Relatedly, the counties at high risk tended to experience a greater increase in the annual number of days with 12-35 μg/m(3) and >35 μg/m(3) than their counterparts. Second, we found that 16.1, 12.0, and 17.6 million people out of 332 million in CONUS reside in the counties in the lowest adaptive capacity decile, highest sensitivity decile, and highest vulnerability decile, respectively. Third, we identified that the US Northwest, California, and Southern regions tended to have higher vulnerability than others. Accurately identifying a community’s vulnerability to wildfire smoke can help individuals, researchers, and policymakers better understand, prepare for, and respond to future wildland fire events.
PURPOSE OF REVIEW: The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS: There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.
OBJECTIVE: To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM(2.5) ) and wildfire-specific PM(2.5) with emergency department (ED) visits for headache. Studies have reported associations between PM(2.5) exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM(2.5) may contribute to more frequent headaches. METHODS: Our study included adult Californian members (aged ≥18 years) of a large de-identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension-type headache, migraine headache, cluster headache, and "other" primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire-specific PM(2.5) to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM(2.5) concentrations, first for primary headache disorders combined, and then by headache subtype. RESULTS: Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (N = 5534/13,623 [47.6%]) followed by "other" primary headache (N = 6489/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7-day average wildfire PM(2.5) (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95-1.44 per 10 μg/m(3) increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM(2.5) for tension-type headache (OR 1.42, 95% CI 0.91-2.22), "other" primary headache (OR 1.40, 95% CI 0.96-2.05), and cluster headache (OR 1.29, 95% CI 0.71-2.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM(2.5) was associated with tension-type headache (OR 1.29, 95% CI 1.03-1.62), but not migraine, cluster, or "other" primary headaches. CONCLUSIONS: Although imprecise, these results suggest short-term wildfire PM(2.5) exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache-related healthcare needs in the wake of wildfires and on poor air quality days.
OBJECTIVES: This study aimed to evaluate the performance of a low-cost smoke sampling platform relative to environmental and occupational exposure monitoring methods in a rural agricultural region in central Washington state. METHODS: We co-located the Thingy AQ sampling platform alongside cyclone-based gravimetric samplers, a nephelometer, and an environmental beta attenuation mass (E-BAM) monitor during August and September of 2020. Ambient particulate matter concentrations were collected during a smoke and non-smoke period and measurements were compared across sampling methods. RESULTS: We found reasonable agreement between observations from two particle sensors within the Thingy AQ platform and the nephelometer and E-BAM measurements throughout the study period, though the measurement range of the sensors was greater during the smoke period compared to the non-smoke period. Occupational gravimetric sampling methods did not correlate with PM(2.5) data collected during smoke periods, likely due to their capture of larger particle sizes than those typically measured by PM(2.5) ambient air quality instruments during wildfire events. CONCLUSION: Data collected before and during an intense wildfire smoke episode in September 2020 indicated that the low-cost smoke sampling platform provides a strategy to increase access to real-time air quality information in rural areas where regulatory monitoring networks are sparse if sensor performance characteristics under wildfire smoke conditions are understood. Improving access to spatially resolved air quality information could help agricultural employers protect both worker and crop health as wildfire smoke exposure increases due to the impacts of climate change. Such information can also assist employers with meeting new workplace wildfire smoke health and safety rules.
Pacific Northwest wildfires are expected to increase in frequency and scale, with more communities exposed to smoke. We explored the environmental justice context for wildfire smoke impact to young children in urban communities in the Pacific Northwest with a focus on Seattle, Washington. We found substantial evidence that young children are vulnerable during wildfire smoke events due to a residential building stock that was primarily built before meaningful energy codes were enacted, along with low air conditioning rates; both contribute to a high transfer of air pollutants indoors from the outdoor environment. While our results are limited to PM2.5, we suggest that preventing injustices at child care settings during wildfire smoke events depends primarily on access to real-time information, use of that information to reduce exposure, and the strategies used by policy actors to make these adaptation options available and affordable for vulnerable communities. To date, adaptation during wildfire smoke events relies on voluntary efforts which may not be effective public health remedies in general, and particularly for vulnerable communities. Licensed child care settings could provide feasible and just risk management options for urban communities in the Pacific Northwest.
To assess wildfire risks to California inpatient health care facilities in 2022. Methods. Locations of inpatient facilities and associated inpatient bed capacities were mapped in relation to California Department of Forestry and Fire Protection fire threat zones (FTZs), which combine expected fire frequency with potential fire behavior. We computed the distances of each facility to the nearest high, very high, and extreme FTZs. Results. Half (107 290 beds) of California’s total inpatient capacity is within 0.87 miles of a high FTZ and 95% (203 665 beds) is within 3.7 miles of a high FTZ. Half of the total inpatient capacity is within 3.3 miles of a very high FTZ and 15.5 miles of an extreme FTZ. Conclusions. Wildfires threaten a large number of inpatient health care facilities in California. In many counties, all health care facilities may be at risk. Public Health Implications. Wildfires in California are rapid-onset disasters with short preimpact phases. Policies should address facility-level preparedness including smoke mitigation, sheltering measures, evacuation procedures, and resource allocation. Regional evacuation needs, including access to emergency medical services and patient transportation, must also be considered. (Am J Public Health. 2023;113(5):555-558. https://doi.org/10.2105/AJPH.2023.307236).
Globally, wildfires have seen remarkable increase in duration and size and have become a health hazard. In addition to vegetation and habitat destruction, rapid release of smoke, dust and gaseous pollutants in the atmosphere contributes to its short and long-term detrimental effects. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a public health concern worldwide that primarily target lungs and respiratory tract, akin to air pollutants. Studies from our lab and others have demonstrated association between air pollution and COVID-19 infection and mortality rates. However, current knowledge on the impact of wildfire-mediated sudden outburst of air pollutants on COVID-19 is limited. In this study, we examined the association of air pollutants and COVID-19 during wildfires burned during August-October 2020 in California, United States. We observed an increase in the tropospheric pollutants including aerosols (particulate matter [PM]), carbon monoxide (CO) and nitrogen dioxide (NO(2)) by approximately 150%, 100% and 20%, respectively, in 2020 compared to the 2019. Except ozone (O(3)), similar proportion of increment was noticed during the peak wildfire period (August 16 – September 15, 2020) in the ground PM(2.5), CO, and NO(2) levels at Fresno, Los Angeles, Sacramento, San Diego and San Francisco, cities with largest active wildfire area. We identified three different spikes in the concentrations of PM(2.5), and CO for the cities examined clearly suggesting wildfire-induced surge in air pollution. Fresno and Sacramento showed increment in the ground PM(2.5), CO and NO(2) levels, while San Diego recorded highest change rate in NO(2) levels. Interestingly, we observed a similar pattern of higher COVID-19 cases and mortalities in the cities with adverse air pollution caused by wildfires. These findings provide a logical rationale to strategize public health policies for future impact of COVID-19 on humans residing in geographic locations susceptible to sudden increase in local air pollution.
BACKGROUND: Wildfire-related fine particulate matter (PM(2.5)) has many adverse health impacts, but its impacts on human epigenome are unknown. We aimed to evaluate the associations between long-term exposure to wildfire-related PM(2.5) and blood DNA methylation, and whether the associations differ from those with non-wildfire-related PM(2.5). METHODS: We studied 479 Australian women comprising 132 twin pairs and 215 of their sisters. Blood-derived DNA methylation was measured using the HumanMethylation450 BeadChip array. Data on 3-year (year of blood collection and previous two years) average wildfire-related and non-wildfire-related PM(2.5) at 0.01°×0.01° spatial resolution were created by combining information from satellite observations, chemical transport models, and ground-based observations. Exposure data were linked to each participant’s home address, assuming the address did not change during the exposure window. For DNA methylation of each cytosine-guanine dinucleotide (CpG), and for global DNA methylation represented by the average of all measured CpGs or CpGs in repetitive elements, we evaluated their associations with wildfire- or non-wildfire-related PM(2.5) using a within-sibship analysis controlling for factors shared between siblings and other important covariates. Differentially methylated regions (DMRs) were defined by comb-p and DMRcate. RESULTS: The 3-year average wildfire-related PM(2.5) (range: 0.3 to 7.6 µg/m(3)(,) mean: 1.6 µg/m(3)) was negatively, but not significantly (p-values greater than 0.05) associated with all seven global DNA methylation measures. There were 26 CpGs and 33 DMRs associated with wildfire-related PM(2.5) (Bonferroni adjusted p-value < 0.05) mapped to 47 genes enriched for pathways related to inflammatory regulation and platelet activation. These genes have been related to many human diseases or phenotypes e.g., cancer, mental disorders, diabetes, obesity, asthma, blood pressure. These CpGs, DMRs and enriched pathways did not overlap with the 1 CpG and 7 DMRs associated with non-wildfire-related PM(2.5). CONCLUSIONS: Long-term exposure to wildfire-related PM(2.5) was associated with various blood DNA methylation signatures in Australian women, and these were distinct from those associated with non-wildfire-related PM(2.5).
BACKGROUND: Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM(2.5)). METHODS: We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM(2.5) data at a resolution of 0.25° × 0.25°. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM(2.5) and the estimates were pooled at the national level using a random-effect meta-analysis. We used a meta-regression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses. RESULTS: During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM(2.5) in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil’s GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM(2.5) was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service. CONCLUSION: Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires.
Climate change is leading to worsening disasters that disproportionately impact older adults. While research has begun to measure disparities, there is a gap in examining wildfire-specific disasters. To address this gap, this scoping review analyzed literature to explore the nexus of wildfires and older adults. We searched peer-reviewed literature using the following inclusion criteria: (1) published in a peer-reviewed journal; (2) available in English; (3) examines at least one topic related to wildfires; and (4) examines how criterion three relates to older adults in at least one way. Authors screened 261 titles and abstracts and 138 were reviewed in full, with 75 articles meeting inclusion criteria. Findings heavily focused on health impacts of wildfires on older adults, particularly of smoke exposure and air quality. While many articles mentioned a need for community-engaged responses that incorporate the needs of older adults, few addressed firsthand experiences of older adults. Other common topics included problems with evacuation, general health impacts, and Indigenous elders’ fire knowledge. Further research is needed at the nexus of wildfires and older adults to highlight both vulnerabilities and needs as well as the unique experience and knowledge of older adults to inform wildfire response strategies and tactics.
Wildfires are relevant sources of PM emissions and can have an important impact on air pollution and human health. In this study, we examine the impact of wildfire PM emissions on the Piemonte (Italy) air quality regional monitoring network using a Generalized Additive Mixed Model. The model is implemented with daily PM10 and PM2.5 concentrations sampled for 8 consecutive years at each monitoring site as the response variable. Meteorological data retrieved from the ERA5 dataset and the observed burned area data stored in the Carabinieri Forest Service national database are used in the model as explanatory variables. Spline functions for predictive variables and smooths for multiple meteorological variables’ interactions improved the model performance and reduced uncertainty levels. The model estimates are in good agreement with the observed PM data: adjusted R-2 range was 0.63-0.80. GAMMs showed rather satisfactory results in order to capture the wildfires contribution: some severe PM pollution episodes in the study area due to wildfire air emissions caused peak daily levels up to 87.3 mu g/m(3) at the Vercelli PM10 site (IT1533A) and up to 67.7 mu g/m(3) at the Settimo Torinese PM2.5 site (IT1130A).
Due in part to climate change, wildfire activity is increasing, with the potential for greater public health impact from smoke in downwind communities. Studies examining the health effects of wildfire smoke have focused primarily on fine particulate matter (PM(2.5)), but there is a need to better characterize other constituents, such as hazardous air pollutants (HAPs). HAPs are chemicals known or suspected to cause cancer or other serious health effects that are regulated by the United States (US) Environmental Protection Agency. Here, we analyzed concentrations of 21 HAPs in wildfire smoke from 2006 to 2020 at 309 monitors across the western US. Additionally, we examined HAP concentrations measured in a major population center (San Jose, CA) affected by multiple fires from 2017 to 2020. We found that concentrations of select HAPs, namely acetaldehyde, acrolein, chloroform, formaldehyde, manganese, and tetrachloroethylene, were all significantly elevated on smoke-impacted versus nonsmoke days (P < 0.05). The largest median increase on smoke-impacted days was observed for formaldehyde, 1.3 μg/m(3) (43%) higher than that on nonsmoke days. Acetaldehyde increased 0.73 μg/m(3) (36%), and acrolein increased 0.14 μg/m(3) (34%). By better characterizing these chemicals in wildfire smoke, we anticipate that this research will aid efforts to reduce exposures in downwind communities.
Climate change favors weather conditions conducive to wildland fires. The intensity and frequency of forest fires are increasing, and fire seasons are lengthening. Exposure of human populations to smoke emitted by these fires increases, thereby contributing to airborne pollution through the emission of gas and particulate matter (PM). The adverse health outcomes associated with wildland fire exposure represent an important burden on the economies and health systems of societies. Even though cardiovascular diseases (CVDs) are the main of cause of the global burden of diseases attributable to PM exposure, it remains difficult to show reliable associations between exposure to wildland fire smoke and cardiovascular disease risk in population-based studies. Optimal health requires a resilient and adaptable network of small blood vessels, namely, the microvasculature. Often alterations of this microvasculature precede the occurrence of adverse health outcomes, including CVD. Biomarkers of microvascular health could then represent possible markers for the early detection of poor cardiovascular outcomes. This review aims to synthesize the current literature to gauge whether assessing the microvasculature can better estimate the cardiovascular impact of wildland fires.
Constraining an increase in global mean temperature below 2 degrees C compared to pre-industrial levels is critical to limiting dangerous and cascading impacts of anthropogenic climate change. Understanding future climatic changes and their spatial heterogeneity at 2 degrees C warming is thus important for policy makers to prepare actionable adaptation and mitigation plans by identifying where and to what extent lives and livelihoods will be impacted. This study uses the recently released NASA Earth eXchange Global Daily Downscaled Projections (NEX-GDDP) CMIP6 data to provide a broad overview of projected changes in six key climate variables and two climate impact indicators at a time when warming exceeds 2 degrees C. Analysis of global mean temperature changes indicates the 2040s as the decade when most CMIP6 models reach 2 degrees C warming with respect to a pre-industrial period (1850-1900). During the 2040s, we find that global mean temperature, precipitation, relative humidity, downwelling shortwave and longwave radiation, and wind speed over land under the high emission scenario are projected to change by +2.8 degrees C, +22.4 mm/year, -0.73%, -2.23 , +15.9 W/m(2), and -0.04 m/s, respectively. Many of the future changes are expected to exacerbate climate impacts including heat stress and fire danger. Our analysis shows geographic patterns of policy-relevant climatic changes, as parts of the globe will experience significant climate impacts even if the goal to keep warming below 2 degrees C goal is achieved. Our results highlight the urgent need for further studies focused on identifying key hotspots and advancing region-specific actionable adaptation and mitigation plans.
People using electricity-dependent durable medical equipment (DME) may be vulnerable to health effects from wildfire smoke, residence near wildfires, or residence in evacuation zones. To our knowledge, no studies have examined their healthcare utilization during wildfires. METHODS: We obtained 2016-2020 counts of residential Zip Code Tabulation Area (ZCTA) level outpatient, emergency department (ED), and inpatient visits made by DME-using Kaiser Permanente Southern California members 45+. We linked counts to daily ZCTA-level wildfire particulate matter (PM) 2.5 and wildfire boundary and evacuation data from the 2018 Woolsey and 2019 Getty wildfires. We estimated the association of lagged (up to 7 days) wildfire PM 2.5 and residence near a fire or in an evacuation zone and healthcare visit frequency with negative binomial and difference-in-differences models. RESULTS: Among 236,732 DME users, 10 µg/m 3 increases in wildfire PM 2.5 concentration were associated with the reduced rate (RR = 0.96; 95% confidence interval [CI] = 0.94, 0.99) of all-cause outpatient visits 1 day after exposure and increased rate on 4 of 5 subsequent days (RR range 1.03-1.12). Woolsey Fire proximity (<20 km) was associated with reduced all-cause outpatient visits, whereas evacuation and proximity were associated with increased inpatient cardiorespiratory visits (proximity RR = 1.45; 95% CI = 0.99, 2.12, evacuation RR = 1.72; 95% CI = 1.00, 2.96). Neither Getty Fire proximity nor evacuation was associated with healthcare visit frequency. CONCLUSIONS: Our results support the hypothesis that wildfire smoke or proximity interrupts DME users' routine outpatient care, via sheltering in place. However, wildfire exposures were also associated with increased urgent healthcare utilization in this vulnerable group.
Wildfires, which have been occurring increasingly in the era of climate change, emit massive amounts of particulate matter (PM) into the atmosphere, strongly affecting air quality and public health. Biomass burning aerosols may contain environmentally persistent free radicals (EPFRs, such as semiquinone radicals) and redox-active compounds that can generate reactive oxygen species (ROS, including center dot OH, superoxide and organic radicals) in the aqueous phase. However, there is a lack of data on EPFRs and ROS associated with size-segregated wildfire PM, which limits our understanding of their climate and health impacts. We collected size-segregated ambient PM in Southern California during two wildfire events to measure EPFRs and ROS using electron paramagnetic resonance spectroscopy. EPFRs are likely associated with soot particles as they are predominantly observed in submicron particles (PM1, aerodynamic diameter <= 1 mu m). Upon extraction in water, wildfire PM mainly generates center dot OH (28-49%) and carbon-centered radicals (similar to 50%) with minor contributions from superoxide and oxygen-centered organic radicals (2-15%). Oxidative potential measured with the dithiothreitol assay (OP-DTT) is found to be high in wildfire PM1, exhibiting little correlation with the radical forms of ROS (r(2) <= 0.02). These results are in stark contrast with PM collected at highway and urban sites, which generates predominantly center dot OH (84-88%) that correlates well with OP-DTT (r(2) similar to 0.6). We also found that PM generated by flaming combustion generates more radicals with higher OP-DTT compared to those by smoldering or pyrolysis.
Some impacts of climate change that are expected to affect the American workforce are rising temperatures, greater prevalence of wildland fires, increase in Lyme disease, and exposure to insecticides. The purpose of this study was to assess how fatal and non-fatal occupational injuries due to environmental heat, forest/brush fires, Lyme disease, and exposure to insecticides have changed over time in the United States and if there were any significant relationships between national occupational injury/illness data and national temperature trends. METHODS: Linear regression models assessed fatal and non-fatal injuries/illnesses since 1992 by both the frequency of incidents and the proportion of total incidents and the effects of national average temperatures. RESULTS: There were significant increases in occupational fatalities and illnesses due to exposure to environmental heat and national average annual temperatures were predictive of heat exposure fatalities and illnesses. CONCLUSION: Heat exposure is an occupational hazard that must be managed carefully in the coming years. Organizations will need to take more aggressive heat exposure control measures as temperatures continue to rise and remain hotter for longer periods during the year. While not currently showing increasing trends on a national scale, the prevalence of occupational incidents due to forest/brush fires, Lyme disease, and insecticides should be monitored as the United States experiences more of the projected impacts of climate change.
Forest fires are extreme natural/artificial events releasing polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic. Most of the released PAHs are trapped in burnt ash, a part of which is transported and settle on different mediums like soil and water. After strong rainfall events, PAHs enter into surface water bodies through surface runoff, thereby deteriorating water quality. Changes in PAHs levels during the post-fire duration and human health risks due to PAHs released from forest fires need attention. This study aim to explain the trends and patterns of PAHs and health risks due to exposure to soil and water contaminated with PAHs. Forest fires release a higher percentage of low molecular weight PAHs (LMW PAHs) than high molecular weight PAHs (HMW PAHs). Ash and burnt soils contain a higher percentage of LMW PAHs since biomass burning releases huge amounts of LMW PAHs. Whereas, sediments contain a higher percentage of HMW PAHs since most of the LMW PAHs are already degraded. HMW PAHs were causing higher risk to humans (both cancer and non-cancer) due to their higher oxidation potential. Exposure to water contaminated by PAHs resulted in higher health risks for both BaP equivalent and a mixture of PAHs. Exposure to sediment produced the highest health risk due to a higher percentage of HMW PAHs, followed by surface water, burnt soil, ash, and unburnt soil. Cancer and non-cancer risk due to dermal exposure was more elevated than oral exposure. The mixture of PAHs in sediment produced a higher average dermal risk for children (2.21E+00 for cancer and 7.69E+03 for non-cancer risk) and oral cancer risk for adults (7.11E-03). However, exposure to BaP equivalent in sediment produced higher oral non-cancer risk (7.01E+02) for children. Thus, effective PAHs monitoring is required in both soil and surface water mediums for ensuring proper treatment in water supply systems.
Wildfires are a significant cause of exposure to ambient air pollution in the United States and other settings. Although indoor air pollution is a known contributor to tuberculosis reactivation and progression, it is unclear whether ambient pollution exposures, including wildfire smoke, similarly increase risk. Objectives: To determine whether tuberculosis diagnosis was associated with recent exposure to acute outdoor air pollution events, including those caused by wildfire smoke. Methods: We conducted a case-crossover analysis of 6,238 patients aged ⩾15 years diagnosed with active tuberculosis disease between 2014 and 2019 in 8 California counties. Using geocoded address data, we characterized individuals’ daily exposure to <2.5 μm-diameter particulate matter (PM(2.5)) during counterfactual risk periods 3-6 months before tuberculosis diagnosis (hazard period) and the same time 1 year previously (control period). We compared the frequency of residential PM(2.5) exposures exceeding 35 μg/m(3) (PM(2.5) events) overall and for wildfire-associated and nonwildfire events during individuals' hazard and control periods. Measurements and Main Results: In total, 3,139 patients experienced 1 or more PM(2.5) events during the hazard period, including 671 experiencing 1 or more wildfire-associated events. Adjusted odds of tuberculosis diagnosis increased by 5% (95% confidence interval, 3-6%) with each PM(2.5) event experienced over the 6-month observation period. Each wildfire-associated PM(2.5) event was associated with 23% (19-28%) higher odds of tuberculosis diagnosis in this time window, whereas no association was apparent for nonwildfire-associated events. Conclusions: Residential exposure to wildfire-associated ambient air pollution is associated with an increased risk of active tuberculosis diagnosis.
Identifying violations is at the heart of environmental compliance, especially detecting contaminants that endanger human health and safety. A review of state drinking water compliance programs demonstrates that the rate and frequency of identifying health-based violations varies significantly across the states. Previous scholarship has attributed much of this variation to anthropogenic causes. Less studied is the role of natural disasters and other natural events, which may also influence compliance outcomes. To address this gap, we build and utilize a novel data set of state-reported health-based violations reported under the Safe Drinking Water Act (SDWA) from 1993 to 2016. We are particularly interested in the role that events, such as severe storms, hurricanes, floods, and fires, have on the patterns of health-based violations. Results indicate that not all focusing events are created equally and that severe storms and hurricanes are associated with state agencies identifying a flurry of violations as compared to fires and flooding.
The 2021 unprecedented Pacific Northwest heatwave broke temperature records by extraordinary amounts. Impacts included hundreds of deaths, mass-mortalities of marine life, increased wildfires, reduced crop and fruit yields, and river flooding. In late June 2021 a heatwave of unprecedented magnitude impacted the Pacific Northwest region of Canada and the United States. Many locations broke all-time maximum temperature records by more than 5 & DEG;C, and the Canadian national temperature record was broken by 4.6 & DEG;C, with a new record temperature of 49.6 & DEG;C. Here, we provide a comprehensive summary of this event and its impacts. Upstream diabatic heating played a key role in the magnitude of this anomaly. Weather forecasts provided advanced notice of the event, while sub-seasonal forecasts showed an increased likelihood of a heat extreme with lead times of 10-20 days. The impacts of this event were catastrophic, including hundreds of attributable deaths across the Pacific Northwest, mass-mortalities of marine life, reduced crop and fruit yields, river flooding from rapid snow and glacier melt, and a substantial increase in wildfires-the latter contributing to landslides in the months following. These impacts provide examples we can learn from and a vivid depiction of how climate change can be so devastating.
The occurrence of wildfires in Indonesia is prevalent during drought seasons. Multiple toxic pollutants emitted from wildfires have deleterious effects on pregnant women. However, the evidence for these on pregnant women was underreported. The study conducted 24-h monitoring of fine particulate matter (PM(2.5)) concentrations indoors and outdoors in 9 low-income homes in Palangka Raya during the 2019 wildfire season and 6 low-income homes during the 2019 non-wildfire season. A hundred and seventy pregnant women had their PM exposure assessed between July and October 2019 using personal monitors. It was observed that outdoor air pollutant levels were greater than those found indoors without indoor sources. The findings indicate that indoor PM(2.5) concentrations were modestly increased by 1.2 times higher than outdoor, suggesting that buildings only partially protected people from exposure during wildfires. The concentrations of PM(2.5) were found to be comparatively higher indoors in residential buildings with wood material than in brick houses. The study findings indicate that 8 out of 12 brick houses exhibited a notable RI/O(24 h) of less than 1 during the wildfires, whereas all I/O(24 h) ratios during the non-wildfire season were >1, suggesting the influence of indoor sources. Based on the estimation of daily PM(2.5) dose, pregnant women received around 21% of their total daily dose during sedentary activity involving cooking. The present research offers empirical support for the view that indoor air quality in low-income households is affected by a complex combination of factors, including wildfire smoke, air tightness, and occupant behaviour. Also, this situation is more likely a potential risk to pregnant women being exposed to wildfire smoke.
Particulate pollution from forest fire smoke threatens the health of communities by increasing the occurrence of respiratory illnesses. Wind drives both fire behaviour and smoke dispersal. Understanding regional wind patterns would assist in effectively managing smoke risk. Sydney, Australia is prone to smoke pollution because it has a large population close to fire-prone eucalypt forests. Here we use the self-organising maps (SOM) technique to identify sixteen unique wind classes for the Sydney region from days with active fires, including identifying sea breeze occurrence. We explored differences in PM(2.5) levels between classes and between hazard reduction burning (HRB) and wildfire days. For HRB days, classes with the highest PM(2.5) mostly had a sea breeze, whereas better air quality days usually had winds aligned across the region (e.g. all westerly). The wind class with the most HRB days had low wind speeds and a sea breeze and was among the worst wind classes for air quality. For wildfire days, days with a sea breeze were also generally of poor air quality but many classes had at least some poor air quality days, most of which were during the 2019-2020 east coast wildfires in New South Wales. Some poor air quality days occurred in wind classes that sent strong plumes directly over air quality stations, spread smoke over a wide area or transported smoke from outside the region. The classes identified may be useful in scheduling HRBs, for example, identifying days with low pollution risk to conduct an HRB, or for assisting in understanding pollution risk and sending health warnings during HRBs and wildfires. Further development of the approach may allow the creation of multi-day classifications for fire managers to plan HRB ignitions over several days to ensure better smoke dispersal. Further research could incorporate other weather predictors or focus on other regions.
Forest fires cause many environmental impacts, including air pollution. Brazil is a very fire-prone region where few studies have investigated the impact of wildfires on air quality and health. We proposed to test two hypotheses in this study: i) the wildfires in Brazil have increased the levels of air pollution and posed a health hazard in 2003-2018, and ii) the magnitude of this phenomenon depends on the type of land use and land cover (e.g., forest area, agricultural area, etc.). Satellite and ensemble models derived data were used as input in our analyses. Wildfire events were retrieved from Fire Information for Resource Management System (FIRMS), provided by NASA; air pollution data from the Copernicus Atmosphere Monitoring Service (CAMS); meteorological variables from the ERA-Interim model; and land use/cover data were derived from pixel-based classification of Landsat satellite images by MapBiomas. We used a framework that infers the “wildfire penalty” by accounting for differences in linear pollutant annual trends (β) between two models to test these hypotheses. The first model was adjusted for Wildfire-related Land Use activities (WLU), considered as an adjusted model. In the second model, defined as an unadjusted model, we removed the wildfire variable (WLU). Both models were controlled by meteorological variables. We used a generalized additive approach to fit these two models. To estimate mortality associated with wildfire penalties, we applied health impact function. Our findings suggest that wildfire events between 2003 and 2018 have increased the levels of air pollution and posed a significant health hazard in Brazil, supporting our first hypothesis. For example, in the Pampa biome, we estimated an annual wildfire penalty of 0.005 μg/m(3) (95%CI: 0.001; 0.009) on PM(2.5). Our results also confirm the second hypothesis. We observed that the greatest impact of wildfires on PM(2.5) concentrations occurred in soybean areas in the Amazon biome. During the 16 years of the study period, wildfires originating from soybean areas in the Amazon biome were associated with a total penalty of 0.64 μg/m(3) (95%CI: 0.32; 0.96) on PM(2.5), causing an estimated 3872 (95%CI: 2560; 5168) excess deaths. Sugarcane crops were also a driver of deforestation-related wildfires in Brazil, mainly in Cerrado and Atlantic Forest biomes. Our findings suggest that between 2003 and 2018, fires originating from sugarcane crops were associated with a total penalty of 0.134 μg/m(3) (95%CI: 0.037; 0.232) on PM(2.5) in Atlantic Forest biome, resulting in an estimated 7600 (95%CI: 4400; 10,800) excess deaths during the study period, and 0.096 μg/m(3) (95%CI: 0.048; 0.144) on PM(2.5) in Cerrado biome, resulting in an estimated 1632 (95%CI: 1152; 2112) excess deaths during the study period. Considering that the wildfire penalties observed during our study period may continue to be a challenge in the future, this study should be of interest to policymakers to prepare future strategies related to forest protection, land use management, agricultural activities, environmental health, climate change, and sources of air pollution.
The quantification of PM(2.5) concentrations solely stemming from both wildfire and prescribed burns (hereafter referred to as ‘fire’) is viable using the Community Multiscale Air Quality (CMAQ), although CMAQ outputs are subject to biases and uncertainties. To reduce the biases in CMAQ-based outputs, we propose a two-stage calibration strategy that improves the accuracy of CMAQ-based fire PM(2.5) estimates. First, we calibrated CMAQ-based non-fire PM(2.5) to ground PM(2.5) observations retrieved during non-fire days using an ensemble-based model. We estimated fire PM(2.5) concentrations in the second stage by multiplying the calibrated non-fire PM(2.5) obtained from the first stage by location- and time-specific conversion ratios. In a case study, we estimated fire PM(2.5) during the Washington 2016 fire season using the proposed calibration approach. The calibrated PM(2.5) better agreed with ground PM(2.5) observations with a 10-fold cross-validated (CV) R(2) of 0.79 compared to CMAQ-based PM(2.5) estimates with R(2) of 0.12. In the health effect analysis, we found significant associations between calibrated fire PM(2.5) and cardio-respiratory hospitalizations across the fire season: relative risk (RR) for cardiovascular disease = 1.074, 95% confidence interval (CI) = 1.021-1.130 in October; RR = 1.191, 95% CI = 1.099-1.291 in November; RR for respiratory disease = 1.078, 95% CI = 1.005-1.157 in October; RR = 1.153, 95% CI = 1.045-1.272 in November. However, the results were inconsistent when non-calibrated PM(2.5) was used in the analysis. We found that calibration affected health effect assessments in the present study, but further research is needed to confirm our findings.
Extreme weather events lead to significant adverse societal costs. Extreme Event Attribution (EEA), a methodology that examines how anthropogenic greenhouse gas emissions had changed the occurrence of specific extreme weather events, allows us to quantify the climate change-induced component of these costs. We collect data from all available EEA studies, combine these with data on the socio-economic costs of these events and extrapolate for missing data to arrive at an estimate of the global costs of extreme weather attributable to climate change in the last twenty years. We find that US[Formula: see text] 143 billion per year of the costs of extreme events is attributable to climatic change. The majority (63%), of this is due to human loss of life. Our results suggest that the frequently cited estimates of the economic costs of climate change arrived at by using Integrated Assessment Models may be substantially underestimated.
PURPOSE OF REVIEW: With increasing industrialization, exposure to ambient and wildfire air pollution is projected to increase, necessitating further research to elucidate the complex relationship between exposure and sinonasal disease. This review aims to summarize the role of ambient and wildfire air pollution in chronic rhinosinusitis (CRS) and olfactory dysfunction and provide a perspective on gaps in the literature. RECENT FINDINGS: Based on an emerging body of evidence, exposure to ambient air pollutants is correlated with the development of chronic rhinosinusitis in healthy individuals and increased symptom severity in CRS patients. Studies have also found a robust relationship between long-term exposure to ambient air pollutants and olfactory dysfunction. Ambient air pollution exposure is increasingly recognized to impact the development and sequelae of sinonasal pathophysiology. Given the rising number of wildfire events and worsening impacts of climate change, further study of the impact of wildfire-related air pollution is a crucial emerging field.
INTRODUCTION: Both exposure to a natural disaster and psychological symptoms may lead to decreases in social support. Few studies have examined ways to improve social support among victims of natural disasters. AIMS: The objective of the study was to assess emotional and tangible support following a 12-session Internet-based cognitive behavioral therapy (ICBT) targeting posttraumatic stress (PTS), insomnia, and depression symptoms and to examine the association between posttreatment symptoms and emotional and tangible support. MATERIALS AND METHODS: One hundred and seventy-eight wildfire evacuees with significant PTS, depression and/or insomnia symptoms were given access to the ICBT. They completed questionnaires at pre- and posttreatment to measure social support and symptom severity. RESULTS: Results show that completion of the treatment led to an improvement in emotional support. Lower posttreatment PTS and insomnia symptoms were associated with higher posttreatment emotional support. CONCLUSION: ICBT may contribute to enhance emotional support through symptom improvement and probably more so when social support is address directly in treatment.
BACKGROUND: In 2020, the American West faced two competing challenges: the COVID-19 pandemic and the worst wildfire season on record. Several studies have investigated the impact of wildfire smoke (WFS) on COVID-19 morbidity and mortality, but little is known about how these two public health challenges impact mortality risk for other causes. OBJECTIVES: Using a time-series design, we evaluated how daily risk of mortality due to WFS exposure differed for periods before and during the COVID-19 pandemic. METHODS: Our study included daily data for 11 counties in the Front Range region of Colorado (2010-2020). We assessed WFS exposure using data from the National Oceanic and Atmospheric Administration and used mortality counts from the Colorado Department of Public Health and Environment. We estimated the interaction between WFS and the pandemic (an indicator variable) on mortality risk using generalized additive models adjusted for year, day of week, fine particulate matter, ozone, temperature, and a smoothed term for day of year. RESULTS: WFS impacted the study area on 10% of county-days. We observed a positive association between the presence of WFS and all-cause mortality risk (incidence rate ratio (IRR) = 1.03, 95%CI: 1.01-1.04 for same-day exposures) during the period before the pandemic; however, WFS exposure during the pandemic resulted in decreased risk of all-cause mortality (IRR = 0.90, 95%CI: 0.87-0.93 for same-day exposures). DISCUSSION: We hypothesize that mitigation efforts during the first year of the pandemic, e.g., mask mandates, along with high ambient WFS levels encouraged health behaviors that reduced exposure to WFS and reduced risk of all-cause mortality. Our results suggest a need to examine how associations between WFS and mortality are impacted by pandemic-related factors and that there may be lessons from the pandemic that could be translated into health-protective policies during future wildfire events.
BACKGROUND: Wildfires cause significant physical and mental ill-health. How physical and mental symptoms interact following wildfire smoke exposure is unclear, particularly in the context of repeated exposures. In this cross-sectional study we investigated how posttraumatic stress and general psychological distress associated with somatic symptoms in a community exposed to multiple smoke events. METHODS: A random weighted sample of 709 adults exposed to smoke during the 2014 Hazelwood coal mine fire in south-eastern Australia completed a survey in 2020. The survey coincided with the Black Summer wildfires that caused a similar period of smoke haze in the region. Participants self-reported somatic symptoms (PHQ-15) and mine fire-related posttraumatic stress (IES-R) experienced over the previous week, general psychological distress (K10) experienced over the previous four weeks, lifetime health diagnoses and demographic information. Associations between posttraumatic stress, general psychological distress, and each PHQ-15 somatic symptom were analysed using ordinal logistic regression models. RESULTS: Overall, 36.2% of participants reported moderate- or high-level somatic symptomology. The most frequent somatic symptoms were fatigue, limb pain, trouble sleeping, back pain, headaches, and shortness of breath. After controlling for confounding factors, general psychological distress and posttraumatic stress were independently associated with all somatic symptoms (except menstrual problems in females for posttraumatic stress). CONCLUSIONS: Results highlight the high prevalence of somatic symptoms and their association with general psychological distress and posttraumatic stress within a community in the midst of a second large-scale smoke event. It is essential that healthcare providers and public health authorities consider the interconnections of these conditions when supporting communities affected by climate-related disasters.
Wildfire is a major disturbance agent in Arctic boreal and tundra ecosystems that emits large quantities of atmospheric pollutants, including PM(2.5). Under the substantial Arctic warming which is two to three times of global average, wildfire regimes in the high northern latitude regions are expected to intensify. This imposes a considerable threat to the health of the people residing in the Arctic regions. Alaska, as the northernmost state of the US, has a sizable rural population whose access to healthcare is greatly limited by a lack of transportation and telecommunication infrastructure and low accessibility. Unfortunately, there are only a few air quality monitoring stations across the state of Alaska, and the air quality of most remote Alaskan communities is not being systematically monitored, which hinders our understanding of the relationship between wildfire emissions and human health within these communities. Models simulating the dispersion of pollutants emitted by wildfires can be extremely valuable for providing spatially comprehensive air quality estimates in areas such as Alaska where the monitoring station network is sparse. In this study, we established a methodological framework that is based on an integration of the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model, the Wildland Fire Emissions Inventory System (WFEIS), and the Arctic-Boreal Vulnerability Experiment (ABoVE) Wildfire Date of Burning (WDoB) dataset, an Arctic-oriented fire product. Through our framework, daily gridded surface-level PM(2.5) concentrations for the entire state of Alaska between 2001 and 2015 for which wildfires are responsible can be estimated. This product reveals the spatio-temporal patterns of the impacts of wildfires on the regional air quality in Alaska, which, in turn, offers a direct line of evidence indicating that wildfire is the dominant driver of PM(2.5) concentrations over Alaska during the fire season. Additionally, it provides critical data inputs for research on understanding how wildfires affect human health which creates the basis for the development of effective and efficient mitigation efforts.
PURPOSE: As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources. AIMS: We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters. METHODS: We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires. RESULTS: We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress. CONCLUSIONS: We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.
BACKGROUND: Few studies investigated the impact of particulate matter (PM(2.5)) on some symptom exacerbations that are not perceived as severe enough to search for medical assistance. We aimed to study the association of short-term daily total PM(2.5) exposure with work loss due to sickness among adults living in California. METHODS: We included 44,544 adult respondents in the workforce from 2015 to 2018 California Health Interview Survey data. Daily total PM(2.5) concentrations were linked to respondents’ home addresses from continuous spatial surfaces of PM(2.5) generated by a geostatistical surfacing algorithm. We estimated the effect of a 2-week average of daily total PM(2.5) exposure on work loss using logistic regression models. RESULTS: About 1.69% (weighted percentage) of adult respondents reported work loss in the week before the survey interview. The odds ratio of work loss was 1.45 (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.03, 2.03) when a 2-week average of daily total PM(2.5) exposure was higher than 12 µg/m(3). The OR for work loss was 1.05 (95% CI: 0.98, 1.13) for each 2.56ug/m(3) increase in the 2-week average of daily total PM(2.5) exposure, and became stronger among those who were highly exposed to wildfire smoke (OR = 1.06, 95% CI: 1.00, 1.13), compared to those with lower wildfire smoke exposure (OR = 1.04, 95% CI: 0.79, 1.39). CONCLUSIONS: Our findings suggest that short-term ambient PM(2.5) exposure is positively associated with work loss due to sickness and the association was stronger among those with higher wildfire smoke exposure. It also indicated that the current federal and state PM(2.5) standards (annual average of 12 µg/m(3)) could be further strengthened to protect the health of the citizens of California.
BACKGROUND: During wildfire smoke episodes, school and childcare facility staff and those who support them rely upon air quality data to inform activity decisions. Where ambient regulatory monitor data is sparse, low-cost sensors can help inform local outdoor activity decisions, and provide indoor air quality data. However, there is no established protocol for air quality decision-makers to use sensor data for schools and childcare facilities. To develop practical, effective toolkits to guide the use of sensors in school and childcare settings, it is essential to understand the perspectives of the potential end-users of such toolkit materials. METHODS: We conducted 15 semi-structured interviews with school, childcare, local health jurisdiction, air quality, and school district personnel regarding sensor use for wildfire smoke response. Interviews included sharing PM(2.5) data collected at schools during wildfire smoke. Interviews were transcribed and transcripts were coded using a codebook developed both a priori and amended as additional themes emerged. RESULTS: Three major themes were identified by organizing complementary codes together: (1) Low-cost sensors are useful despite data quality limitations, (2) Low-cost sensor data can inform decision-making to protect children in school and childcare settings, and (3) There are feasibility and public perception-related barriers to using low-cost sensors. CONCLUSIONS: Interview responses provided practical implications for toolkit development, including demonstrating a need for toolkits that allow a variety of sensor preferences. In addition, participants expected to have a wide range of available time for monitoring, budget for sensors, and decision-making types. Finally, interview responses revealed a need for toolkits to address sensor uses outside of activity decisions, especially assessment of ventilation and filtration.
Large-scale wildfires in California, USA, are increasing in both size and frequency, with substantial health consequences. The capacity for wildfire smoke to displace microbes and cause clinically significant fungal infections is poorly understood. We aimed to determine whether exposure to wildfire smoke was associated with an increased risk of hospital admissions for systemic fungal infections. METHODS: In this population-based, retrospective study, we used hospital administrative data from 22 hospitals in California, USA, to analyse the association between wildfire smoke exposure and monthly hospital admissions for aspergillosis and coccidioidomycosis. We included hospitals that were members of the Vizient Clinical Data Base or Resource Manager during the study and excluded those that did not have complete reporting into Vizient during the study period. Smoke exposure was estimated using satellite-imaged smoke plumes in the hospital county. Incident rate ratios were calculated for all infection types 1 month and 3 months after smoke exposure. FINDINGS: Between Oct 1, 2014, and May 31, 2018, there were a median of 1638 annual admissions per hospital in the study sample. Individual patient demographics were not collected. We did not observe an association between smoke exposure and rate of hospital admission for aspergillosis. However, hospital admission for coccidioidomycosis increased by 20% (95% CI 5-38) in the month following any smoke exposure. Hospital admission increased by 2% (0-4) for every day that there had been smoke exposure in the previous month, after adjustment for temperature and temporal trend. Similar results were obtained with smoke exposure data from the 3 months before admission. INTERPRETATION: In the months following wildfire smoke exposure, California hospitals saw increased coccidioidomycosis infections. Given the projected increase in California wildfires and their expansion in endemic territories of soil-dwelling fungi, the ability for wildfire smoke to carry microbes and cause human disease warrants further research. FUNDING: None.
California plans to substantially increase the use of prescribed fire to reduce risk of catastrophic wildfires. Although for a beneficial purpose, prescribed fire smoke may still pose a health concern, especially among sensitive populations. We sought to understand community health experience, adaptive capacity, and attitudes regarding wildland and prescribed fire smoke to inform public health guidance. We conducted a cross-sectional survey of medically vulnerable persons in a rural, high fire risk county (N = 106, 76% > 65 years) regarding wildfire and prescribed smoke health effects; health protective actions; information needs; and support for fire management policies. Qualitative comments were reviewed for context and emerging themes. More than half (58%) of participants reported health impacts from wildfire smoke; 26% experienced impacts from prescribed fire smoke. Participants expressed strong support for prescribed fire, although also concerns about safety and smoke. Respondents reported taking actions to reduce smoke exposure (average 5 actions taken per person), but many (47%) lacked confidence that they could successfully protect their health. Persons who were satisfied with the information received tended to be more confident in their ability to protect their health compared to those who were not satisfied (61% vs. 35%). More information was desired on many topics, including notifications about prescribed fire, health protection and exposure reduction. As California expands use of prescribed fire, the need for effective health protective communication regarding smoke is increasingly vital. We recommend seeking solutions that strengthen community resilience and address equity for vulnerable populations.
Wildfires are a significant source of organic aerosol during summer, with major impacts on air quality and climate. However, studies in Europe suggest a surprisingly low (less than 10%) contribution of biomass burning organic aerosol to average summertime fine particulate matter levels. In this study we combine field measurements and atmospheric chemical transport modeling, to demonstrate that the contribution of wildfires to fine particle levels in Europe during summer is seriously underestimated. Our work suggests that the corresponding contribution has been underestimated by a factor of 4-7 and that wildfires were responsible for approximately half of the total OA in Europe during July 2022. This discrepancy with previous work is due to the rapid physicochemical transformation of these emissions to secondary oxidized organic aerosol with an accompanying loss of its organic chemical fingerprints. These atmospheric reactions lead to a regionally distributed background organic aerosol that is responsible for a significant fraction of the health-related impacts caused by fine particles in Europe and probably in other continents. These adverse health effects can occur hundreds or even thousands of kilometers away from the fires. We estimate that wildfire emissions are responsible for 15-22% of the deaths in Europe due to exposure to fine particulate matter during summer.
Emissions from wildfires worsen air quality and can adversely impact human health. This study utilized the fire inventory from NCAR (FINN) as wildfire emissions, and performed air quality modeling of April-October 2012, 2013, and 2014 using the U.S. Environmental Protection Agency CMAQ model under two cases: with and without wildfire emissions. This study then assessed the health impacts and economic values attributable to PM(2.5) from fires. Results indicated that wildfires could lead annually to 4000 cases of premature mortality in the U.S., corresponding to $36 billion losses. Regions with high concentrations of fire-induced PM(2.5) were in the west (e.g., Idaho, Montana, and northern California) and Southeast (e.g., Alabama, Georgia). Metropolitan areas located near fire sources, exhibited large health burdens, such as Los Angeles (119 premature deaths, corresponding to $1.07 billion), Atlanta (76, $0.69 billion), and Houston (65, $0.58 billion). Regions in the downwind of western fires, although experiencing relatively low values of fire-induced PM(2.5), showed notable health burdens due to their large population, such as metropolitan areas of New York (86, $0.78 billion), Chicago (60, $0.54 billion), and Pittsburgh (32, $0.29 billion). Results suggest that impacts from wildfires are substantial, and to mitigate these impacts, better forest management and more resilient infrastructure would be needed.
Rapidly changing wildfire regimes across the Western United States have driven more frequent and severe wildfires, resulting in wide-ranging societal threats from wildfires and wildfire-generated smoke. However, common measures of fire severity focus on what is burned, disregarding the societal impacts of smoke generated from each fire. We combine satellite-derived fire scars, air parcel trajectories from individual fires, and predicted smoke PM2.5 to link source fires to resulting smoke PM2.5 and health impacts experienced by populations in the contiguous United States from April 2006 to 2020. We quantify fire-specific accumulated smoke exposure based on the cumulative population exposed to smoke PM2.5 over the duration of a fire and estimate excess asthma-related emergency department (ED) visits as a result of this exposure. We find that excess asthma visits attributable to each fire are only moderately correlated with common measures of wildfire severity, including burned area, structures destroyed, and suppression cost. Additionally, while recent California fires contributed nearly half of the country’s smoke-related excess asthma ED visits during our study period, the most severe individual fire was the 2007 Bugaboo fire in the Southeast. We estimate that a majority of smoke PM2.5 comes from sources outside the local jurisdictions where the smoke is experienced, with 87% coming from fires in other counties and 60% from fires in other states. Our approach could enable broad-scale assessment of whether specific fire characteristics affect smoke toxicity or impact, inform cost-effectiveness assessments for allocation of suppression resources, and help clarify the growing transboundary nature of local air quality.
BACKGROUND: Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients’ hospital utilization. METHODS: We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients’ primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). RESULTS: Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. CONCLUSIONS: Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.
Forest fires release harmful pollutants, endangering public health and incurring substantial healthcare costs. This study empirically investigates the environment-health-economy relationship, utilizing a robust MM-QR approach. Findings divulge that economic growth, urbanization, and tourism drive healthcare expenditure, while environmental factors like forest fires, resource depletion, species extinction, and environmental policy stringency also increase health spending. Conversely, renewable energy consumption lowers healthcare costs, while coal extraction raises them. Empirical estimates reveal that 1%$$ 1% $$ increase in forest fires raises health spending by 0.03%-0.08%$$ 0.03%-0.08% $$, socioeconomic indicators by 0.01%-1.07%$$ 0.01%-1.07% $$, and environmental factors by 0.03%-3.74%$$ 0.03%-3.74% $$. Conversely, a 1%$$ 1% $$ rise in renewable energy usage cuts healthcare expenses by 0.06%-0.19%$$ 0.06%-0.19% $$. This study underscores the urgency of addressing environmental degradation, especially forest fires, to mitigate their impacts on human well-being.
After a traumatic event, several people are resilient, and some might even experience posttraumatic growth (PTG), that is, positive changes that occur after a life crisis. According to Tedeschi and Calhoun’s model (2004), growth after a traumatic event is influenced by one’s level of distress, their cognitions, coping strategies, and social support. However, the literature shows inconsistent findings about this model and about the positive impacts of PTG on individuals’ daily lives. Moreover, the relationship between PTG and daily functioning is not well understood. The objectives were to describe how PTG and daily functioning evolve over time after a disaster, to test whether posttraumatic stress disorder (PTSD) symptom severity can predict PTG and whether PTG can predict daily functioning longitudinally and to explore the contribution of posttraumatic cognitions, coping strategies, and perceived social support in the relationship between PTSD symptom severity and PTG. Evacuees from the 2016 Fort McMurray fires (n = 384) completed self-report questionnaires 4 times over a 2-year period after the fires. Results revealed that PTG and daily functioning remained stable up to 3 years after the fires. PTSD symptom severity and functioning disability positively predicted PTG at certain timepoints. No indirect effects were found, indicating that posttraumatic cognitions, social support, and coping strategies could not explain the relationship between PTSD symptom severity and PTG. This study provides partial support for Tedeschi and Calhoun’s theory that some distress is necessary for PTG to occur and supports the need to find ways to help disaster survivors improve their functioning.
In the summer of 2018, Sweden experienced widespread wildfires, particularly in the region of Jamtland Harjedalen during the final weeks of July. We previously conducted an epidemiological study and investigated acute respiratory health effects in eight municipalities relation to the wildfire air pollution. In this study, we aimed to estimate the potential health impacts under less favorable conditions with different locations of the major fires. Our scenarios focused on the most intense plume from the 2018 wildfire episode affecting the largest municipality, which is the region’s only city. Combining modeled PM2.5 concentrations, gridded population data, and exposure-response functions, we assessed the relative increase in acute health effects. The cumulative population-weighted 24 h PM2.5 exposure during the nine highest-level days reached 207 mu g/m(3) days for 63,227 inhabitants. We observed a small number of excess cases, particularly in emergency unit visits for asthma, with 13 additional cases compared to the normal 12. Overall, our scenario-based health impact assessment indicates minor effects on the studied endpoints due to factors such as the relatively small population, limited exposure period, and moderate increase in exposure compared to similar assessments. Nonetheless, considering the expected rise in fire potential due to global warming and the long-range transport of wildfire smoke, raising awareness of the potential health risks in this region is important.
Wildland firefighters (WLFFs) are inserted as the front-line defense to minimize loss of natural resources, property, and human life when fires erupt in forested regions of the world. The WLFF occupation is physically demanding as exemplified by total daily energy expenditures that can exceed 25 MJ/day (6000 calories). WLFFs must also cope with complex physical and environmental situations (i.e., heat, altitude, smoke, compromised sleep, elevated stress) which challenge thermoregulatory responses, impair recovery, and increase short- and long-term injury/health risks while presenting logistical obstacles to nutrient and fluid replenishment. The occupation also imposes emotional strain on both the firefighter and their families. The long-term implications of wildfire management and suppression on the physical and mental health of WLFFs are significant, as the frequency and intensity of wildland fire outbreaks as well as the duration of the fire season is lengthening and expected to continue to expand over the next three decades. This article details the physical demands and emerging health concerns facing WLFFs, in addition to the challenges that the U.S. Forest Service and other international agencies must address to protect the health and performance of WLFFs and their ability to endure the strain of an increasingly dangerous work environment. © 2023 American Physiological Society. Compr Physiol 13:4587-4615, 2023.
PURPOSE OF REVIEW: As the incidence of allergic conditions has increased in recent decades, the effects of climate change have been implicated. There is also increased knowledge on the effects of other physical influences, such as scratching and Staphylococcus aureus . The skin barrier is the first line of defense to the external environment, so understanding the ways that these factors influence skin barrier dysfunction is important. RECENT FINDINGS: Although the impact on environmental exposures has been well studied in asthma and other allergic disorders, there is now more literature on the effects of temperature, air pollution, and detergents on the skin barrier. Factors that cause skin barrier dysfunction include extreme temperatures, air pollution (including greenhouse gases and particulate matter), wildfire smoke, pollen, scratching, S. aureus, and detergents. SUMMARY: Understanding the ways that external insults affect the skin barrier is important to further understand the mechanisms in order to inform the medical community on treatment and prevention measures for atopic conditions.
During emergencies, older adults stand among the most vulnerable, facing long-lasting food insecurity and overall health issues. The “365+ Days of Care” food aid program addressed food insecurity and poor quality of life among vulnerable older adults following a devastating wildfire in Greece. Our aim was to evaluate the program’s efficiency, using a process evaluation framework and a partial cost-utility analysis. In total, n = 133 wildfire-hit residents (≥65 years) received daily tailored, pre-cooked meals and/or weekly food packages. The study outcomes were assessed from baseline to 12 months later. Focus groups and interviews (n = 30), researcher observations, and questionnaires were used to assess the beneficiaries’ perception of the initiative. Within the 12-month follow-up period, food insecurity and malnutrition risk decreased, whereas Mediterranean diet adherence; quality of life; and physical, social, and mental health were improved (p < 0.05). A one-point increase in food insecurity was positively associated with improved quality of life, general health, limitation in activities, body pain, vitality, and pain/discomfort (p's < 0.05), and it was marginally associated with mobility, anxiety/depression, and self-evaluated health status (p's < 0.1). Quantitative and qualitative data characterized it as successful, acceptable, beneficial, and of high quality. The partial cost-utility ratio was one QALY gained per EUR 22.608. The utilization of well-designed food aid programs during emergencies can alleviate food insecurity and improve quality of life in older adults.
This article employs new materialist theory to the accounts of women who were pregnant, giving birth or parenting new-borns during the Australian bushfires of 2019/2020. As feminist scholars we are concerned with the inequitable responsibility accorded to women during this time to limit their (un)born children’s exposure to smoke. Drawing on Barad’s (2007) relational ontology we trace how (non)human phenomena like ‘smoke’, ‘public health advice’ and discourses of ‘the good mother’ work intra-actively to establish conditions of possibility in relation to mother’s agency and responsibility in this crisis. Via in-depth interviews with 25 women, we discovered these coagulating forces meant many experienced feelings of ‘powerlessness’ and subsequent ‘guilt’ at their inability to prevent smoke inhalation for their (un)born children. To challenge this burden of responsibility, we (re)configure conventional notions of ‘agency’ and ‘responsibility’ within a new materialist frame. When agency is understood as an intra-active becoming and response-ability as preceding the subject, responsibility for the air shifts to a recognition that everyone/thing is complicit in the world’s differential becoming. We extend this thinking to consider human response-ability and agency in relation to the climate change that has been attributed to causing the fires.
The smoke produced by wildfires can travel great distances and lead to respiratory and/or cardiovascular health impacts through inhalation. Individuals can reduce exposure by implementing smoke mitigation measures in their homes and beyond. In this article, we examine household level survey data (n = 543) on wildfire smoke mitigation in response to the September 2020 wildfires that occurred in the state of Oregon (and beyond). The air quality was hazardous for about 10 days in many affected regions. This study assessed the implementation of six commonly referenced approaches to reducing exposure to smoke: staying indoors; keeping doors and windows closed, turning on HVAC; using air purifiers; replacing air filters, and wearing face masks. We found high levels of implementation of staying indoors and keeping doors and windows closed; however, statistical analysis of socioeconomic demographics suggests that respondents vary in the implementation of the other measures. Income, number of exposure days, and access to information on smoke mitigation were positively associated with the implementation. Given the importance of information access for implementation for three of the measures, we also present data on how different age groups prefer to be contacted about air quality and smoke mitigation. For example, participants above 65 years of age prefer local TV as opposed to social media, whereas text messages were favored by all age groups. These survey results will help to inform the design of campaigns to engage community members differentially and potentially affect best communication practices and other assistance/preparation for smoke mitigation across demographics.
Accentuated by climate change, catastrophic wildfires are a growing, distributed global public health risk from inhalation of smoke and dust. Underrecognized, however, are the health threats arising from fire-altered toxic metals natural to soils and plants. Here, we demonstrate that high temperatures during California wildfires catalyzed widespread transformation of chromium to its carcinogenic form in soil and ash, as hexavalent chromium, particularly in areas with metal-rich geologies (e.g., serpentinite). In wildfire ash, we observed dangerous levels (327-13,100 µg kg(-1)) of reactive hexavalent chromium in wind-dispersible particulates. Relatively dry post-fire weather contributed to the persistence of elevated hexavalent chromium in surficial soil layers for up to ten months post-fire. The geographic distribution of metal-rich soils and fire incidents illustrate the broad global threat of wildfire smoke- and dust-born metals to populations. Our findings provide new insights into why wildfire smoke exposure appears to be more hazardous to humans than pollution from other sources.
Natural hazards are increasing because of climate change, and they disproportionately affect vulnerable populations. Prior reviews of the mental health consequences of natural hazard events have not focused on the particular experiences of vulnerable groups. Based on the expected increase in fires and droughts in the coming years, the aim of this systematic review is to synthesize the global evidence about the mental health of vulnerable populations after experiencing natural hazards. We searched databases such as Ovid MEDLINE, EMBASE, CINAHL and Ovid PsycInfo using a systematic strategy, which yielded 3,401 publications. We identified 18 eligible studies conducted in five different countries with 15,959 participants. The most common vulnerabilities were living in a rural area, occupying a low socioeconomic position, being a member of an ethnic minority and having a medical condition. Common experiences reported by vulnerable individuals affected by drought included worry, hopelessness, isolation and suicidal thoughts and behaviors. Those affected by fire reported experiencing posttraumatic stress disorder (PTSD) and anger. These mental health problems exacerbated existing health and socioeconomic challenges. The evidence base about mental health in vulnerable communities affected by natural hazards can be improved by including standardized measures and comparison groups, examining the role of intersectional vulnerabilities, and disaggregating data routinely to allow for analyses of the particular experiences of vulnerable communities. Such efforts will help ensure that programs are informed by an understanding of the unique needs of these communities.
The intensity and frequency of wildfires is increasing globally. The systematic review of the current evidence on long-term impacts of non-occupational wildfire exposure on human health has not been performed yet. To provide a systematic review and identify potential knowledge gaps in the current evidence of long-term impacts of non-occupational exposure to wildfire smoke and/or wildfire impacts on human health. We conducted a systematic search of the literature via MEDLINE, Embase and Scopus from the database inception to July 05, 2022. References from the included studies and relevant reviews were also considered. The Newcastle-Ottawa Scale (NOS) and a validated quality assessment framework were used to evaluate the quality of observational studies. Study results were synthesized descriptively. A total of 36 studies were included in our systematic review. Most studies were from developed countries (11 in Australia, 9 in Canada, 7 in the United States). Studies predominantly focused on mental health (21 studies, 58.33%), while evidence on long-term impacts of wildfire exposure on health outcomes other than mental health is limited. Current evidence indicated that long-term impacts of non-occupational wildfire exposure were associated with mortality (COVID-19 mortality, cardiovascular disease mortality and acute myocardial disease mortality), morbidity (mainly respiratory diseases), mental health disorders (mainly posttraumatic stress disorder), shorter height of children, reduced lung function and poorer general health status. However, no significant associations were observed for long-term impacts of wildfire exposure on child mortality and respiratory hospitalizations. The population-based high-quality evidence with quantitative analysis on this topic is still limited. Future well-designed studies considering extensive wildfire smoke air pollutants (e.g., particulate matter, ozone, nitrogen oxides) and estimating risk coefficient values for extensive health outcomes (e.g., mortality, morbidity) are warranted to fill current knowledge gaps.
BACKGROUND: Long-term improvements in air quality and public health in the continental USA were disrupted over the past decade by increased fire emissions that potentially offset the decrease in anthropogenic emissions. This study aims to estimate trends in black carbon and PM(2·5) concentrations and their attributable mortality burden across the USA. METHODS: In this study, we derived daily concentrations of PM(2·5) and its highly toxic black carbon component at a 1-km resolution in the USA from 2000 to 2020 via deep learning that integrated big data from satellites, models, and surface observations. We estimated the annual PM(2·5)-attributable and black carbon-attributable mortality burden at each 1-km(2) grid using concentration-response functions collected from a national cohort study and a meta-analysis study, respectively. We investigated the spatiotemporal linear-regressed trends in PM(2·5) and black carbon pollution and their associated premature deaths from 2000 to 2020, and the impact of wildfires on air quality and public health. FINDINGS: Our results showed that PM(2·5) and black carbon estimates are reliable, with sample-based cross-validated coefficients of determination of 0·82 and 0·80, respectively, for daily estimates (0·97 and 0·95 for monthly estimates). Both PM(2·5) and black carbon in the USA showed significantly decreasing trends overall during 2000 to 2020 (22% decrease for PM(2·5) and 11% decrease for black carbon), leading to a reduction of around 4200 premature deaths per year (95% CI 2960-5050). However, since 2010, the decreasing trends of fine particles and premature deaths have reversed to increase in the western USA (55% increase in PM(2·5), 86% increase in black carbon, and increase of 670 premature deaths [460-810]), while remaining mostly unchanged in the eastern USA. The western USA showed large interannual fluctuations that were attributable to the increasing incidence of wildfires. Furthermore, the black carbon-to-PM(2·5) mass ratio increased annually by 2·4% across the USA, mainly due to increasing wildfire emissions in the western USA and more rapid reductions of other components in the eastern USA, suggesting a potential increase in the relative toxicity of PM(2·5). 100% of populated areas in the USA have experienced at least one day of PM(2·5) pollution exceeding the daily air quality guideline level of 15 μg/m(3) during 2000-2020, with 99% experiencing at least 7 days and 85% experiencing at least 30 days. The recent widespread wildfires have greatly increased the daily exposure risks in the western USA, and have also impacted the midwestern USA due to the long-range transport of smoke. INTERPRETATION: Wildfires have become increasingly intensive and frequent in the western USA, resulting in a significant increase in smoke-related emissions in populated areas. This increase is likely to have contributed to a decline in air quality and an increase in attributable mortality. Reducing fire risk via effective policies besides mitigation of climate warming, such as wildfire prevention and management, forest restoration, and new revenue generation, could substantially improve air quality and public health in the coming decades. FUNDING: National Aeronautics and Space Administration (NASA) Applied Science programme, NASA MODIS maintenance programme, NASA MAIA satellite mission programme, NASA GMAO core fund, National Oceanic and Atmospheric Administration (NOAA) GEO-XO project, NOAA Atmospheric Chemistry, Carbon Cycle, and Climate (AC4) programme, and NOAA Educational Partnership Program with Minority Serving Institutions.
In Portugal, each year, the news typically report one or two cases of elderly farmer fatalities or injuries. However, in 2018, a startling 20 incidents were documented. This study aims to analyse the various factors that may account for this unusual surge in the numbers. To gather comprehensive and organized data on the incidents, a meticulous review of both regional and national news sources was conducted from 2008 to 2021. This enabled the collection of various variables, including date, location, gender, age, and other pertinent information. Additionally, meteorological data related to wildfire risk, sociodemographic indices, and the legislative context were also incorporated to provide a more complete understanding of the incidents. Between 2008 and 2021, a total of 54 incidents were recorded, with fatalities accounting for 78% of cases. The exceptional rise in incidents in 2018 constituted 37% of the total incidents. The majority of incidents involved elderly individuals (82%) and were primarily males (80%). March and October were the months when most incidents occurred. After conducting meteorological, social, and legislative analyses, it was found that the primary driver behind the dramatic increase in incidents in 2018 was most probably the intense pressure to manage the vegetation, due to an impending deadline for fuel reductions, along with stricter inspections and law enforcement that doubled the fines for non-compliance.
In 2019/20 major bushfires devastated Australia’s East Coast. Shortly afterward the COVID-19 pandemic was declared. Older people are disproportionately affected by disasters and are at high risk from respiratory pandemics. However, little is known about how these events impact on older peoples’ health and well-being and engagement with services such as primary care. OBJECTIVE: To explore the health impacts of the 2019/20 bushfires and the COVID-19 pandemic on older Australians’ health and well-being. METHODS: One hundred and fifty-five people aged over 65 years living in South-eastern New South Wales, Australia participated in an online survey. The survey measured the impacts of the bushfires and COVID-19 on physical and mental health and the capacity of older people to manage these impacts. RESULTS: Most respondents felt that the bushfires caused them to feel anxious/worried (86.2%) and negatively affected their physical (59.9%) and mental (57.2%) health. While many participants had similar feelings about COVID-19, significantly fewer felt these physical and mental health impacts than from the bushfires. A significantly greater perceived level of impact was observed for females and those with health problems. More respondents described negative mental health than physical health effects. Those who felt more impacted by the events had lower levels of resilience, social connection and support, and self-rated health. CONCLUSION: The health impacts identified in this study represent an opportunity for primary care to intervene to both ensure that people with support needs are identified and provided timely support and that older people are prepared for future disasters.
Research on sense of place suggests that people’s understandings of themselves and others is closely tied to the feelings they have about the place where they reside. Solastalgia expands on this sociological concept by considering the impacts on the various benefits derived from place when a landscape is changed through acute or chronic environmental disruptions. As such, climate-related disasters affect both tangible and intangible goods. Using 24 qualitative interviews with residents of Paradise, California several months after a wildfire destroyed their town, this exploratory study examines three ways in which the solastalgia experience is socially constructed. This occurs through disruptions to coping resources found in the natural world, embeddedness of history in place, and the experience of “homesickness” for a changed landscape.
PURPOSE OF REVIEW: Wildfire smoke is associated with human health, becoming an increasing public health concern. However, a comprehensive synthesis of the current evidence on the health impacts of ambient wildfire smoke on children and adolescents, an exceptionally vulnerable population, is lacking. We conduct a systematic review of peer-reviewed epidemiological studies on the association between wildfire smoke and health of children and adolescents. RECENT FINDINGS: We searched for studies available in MEDLINE, EMBASE, and Scopus from database inception up to October 11, 2022. Of 4926 studies initially identified, 59 studies from 14 countries were ultimately eligible. Over 33.3% of the studies were conducted in the USA, and two focused on multi-countries. The exposure assessment of wildfire smoke was heterogenous, with wildfire-specific particulate matters with diameters ≤ 2.5 µm (PM(2.5), 22.0%) and all-source (22.0%) PM(2.5) during wildfire period most frequently used. Over half of studies (50.6%) focused on respiratory-related morbidities/mortalities. Wildfire smoke exposure was consistently associated with enhanced risks of adverse health outcomes in children/adolescents. Meta-analysis results presented a pooled relative risk (RR) of 1.04 (95% confidence interval [CI], 0.96-1.12) for all-cause respiratory morbidity, 1.11 (95% Ci: 0.93-1.32) for asthma, 0.93 (95% CI, 0.85-1.03) for bronchitis, and 1.13 (95% CI, 1.05-1.23) for upper respiratory infection, whilst - 21.71 g for birth weight (95% CI, - 32.92 to - 10.50) per 10 µg/m(3) increment in wildfire-specific PM(2.5)/all-source PM(2.5) during wildfire event. The majority of studies found that wildfire smoke was associated with multiple adverse health outcomes among children and adolescents, with respiratory morbidities of significant concern. In-utero exposure to wildfire smoke may increase the risk of adverse birth outcomes and have long-term impacts on height. Higher maternal baseline exposure to wildfire smoke and poor family-level baseline birthweight respectively elevated risks in preterm birth and low birth weight associated with wildfire smoke. More studies in low- and middle-income countries and focusing on extremely young children are needed. Despite technological progress, wildfire smoke exposure measurements remain uncertain, demanding improved methodologies to have more precise assessment of wildfire smoke levels and thus quantify the corresponding health impacts and guide public mitigation actions.
Wildfires are thought to be increasing in severity and frequency as a result of climate change(1-5). Air pollution from landscape fires can negatively affect human health(4-6), but human exposure to landscape fire-sourced (LFS) air pollution has not been well characterized at the global scale(7-23). Here, we estimate global daily LFS outdoor fine particulate matter (PM(2.5)) and surface ozone concentrations at 0.25° × 0.25° resolution during the period 2000-2019 with the help of machine learning and chemical transport models. We found that overall population-weighted average LFS PM(2.5) and ozone concentrations were 2.5 µg m(-3) (6.1% of all-source PM(2.5)) and 3.2 µg m(-3) (3.6% of all-source ozone), respectively, in 2010-2019, with a slight increase for PM(2.5), but not for ozone, compared with 2000-2009. Central Africa, Southeast Asia, South America and Siberia experienced the highest LFS PM(2.5) and ozone concentrations. The concentrations of LFS PM(2.5) and ozone were about four times higher in low-income countries than in high-income countries. During the period 2010-2019, 2.18 billion people were exposed to at least 1 day of substantial LFS air pollution per year, with each person in the world having, on average, 9.9 days of exposure per year. These two metrics increased by 6.8% and 2.1%, respectively, compared with 2000-2009. Overall, we find that the global population is increasingly exposed to LFS air pollution, with socioeconomic disparities.
Forest fires are a potential threat to life, as they contribute to reducing forest areas, impact on the services we expect from ecosystems, the health of the inhabitants is affected by smoke and the economic costs for the recovery of affected areas is high. The objective of the study is to apply fuzzy logic to model the risk of forest fires in the Cajamarca-Peru region, incorporating variables that represent biological, topographic, socioeconomic, and meteorological factors. The analysis was based on the acquisition, editing and rasterization of the database, application of fuzzy membership functions and image fuzzification, fuzzy superposition and spatial reclassification of forest fire risk. The results obtained show that 71.68% of the area is under very low or medium forest fire risk. However, 28.32% of the study area has a high to very high fire risk, which makes the occurrence of fires susceptible to the lack of rain and water in the soil. It was found that biological, topographic, and socioeconomic factors with their respective variables are directly influenced by meteorological factor variables such as temperature, rainfall and water availability. Fuzzy logic offered flexibility in modeling wildfire risk in the region, proving to be a useful tool for predicting and mapping wildfire risk.(c) 2023 by the authors; licensee Growing Science, Canada.
Extreme weather events are increasing in frequency and severity due to climate change, yet many of their impacts on human populations are not well understood. We examine the relationship between prior extreme weather events and food environment characteristics. To do so, we conduct a U.S. county-level analysis that assesses the association between extreme weather events and two common food retail environment dimensions. Overall, we find a relationship between higher levels of historic extreme weather exposure and lower food availability and accessibility. In addition, we find heterogeneity in association across the distribution of the number of extreme weather events and event type. Specifically, we find that more localized extreme weather events are more associated with a reduction of access and availability than broad geographic events. Our findings suggest that as extreme weather events amplify in intensity and increase in frequency, new approaches for mitigating less acute and longer-term impacts are needed to address how extreme weather may interact with and reinforce existing disparities in food environment factors. Furthermore, our research argues that integrated approaches to improving vulnerable food retail environments will become an important component of extreme weather planning and should be a consideration in both disaster- and food-related policy.
This study analyzed fire-pollutant-meteorological variables and their impact on cardio-respiratory mortality in Portugal during wildfire season. Data of burned area, particulate matter with a diameter of 10 or 2.5 μm (μm) or less (PM(10), PM(2.5)), carbon monoxide (CO), nitrogen dioxide (NO(2)), ozone (O(3)), temperature, relative humidity, wind speed, aerosol optical depth and mortality rates of Circulatory System Disease (CSD), Respiratory System Disease (RSD), Pneumonia (PNEU), Chronic Obstructive Pulmonary Disease, and Asthma (ASMA), were used. Only the months of 2011-2020 wildfire season (June-July-August-September-October) with a burned area greater than 1,000 ha were considered. Principal component analysis was used on fire-pollutant-meteorological variables to create two indices called Pollutant-Burning Interaction (PBI) and Atmospheric-Pollutant Interaction (API). PBI was strongly correlated with the air pollutants and burned area while API was strongly correlated with temperature and relative humidity, and O(3). Cluster analysis applied to PBI-API divided the data into two Clusters. Cluster 1 included colder and wetter months and higher NO(2) concentration. Cluster 2 included warmer and dried months, and higher PM(10), PM(2.5), CO, and O(3) concentrations. The clusters were subjected to Principal Component Linear Regression to better understand the relationship between mortality and PBI-API indices. Cluster 1 showed statistically significant (p-value < 0.05) correlation (r) between RSDxPBI (r (RSD) = 0.58) and PNEUxPBI (r (PNEU) = 0.67). Cluster 2 showed statistically significant correlations between RSDxPBI (r (RSD) = 0.48), PNEUxPBI (r (PNEU) = 0.47), COPDxPBI (r (COPD) = 0.45), CSDxAPI (r (CSD) = 0.70), RSDxAPI (r (CSD) = 0.71), PNEUxAPI (r (PNEU) = 0.49), and COPDxAPI (r (PNEU) = 0.62). Cluster 2 analysis indicates that the warmest, driest, and most polluted months of the wildfire season were associated with cardio-respiratory mortality.
This paper investigates the causal effect of wildfire exposure on birth outcomes and older people’s health outcomes in United States (US). The study focuses on three sub-questions for each health outcome: (1) the causal effect of each of the five largest wildfires on individual health, (2) the causal impact of multiple large wildfires on individual health outcomes, and (3) the causal influence of wildfires larger than different sizes within different distances of counties on health outcomes at the county level. The analysis exploits data from National Vital Statistics System, Behavioural Risk Factor Surveillance System and FIRESTAT. In terms of birth outcomes, the findings show that the largest wildfire slightly increased the risk of other circulatory or respiratory anomalies. Multiple large wildfires moderately raised the risk of prematurity and led to a small decline in the probability of getting omphalocele and cleft lip. The county-level analysis suggests an increased risk of macrosomia following maternal exposure to wildfires. As for the elderly aged 65 + , the results indicate that exposure to multiple massive wildfires led to frequent occurrence of asthma symptoms, while the largest wildfire led to sleeping difficulty caused by asthma symptoms. The number of days older people experienced psychological problems was increased following exposure to multiple large wildfires.
As described in the previous chapter, Chapter 4: Air pollution and pregnancy, there is robust literature on the adverse health impacts of ambient air pollution on perinatal outcomes. With climate change contributing to more extreme weather patterns, wildfire events are becoming more intense and frequent. Wildfire smoke is a major contributor to poor air quality and data are beginning to emerge with respect to the negative impact on perinatal outcomes. The aim of this chapter is to provide an overview of the current literature on wildfire smoke exposure in pregnancy and associated adverse outcomes.
Despite the existing knowledge about stress, trauma and pregnancy and maternal stress during natural disasters, little is known about what types of trauma pregnant or preconception women experience during these disasters. In May 2016, the worst natural disaster in modern Canadian history required the evacuation of nearly 90,000 residents of the Fort McMurray Wood Buffalo (FMWB) area of northern Alberta. Among the thousands of evacuees were an estimated 1850 women who were pregnant or soon to conceive. In August 2017, Hurricane Harvey devastated areas of the United States including Texas, with 30,000 people forced to flee their homes due to the intense flooding. OBJECTIVE: To explore immediate and past traumatic experiences of pregnant or preconception women who experienced one of two natural disasters (a wildfire and a hurricane) as captured in their expressive writing. Research questions were: (1) What trauma did pregnant or preconception women experience during the fire and the hurricane? (2) What past traumatic experiences, apart from the disasters, did the women discuss in their expressive writing? METHODS: A qualitative secondary analysis of expressive writing using thematic content analysis was conducted on the expressive writing of 50 pregnant or preconception women who experienced the 2016 Fort McMurray Wood Buffalo Wildfire (n = 25) and the 2017 Houston Hurricane Harvey (n = 25) Narrative data in the form of expressive writing entries from participants of two primary studies were thematically analyzed. One of the expressive writing questions was used in this analysis: “What is the most traumatic, upsetting experience of your entire life, especially that you have never discussed in great detail with others?” NVivo 12 supported thematic content analysis. RESULTS: For some women, the disasters elicited immense fear and anxiety that surpassed previous traumatic life events. Others, however, disclosed significant past traumas that continue to impact them, including betrayal by a loved one, abuse, maternal health complications, and illness. CONCLUSION: We recommend a strengths-based and trauma-informed care approach in both maternal health and post-disaster relief care.
BACKGROUND: The impact of wildfire smoke is a growing public health issue, especially for those living with preexisting respiratory conditions. Understanding perceptions and behaviors relevant to the use of individual protective strategies, and how these affect the adoption of these strategies, is critical for the development of future communication and support interventions. This study focused on the use of masks by people living in the Australian community with asthma or chronic obstructive pulmonary disease (COPD). METHODS: Semi-structured phone interviews were undertaken with people living in the community aged 18 years and over. Participants lived in a bushfire-prone area and reported having been diagnosed with asthma or COPD. RESULTS: Twenty interviews were undertaken between July and September 2021. We found that, during wildfire episodes, there was an overwhelming reliance on closing windows and staying inside as a means of mitigating exposure to smoke. There was limited use of masks for this purpose. Even among those who had worn a mask, there was little consideration given to the type of mask or respirator used. Reliance on sensory experiences with smoke was a common prompt to adopting an avoidance behavior. Participants lacked confidence in the information available from air-quality apps and websites, however they were receptive to the idea of using masks in the future. CONCLUSIONS: Whilst COVID-19 has changed the nature of community mask use over the last couple of years, there is no guarantee that this event will influence an individual’s mask behavior during other events like bushfires. Instead, we must create social support processes for early and appropriate mask use, including the use of air quality monitoring.
We conducted a pre-registered, between-subjects experiment to investigate whether experiencing climate change consequences virtually can influence cognitions, emotions, and pro-environmental intentions and behaviors. Participants (N = 277) experienced a wildfire through different media that varied in their degree of technological immersiveness (virtual reality vs. regular video vs. magazine articles only). Participants in the virtual reality condition reported higher spatial presence, stronger emotional responses, stronger bodily responses, and reported that the experience felt more life-like. Increased spatial presence was associated with increased risk perceptions and negative emotions. Risk perceptions and negative emotions were subsequently associated with reduced intentions to consume dairy and meat, but not associated with actual plant-based food choices (vegan vs. non-vegan chocolate bar). Actual donations to ENGOs were only influenced by risk perceptions, not emotions. The role of psychological distance was explored, which led to different conclusions for quantitative (no effect of virtual reality) and qualitative measures (virtual reality can reduce psychological distance).
Sub-micron particles are ubiquitous in the indoor environment, especially during wildfire smoke episodes, and have a higher impact on human health than larger particles. Conventional fibrous air filters installed in heating, ventilation, and air conditioning (HVAC) systems play an important role in controlling indoor air quality by removing various air pollutants, including particulate matter (PM). However, it is evident that the removal efficiency of wildfire smoke PM and its effect on filter performance is significantly under-studied. This study delves into the size-specific removal efficiency of pine needle smoke, a representative of wildfire smoke and emissions. We test an array of filter media with minimum efficiency reporting values (MERV) spanning 11-15. Both size-resolved particle number concentrations and mass concentrations were measured using an Optical Particle Sizer (OPS, TSI, Inc.) and a Scanning Mobility Particle Sizer (SMPS, TSI, Inc.). Furthermore, we characterize the filter media morphology and smoke particles deposited on filter fibers using Scanning Electron Microscopy (SEM) to gain insights into the interaction dynamics of these particles. Our findings add to the comprehension of the relationship between MERV designations and smoke removal efficiency. Such insight can inform standards and guidelines and equip decision-makers with the knowledge needed to initiate measures for mitigating the impact of air pollution, specifically on the indoor environment.
Wildfire smoke has been associated with adverse respiratory outcomes, but the impacts of wildfire on other health outcomes and sensitive subpopulations are not fully understood. We examined associations between smoke events and emergency department visits (EDVs) for respiratory, cardiovascular, diabetes, and mental health outcomes in California during the wildfire season June-December 2016-2019. Daily, zip code tabulation area-level wildfire-specific fine particulate matter (PM(2.5)) concentrations were aggregated to air basins. A “smoke event” was defined as an air basin-day with a wildfire-specific PM(2.5) concentration at or above the 98th percentile across all air basin-days (threshold = 13.5 μg/m(3)). We conducted a two-stage time-series analysis using quasi-Poisson regression considering lag effects and random effects meta-analysis. We also conducted analyses stratified by race/ethnicity, age, and sex to assess potential effect modification. Smoke events were associated with an increased risk of EDVs for all respiratory diseases at lag 1 [14.4%, 95% confidence interval (CI): (6.8, 22.5)], asthma at lag 0 [57.1% (44.5, 70.8)], and chronic lower respiratory disease at lag 0 [12.7% (6.2, 19.6)]. We also found positive associations with EDVs for all cardiovascular diseases at lag 10. Mixed results were observed for mental health outcomes. Stratified results revealed potential disparities by race/ethnicity. Short-term exposure to smoke events was associated with increased respiratory and schizophrenia EDVs. Cardiovascular impacts may be delayed compared to respiratory outcomes.
BACKGROUND: In February 2022, an online Wildfire Smoke Communication Workshop series identified priorities and strategies to improve wildfire smoke communication in Canada. We evaluated the engagement methods, the workshop series and workshop summary report, to determine if participants/organizations initiated changes identified in the workshop to optimize wildfire smoke communication plans. METHODS: Three evaluation surveys were developed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework dimensions and PRISM (Practical, Robust, Implementation, and Sustainability Model) contextual domains to measure the engagement impact. Surveys 1, 2, and 3 were disseminated to workshop participants between February 2022 (post-workshop series), May 2022 (pre-wildfire season), and September 2022 (post-wildfire season). Likert survey responses were analyzed descriptively using means and standard deviations. Open-ended written responses were analyzed using deductive reasoning and response proportions. RESULTS: Of 69 workshop participants, 28, 19, and 13 responded to surveys 1, 2, and 3, respectively. Workshop participation helped survey 1 respondents consider optimizing wildfire smoke communication (M = 3.93, SD = 0.88). Workshop participation and the summary report helped survey 2 respondents consider new actions to optimize wildfire smoke communication (M = 3.84, SD = 0.74). The most intended action in survey 2 (68%, n = 13) and the most common action taken in survey 3 (62%, n = 8) was to simplify message content. The primary limitation to optimization was capacity. CONCLUSION: The engagement methods, particularly the summary report, were beneficial for organizations to take action to optimize wildfire smoke communication in Canada. Future engagement methods should examine persisting system-level issues and capacity limitations as they undermine the ability to optimize wildfire smoke communication in Canada.
This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 > 23) or mild PTSD symptoms (PCL-5 > 10) with mod-erate depression (PHQ-9 > 10) or subthreshold insomnia symptoms (ISI > 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Signifi-cant Assessment Time x Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] =12.128, p = .001; d = .519, 95% CI = .142- .895),depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141-.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132-.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044- .797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200-.963). Larger effect sizes (d = 0.823-1.075) were observed in participants who completed at least half of the treatment. The RESILI-ENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.
The results of two previously published reports of the events and impacts of the Campfire wildfire smoke exposure that occurred in California in 2018 are amplified from the point of view of the potential toxic mechanism involved. The Campfire wildfire led to the exposure of a breeding colony of macaque monkeys (Macaca mulatta) during the peak of their breeding season in 2018-2019. Considering the timing, adverse effects, and endocrine implications reported, the cumulative evidence points to an early toxic sensitive period that can lead to birth defects in higher primates and human pregnancies. This deeper inspection of the published observations provides important caveats and useful guidance for future investigators. The unique higher primate placental-adrenal-brain axis may limit the use of many traditional toxicologic approaches. Retrospective neurological evaluations of human fetuses exposed to air pollutants during organogenesis and subsequent retrospective characterization of air samples using in vitro and animal models may be the best procedures to follow.
This study examined how community vulnerabilities contextualized the impact of exposure to five major disasters in 2017 on individuals’ disaster preparedness. We pooled two panels of the Federal Emergency Management Agency (FEMA)’s National Household Survey in 2017 (pre-disaster) and 2018 (post-disaster) and further merged the data with 15 Centers for Disease Control and Prevention Social Vulnerability Index factors to examine the moderating impact of county-level vulnerabilities. Latent class analysis was used to identify patterns of disaster preparedness based on six preparedness items defined by FEMA with a total of 10,045 individuals. Three groups were identified and named basic preparedness (BP) group, high preparedness: socially engaged (HP-SE) group, and high preparedness: advanced socially engaged (HP-ASE) group. A working sample with a smaller sample size was constructed to include 2,179 individuals from 92 counties with disaster declarations of Hurricane Harvey, Hurricane Irma, Hurricane Maria, Hurricane Nate, and California Wildfires in 2017. Multinomial logistic regression indicated that post-disaster respondents were more likely to be in the HP-SE relative to the BP group. Two-level multinomial logistic regression showed that post-disaster respondents in communities with higher percentages of single-parent households and those of no vehicles were less likely to be in the HP-SE vs. the BP group. Post-disaster respondents in communities with higher percentages of unemployment, no high school diploma, and occupied housing units with more people than rooms were less likely to be in the HP-ASE vs. the BP group. Post-disaster respondents in communities with higher percentages of older adults and mobile homes were more likely to be in the HP-SE vs. the BP group. The findings also highlighted the importance of social engagement in disaster preparedness disparities and the need for community-level intervention to promote individuals’ disaster preparedness.
Extreme weather events are increasing in frequency and severity owing to climate change. Individual-level behavioural responses-notably, disaster preparedness and community helping actions (such as donating and volunteering)-supplement government efforts to respond to such phenomena, but rarely have they been explored together. Using data from a survey administered soon after the 2020 Oregon wildfires, this paper compares a range of socio-demographic, experiential, attitudinal, and communication-related factors associated with these two individual-level behavioural responses. Findings indicate that respondents who reported experiencing a higher degree of harm and heightened concern about climate change after the wildfires were more likely to report disaster preparedness and community helping actions. Those who reported more frequent informal discussions about the wildfires, consulting more sources to seek information on them, and higher percentages of friends, neighbours, and community members taking actions to prepare for future wildfires also reported more disaster preparedness and community helping actions. Disaster preparedness actions were also positively associated with seeking information from formal/official sources.
Anxiety related to disasters is a topic of emergent research significance. Literature has shown that the potential occurrence of disasters can trigger feelings of anxiety for individuals. While a scale for measuring general anxiety and anxiety symptoms exists, a scale that measures worried thoughts related to land and forest fire is not yet available in the disaster and land and forest fire literature. The aim of this research was to measure and develop a valid scale for worried thoughts related to land and forest fire. We mapped worried thoughts related to land and forest fire onto anxiety over land and forest fire. We used focus groups to generate items for anxiety over land and forest fire and validated the scale for anxiety over land and forest fire. We used an online sur-vey to collect the data in Indonesia and we targeted residents who live near the fire prone areas in Kalimantan and Sumatra islands of Indonesia as participants. Through a systematic scale devel-opment procedure: Exploratory Factor Analysis (n=430), Confirmatory Factor Analysis (n=252), Confirmatory Factor Analysis for external validity (n=254), we developed a three -dimension scale for anxiety over land and forest fire i.e., habitat loss-related anxiety, economic and financial-related anxiety, and health-related anxiety. A further nomological network (n=370) established the validity and reliability of the scale. Our newly developed scale is found to be psychometrically sound as a valid instrument for the purpose of measuring anxiety over land and forest fire.
Anthropogenic and natural disasters (e.g., wildfires, oil spills, mine spills, sewage treatment facilities) cause water quality disturbances in fluvial networks. These disturbances are highly unpredictable in space-time, with the potential to propagate through multiple stream orders and impact human and environmental health over days to years. Due to challenges in monitoring and studying these events, we need methods to strategize the deployment of rapid response research teams on demand. Rapid response research has the potential to close the gap in available water quality data and process understanding through time-sensitive data collection efforts. This manuscript presents a protocol that can guide researchers in preparing for and researching water quality disturbance events. We tested and refined the protocol by assessing the longitudinal propagation of water quality disturbances from the 2022 Hermit’s Peak-Calf Canyon, NM, USA, the largest in the state’s recorded history. Our rapid response research allowed us to collect high-resolution water quality data with semi-continuous sensors and synoptic grab sampling. The data collected have been used for traditional peer-reviewed publications and pragmatically to inform water utilities, restoration, and outreach programs.
Many survivors of wildfires report elevated levels of psychological distress following the trauma of wildfires. However, there is only limited research on the effects of wildfires on mental health. This study examined differences in anxiety, depression, insomnia, sleep quality, nightmares, and post-traumatic stress disorder (PTSD) symptoms following wildfires in Australia, Canada, and the United States of America (USA). One hundred and twenty-six participants from Australia, Canada, and the USA completed an online survey. The sample included 102 (81%) women, 23 (18.3%) men, and one non-binary (0.8%) individual. Participants were aged between 20 and 92 years (M age = 52 years, SD = 14.4). They completed a demographic questionnaire, the Disturbing Dream and Nightmare Severity Index (DDNSI), Generalized Anxiety Disorder Questionnaire (GAD-7), the Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist (PCL-5). Results showed that participants from the USA scored significantly higher on the GAD-7 (p = 0.009), ISI (p = 0.003), and PCL-5 (p = 0.021) than participants from Australia and Canada. The current findings suggest a need for more international collaboration to reduce the severity of mental health conditions in Australia, Canada, and the USA.
Air pollution associated with agricultural activities and land-cover change poses significant health problems in developing countries. However, studies on the respiratory health impacts of these activities are scarce. Su-matra, Indonesia, is a region well known for its frequent land fires and haze. Here, we link data on healthcare attendances for respiratory illnesses between 2001 and 2018 with biophysical and socioeconomic variables known to be important drivers of respiratory ailments. We show that the prevalence of respiratory illnesses increased by 8.5% during dry years over the last two decades. This was largely attributed to changes in rain-fall patterns and land cover. Increasingly severe drought during El Nin similar to o events, combined with reduced forest cover and increased land degradation on peatland, has further escalated fires with concomitant air pollution impacts on respiratory health. Our study highlights the need to explicitly incorporate health costs of environ-mental damage into land-use planning and public health interventions.
Climate change presents a major public health concern in Australia, marked by unprecedented wildfires, heatwaves, floods, droughts, and the spread of climate-sensitive infectious diseases. Despite these challenges, Australia’s response to the climate crisis has been inadequate and subject to change by politics, public sentiment, and global developments. This study illustrates the spatiotemporal patterns of selected climate-related environmental extremes (heatwaves, wildfires, floods, and droughts) across Australia during the past two decades, and summarizes climate adaptation measures and actions that have been taken by the national, state/territory, and local governments. Our findings reveal significant impacts of climate-related environmental extremes on the health and well-being of Australians. While governments have implemented various adaptation strategies, these plans must be further developed to yield concrete actions. Moreover, Indigenous Australians should not be left out in these adaptation efforts. A collaborative, comprehensive approach involving all levels of government is urgently needed to prevent, mitigate, and adapt to the health impacts of climate change.
Wildland firefighters (WFFs) are exposed to many inhalation hazards working in the wildland fire environment. To assess occupational exposures and acute and subacute health effects among WFFs, the wildland firefighter exposure and health effects study collected data for a 2-year repeated measures study. This manuscript describes the exposure assessment from one Interagency Hotshot Crew (N = 19) conducted at a wildfire incident. Exposures to benzene, toluene, ethylbenzene, xylene isomers, formaldehyde, acetaldehyde, and naphthalene were measured through personal air sampling each work shift. Biological monitoring was done for creatinine-adjusted levoglucosan in urine pre- and post-shift. For 3 days sampling at the wildfire incident, benzene, toluene, ethylbenzene, xylene isomers (m and p, and o) exposure was highest on day 1 (geometric mean [GM] = 0.015, 0.042, 0.10, 0.42, and 0.15 ppm, respectively) when WFFs were not exposed to smoke but used chainsaws to remove vegetation and prepare fire suppression breaks. Exposure to formaldehyde and acetaldehyde was highest on day 2 (GM = 0.03 and 0.036 ppm, respectively) when the WFFs conducted a firing operation and were directly exposed to wildfire smoke. The greatest difference of pre- and post-shift levoglucosan concentrations were observed on day 3 (pre-shift: 9.7 and post-shift: 47 μg/mg creatinine) after WFFs conducted mop up (returned to partially burned area to extinguish any smoldering vegetation). Overall, 65% of paired samples (across all sample days) showed a post-shift increase in urinary levoglucosan and 5 firefighters were exposed to benzene at concentrations at or above the National Institute for Occupational Safety and Health (NIOSH) recommended exposure limit. Our findings further demonstrate that exposure to inhalation hazards is one of many risks that wildland firefighters experience while suppressing wildfires.
The mobilisation of potentially harmful chemical constituents in wildfire ash can be a major consequence of wildfires, posing widespread societal risks. Knowledge of wildfire ash chemical composition is crucial to anticipate and mitigate these risks. Here we present a comprehensive dataset on the chemical characteristics of a wide range of wildfire ashes (42 types and a total of 148 samples) from wildfires across the globe and examine their potential societal and environmental implications. An extensive review of studies analysing chemical composition in ash was also performed to complement and compare our ash dataset. Most ashes in our dataset had an alkaline reaction (mean pH 8.8, ranging between 6 and 11.2). Important constituents of wildfire ash were organic carbon (mean: 204 g kg(-1)), calcium, aluminium, and iron (mean: 47.9, 17.9 and 17.1 g kg(-1)). Mean nitrogen and phosphorus ranged between 1 and 25 g kg(-1), and between 0.2 and 9.9 g kg(-1), respectively. The largest concentrations of metals of concern for human and ecosystem health were observed for manganese (mean: 1488 mg kg(-1); three ecosystems > 1000 mg kg(-1)), zinc (mean: 181 mg kg(-1); two ecosystems > 500 mg kg(-1)) and lead (mean: 66.9 mg kg(-1); two ecosystems > 200 mg kg(-1)). Burn severity and sampling timing were key factors influencing ash chemical characteristics like pH, carbon and nitrogen concentrations. The highest readily dissolvable fractions (as a % of ash dry weight) in water were observed for sodium (18 %) and magnesium (11.4 %). Although concentrations of elements of concern were very close to, or exceeded international contamination standards in some ashes, the actual effect of ash will depend on factors like ash loads and the dilution into environmental matrices such as water, soil and sediment. Our approach can serve as an initial methodological standardisation of wildfire ash sampling and chemical analysis protocols.
PURPOSE OF REVIEW: This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires. The information gathered from this review will help health experts understand and address the mental health needs of children during wildfire disasters and may serve as a base for future studies to evaluate evidence-based public health responses to mitigate adverse outcomes. RECENT FINDINGS: The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescent post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies). This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents’ mental health, including children with disabilities in the communities that have experienced wildfire disasters.
BACKGROUND: The compounding effects of climate change catastrophes such as bushfires and pandemics impose significant burden on individuals, societies, and their economies. The enduring effects of such syndemics on mental health remain poorly understood, particularly for at-risk populations (e.g., pregnant women and newborns). The aim of this study was to investigate the impact of direct and indirect exposure to the 2019/20 Australian Capital Territory and South-Eastern New South Wales bushfires followed by COVID-19 on the mental health and wellbeing of pregnant women and mothers with newborn babies. METHODS: All women who were pregnant, had given birth, or were within three months of conceiving during the 2019/2020 bushfires, lived within the catchment area, and provided consent were invited to participate. Those who consented were asked to complete three online surveys. Mental health was assessed with the DASS-21 and the WHO-5. Bushfire, smoke, and COVID-19 exposures were assessed by self-report. Cross-sectional associations between exposures and mental health measures were tested with hierarchical regression models. RESULTS: Of the women who participated, and had minimum data (n = 919), most (>75%) reported at least one acute bushfire exposure and 63% reported severe smoke exposure. Compared to Australian norms, participants had higher depression (+12%), anxiety (+35%), and stress (+43%) scores. Women with greater exposure to bushfires/smoke but not COVID-19 had poorer scores on all mental health measures. CONCLUSIONS: These findings provide novel evidence that the mental health of pregnant women and mothers of newborn babies is vulnerable to major climate catastrophes such as bushfires.
Landscape fires are increasing in frequency and severity globally. In Australia, extreme bushfires cause a large and increasing health and socioeconomic burden for communities and governments. People with asthma are particularly vulnerable to the effects of landscape fire smoke (LFS) exposure. Here, we present a position statement from the Thoracic Society of Australia and New Zealand. Within this statement we provide a review of the impact of LFS on adults and children with asthma, highlighting the greater impact of LFS on vulnerable groups, particularly older people, pregnant women and Aboriginal and Torres Strait Islander peoples. We also highlight the development of asthma on the background of risk factors (smoking, occupation and atopy). Within this document we present advice for asthma management, smoke mitigation strategies and access to air quality information, that should be implemented during periods of LFS. We promote clinician awareness, and the implementation of public health messaging and preparation, especially for people with asthma.
During April 30-August 4, 2023, smoke originating from wildfires in Canada affected most of the contiguous United States. CDC used National Syndromic Surveillance Program data to assess numbers and percentages of asthma-associated emergency department (ED) visits on days with wildfire smoke, compared with days without wildfire smoke. Wildfire smoke days were defined as days when concentrations of particulate matter (particles generally ≤2.5 μm in aerodynamic diameter) (PM(2.5)) triggered an Air Quality Index ≥101, corresponding to the air quality categorization, “Unhealthy for Sensitive Groups.” Changes in asthma-associated ED visits were assessed across U.S. Department of Health and Human Services regions and by age. Overall, asthma-associated ED visits were 17% higher than expected during the 19 days with wildfire smoke that occurred during the study period; larger increases were observed in regions that experienced higher numbers of continuous wildfire smoke days and among persons aged 5-17 and 18-64 years. These results can help guide emergency response planning and public health communication strategies, especially in U.S. regions where wildfire smoke exposure was previously uncommon.
IMPORTANCE: With a changing climate, wildfire activity in the US has increased dramatically, presenting multifaceted and compounding health hazards. Individuals discharged from the hospital following surgical resection of non-small cell lung cancer (NSCLC) are potentially at higher risk from wildfires’ health hazards. OBJECTIVE: To assess the association between wildfire exposure and postoperative long-term overall survival among patients with lung cancer in the US. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, individuals who underwent curative-intent NSCLC resection between January 1, 2004, and December 31, 2019, were selected from the National Cancer Database. Daily wildfire information was aggregated at the zip code level from the National Aeronautics and Space Administration Fire Information for Resource Management System. The data analysis was performed between July 19, 2022, and April 14, 2023. EXPOSURE: An active wildfire detected at the zip code of residence between 0 and 3, 4 and 6, or 7 and 12 months after NSCLC surgery. MAIN OUTCOME: Overall survival was defined as the interval between age at hospital discharge and age at death, last contact, or study end, whichever came first. Cox proportional hazards were used for estimating hazard ratios (HRs) adjusted for sex, region, metropolitan category, health insurance type, comorbidities, tumor size, lymph node involvement, era, and facility type. RESULTS: A total of 466 912 individuals included in the study (249 303 female and [53.4] and 217 609 male [46.6%]; mean [SD] age at diagnosis, 67.3 [9.9] years), with 48 582 (10.4%) first exposed to a wildfire between 0 and 3 months, 48 328 (10.6%) between 4 and 6 months, and 71 735 (15.3%) between 7 and 12 months following NSCLC surgery. Individuals exposed to a wildfire within 3 months (adjusted HR [AHR], 1.43; 95% CI, 1.41-1.45), between 4 and 6 months (AHR, 1.39; 95% CI, 1.37-1.41), and between 7 and 12 months (AHR, 1.17; 95% CI, 1.15-1.19) after discharge from the hospital following stage I to III NSCLC resection had worse overall survival than unexposed individuals. CONCLUSIONS: In this cohort study, wildfire exposure was associated with worse overall survival following NSCLC surgical resection, suggesting that patients with lung cancer are at greater risk from the health hazards of wildfires and need to be prioritized in climate adaptation efforts.
Little is known about the associations between long-term exposure to wildfire-related fine particulate matter (PM(2.5)) and mortality. We aimed to explore theses associations using the data from the UK Biobank cohort. Long-term wildfire-related PM(2.5) exposure was defined as the 3-year cumulative concentrations of wildfire-related PM(2.5) within a 10-km buffer surrounding the residential address for each individual. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using the time-varying Cox regression model. We included 492,394 participants aged between 38 and 73 years. We found that after adjusting for potential covariates, a 10 μg/m(3) increase of wildfire-related PM(2.5) exposure was associated with a 0.4% higher risk of all-cause mortality (HR = 1.004 [95% CI: 1.001, 1.006]) and nonaccidental mortality (HR = 1.004 [95% CI: 1.002, 1.006]), and a 0.5% higher risk of neoplasm mortality (HR = 1.005 [95% CI: 1.002, 1.008]). However, no significant associations were observed between wildfire-related PM(2.5) exposure and mortality from cardiovascular, respiratory, and mental diseases. Additionally, no significant modification effects of a series of modifiers were observed. Targeted health protection strategies should be adopted in response to wildfire-related PM(2.5) exposure, in order to reduce the risk of premature mortality.
The frequency and severity of wildfires in the Western United States have increased over recent decades, motivating hypotheses that wildfires contribute to the incidence of coccidioidomycosis, an emerging fungal disease in the Western United States with sharp increases in incidence observed since 2000. While coccidioidomycosis outbreaks have occurred among wildland firefighters clearing brush, it remains unknown whether fires are associated with an increased incidence among the general population. METHODS: We identified 19 wildfires occurring within California’s highly endemic San Joaquin Valley between 2003 and 2015. Using geolocated surveillance records, we applied a synthetic control approach to estimate the effect of each wildfire on the incidence of coccidioidomycosis among residents that lived within a hexagonal buffer of 20 km radii surrounding the fire. RESULTS: We did not detect excess cases due to wildfires in the 12 months (pooled estimated percent change in cases: 2.8%; 95% confidence interval [CI] = -29.0, 85.2), 13-24 months (7.9%; 95% CI = -27.3, 113.9), or 25-36 months (17.4%; 95% CI = -25.1, 157.1) following a wildfire. When examined individually, we detected significant increases in incidence following three of the 19 wildfires, all of which had relatively large adjacent populations, high transmission before the fire, and a burn area exceeding 5,000 acres. DISCUSSION: We find limited evidence that wildfires drive increases in coccidioidomycosis incidence among the general population. Nevertheless, our results raise concerns that large fires in regions with ongoing local transmission of Coccidioides may be associated with increases in incidence, underscoring the need for field studies examining Coccidioides spp. in soils and air pre- and post-wildfires.
IMPORTANCE: It is uncertain whether emergency preparedness and regulatory oversight for US nursing homes are aligned with local wildfire risk. OBJECTIVE: To evaluate the likelihood that nursing homes at elevated risk of wildfire exposure meet US Centers for Medicare & Medicaid Services (CMS) emergency preparedness standards and to compare the time to reinspection by exposure status. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of nursing homes in the continental western US from January 1, 2017, through December 31, 2019, was conducted using cross-sectional and survival analyses. The prevalence of high-risk facilities within 5 km of areas at or exceeding the 85th percentile of nationalized wildfire risk across areas overseen by 4 CMS regional offices (New Mexico, Mountain West, Pacific/Southwest, and Pacific Northwest) was determined. Critical emergency preparedness deficiencies cited during CMS Life Safety Code Inspections were identified. Data analysis was performed from October 10 to December 12, 2022. MAIN OUTCOMES AND MEASURES: The primary outcome classified whether facilities were cited for at least 1 critical emergency preparedness deficiency during the observation window. Regionally stratified generalized estimating equations were used to evaluate associations between risk status and the presence and number of deficiencies, adjusted for nursing home characteristics. For the subset of facilities with deficiencies, differences in restricted mean survival time to reinspection were evaluated. RESULTS: Of the 2218 nursing homes in this study, 1219 (55.0%) were exposed to elevated wildfire risk. The Pacific/Southwest had the highest percentage of both exposed (680 of 870 [78.2%]) and unexposed (359 of 486 [73.9%]) facilities with 1 or more deficiencies. The Mountain West had the largest difference in the percentage of exposed (87 of 215 [40.5%]) vs unexposed (47 of 193 [24.4%]) facilities with 1 or more deficiencies. Exposed facilities in the Pacific Northwest had the greatest mean (SD) number of deficiencies (4.3 [5.4]). Exposure was associated with the presence of deficiencies in the Mountain West (odds ratio [OR], 2.12 [95% CI, 1.50-3.01]) and the presence (OR, 1.84 [95% CI, 1.55-2.18]) and number (rate ratio, 1.39 [95% CI, 1.06-1.83]) of deficiencies in the Pacific Northwest. Exposed Mountain West facilities with deficiencies were reinspected later, on average, than unexposed facilities (adjusted restricted mean survival time difference, 91.2 days [95% CI, 30.6-151.8 days]). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, regional heterogeneity in nursing home emergency preparedness for and regulatory responsiveness to local wildfire risk was observed. These findings suggest that there may be opportunities to improve the responsiveness of nursing homes to and regulatory oversight of surrounding wildfire risk.
In recent years, Germany has seen an increase in forest fires, and many fires have occurred in mil-itary training areas that are difficult to access for firefighting. While casualties are still low and mostly restricted to firefighting personnel, settlements are also increasingly threatened. Increas-ing impacts from extreme events due to climate change will likely increase the ignition and spread of fires. More people are being affected by fires, and in need of external help to evacuate and cope with the resulting damages and losses. Forest fires also threaten military training site, with additional risks created by the presence of ammunition depots. Despite this hazard scenario, Germany so far lacks an overview of the spatial occurrence of forest fires and the related risk. This study develops a spatial exposure and social vulnerability as-sessment of settlements to forest fires in Germany. The results reveal that social vulnerability is an important variable in determining which settlements are potentially exposed to fire. Areas ex-posed to fire risk are characterised by having a higher proportion of women, a higher-than -average age, a higher number of young people under 18 years, a higher number of persons over 65 years and foreigners than the national average. Furthermore, exposed communities are char-acterised by higher rates of unoccupied housing units and lower living space per dwelling, as well as living in areas with high population densities within forested areas. The results can help to im-prove emergency management and spatial planning to prevent the development of fire risk areas.
Major wildfires and their smoke pose a threat to public health and are becoming more frequent in the United States, particularly in California and other populated, fire-prone states. Therefore, it is crucial to understand how California residents view wildfires and engage in risk-reducing behaviors during wildfire events. Currently, there is a knowledge gap concerning this area of inquiry. We disseminated a 40-question cross-sectional survey to explore wildfire perception and knowledge along with related risk-reducing measures and policies among 807 adult residents in the fire-prone region of Orange County, California. Results demonstrated that nearly all (>95%) participants had (or knew someone who had) previously experienced a wildfire. Female gender, knowing a wildfire victim and reporting to have a general interest/passion for environmental issues were the three factors most strongly associated with (1) wildfires (and smoke) being reported as a threat, (2) participants’ willingness to evacuate if threatened by a nearby wildfire, and (3) participants’ willingness to support a wildfire-related tax increase (p < 0.05). The majority (57.4%) of participants agreed that the occurrence of wildfires is influenced by climate change, with the most commonly reported risk-reducing actions (by 44% of participants) being informational actions (e.g., tracking the news) rather than self-motivated physical safety actions (e.g., using an air purifier) (29%). The results of this study can help to inform decision- and policy-making regarding future wildfire events as well as allow more targeted and effective public health messaging and intervention measures, in turn helping to reduce the risk associated with future wildfire/smoke episodes.
BACKGROUND: Understanding lung deposition dose of black carbon is critical to fully reconcile epidemiological evidence of combustion particles induced health effects and inform the development of air quality metrics concerning black carbon. Macrophage carbon load (MaCL) is a novel cytology method that quantifies lung deposition dose of black carbon, however it has limited feasibility in large-scale epidemiological study due to the labor-intensive manual counting. OBJECTIVE: To assess the association between MaCL and episodic elevation of combustion particles; to develop artificial intelligence based counting algorithm for MaCL assay. METHODS: Sputum slides were collected during episodic elevation of ambient PM(2.5) (n = 49, daily PM(2.5) > 10 µg/m(3) for over 2 weeks due to wildfire smoke intrusion in summer and local wood burning in winter) and low PM(2.5) period (n = 39, 30-day average PM(2.5) < 4 µg/m(3)) from the Lovelace Smokers cohort. RESULTS: Over 98% individual carbon particles in macrophages had diameter <1 µm. MaCL levels scored manually were highly responsive to episodic elevation of ambient PM(2.5) and also correlated with lung injury biomarker, plasma CC16. The association with CC16 became more robust when the assessment focused on macrophages with higher carbon load. A Machine-Learning algorithm for Engulfed cArbon Particles (MacLEAP) was developed based on the Mask Region-based Convolutional Neural Network. MacLEAP algorithm yielded excellent correlations with manual counting for number and area of the particles. The algorithm produced associations with ambient PM(2.5) and plasma CC16 that were nearly identical in magnitude to those obtained through manual counting. IMPACT STATEMENT: Understanding lung black carbon deposition is crucial for comprehending health effects of combustion particles. We developed "Machine-Learning algorithm for Engulfed cArbon Particles (MacLEAP)", the first artificial intelligence algorithm for quantifying airway macrophage black carbon. Our study bolstered the algorithm with more training images and its first use in air pollution epidemiology. We revealed macrophage carbon load as a sensitive biomarker for heightened ambient combustion particles due to wildfires and residential wood burning.
U.S. wildfire activity has increased over the past several decades, disrupting the systems and infrastructure that support community health and resilience. As the cumulative burden of wildfire damage is projected to increase, understanding an effective community recovery process is critically important. Through qualitative interviews with leaders of long-term recovery organizations (LTROs), a key component of wildfire recovery, we explored barriers and facilitators to LTROs’ ability to support post-wildfire needs among rural communities. Between February-May 2022, we conducted surveys and semi-structured interviews with 18 leaders from six LTROs serving rural communities in Washington, Oregon, and California impacted by wildfires between 2015-2020. The Robert Wood Johnson Foundation’s Culture of Health Framework informed the semi-structured interview guide and a priori codebook, to examine LTROs’ ability to address post-wildfire community needs from a health equity perspective. Additional codes were added through an inductive approach, and emerging themes were identified. Our findings indicate that LTROs face many barriers in addressing community needs post-wildfire, including the policies governing access to and the slow arrival of recovery resources, the intertwined nature of community economic health and built environment restoration, and the challenge of forming a functional LTRO structure. However, participants also identified facilitators of LTROs’ work, including the ability of LTROs and their government partners to adapt policies and procedures, and close collaboration with other community organizations. Factors both internal and external to the community and LTROs’ organizational characteristics influence their ability to address community needs, essential to health, post-wildfire. This study’s findings suggest the need for policy improvements to promote more equitable recovery resource access, that economic recovery should be a core LTRO function, and that recovery planning should be incorporated into community disaster preparedness activities. Future research should focus on LTROs’ role in other contexts and in response to other disasters.
BACKGROUND: Fire seasons are longer, with more and larger wildfires, placing increased demands and risks on those fighting wildland fires. There are multiple agencies involved with fighting wildland fires and unique worksite conditions make meeting these workers’ needs a challenge. OBJECTIVE: The aim of the study is to develop and establish the effectiveness of a web-based safety and health program for those fighting wildland fires. METHODS: This mixed methods project had 3 phases. The initial qualitative phase assessed the needs of 150 diverse firefighters through interviews and focus groups across 11 US sites to establish and prioritize program content. Interview transcripts were read for thematic content with iterative readings used to identify, code, and rank health and safety issues. The second phase used that information to build a comprehensive Total Worker Health program for those fighting wildfires. The program content was based on the qualitative interview data and consisted of 6 core and 8 elective 30-minute, web-based modules primarily done individually on a smartphone or computer. The final, third phase evaluated the program with a quantitative prospective proof-of-concept, usability, and effectiveness trial among wildland firefighter participants. Effectiveness was assessed with paired 2-tailed t tests for pre- and post-Likert agreement scale survey items, adjusted for multiple comparisons. In addition to assessing mean and SD at baseline and postsurvey, observed effect sizes were calculated (Cohen d). Usability and reaction to the program among firefighters who responded to postsurvey were also assessed. RESULTS: The qualitative themes and subthemes were used to inform the program’s content. For the effectiveness trial, 131 firefighters completed the presurvey, and 50 (38.2%) completed the postsurvey. The majority of the participants were White (n=123, 93.9%), male (n=117, 89.3%), with an average age of 41 (SD 12.9) years. Significant increases in knowledge and desired health and safety behaviors were found for both cancer (P<.001) and cardiovascular risk (P=.01), nutrition behaviors (P=.01), hydration or overheating (P=.001), binge drinking (P=.002), and getting medical checkups (P=.001). More than 80% (n=40) of postsurvey respondents agreed or strongly agreed that the program was easy to use and would recommend it to others. CONCLUSIONS: An innovative web-based safety and health promotion program for those fighting wildland fires was feasible, scalable, and usable. It improved the health and safety of those fighting wildland fires. TRIAL REGISTRATION: ClinicalTrials.gov NCT05753358; https://classic.clinicaltrials.gov/ct2/show/NCT05753358.
Wildfires are increasingly impacting the environment and human health. Among the top 20 California wildfires, those in 2020-2021 burned more acres than the last century combined. Lack of an adequate early warning system impacts the health and safety of vulnerable populations disproportionately and widens the inequality gap. In this project, a multi-modal wildfire prediction and early warning system has been developed based on a novel spatio-temporal machine learning architecture. A comprehensive wildfire database with over 37 million data points was created, including the historical wildfires, environmental and meteorological sensor data from the Environmental Protection Agency, and geological data. The data was augmented into 2.53 km × 2.53 km square grids to overcome the sensor network coverage limitations. Leading and trailing indicators for the wildfires are proposed, classified, and tested. The leading indicators are correlated to the risks of wildfire conception, whereas the trailing indicators are correlated to the byproducts of the wildfires. Additionally, geological data was incorporated to provide additional information for better assessment on wildfire risks and propagation. Next, a novel U-Convolutional Long Short-Term Memory (ULSTM) neural network was developed to extract key spatial and temporal features of the dataset, specifically to address the spatial nature of the location of the wildfire and time-progression temporal nature of the wildfire evolution. Through iterative improvements and optimization, the final ULSTM network architecture, trained with data from 2012 to 2017, achieved >97% accuracy for predicting wildfires in 2018, as compared to ∼76% using traditional Convolutional Neural Network (CNN) techniques. The final model was applied to conduct a retrospective study for the 2018-2022 wildfire seasons, and successfully predicted 85.7% of wildfires >300 K acres in size. This technique could enable fire departments to anticipate and prevent wildfires before they strike and provide early warnings for at-risk individuals for better preparation, thereby saving lives, protecting the environment, and avoiding economic damages.
BACKGROUND: Australian rural and regional communities are marked by geographic isolation and increasingly frequent and severe natural disasters such as drought, bushfires and floods. These circumstances strain the mental health of their inhabitants and jeopardise the healthy mental and emotional development of their adolescent populations. Professional mental health care in these communities is often inconsistent and un-coordinated. While substantial research has examined the barriers of young people’s mental health and help-seeking behaviours in these communities, there is a lack of research exploring what adolescents in rural and regional areas view as facilitators to their mental health and to seeking help when it is needed. This study aims to establish an in-depth understanding of those young people’s experiences and needs regarding mental health, what facilitates their help-seeking, and what kind of mental health education and support they want and find useful. METHOD: We conducted a qualitative study in 11 drought-affected rural and regional communities of New South Wales, Australia. Seventeen semi-structured (14 group; 3 individual) interviews were held with 42 year 9 and 10 high school students, 14 high school staff, and 2 parents, exploring participants’ experiences of how geographical isolation and natural disasters impacted their mental health. We further examined participants’ understandings and needs regarding locally available mental health support resources and their views and experiences regarding mental illness, stigma and help-seeking. RESULTS: Thematic analysis highlighted that, through the lens of participants, young people’s mental health and help-seeking needs would best be enabled by a well-coordinated multi-pronged community approach consisting of mental health education and support services that are locally available, free of charge, engaging, and empowering. Participants also highlighted the need to integrate young people’s existing mental health supporters such as teachers, parents and school counselling services into such a community approach, recognising their strengths, limitations and own education and support needs. CONCLUSIONS: We propose a three-dimensional Engagement, Empowerment, Integration model to strengthen young people’s mental health development which comprises: 1) maximising young people’s emotional investment (engagement); 2) developing young people’s mental health self-management skills (empowerment); and, 3) integrating mental health education and support programs into existing community and school structures and resources (integration).
Solastalgia is a recent concept that refers to disruptive psychological responses in people exposed to environmental degradation. The aim of this study was to determine the number of dimensions solastalgia has using a sample of people exposed to the effects of climate change in the coastal dry land of Maule region, Chile. In order to achieve this, a Scale Of Solastalgia (SOS) was designed and then validated, by means of applying it to 223 inhabitants at the municipalities of Pencahue (n = 105) and Curepto (n = 118), who were also evaluated by the Short Post-traumatic Stress Disorder Rating Interview (SPRINT-E). Using robust validation methods (Parallel factor analysis and Omega), two dimensions were obtained for solastalgia: solace and algia. Both correlate with the SPRINT-E scale (r = 0.150, p < 0.01 and r = 0.359, p < 0.01, respectively) and have 58% sensitivity and 67% specificity to detect cases of post-traumatic stress disorder (PTSD). Like PTSD, solastalgia is related to psychopathologies expected after disasters and also presents a spatial pattern where the concentration of positive cases occurs in places of greater exposure to environmental change or degradation.
INTRODUCTION: As wildfire smoke events increase in intensity and frequency in the Pacific Northwest, there is a growing need for effective communication on the health risks of smoke exposure. Delivery through a trusted source or intermediary has been shown to improve reception of risk communication messages. This is especially salient in rural and tribal communities who may be hesitant to trust information from state and federal agency sources. This study aims to identify and characterize trusted sources for smoke risk information in the Okanogan River Airshed Emphasis Area (ORAEA), a rural region of North Central Washington state that is heavily impacted by smoke from wildfires and prescribed fire. METHODS: The research team conducted a qualitative study using data collected through key informant interviews and focus groups to assess the role of various sources and intermediaries in disseminating smoke risk information. We used a consensual coding approach in NVivo Qualitative Analysis Software to sort data into preliminary categories, which were grouped into themes using a thematic analysis approach. We used member checking and iterative feedback processes with local project partners throughout the project to ensure credibility of results. RESULTS: Through the analysis, we identified three themes characterizing trusted sources for smoke risk communication in the ORAEA. These themes were: (1) local and tribal sources of information are perceived as more trustworthy than state and federal government sources, (2) trustworthiness is determined by an evaluation of multiple factors, in particular, perceived credibility, quality of information, and relationship with the source, and (3) conservative political ideology and perceived parallels with COVID-19 communication influence perception of trust. Within each theme, we identified several sub-themes, which contributed additional nuance to our analysis. CONCLUSION: This study provides insights into which sources of information are trusted by rural and tribal community members in the ORAEA and why. Results from our study emphasize the importance of relationships and collaboration with local and tribal partners in smoke risk communication. In this paper, we discuss implications for state and federal agency practitioners and present recommendations for how to work with local and tribal partners on smoke risk communication.
Wildfire severity is a key indicator of both direct ecosystem impacts and indirect emissions impacts that affect air quality, climate, and public health far beyond the spatial footprint of the flames. Comprehensive, accurate inventories of severity and emissions are essential for assessing these impacts and setting appropriate fire management and health care preparedness strategies, as is the ability to project emissions for future wildfires. The frequency of large wildfires and the magnitude of their impacts have increased in recent decades, fueling concerns about decreased air quality. To improve the availability of accurate fire severity and emissions estimates, we developed the wildfire burn severity and emissions inventory (WBSE). WBSE is a retrospective spatial burn severity and emissions inventory at 30 m resolution for event-based assessment and 500 m resolution for daily emissions calculation. We applied the WBSE framework to calculate burn severity and emissions for historically observed large wildfires (>404 hectares (ha)) that burned during 1984-2020 in the state of California, U.S., a substantially more extended period than existing inventories. We assigned the day of burning and daily emissions for each fire during 2002-2020. The framework described here can also be applied to estimate severity for smaller wildfires and can also be used to estimate emissions for fires simulated in California for future climate and land-use scenarios. The WBSE framework implemented in R and Google Earth Engine can provide quick estimates once a desired fire perimeter is available. The framework developed here could also easily be applied to other regions with user-modified vegetation, fuel data, and emission factors.
Air quality impacts from wildfires are poorly understood, particularly indoors. As frequencies increase, it is important to optimize methodologies to understand and reduce chemical exposures from wildfires. Public health recommendations use air quality estimates from outdoor stationary air monitors, discounting indoor air conditions, and do not consider chemicals in the vapor phase, known to elicit adverse effects. We investigated vapor-phase polycyclic aromatic hydrocarbons (PAHs) in indoor and outdoor air before, during, and after wildfires using a community-engaged research approach. Paired passive air samplers were deployed at 15 locations across four states. Twelve unique PAHs were detected only in outdoor air during wildfires, highlighting a PAH exposure mixture for future study. Heavy-molecular-weight (HMW) outdoor PAH concentrations and average Air Quality Index (AQI) values were positively correlated (p < 0.001). Indoor PAH concentrations were higher in 77% of samples across all sampling events. Even during wildfires, 58% of sampled locations still had higher indoor PAH air concentrations. When AQI values exceeded 140 (unhealthy for sensitive groups), outdoor PAH concentrations became similar to or higher than indoors. Cancer and noncancer inhalation risk estimates from vapor-phase PAHs were higher indoors than outdoors, regardless of the wildfire impact. Consideration of indoor air quality and vapor-phase PAHs could inform public health recommendations regarding wildfires.
The prevalence of wildfires continues to grow globally with exposures resulting in increased disease risk. Characterizing these health risks remains difficult due to the wide landscape of exposures that can result from different burn conditions and fuel types. This study tested the hypothesis that biomass smoke exposures from variable fuels and combustion conditions group together based on similar transcriptional response profiles, informing which wildfire-relevant exposures may be considered as a group for health risk evaluations. Mice (female CD-1) were exposed via oropharyngeal aspiration to equal mass biomass smoke condensates produced from flaming or smoldering burns of eucalyptus, peat, pine, pine needles, or red oak species. Lung transcriptomic signatures were used to calculate transcriptomic similarity scores across exposures, which informed exposure groupings. Exposures from flaming peat, flaming eucalyptus, and smoldering eucalyptus induced the greatest responses, with flaming peat grouping with the pro-inflammatory agent lipopolysaccharide. Smoldering red oak and smoldering peat induced the least transcriptomic response. Groupings paralleled pulmonary toxicity markers, though they were better substantiated by higher data dimensionality and resolution provided through -omic-based evaluation. Interestingly, groupings based on smoke chemistry signatures differed from transcriptomic/toxicity-based groupings. Wildfire-relevant exposure groupings yield insights into risk assessment strategies to ultimately protect public health.
PURPOSE OF REVIEW: Increasing wildfire size and severity across the western United States has created an environmental and social crisis that must be approached from a transdisciplinary perspective. Climate change and more than a century of fire exclusion and wildfire suppression have led to contemporary wildfires with more severe environmental impacts and human smoke exposure. Wildfires increase smoke exposure for broad swaths of the US population, though outdoor workers and socially disadvantaged groups with limited adaptive capacity can be disproportionally exposed. Exposure to wildfire smoke is associated with a range of health impacts in children and adults, including exacerbation of existing respiratory diseases such as asthma and chronic obstructive pulmonary disease, worse birth outcomes, and cardiovascular events. Seasonally dry forests in Washington, Oregon, and California can benefit from ecological restoration as a way to adapt forests to climate change and reduce smoke impacts on affected communities. RECENT FINDINGS: Each wildfire season, large smoke events, and their adverse impacts on human health receive considerable attention from both the public and policymakers. The severity of recent wildfire seasons has state and federal governments outlining budgets and prioritizing policies to combat the worsening crisis. This surging attention provides an opportunity to outline the actions needed now to advance research and practice on conservation, economic, environmental justice, and public health interests, as well as the trade-offs that must be considered. Scientists, planners, foresters and fire managers, fire safety, air quality, and public health practitioners must collaboratively work together. This article is the result of a series of transdisciplinary conversations to find common ground and subsequently provide a holistic view of how forest and fire management intersect with human health through the impacts of smoke and articulate the need for an integrated approach to both planning and practice.
The increasing prevalence and severity of wildfire events around the world have emphasized the importance of wildfire resiliency in indoor environmental design. This study focuses on developing wildfire-resilient me-chanical ventilation systems and ventilation strategies for application in single-detached residences in western Canada. Outdoor PM2.5 concentration datasets during wildfire conditions were used in conjunction with indoor air quality (IAQ) mathematical models to assess the impact of ventilation and building-related input variables on indoor PM2.5 levels. A cost-benefit analysis was conducted to compare the cost of ventilation retrofit options with regional estimates of reasonable monetary contributions per resident towards health risk mitigation. Ventilation retrofit options were recommended based on IAQ simulations, model sensitivity, and cost-benefit analysis results. It was recommended that residential ventilation systems increase the minimum filter effi-ciency from MERV6 to MERV11 or MERV13 during wildfire operation and implement higher recirculation ratios during peak exposure scenarios. Multi-filter mechanical ventilation system configurations were recommended for residential dwellings located in regions prone to severe PM2.5 exposure. This study provides insight into the integration of wildfire-resiliency in existing residential mechanical ventilation systems for indoor air quality improvement. This work sets the foundation for future experimental verification of the performance of venti-lation strategies to improve urban safety, health and wellness in wildfire conditions.
BACKGROUND: Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health. However, these studies vary in study design, demographics, and outcome variables, and existing research has not been mapped. OBJECTIVE: In this review, we aimed to map existing research on wearables used to detect direct health impacts and individual exposure during climate change-induced weather extremes, such as heat waves or wildfires. METHODS: We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and systematically searched 6 databases (PubMed [MEDLINE], IEEE Xplore, CINAHL [EBSCOhost], WoS, Scopus, Ovid [MEDLINE], and Google Scholar). The search yielded 1871 results. Abstracts and full texts were screened by 2 reviewers (MK and IM) independently using the inclusion and exclusion criteria. The inclusion criteria comprised studies published since 2010 that used off-the-shelf wearables that were neither invasive nor obtrusive to the user in the setting of climate change-related weather extremes. Data were charted using a structured form, and the study outcomes were narratively synthesized. RESULTS: The review included 55,284 study participants using wearables in 53 studies. Most studies were conducted in upper-middle-income and high-income countries (50/53, 94%) in urban environments (25/53, 47%) or in a climatic chamber (19/53, 36%) and assessed the health effects of heat exposure (52/53, 98%). The majority reported adverse health effects of heat exposure on sleep, physical activity, and heart rate. The remaining studies assessed occupational heat stress or compared individual- and area-level heat exposure. In total, 26% (14/53) of studies determined that all examined wearables were valid and reliable for measuring health parameters during heat exposure when compared with standard methods. CONCLUSIONS: Wearables have been used successfully in large-scale research to measure the health implications of climate change-related weather extremes. More research is needed in low-income countries and vulnerable populations with pre-existing conditions. In addition, further research could focus on the health impacts of other climate change-related conditions and the effectiveness of adaptation measures at the individual level to such weather extremes.
Disasters cost the world $US268bn in 2020 in economic, property and human losses. In Queensland, the most disaster-prone of Australian states, flood, cyclone and bushfire will cost $466bn over the next 40 years. Individual preparation for natural hazards has been shown to reduce this cost by reducing adverse experiences, physical health problems and post-traumatic stress, and improving the speed of disaster recovery. This study categorises preparation activity into clusters according to the activity’s purpose in order to survey residents of a bushfire-vulnerable area in Queensland, Australia. This cluster approach enabled identification of specific areas of weakness in preparation plans, finding that evacuation planning activity, and safety planning activity were especially weak. These results show that emergency agency communicators and community engagement practitioners can use cluster-based research to better plan messaging within their bushfire preparation communication campaigns to target and motivate specific safety behaviours. Improved safety of people and property will mitigate the costs of bushfires in Queensland in future.
BACKGROUND: Traditional epidemiologic approaches such as time-series or case-crossover designs are often used to estimate the effects of extreme weather events but can be limited by unmeasured confounding. Quasi-experimental methods are a family of methods that leverage natural experiments to adjust for unmeasured confounding indirectly. The recently developed generalized synthetic control method that exploits the timing of an exposure is well suited to estimate the impact of acute environmental events on health outcomes. To demonstrate how this method can be used to study extreme weather events, we examined the impact of the 20-26 October 2007 Southern California wildfire storm on respiratory hospitalizations. METHODS: We used generalized synthetic control to compare the average number of ZIP code-level respiratory hospitalizations during the wildfire storm between ZIP codes that were classified as exposed versus unexposed to wildfire smoke. We considered wildfire exposure eligibility for each ZIP code using fire perimeters and satellite-based smoke plume data. We retrieved respiratory hospitalization discharge data from the Office of Statewide Health Planning and Development. R code to implement the generalized synthetic control method is included for reproducibility. RESULTS: The analysis included 172 exposed and 578 unexposed ZIP codes. We estimated that the average effect of the wildfire storm among the exposed ZIP codes was an 18% (95% confidence interval: 10% to 29%) increase in respiratory hospitalizations. CONCLUSIONS: We illustrate the use of generalized synthetic control to leverage natural experiments to quantify the health impacts of extreme weather events when traditional approaches are unavailable or limited by assumptions.
Assessing vulnerability to natural hazards is at the heart of hazard risk reduction. However, many countries such as Australia lack measuring systems to quantity vulnerability for hazard risk evaluation. Drawing on 41 indicators from multiple data sources at the finest spatial unit of the Australian census, we re-forged the Cutter’s classic vulnerability measuring framework by involving the ‘4D’ quantification of built environment (diversity, design, density and distance), and constructed the first nationwide fine-grained measures of vulnerability for urban and rural locales, respectively. Our measures of vulnerability include five themes-(1) socioeconomic status; (2) demographics and disability; (3) minority and languages; (4) housing characteristics; and (5) built environment-that were further used to assess the inequality of vulnerability to three widely affected natural hazards in Australia (wildfires, floods, and earthquakes). We found the inequality of vulnerability in the affected areas of the three hazards in eight capital cities are more significant than that of their rural counterparts. The most vulnerable areas in capital cities were peri-urban locales which must be prioritised for hazard adaptation. Our findings contribute to the risk profiling and sustainable urban-rural development in Australia, and the broad understanding of place-based risk reduction in South Hemisphere.
Wildfires cause elevated air pollution that can be detrimental to human health. However, health impact assessments associated with emissions from wildfire events are subject to uncertainty arising from different sources. Here, we quantify and compare major uncertainties in mortality and morbidity outcomes of exposure to fine particulate matter (PM(2.5)) pollution estimated for a series of wildfires in the Southeastern U.S. We present an approach to compare uncertainty in estimated health impacts specifically due to two driving factors, wildfire-related smoke PM(2.5) fields and variability in concentration-response parameters from epidemiologic studies of ambient and smoke PM(2.5). This analysis, focused on the 2016 Southeastern wildfires, suggests that emissions from these fires had public health consequences in North Carolina. Using several methods based on publicly available monitor data and atmospheric models to represent wildfire-attributable PM(2.5), we estimate impacts on several health outcomes and quantify associated uncertainty. Multiple concentration-response parameters derived from studies of ambient and wildfire-specific PM(2.5) are used to assess health-related uncertainty. Results show large variability and uncertainty in wildfire impact estimates, with comparable uncertainties due to the smoke pollution fields and health response parameters for some outcomes, but substantially larger health-related uncertainty for several outcomes. Consideration of these uncertainties can support efforts to improve estimates of wildfire impacts and inform fire-related decision-making.
SignificanceRecord-setting fires in the western United States over the last decade caused severe air pollution, loss of human life, and property damage. Enhanced drought and increased biomass in a warmer climate may fuel larger and more frequent wildfires in the coming decades. Applying an empirical statistical model to fires projected by Earth System Models including climate-ecosystem-socioeconomic interactions, we show that fine particulate pollution over the US Pacific Northwest could double to triple during late summer to fall by the late 21st century under intermediate- and low-mitigation scenarios. The historic fires and resulting pollution extremes of 2017-2020 could occur every 3 to 5 y under 21st-century climate change, posing challenges for air quality management and threatening public health.
Fire risk management is at a crossroads. The last three fire seasons worldwide, dotted by extreme fire behavior and “megafire” events, highlighted the need for a shifting mentality towards a novel and integrated fire management framework, flexible, adaptive, and responsive to the changing environmental and societal conditions. In this context, the pandemic outbreak added other elements of concern due to its impacts on fire management. The health crisis shined also a spotlight on the government’s capacity to manage interconnected risks and anticipatory risk management and the urgent need to change the dominating paradigm in fire policy and management. Based on the review of several proposed approaches framing the impelling fire management perspectives, from the socio-ecological systems to the fire resilience concepts, here we provide a new “systemic fire management framework”. The approach integrates the multiple perspectives in fire management (multi-level, multi-actor, cross-sectoral and multi-purpose) in four pillars: (i) disaster risk reduction and climate change adaptation connection; (ii) community engagement support; (iii) adaptive management towards system resilience; (iv) and adaptive governance. The approach aims to contribute to go beyond the short term and sectoral governance toward a more sustainable long term perspective, promoting a multifunctional, fire-resistant, and resilient mosaic landscape based on sustainable development processes.
The present study reviews existing evidence regarding the role of nursing in responses to climate change and wildfires caused by climate change, with the aim of enhancing nurses’ awareness about these issues. A total of 21 studies published between 2014 to 2021 and written in English or Turkish were included in the review. Analysis focused on the role of nursing in lessening negative impacts from climate change and wildfires. There is evidence to suggest that nurses can significantly assist with the prevention and alleviation of the effects of climate change and wildfires. Based on these findings, it is recommended that nurses take an active role in reducing likely risks and responding effectively when needed. The importance of flexible and proactive health systems that can predict needs during emergencies is also highlighted. Nurses should lead the way in designing national and international policies on emergencies and disasters, making suggestions, and contributing to national emergency response plans, management of human resources, and the continuity of basic care services.
Along with the increase in the frequency of disastrous wildfires and bushfires around the world during the recent decades, scholarly research efforts have also intensified in this domain. This work investigates divisions and trends of the domain of wildfire/bushfire research. Results show that this research domain has been growing exponentially. It is estimated that the field, as of 2021, it has grown to larger than 13,000 research items, with an excess of 1,200 new articles appearing every year. It also exhibits distinct characteristics of a multidisciplinary research domain. Analyses of the underlying studies reveal that the field is made up of five major divisions. These divisions embody research activities around (i) forest ecology and climate, (ii) fire detection and mapping technologies, (iii) community risk mitigation and planning, (iv) soil and water ecology, and (v) atmospheric science. Research into the sub-topics of reciprocal effects between climate change and fire activities, fire risk modelling/mapping (including burned area modelling), wildfire impact on organic matter, biomass burning, and human health impacts currently constitute trending areas of this field. Amongst these, the climate cluster showed an explosion of activities in 2020 while the human health cluster is identified as the most recent emerging topic of this domain. On the other hand, dimensions of wildfire research related to human behaviour-particularly issues of emergency training, risk perception and wildfire hazard education-seem to be notably underdeveloped in this field, making this one of its most apparent knowledge gaps. A scoping review of all reviews and meta-analysis of this field demonstrates that this sub-topic is also virtually non-existent on the research synthesis front. This meta-synthesis further reveals how a western, deductive view excludes socioecological and traditional knowledge of fire.
Purpose of Review The increase in wildfire prevalence and severity has generated alarm as wildfire air pollution is associated with significant respiratory morbidity. We aim to summarize the pathophysiology of wildfire air pollution causing lung disease, current knowledge of pulmonary health effects, and precautionary guidance to the public. We also propose specific guidance for high-risk patients during wildfires. Recent Findings Health effects of wildfire air pollution have been difficult to evaluate; however, respiratory morbidity has been firmly established including exacerbation of known pulmonary disease and increased hospitalizations, emergency department visits, and dispensation of reliever medications. Public health agencies and officials provide wildfire preparation recommendations and active updates to the public during a wildfire event but fail to address specific needs of chronic lung disease patients considered high-risk for pulmonary complications. To fill this void, it is increasingly important for pulmonary physicians to understand wildfire-related pulmonary morbidity and provide specific guidance to their patients. This review summarizes the health effects of wildfire air pollution and provides guidance for the management of high-risk patients during wildfires.
BACKGROUND: The long-term health effects of bushfires include the potential to trigger new and exacerbate existing mental health problems. OBJECTIVE: This review aimed to determine the prevalence of long-term mental health issues in Australian populations exposed to bushfires. METHOD: A systematic search was conducted in five databases (Embase, Medline, PsycINFO, Scopus, and Web of Science) to identify studies focusing on Australian populations impacted by bushfires with the prevalence of mental health issues reported at 2+ years after bushfire. The Joanna Briggs Institute prevalence critical appraisal tool was utilised. We conducted meta-analyses to determine the prevalence of general psychological distress in the general population, and a narrative synthesis. RESULTS: We included 21 articles based on 5 studies and conducted on 3 bushfire events. Meta-analyses showed a pooled prevalence of 14% (95% CI 12%-16%) for psychological distress in the general population at 2-4 years post bushfire. The overall prevalence of long-term psychological problems in firefighters at 2-7 years ranged from 28% to 47.6%. The prevalence of some psychological issues decreased with time and was directly proportional to the level of bushfire impact. CONCLUSIONS: As the magnitude of long-term bushfire-related mental health impacts in Australia is severe, it is important to monitor psychological problems and assist communities in future. Future research needs include: (a) more studies on the full range of long-term psychological impacts of bushfires, and (b) consensus on instruments and diagnostic criteria to define mental health issues. HIGHLIGHTS: First systematic review of long-term bushfire mental health issues in Australia.Indicating substantial mental health problems among affected populations.Long-term issues were linked to bushfire impact and elevated among firefighters.Highlighting need for further rigorous research on long-term disaster sequalae.
BACKGROUND AND AIMS: As average temperatures rise and wildfire events increase in the United States, outdoor workers may be at an increased risk of injury. Recent research suggests that heat exposure increases outdoor workers’ risk of traumatic injuries, but co-exposures of heat and wildfire smoke have not been evaluated. METHODS: Oregon workers’ compensation data from 2009 to 2018 were linked to satellite data by the date of injury to determine if acute heat (maximum Heat Index) and wildfire smoke (presence/absence) were associated with a traumatic injury. North American Industry Classification System (NAICS) codes were utilized to identify accepted, disabling injury claims from construction (NAICS 23) and agriculture, forestry, fishing, and hunting (NAICS 11). Claims from April to October were analyzed using negative binomial models to calculate incident rate ratios (IRR) by heat and wildfire exposure for All workers and specifically for Agricultural (Ag)/Construction workers. RESULTS: During the study period, 91,895 accepted, traumatic injury claims were analyzed. All workers had an injury IRR of 1.04 (95% confidence interval [CI]: 1.02-1.06) while Ag/Construction workers had an IRR of 1.11 (95% CI: 1.06-1.16) when wildfire smoke was present. When the maximum Heat Index was 75°F or greater, the IRR significantly increased as temperatures increased. When the maximum Heat Index was above 80-84°F, All workers had an IRR of 1.04 (95% CI: 1.01-1.06) while Ag/construction workers had an IRR of 1.14 (95% CI: 1.08-1.21) with risk increasing with increased temperatures. In joint models, heat remained associated with injury rates, but not wildfire smoke. No multiplicative interactions between exposures were observed. CONCLUSION: Increasing temperature was associated with increased rates of traumatic injury claims in Oregon that were more pronounced in Ag/Construction workers. Future work should focus on further understanding these associations and effective injury prevention strategies.
BACKGROUND: Indonesian peatlands have been drained for agricultural development for several decades. This development has made a major contribution to economic development. At the same time, peatland drainage is causing significant air pollution resulting from peatland fires. Peatland fires occur every year, even though their extent is much larger in dry (El Niño) years. We examine the health effects of long-term exposure to fine particles (PM(2.5)) from all types of peatland fires (including the burning of above and below ground biomass) in Sumatra and Kalimantan, where most peatland fires in Indonesia take place. METHODS: We derive PM(2.5) concentrations from satellite imagery calibrated and validated with Indonesian Government data on air pollution, and link increases in these concentrations to peatland fires, as observed in satellite imagery. Subsequently, we apply available epidemiological studies to relate PM(2.5) exposure to a range of health outcomes. The model utilizes the age distribution and disease prevalence of the impacted population. RESULTS: We find that PM(2.5) air pollution from peatland fires, causes, on average, around 33,100 adults and 2900 infants to die prematurely each year from air pollution. In addition, peatland fires cause on average around 4390 additional hospitalizations related to respiratory diseases, 635,000 severe cases of asthma in children, and 8.9 million lost workdays. The majority of these impacts occur in Sumatra because of its much higher population density compared to Kalimantan. A main source of uncertainty is in the Concentration Response Functions (CRFs) that we use, with different CRFs leading to annual premature adult mortality ranging from 19,900 to 64,800 deaths. Currently, the population of both regions is relatively young. With aging of the population over time, vulnerabilities to air pollution and health effects from peatland fires will increase. CONCLUSIONS: Peatland fire health impacts provide a further argument to combat fires in peatlands, and gradually transition to peatland management models that do not require drainage and are therefore not prone to fire risks.
BACKGROUND: Patients on long-term opioid therapy are particularly vulnerable to disruptions in medication access, especially during traumatic and chaotic events such as wildfires and other natural disasters. OBJECTIVES: To determine whether past highly destructive California wildfires were associated with disrupted access to prescription opioids for patients receiving long-term, and therefore physically dependent on, opioid medications. METHODS: Using California prescription drug monitoring program data, this retrospective study selected patients with long-term prescription opioid use episodes residing in ZIP code tabulation areas impacted by either the Camp Fire or Tubbs Fire. Autoregressive integrated moving average time series models were fit to pre-fire data to forecast post-fire expected values and then compared with observed post-fire data, specifically for weekly proportions of long-term episodes with early fills, late fills, changes in patients’ prescriber and pharmacy, and fills within a different ZIP code tabulation area than the patient’s residence. RESULTS: After the Camp Fire, there were significant spikes in the proportions of early fills (peak at 56% of total, week 1 after fire), late fills (peak at 29%, week 6), and immediate significant increases in prescriber (peak at 37%, week 3) and pharmacy changes (peak at 71%, week 1) in high-impact ZIP code tabulation areas. Low-impact ZIP code tabulation areas experienced no similar disruptions. Disruptions due to the Tubbs Fire were far less severe. CONCLUSION: Access to prescription opioids was greatly disrupted for patients living in areas most impacted by the Camp Fire. Future research should explore effectiveness of current state and federal controlled substance prescribing policies to determine what improvements are needed to minimize disruptions in medication access due to wildfires and other natural disasters.
Climate change is intensifying fire regimes across boreal regions, and thus both burned area and carbon emissions from combustion are expected to increase significantly over the next several decades. Fire management through initial suppression of fires is effective at reducing burned area, but limited work has addressed the role that fire management can play in reducing wildfire carbon emissions and their impacts on climate change. In this work, we draw on historical data covering fire and fire management in Alaska to project burned area and management outcomes to 2100. We allow management to both respond to and impact variations in annual burned area and carbon emissions, while keeping decadal-average burned area at or above historical levels. The total cost of a fire is calculated as the combination of management expenditures and the social cost of carbon (SCC) emissions during combustion, using the SCC framework. Incorporating the tradeoff between management expenditures and burned area, we project that by 2100, increasing management effort by 5-10 times relative to current expenditures would minimize combined management and emissions costs. This is driven by the finding that the social costs of carbon emissions greatly exceed management costs unless burned area is constrained to near the average historical level. Our analysis does not include the many health, economic, and non-CO2 climate impacts from fires, so we likely underestimate the benefits of increased fire suppression and thus the optimal management level. As fire regimes continue to intensify, our work suggests increased management expenditures will be necessary to counteract increasing carbon combustion and lower overall climate impact.
Wildfire is an integral part of many ecosystems, and wildland fires also have the potential for costly impacts to human health and safety, and damage to structures and natural resources. Public land managers use various strategies for managing landscape conditions that can affect wildfire, broadly: fuel treatment (and other pre-fire risk mitigation), fire suppression, and post-fire landscape rehabilitation. However, with any of these strategies there is considerable uncertainty in the outcomes that managers can obtain, and thus on the societal costs and benefits associated with wildland fire management. Managers address that uncertainty by using available information to inform their strategy choices. The value of information (VOI) to the land manager is defined as the expected gains from improved wildland fire management outcomes that result from using the information. This paper discusses estimating the value of information using two approaches: a microeconomic theoretical approach, and the Bayesian decision-tree approach frequently used in the VOI literature. These approaches could be used for valuing specific pieces of information (with absolute values), and for prioritizing (with relative values) which areas to focus on for future research.
Wildfire is a natural phenomenon with substantial economic consequences, and its management is complex, dynamic, and rife with incentive problems. This article reviews the contribution of economics to our understanding of wildfire and highlights remaining knowledge gaps. We first summarize economic impacts to illustrate scale and trends. We then focus on wildfire management in three phases: mitigation before fires occur, response during fires, and response after fires. The literature highlights economic interdependencies and spillover effects across fire-prone landscapes as the source of economic inefficiencies and motivation for public institutional response. The literature illustrates the complexity of this problem with its myriad threads, including the trade-offs of living in fire-prone environments, the prospects for using controlled fire and mechanical fuel removal for reducing wildfire severity, the decision-making environment that firefighters face, and the economic consequences of wildfire smoke on health. Economics provides valuable insights, but fundamental questions remain unanswered.
Airborne particles in urban Palangka Raya, Kalimantan from Oct 2011 until Oct 2020 have been collected and analyzed for PM(2.5), PM(10), and Black Carbon (BC) concentrations. Palangka Raya is a city that serves the capital of the Central Kalimantan province on the island of Borneo. Kalimantan is affected by peat fires that occur periodically. There were identified increases in PM(2.5) and PM(10) concentrations during El Niño periods. During the forest fire episode in September – October 2015, PM(2.5) and PM(10) concentrations increased significantly, to nearly 400 µg/m(3) and 800 µg/m(3), respectively, and visibility in the city was reduced to < 0.2 miles. The highest BC concentrations were observed during this massive forest fires episode. The regression analyses for PM(2.5), PM(10) and visibility in Palangka Raya during the period of 2011-2020, showed a non-linear correlation with reduction in visibility due to increased PM(2.5) and PM(10). There was no correlation for BC with visibility. Air quality in Palangka Raya was at a relatively good level with concentrations below the national ambient air quality standard when there were no forest fires event. Emissions from forest fires caused a substantial reduction in air quality reaching concentrations well above ambient air quality standards and are likely to have caused adverse health effects on the people living in the area.Implications: Indonesia has repeatedly experienced forest fires, especially on Kalimantan and Sumatera Islands, which burned large areas of peatland. The forest fires leading to increasing PM concentrations especially in the PM(2.5) size range which influence visibility. The seasonal variations of BC in Palangka Raya and the relationships of fine particulates with visibility were assessed. The results of regression analyses for PM(2.5) and PM(10) to visibility during the period of 2011-2020 showed non-linear relationships. An increasing of PM(2.5) and PM(10) concentrations during El Nino periods were detected well above the ambient air quality standard. To ensure effective and continued handling and prevention of forest and peatland fires, the government set up a special task force and review on several rules, including laws and government regulations as well as governor regulations that permit the burning of forest and peatland areas. These results are expected to be used to formulate more effective mitigations in reducing forest fires events in Indonesia.
The 2020 COVID-19 outbreak in New South Wales (NSW), Australia, followed an unprecedented wildfire season that exposed large populations to wildfire smoke. Wildfires release particulate matter (PM), toxic gases and organic and non-organic chemicals that may be associated with increased incidence of COVID-19. This study estimated the association of wildfire smoke exposure with the incidence of COVID-19 in NSW. A Bayesian mixed-effect regression was used to estimate the association of either the average PM(10) level or the proportion of wildfire burned area as proxies of wildfire smoke exposure with COVID-19 incidence in NSW, adjusting for sociodemographic risk factors. The analysis followed an ecological design using the 129 NSW Local Government Areas (LGA) as the ecological units. A random effects model and a model including the LGA spatial distribution (spatial model) were compared. A higher proportional wildfire burned area was associated with higher COVID-19 incidence in both the random effects and spatial models after adjustment for sociodemographic factors (posterior mean = 1.32 (99% credible interval: 1.05-1.67) and 1.31 (99% credible interval: 1.03-1.65), respectively). No evidence of an association between the average PM(10) level and the COVID-19 incidence was found. LGAs in the greater Sydney and Hunter regions had the highest increase in the risk of COVID-19. This study identified wildfire smoke exposures were associated with increased risk of COVID-19 in NSW. Research on individual responses to specific wildfire airborne particles and pollutants needs to be conducted to further identify the causal links between SARS-Cov-2 infection and wildfire smoke. The identification of LGAs with the highest risk of COVID-19 associated with wildfire smoke exposure can be useful for public health prevention and or mitigation strategies.
INTRODUCTION: In this study, we examined the association between telemedicine use before a disaster and utilization of emergency or hospital services for ambulatory care sensitive conditions post-disaster. METHODS: Difference-in-differences analyses were conducted in 2020‒2021 to assess pre- to post-fire changes in emergency or hospital utilization for 5 ambulatory care sensitive conditions: asthma, diabetes, hypertension, coronary artery disease, and heart failure across all Kaiser Permanente Santa Rosa patients (N=108,113) based on telemedicine utilization before the 2017 Tubbs wildfire. Inverse probability of treatment weighting was employed for cohort balancing across telemedicine familiar status. RESULTS: Utilization for any ambulatory care sensitive condition increased from 9.03% pre-fire to 9.45% post-fire across the full cohort. Telemedicine familiarity (ref: not familiar) was associated with decreased absolute risk in pre- to post-fire inpatient and emergency department utilization for 4 conditions: asthma (absolute risk= -1.59%, 95% CI= -2.02%, -1.16%), diabetes (absolute risk= -0.68%, 95% CI= -0.89%, -0.47%), hypertension (absolute risk= -2.07%, 95% CI= -2.44%, -1.71%), and coronary artery disease (absolute risk= -0.43%, 95% CI= -0.61%, -0.24%). Telemedicine familiarity was associated with decreased relative change in pre- to post-fire utilization for 5 conditions: asthma (RRR=0.70, 95% CI=0.64, 0.75), diabetes (RRR=0.54, 95% CI=0.47, 0.63), hypertension (RRR=0.57, 95% CI=0.52, 0.62), heart failure (RRR=0.64, 95% CI=0.50, 0.82), and coronary artery disease (RRR=0.56, 95% CI=0.47, 0.67). Similar results were seen among patients residing in evacuation zones. CONCLUSIONS: Telemedicine familiarity pre-fire was associated with decreased inpatient and emergency department utilization for certain ambulatory care sensitive conditions for 1-year post-fire. These results suggest a role for telemedicine in preventing unnecessary emergency and hospital utilization following disasters.
Several regions in the world are seeing an increase in the chances of catastrophic wildfires, driven primarily by climate change. Power companies in places like California are enacting public safety power shutoffs (PSPS), a type of indirect climate adaptation policy, to reduce the risk of wildfires during periods of favorable wildfire conditions. While PSPS may reduce the risk of wildfires, it may also impact health and normal daily activities – e. g., inability to use certain home medical equipment or use a fan during a heat wave to being unable to attend school or perform work. Little is known about how Californians view PSPS, and how personal wildfire experience and existing vulnerabilities may relate to those views. In December 2020, a representative sample of 1,108 Californians was surveyed online and by phone to address this gap. Moderate levels of support for PSPS were observed. More personal wildfire experiences in terms of health, hazard exposures, and hazard outcomes were positively related to wildfire risk appraisal and hazard worries, which in turn was associated with more support for PSPS. However, worry about possible negative impacts from PSPS was negatively related to support for PSPS. Improved communications may provide targeted information to households that are the most exposed or vulnerable to wildfires and their impacts, as well as on ways exposure can be reduced. Climate adaptation policies informed by understanding the climate hazard and climate solutions risks the public faces may reduce unintended consequences, while also allowing for more rapid adaptation to climate change.
Wildfires and hazard reduction burns produce smoke that contains pollutants including particulate matter. Particulate matter less than 2.5 mu m in diameter (PM2.5) is harmful to human health, potentially causing cardiovascular and respiratory issues that can lead to premature deaths. PM2.5 levels depend on environmental conditions, fire behaviour and smoke dispersal patterns. Fire management agencies need to understand and predict PM2.5 levels associated with a particular fire so that pollution warnings can be sent to communities and/or hazard reduction burns can be timed to avoid the worst conditions for PM2.5 pollution. We modelled PM2.5, measured at air quality stations in New South Wales (Australia) from similar to 1400 d when individual fires were burning near air quality stations, as a function of fire and weather variables. Using Visible Infrared Imaging Radiometer Suite (VIIRS) satellite hotspots, we identified days when one fire was burning within 150 km of at least 1 of 48 air quality stations. We extracted ERAS grid-ded weather data and daily active fire area estimates from the hotspots for our modelling. We created random forest models for afternoon, night and morning PM2.5 levels to understand drivers of and predict PM2.5. Fire area and boundary layer height were important predictors across the models, with temperature, wind speed and relative humidity also being important. There was a strong increase in PM2.5 with decreasing distance, with a sharp increase when the fire was within 20 km. The models improve our understanding of the drivers of PM2.5 from individual fires and demonstrate a promising approach to PM2.5 model development. However, although the models predicted well overall, there were several large under-predictions of PM2.5 that mean further model development would be required for the models to be deployed operationally.
Wildfires are an important disturbance in the Earth system, and their emissions have regional and even global impacts on radiation, clouds, and climate. The increased frequency and magnitude of California wildfires in recent years is altering the terrestrial carbon cycle, undermining the state’s efforts to reduce the Greenhouse Gases (GHGs) to confront climate change. Air quality and public health are also greatly affected by air pollution from wildfires. The severity of wildfire burns is a critical indicator of both their direct and indirect ecological and human impacts. To formulate targeted mitigation strategies, it is imperative to understand the evolving scale, location and timing of wildfire burn severity and emissions. This study analyzed spatial and temporal patterns of burn severity and emissions at 30 m resolution from large wildfires (>404 hectares) burning in California during 1984-2020 from the recently developed Wildfire Burn Severity and Emissions Inventory. Results show vegetation and severity play critical roles in controlling the spatial and seasonal distribution of emissions. California’s annual burned area and emissions increased, notably in early and late parts of what once was the typical fire season, although peak wildfire burned area and emissions continue to occur in mid-Summer. Emissions and areas burned in moderate to high severity were particularly high and increasing in North Coast and Sierra Nevada forests. The 2020 fire year-with the most megafires in California history-had 15 times the annual average emissions that occurred during 1984-2015.
BACKGROUND: There is increasing evidence that long-term exposure to fine particulate matter [PM ≤ 2.5 μm in aerodynamic diameter (PM2.5)] may adversely impact cognitive performance. Wildfire smoke is one of the biggest sources of PM2.5 and concentrations are likely to increase under climate change. However, little is known about how short-term exposure impacts cognitive function. OBJECTIVES: We aimed to evaluate the associations between daily and subdaily (hourly) PM2.5 and wildfire smoke exposure and cognitive performance in adults. METHODS: Scores from 20 plays of an attention-oriented brain-training game were obtained for 10,228 adults in the United States (U.S.). We estimated daily and hourly PM2.5 exposure through a data fusion of observations from multiple monitoring networks. Daily smoke exposure in the western U.S. was obtained from satellite-derived estimates of smoke plume density. We used a longitudinal repeated measures design with linear mixed effects models to test for associations between short-term exposure and attention score. Results were also stratified by age, gender, user behavior, and region. RESULTS: Daily and subdaily PM2.5 were negatively associated with attention score. A 10 μg/m3 increase in PM2.5 in the 3 h prior to gameplay was associated with a 21.0 [95% confidence interval (CI): 3.3, 38.7]-point decrease in score. PM2.5 exposure over 20 plays accounted for an estimated average 3.7% (95% CI: 0.7%, 6.7%) reduction in final score. Associations were more pronounced in the wildfire-impacted western U.S. Medium and heavy smoke density were also negatively associated with score. Heavy smoke density the day prior to gameplay was associated with a 117.0 (95% CI: 1.7, 232.3)-point decrease in score relative to no smoke. Although differences between subgroups were not statistically significant, associations were most pronounced for younger (18-29 y), older ( ≥ 70 y), habitual, and male users. DISCUSSION: Our results indicate that PM2.5 and wildfire smoke were associated with reduced attention in adults within hours and days of exposure, but further research is needed to elucidate these relationships. https://doi.org/10.1289/EHP10498.
To assess mortality risks and burdens associated with short-term exposure to wildfire-related fine particulate matter with diameter ≤ 2.5 μm (PM(2.5)), we collect daily mortality data from 2000 to 2016 for 510 immediate regions in Brazil, the most wildfire-prone area. We integrate data from multiple sources with a chemical transport model at the global scale to isolate daily concentrations of wildfire-related PM(2.5) at a 0.25 × 0.25 resolution. With a two-stage time-series approach, we estimate (i) an increase of 3.1% (95% confidence interval [CI]: 2.4, 3.9%) in all-cause mortality, 2.6% (95%CI: 1.5, 3.8%) in cardiovascular mortality, and 7.7% (95%CI: 5.9, 9.5) in respiratory mortality over 0-14 days with each 10 μg/m(3) increase in daily wildfire-related PM(2.5); (ii) 0.65% of all-cause, 0.56% of cardiovascular, and 1.60% of respiratory mortality attributable to acute exposure to wildfire-related PM(2.5), corresponding to 121,351 all-cause deaths, 29,510 cardiovascular deaths, and 31,287 respiratory deaths during the study period. In this study, we find stronger associations in females and adults aged ≥ 60 years, and geographic difference in the mortality risks and burdens.
BACKGROUND:The challenges of climate change and increasing frequency of severe weather conditions has demanded innovative approaches to wildfire suppression. Australia’s wildfire management includes an expanding aviation program, providing both fixed and rotary wing aerial platforms for reconnaissance, incident management, and quick response aerial fire suppression. These operations have typically been limited to day visual flight rules operations, but recently trials have been undertaken extending the window of operations into the night, with the assistance of night vision systems. Already a demanding job, night aerial firefighting operations have the potential to place even greater physical and mental demands on crewmembers. This study was designed to investigate sleep, fatigue, and performance outcomes in Australian aerial firefighting crews.METHODS:A total of nine subjects undertook a 21-d protocol, completing a sleep and duty diary including ratings of fatigue and workload. Salivary cortisol was collected daily, with additional samples provided before and after each flight, and heart rate variability was monitored during flight. Actigraphy was also used to objectively measure sleep during the data collection period.RESULTS:Descriptive findings suggest that subjects generally obtained >7 h sleep prior to flights, but cortisol levels and self-reported fatigue increased postflight. Furthermore, the greatest reported workload was associated with the domains of ‘performance’ and ‘mental demand’ during flights.DISCUSSION:Future research is necessary to understand the impact of active wildfire response on sleep, stress, and workload on aerial firefighting crews.Sprajcer M, Roberts S, Aisbett B, Ferguson S, Demasi D, Shriane A, Thomas MJW. Sleep, workload, and stress in aerial firefighting crews. Aerosp Med Hum Perform. 2022; 93(10):749-754.
Recent evidence has shown an association between wildfire smoke and COVID-19 cases and deaths. The San Francisco Bay Area, in California (USA), experienced two major concurrent public health threats in 2020: the COVID-19 pandemic and dense smoke emitted by wildfires. This provides a unprecedented context to unravel the role of acute air pollution exposure on COVID-19 severity. A smoke product provided by the National Oceanic and Atmospheric Association Hazard Mapping System was used to identify counties exposed to heavy smoke in summer and fall of 2020. Daily COVID-19 cases and deaths for the United States were downloaded at the County-level from the CDC COVID Data Tracker. Synthetic control methods were used to estimate the causal effect of the wildfire smoke on daily COVID-19 case fatality ratios (CFRs), adjusting for population mobility. Evidence of an impact of wildfire smoke on COVID-19 CFRs was observed, with precise estimates in Alameda and San Francisco. Up to 58 (95% CI: 29, 87) additional deaths for every 1000 COVID-19 incident daily cases attributable to wildfire smoke was estimated in Alameda in early September. Findings indicated that extreme weather events such as wildfires smoke can drive increased vulnerability to infectious diseases, highlighting the need to further study these colliding crises. Understanding the environmental drivers of COVID-19 mortality can be used to protect vulnerable populations from these potentially concomitant public health threats.
Wildfires are occurring worldwide with greater frequency and intensity. Wildfires, as well as other sources of air pollution including environmental tobacco smoke, household biomass combustion, agricultural burning, and vehicular emissions, release large amounts of toxic substances into the atmosphere. The ocular surface is constantly exposed to the ambient air and is hence vulnerable to damage from air pollutants. This review describes the detrimental effects of wildfire smoke and air pollution on the ocular surface and resultant signs and symptoms. The latest relevant evidence is synthesised and critically evaluated. A mechanism for the pathophysiology of ocular surface damage will be proposed considering the existing literature on respiratory effects of air pollution. Current strategies to reduce human exposure to air pollutants are discussed and specific possible approaches to protect the ocular surface and manage air pollution induced ocular surface damage are suggested. Further avenues of research are suggested to understand how acute and chronic air pollution exposure affects the ocular surface including the short and long-term implications.
Extreme wildfires are increasingly rising to intense and uncontrolled fires, with dimension and destructive potentials that are greater than what has been seen and dealt with. The hazards posed by these fires increase significantly when they approach the wild-urban interface, with relevant environmental and socio-economic consequences. The 2009 Victorian bushfires and the 2017 Portugal wildfires are powerful reminders, and they have demonstrated the need to better understand why mitigation plans have failed to protect the community in these events and to improve community resilience. The year 2017 is a milestone in the history of wildfires in Portugal, not only because of the vast burned area but also due to the high number of fatalities. The two occurrences were at different times (June and October) but were geographically close (region of centre of Portugal). A total of 117 deaths occurred in both events and 92% of the victims were in wild-urban interface areas. This paper analyses and discusses the characteristics and causes of death of the victims of these two events: age, place of death, distance from place of death to place of residence and last-minute choices to aim to understand the actions that people took in the face of the approaching fire, which led to their death. In both cases, most people died fleeing the fire without any information from the competent authorities. In the end, it is possible to identify risk factors that lead to the death of civilians due to wildfires, such as the increase in demand for rurality by young people from big cities with no previous contact with wildfires; on the other hand, there is the ageing of the population residing in forest areas, who were previously physically and structurally prepared to deal with fires and are currently no longer able to.
OBJECTIVE: To examine respiratory-related ED admissions and presentations at Bathurst Base Hospital during the 2019-2020 New South Wales bushfire crisis. METHODS: A retrospective clinical audit was undertaken. Publicly available data on air quality were also examined. RESULTS: Poorer air quality (measured by PM10 levels) was correlated with increased presentations to the ED (R = 0.228, P = 0.012). ED patients with respiratory diagnoses were more likely to be admitted for inpatient care in 2019-2020 (n = 234, 49.3%) compared with 2018-2019 (n = 165, 39.6%). CONCLUSION: The impact of bushfire smoke needs to be considered in the allocation of resources in this area in future, but further research is warranted to understand the full extent of impact at the local level.
The University of Colorado Airborne Solar Occultation Flux (CU AirSOF) instrument conducted the first suborbital carbon monoxide (CO) mass flux measurements on the scale of large wildfires, showing that the destructive fires in northern California in October 2017 emitted 2,040 +/- 316 tonnes CO hr(-1). Pyrogenic estimates from seven satellite-based emission inventories bracket the observed flux, but their range spans a factor of 83. The simulated air quality impacts in the form of ozone and fine particulate matter scale primarily with these uncertain emission amounts, and range from insignificant to very severe. This uncertainty in predicting emissions is reduced to a factor of similar to 2 by the CU AirSOF flux measurements, with potential for future improvements. The uncertainty is primarily the result of uncertain vegetation types and sources of radiative power measurements, and to a lesser extent uncertain emission factors and fire diurnal cycles. Plain Language Summary Wildfire smoke is a major source of air pollution that affects public health and natural areas, but the amounts of vegetation that go up in smoke and the emitted amounts of smoke are not well known, due to a lack of direct measurements. The accuracy of models used to predict smoke impacts on public health in affected communities is significantly impacted by their reliance on uncertain emissions estimates. In this study, a new instrument, the University of Colorado Airborne Solar Occultation Flux (CU AirSOF), measured the amount of carbon monoxide (CO) produced by the destructive fires in northern California during October 2017. These are the first airborne emission measurements on the scale of a large wildfire. The measured CO emissions from the fires fall within the large range among satellite-based emission estimates, reducing the uncertainty in fire emissions. Air quality impacts in the form of ozone (O-3) and fine particulate matter (PM2.5) range from insignificant to very severe, in direct relationship to the uncertain satellite-based emission estimates.
Wildfires emit smoke particles and gaseous pollutants that greatly aggravate air quality and cause adverse health impacts in the western US (WUS). This study evaluates how wildfire impacts on air pollutants and air toxics evolve from the present climate to the future climate under a high anthropogenic emission scenario at regional and city scales. Through employing multiple climate and chemical transport models, small changes in domain-averaged air pollutant concentrations by wildfires are simulated over WUS. However, such changes significantly increase future city-scale pollutant concentrations by up to 53 ppb for benzene, 158 ppb for formaldehyde, 655 μg/m(3) for fine particulate matter (PM(2.5)), and 102 ppb for ozone, whereas that for the present climate are 104 ppb for benzene, 332 ppb for formaldehyde, 1,378 μg/m(3) for PM(2.5), and 140 ppb for ozone. Despite wildfires induce smaller changes in the future, the wildfire contribution ratios can increase by more than tenfold compared to the present climate, indicating wildfires become a more critical contributor to future air pollution in WUS. In addition, additional 6 exceedance days/year for formaldehyde and additional 3 exceedance days/year for ozone suggest increasing health impacts by wildfires in the future.
Wildfire smoke is a rapidly growing threat to global cardiovascular health. We review the literature linking wildfire smoke exposures to cardiovascular effects. We find substantial evidence that short-term exposures are associated with key cardiovascular outcomes, including mortality, hospitalization, and acute coronary syndrome. Wildfire smoke exposures will continue to increase over the majority of Earth’s surface. For example, the United States alone has experienced a 5-fold increase in annual area burned since 1972, with 82 million individuals estimated to be exposed to wildfire smoke by midcentury. The associated rise in excess morbidity and mortality constitutes a growing global public health crisis. Fortunately, the effect of wildfire smoke on cardiovascular health is modifiable at the individual and population levels through specific interventions. Health systems therefore have an opportunity to help safeguard patients from smoke exposures. We provide a roadmap of evidence-based interventions to reduce risk and protect cardiovascular health. Key interventions include preparing health systems for smoke events; identifying and educating vulnerable patients; reducing outdoor activities; creating cleaner air environments; using air filtration devices and personal respirators; and aggressive management of chronic diseases and traditional risk factors. Further research is needed to test the efficacy of interventions on reducing cardiovascular outcomes.
Wildfire smoke events are increasing in British Columbia (BC), Canada and environmental and public health agencies are responsible for communicating the health-related risks and mitigation strategies. To evaluate and identify opportunities for improving public communications about wildfire smoke and associated health risks we collaborated with end-users and developed a 32-question online survey. The survey was deployed province-wide from 29 September to 31 December 2020 following a severe wildfire smoke episode, which impacted large parts of BC. Using a convenience sample, we disseminated the survey through email lists, radio advertisements, a provincial research platform, and snowball methods. There were 757 respondents, who were generally representative of provincial demographics. Respondents indicated that they receive wildfire smoke messages from diverse sources, including: websites, social media, radio, and television. Radio was identified as the most important source of information for populations that may have increased exposure or health risks, including Indigenous respondents and those working in the trades. Respondents with lower educational attainment expressed that messaging should be simplified. Environmental and public health agencies should continue to share wildfire smoke messages using diverse methods, ideally tailoring the messages and methods to specific populations at risk for exposure and health effects.
One of the world’s biggest disasters are wildfires. The firefighting environment involves physical and respiratory risks, due the inhalation of fire smoke. This study aims to determine the respiratory function of firefighters exposed to wildfire smoke and explore the potential risk factors associated with poor respiratory function. The sample involved 53 firefighters, aged between 23 and 60 years (39.28 ± 8.71), 41 (77.40%) male and 12 (22.60%) female, who fought in wildfires. The measurement instruments used were as follows: a scale, a stadiometer, a questionnaire, a Fagerstrom test and a spirometer. Thirty-six (67.9%) firefighters showed a restrictive pattern. Firefighters fought between 1 and 9 (3.64 ± 1.97) fires and in total between 5 and 212 (62.34 ± 46.89) h. Nineteen (52.8%) firefighters, who showed a restrictive pattern, did not perform any physical exercise (p = 0.045). Twelve (70.6%) firefighters who practiced exercise and revealed a restrictive pattern trained at least 3 or less hours weekly, whilst five (29.4%) practiced more than 3 h (p = 0.030) of weekly exercise. Twenty (55.6%) firefighters with a restrictive pattern spent more than 48 h in combat (p = 0.029) and twenty-two (61.1%) did not use any respiratory protection (p = 0.011). The study data showed that occupational exposure to wildfire smoke was associated with the development of a restrictive pattern and associated factors included a sedentary lifestyle, limited duration of physical exercise, longer exposure to fire smoke and non-use of respiratory protection.
Many people do not make choices that minimize risk in the face of health and environmental threats. Using pre-registered analyses, we tested whether a risk communication that primed perceptions about health-protective preparation and behavior of close social contacts promoted protection views and protective behaviors. From December 10-24, 2020, we fielded a 2 (threat vignette: wildfire or COVID-19) x 3 (social contact prime: control, inaction, or action) experiment to a representative sample of 1,108 California residents facing increased COVID-19 cases/deaths, who had recently experienced the most destructive wildfire season in California history. Outcome variables were protection views and protective behavior (i.e., information seeking). Across threat conditions, stronger social norms, efficacy, and worry predicted greater protection views and some protective behaviors. Priming social-contact action resulted in greater COVID-19 information-seeking compared to the control. In the wildfire smoke condition, priming social contact action and inaction increased perceived protective behavior social norms compared to the control; social norms partially mediated the relationships of priming with protection views and protective behaviors; and having existing mask supplies enhanced the relationship between priming inaction and greater protection views compared to priming action or the control. Findings highlight the importance of social influence for health protection views and protective behaviors. Communications enhancing social norms that are sensitive to resource contexts may help promote protective behaviors.
Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21−126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95−12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40−14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54−12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92−63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.
Climate change represents a threat to life; as such, it is associated with psychological disorders. The subjective perceptions of life impacts from different traumatic experiences develop understanding and the enable predictions of future consequences. This psychological impact also tends to increase the risk perception of climate change and the intention to prevent it. Greater emphasis on place identity can promote resilience and prevent psychological distress. The aim of this descriptive cross-sectional study is to describe the ontological life impact of fires, based on socio-demographic variables, risk perception, self-perceived resistance (SPR), and place identity. The sample consisted of 210 residents of areas affected by forest fires in Gran Canaria (Spain), who answered a questionnaire consisting of multiple scales and an assessment of the traumatic experience through the VIVO (Spanish initials of Ontological Vital Impact Assessment) questionnaire. The clustering of areas according to SPR and neighbourhood was considered a new variable, referred to as territorial resistance. This variable was useful in describing the different profiles of ontological life impacts and risk perceptions. The ontological life impact of the extreme experience differed between unaffected and affected people. Feeling that they had been judged for the occurrence was associated with lower psychological adjustment and a greater perception of control over the risk. Control also increased with place identity and the number of experiences. Emphasising risk, recognising the local knowledge of residents, and including them in decision-making and future action plans contributes to a sense of community, and thus, can improve coping.
This study aimed to assess current perceptions of heat stress, heat strain, acclimatisation and recovery practices in wildland fire suppression. A total of 1459 wildfire and structural firefighters, all involved in wildland fire suppression, completed an 18-question survey. Most participants (81.3%) reported heat strain as one of the main risks faced during wildland firefighting. Thermal strain is considered an important risk for health and safety in wildland firefighting. The best-valued heat strain mitigation strategies were those traditionally recommended in wildland fire suppression: (i) an adequate work/rest ratio (79.0%), (ii) acclimatisation (71.6%), (iii) enhancing body ventilation by opening protective clothing or removing helmets or gloves (63.5%), and (iv) drinking water and food supplementation (52.1%). Despite these results, only 22% of the participants reported carrying out acclimatisation in the workplace. The vast majority of the respondents (87.4%) consider active cooling strategies (i.e., ice slurry ingestion, ice vests, etc.) impractical in combating heat strain during wildfire suppression. We identified a gap between knowledge about heat strain, its mitigation strategies and the level of actual implementation of these practices in the workplace. Our results highlight the need to improve heat strain management and implement operational directives for acclimatisation and active cooling interventions.
BACKGROUND: During the summer of 2019/2020, Australia experienced a catastrophic wildfire season that affected nearly 80% of Australians either directly or indirectly. The impacts of climate crisis on perinatal health have only recently begun to receive attention. The objective of this study was to understand experiences of perinatal women during the bushfire and smoke events of 2019-2020 regarding health, health care, and public health messaging. METHODS: Semistructured interviews were conducted by phone or web conferencing platforms with 43 participants living in the south-east of Australia who were either pregnant or who had recently had a baby during the 2019/2020 fires. RESULTS: The health impacts on participants of the fires, associated smoke, and evacuations for some, were both physical and psychological. Many participants sought information regarding how to protect their own health and that of their unborn/recently born children, but reported this difficult to find. CONCLUSIONS: Pregnant women and new mothers exposed to bushfire events are a risk group for adverse physical and psychological outcomes. At the time of the 2019/2020 Australian bushfires, exposed women could not easily access evidence-based information to mitigate this risk. Family practitioners are well placed to provide pregnant women and new mothers with this sought-after information, but they need to be prepared well in advance of future similar events.
Wildfires have increased in frequency and magnitude and pose a significant public health challenge. The principal objective of this study was to assess the impact of wildfire smoke on respiratory peak flow performance of patients exposed to two different wildfire events. This longitudinal study utilized an observational approach and a cohort study design with a patient-level clinical dataset from a local outpatient allergy clinic (n = 842). Meteorological data from a local weather station served as a proxy for smoke exposure because air quality measurements were not available. This study found that there were decreases in respiratory peak flow among allergy clinic patients one year after each wildfire event. For every one percent increase in wind blowing from the fire towards the community, there was, on average, a 2.21 L per minute decrease in respiratory peak flow. This study observed an effect on respiratory peak flow performance among patients at a local allergy clinic one year after suspected exposure to wildfire smoke. There are likely multiple reasons for the observation of this relationship, including the possibility that wildfire smoke may enhance allergic sensitization to other allergens or that wildfire smoke itself may elicit a delayed immune response.
The vegetation burning caused by wildfires can release significant quantities of aerosols and toxic chemicals into the atmosphere and result in health risk. Among these emitted pollutants, Benzo(a)pyrene (BaP), the most toxic congener of 16 parent PAHs (polycyclic aromatic hydrocarbons), has received widespread concerns because of its carcinogenicity to human health. Efforts have been made to investigate the environmental and health consequences of wildfire-induced BaP emissions in Africa. Still, uncertainties remain due to knowledge and data gaps in wildfire incidences and biomass burning emissions. Based on a newly-developed BaP emission inventory, the present study assesses quantitatively the BaP environment cycling in Africa and its effects on other continents from 2001 to 2014. The new inventory reveals the increasing contribution of BaP emission from African wildfires to the global total primarily from anthropogenic sources, accounting for 48% since the 2000 s. We identify significantly higher BaP emissions and concentrations across sub-Saharan Africa, where the annual averaged BaP concentrations were as high as 5-8 ng/m(3). The modeled BaP concentrations were implemented to estimate the lifetime cancer risk (LCR) from the inhalation exposure to BaP concentrations. The results reveal that the LCR values in many African countries exceeded the acceptable risk level at 1 × 10(-6), some of which suffer from very high exposure risk with the LCR>1 × 10(-4). We show that the African BaP emission from wildfires contributed, to some extent, BaP contamination to Europe as well as other regions, depending on source proximity and atmospheric pathways under favorable atmospheric circulation patterns.
This paper examines the effect of biomass burning on adolescent health in India. The biomass burning problem is quite acute especially in North India, with some states experiencing forest fires and few states actively engaging in crop burning practice. We combine remote sensing data on biomass burning events with a pan-India survey on teenage girls (TAG survey). We exploit regional and temporal variation in our data to establish the link between occurrence of extremely high levels of biomass burning during early life and adolescent height for girls in India. Our results indicate that exposure to extremely high level of biomass burning during prenatal and postnatal period is associated with lower height (by 0.7 percent or 1.07 cm) later in life. Girls from North India are found to be especially vulnerable to the harmful effects of exposure to biomass burning. (c) 2021 Elsevier B.V. All rights reserved.
Smoke from wildfires is a growing health risk across the US. Understanding the spatial and temporal patterns of such exposure and its population health impacts requires separating smoke-driven pollutants from non-smoke pollutants and a long time series to quantify patterns and measure health impacts. We develop a parsimonious and accurate machine learning model of daily wildfire-driven PM(2.5) concentrations using a combination of ground, satellite, and reanalysis data sources that are easy to update. We apply our model across the contiguous US from 2006 to 2020, generating daily estimates of smoke PM(2.5) over a 10 km-by-10 km grid and use these data to characterize levels and trends in smoke PM(2.5). Smoke contributions to daily PM(2.5) concentrations have increased by up to 5 μg/m(3) in the Western US over the last decade, reversing decades of policy-driven improvements in overall air quality, with concentrations growing fastest for higher income populations and predominantly Hispanic populations. The number of people in locations with at least 1 day of smoke PM(2.5) above 100 μg/m(3) per year has increased 27-fold over the last decade, including nearly 25 million people in 2020 alone. Our data set can bolster efforts to comprehensively understand the drivers and societal impacts of trends and extremes in wildfire smoke.
Amid worsening climate change, the recurrent wildfires have substantially worsened air quality in the Western United States (U.S.). Understanding the knowledge, attitudes, perception, and practices (KAPP) over time in response to natural disasters such as wildfires is crucial for public health interventions and disaster preparedness. This is the first study to investigate the change in air quality KAPP over time in response to natural disasters. Previous studies have only assessed KAPP at a fixed time point. Using a two-wave panel survey (during and post-wildfires), we assessed the association between KAPP and respiratory health indicators as well as the changes over time in 212 participants in the U.S. Between the two waves, we found a significant 8% increase in knowledge, which was mainly driven by participants in areas unaffected by the wildfires. In addition, we found differential associations between KAPP and respiratory health indicators between areas affected and unaffected by the wildfires. These findings suggest that experiencing wildfires may affect KAPP and more longitudinal studies are warranted, particularly during periodic air quality crises.
The smart helmet is designed for a wildland firefighter to send vital data to their supervisor while they are working to extinguish an active fire. The smart helmet collects temperature, heart rate, and acceleration data from each firefighter via sensors inside and around the helmet. The data is used to alert the supervisor of potential health or emergency issues, such as heat-related illness, dehydration, potential falls or abnormal heart rates. A mobile app that the supervisor connects to their smart helmet device collects data in real time from the firefighters, without the need of any cellular coverage or WiFi.
The impacts of wildfires on the health of children are becoming a more urgent matter as wildfires become more frequent, intense and affecting, not only forested areas, but also urban locations. It is important that medical professionals be prepared to provide information to patients and families on how to minimize the adverse health effects on children of wildfire smoke and ash from wildfires. (C) 2021 Elsevier Inc. All rights reserved.
Elevated ambient temperatures and extreme weather events have increased the incidence of wildfires world-wide resulting in increased wood smoke particle (WSP). Epidemiologic data suggests that WSP exposure associates with exacerbations of respiratory diseases, and with increased respiratory viral infections. To assess the impact of WSP exposure on host response to viral pneumonia, we performed WSP exposures in rodents followed by infection with mouse adapted influenza (HINI-PR8). C57BL/6 male mice aged 6-8 weeks were challenged with WSP or PBS by oropharyngeal aspiration in acute (single dose) or sub-acute exposures (day 1, 3, 5, 7 and 10). Additional groups underwent sub-acute exposure followed by infection by influenza or heat-inactivated (HI) virus. Following exposures/infection, bronchoalveolar lavage (BAL) was performed to assess for total cell counts/differentials, total protein, protein carbonyls and hyaluronan. Lung tissue was assessed for viral counts by real time PCR. When compared to PBS, acute WSP exposure associated with an increase in airspace macrophages. Alternatively, sub-acute exposure resulted in a dose dependent increase in airspace neutrophils. Sub-acute WSP exposure followed by influenza infection was associated with improved respiratory viral outcomes including reduced weight loss and increased blood oxygen saturation, and decreased protein carbonyls and viral titers. Flow cytometry demonstrated dynamic changes in pulmonary macrophage and T cell subsets based on challenge with WSP and influenza. This data suggests that sub-acute WSP exposure can improve host response to acute influenza infection.
Understanding whether and how wildfires exacerbate COVID-19 outcomes is important for assessing the efficacy and design of public sector responses in an age of more frequent and simultaneous natural disasters and extreme events. Drawing on environmental and emergency management literatures, we investigate how wildfire smoke (PM(2.5)) impacted COVID-19 infections and deaths during California’s 2020 wildfire season and how public housing resources and hospital capacity moderated wildfires’ effects on COVID-19 outcomes. We also hypothesize and empirically assess the differential impact of wildfire smoke on COVID-19 infections and deaths in counties exhibiting high and low social vulnerability. To test our hypotheses concerning wildfire severity and its disproportionate impact on COVID-19 outcomes in socially vulnerable communities, we construct a county-by-day panel dataset for the period April 1 to November 30, 2020, in California, drawing on publicly available state and federal data sources. This study’s empirical results, based on panel fixed effects models, show that wildfire smoke is significantly associated with increases in COVID-19 infections and deaths. Moreover, wildfires exacerbated COVID-19 outcomes by depleting the already scarce hospital and public housing resources in local communities. Conversely, when wildfire smoke doubled, a one percent increase in the availability of hospital and public housing resources was associated with a 2 to 7 percent decline in COVID-19 infections and deaths. For California communities exhibiting high social vulnerability, the occurrence of wildfires worsened COVID-19 outcomes. Sensitivity analyses based on an alternative sample size and different measures of social vulnerability validate this study’s main findings. An implication of this study for policymakers is that communities exhibiting high social vulnerability will greatly benefit from local government policies that promote social equity in housing and healthcare before, during, and after disasters.
The 2020 California wildfire season coincided with the peak of the COVID-19 pandemic affecting many counties in California, with impacts on air quality. We quantitatively analyzed the short-term effect of air pollution on COVID-19 transmission using county-level data collected during the 2020 wildfire season. Using time-series methodology, we assessed the relationship between short-term exposure to particulate matter (PM(2.5)), carbon monoxide (CO), nitrogen dioxide (NO(2)), and Air Quality Index (AQI) on confirmed cases of COVID-19 across 20 counties impacted by wildfires. Our findings indicate that PM(2.5), CO, and AQI are positively associated with confirmed COVID-19 cases. This suggests that increased air pollution could worsen the situation of a health crisis such as the COVID-19 pandemic. Health policymakers should make tailored policies to cope with situations that may increase the level of air pollution, especially during a wildfire season.
Background: Air pollution has been linked to increased susceptibility to SARS-CoV-2. Thus, it has been suggested that wildfire smoke events may exacerbate the COVID-19 pandemic. Objectives: Our goal was to examine whether wildfire smoke from the 2020 wildfires in the western United States was associated with an increased rate of SARS-CoV-2 infections in Reno, Nevada. Methods: We conducted a time-series analysis using generalized additive models to examine the relationship between the SARS-CoV-2 test positivity rate at a large regional hospital in Reno and ambient PM2.5 from 15 May to 20 Oct 2020. Results: We found that a 10 µg/m3 increase in the 7-day average PM2.5 concentration was associated with a 6.3% relative increase in the SARS-CoV-2 test positivity rate, with a 95% confidence interval (CI) of 2.5 to 10.3%. This corresponded to an estimated 17.7% (CI: 14.4-20.1%) increase in the number of cases during the time period most affected by wildfire smoke, from 16 Aug to 10 Oct. Significance: Wildfire smoke may have greatly increased the number of COVID-19 cases in Reno. Thus, our results substantiate the role of air pollution in exacerbating the pandemic and can help guide the development of public preparedness policies in areas affected by wildfire smoke, as wildfires are likely to coincide with the COVID-19 pandemic in 2021.
BACKGROUND: On May 3, 2016, residents of Fort McMurray Wood Buffalo, Alberta were evacuated due to an uncontrolled wildfire. The short-notice evacuation had destabilizing consequences for residents, including changes in routines, loss of control, and increased uncertainty. These consequences were especially detrimental to women who were pregnant or pre-conception during the evacuation. Pregnant and pre-conception women are particularly susceptible to a vast range of negative consequences during and post natural disasters, including elevated stress and higher incidence of pregnancy complications including gestational diabetes mellitus, pregnancy induced hypertension and C-section. The aim of this study was to understand the experiences, perceived stress and resilience of women who were pregnant during the wildfire. As well as to explore potential interventions to promote the health and enhance resilience of pregnant women and to assist in recovery after exposure to a natural disaster or other traumatic events. METHODS: A qualitative thematic analysis of 16 narratives penned by pregnant women and recounted in Ashley Tobin’s compilations 93/88,000 and 159 More/ 88,000: Stories of Evacuation, Re-Entry and the In-Between was conducted. RESULTS: Analysis revealed five key themes: (1) experience of stress responses due to personal and external factors, (2) social connectedness and support as a facilitator of resilience, (3) performance of resilience-enhancing activities, (4) the roles of pregnancy and motherhood in the experiences of loss and resilience, and (5) the importance of home. CONCLUSION: Pregnant women have unique barriers that may negatively impact them during a natural disaster or other form of stressful event. They may benefit from assistance with navigating role transition during pregnancy, training in stress management strategies, and writing interventions to build resiliency and begin the process of recovery from trauma.
OBJECTIVES: The increase in global wildland fire activity has accelerated the urgency to understand health risks associated with wildland fire suppression. The aim of this project was to identify occupational health research priorities for wildland firefighters and related personnel. DESIGN: In order to identify, rank and rate health research priorities, we followed a modified Delphi approach. Data collection involved a two-stage online survey followed by semi-structured interviews. SETTING: British Columbia, Canada. PARTICIPANTS: Participants included any current or past wildland firefighter or individuals engaged in related roles. There were 132 respondents to the first survey. Responses to the first survey were analysed to produce 10 research topics which were ranked by 75 participants in the second survey (response rate: 84%). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the identification, ranking and level of agreement of research priorities through a two-round online survey. We contextualised these findings through deductive and inductive qualitative content analysis of semi-structured interviews. RESULTS: The most important research priorities identified were (% consensus): effects of smoke inhalation on respiratory health (89%), fatigue and sleep (80%), mental health (78%), stress (76%) and long-term risk of disease (67%). Interviews were completed with 14 individuals. Two main themes were developed from an inductive content analysis of interview transcripts: (1) understanding the dynamic risk environment; and (2) organisational fit of mitigation strategies. CONCLUSIONS: Participants expressed a general concern with the unknown mental and physical health impacts of their jobs, including the long-term risk of morbidity and mortality. Future research must address knowledge gaps in our understanding of the health impacts of wildland fire and work to develop appropriate mitigation strategies while considering the needs of workers and unpredictable workplace environment. TRIAL REGISTRATION NUMBER: Open Science Framework, https://osf.io/ugz4s/.
Rising emissions from wildfires over recent decades in the Pacific Northwest are known to counteract the reductions in human-produced aerosol pollution over North America. Since amplified Pacific Northwest wildfires are predicted under accelerating climate change, it is essential to understand both local and transported contributions to air pollution in North America. Here, we find corresponding increases for carbon monoxide emitted from the Pacific Northwest wildfires and observe significant impacts on both local and down-wind air pollution. Between 2002 and 2018, the Pacific Northwest atmospheric carbon monoxide abundance increased in August, while other months showed decreasing carbon monoxide, so modifying the seasonal pattern. These seasonal pattern changes extend over large regions of North America, to the Central USA and Northeast North America regions, indicating that transported wildfire pollution could potentially impact the health of millions of people.
OBJECTIVE: The purpose of this study was to assess health-related responses to wildfire smoke on social media. We examined whether seasonal wildfire smoke is an active topic on Twitter, the correlation between fine particulate matter (PM(2.5) ) and Twitter search terms, and dimensions of community-level expression to wildfire smoke through tweets. DESIGN: Search terms were identified using a conceptual model developed and refined by healthcare providers and public health experts. Wildfire-related tweets were downloaded from Twitter users in Spokane, Washington during the 2017 and 2018 wildfire seasons. PM(2.5) data were correlated with the search terms. A subset of tweets was deductively and then inductively coded to identify perceptions and behavioral responses to wildfire smoke. RESULTS: Seasonal wildfire smoke is an active topic on Twitter. The term “smoke” was strongly correlated with poor air quality and “unhealthy” was moderately correlated. Deductive analyses revealed a multidimensional response to wildfire smoke. Inductive analysis identified new areas of concern, such as pet and animal health. CONCLUSIONS: Social media is a lens through which public health professionals can assess and respond to local community needs. Findings will be used to broaden the conceptual model, enhance ongoing surveillance of community-identified health risks, and communicate protective actions.
The purpose of this study was to assess the effect of wildland firefighting on measures of cardiovascular health. The study was carried out in two parts. Part one assessed relationships between years of wildland firefighting and cardiovascular variables (n = 28). Part two looked at cardiovascular variables pre and post a wildland firefighting season (n = 18). Independent of age, a statistically significant relationship between number of seasons firefighting and VO(2max) was found (r(2)=.140, p=.048). A statistically significant reduction in VO(2max) of -4.1 ± 5.7 ml·kg(-1) min(-1) was witnessed following fire season (95%CI=-6.9 to -1.3, p=.048). Year to date hazard pay was significantly correlated with ankle-brachial index (r=-.474, p=.040). Wildland firefighters who reported >640 h of hazard pay had a greater VO(2max) reduction than those reporting less hazard pay (-1.7 ± 5.7 ml·kg(-1)·min(-1) vs. -7.1 ± 4.3 ml·kg(-1)·min(-1), p=.037). Wildland firefighting may negatively impact cardiorespiratory fitness and arterial health.
Wildfires are becoming more frequent and destructive in a changing climate. Fine particulate matter, PM(2.5), in wildfire smoke adversely impacts human health. Recent toxicological studies suggest that wildfire particulate matter may be more toxic than equal doses of ambient PM(2.5). Air quality regulations however assume that the toxicity of PM(2.5) does not vary across different sources of emission. Assessing whether PM(2.5) from wildfires is more or less harmful than PM(2.5) from other sources is a pressing public health concern. Here, we isolate the wildfire-specific PM(2.5) using a series of statistical approaches and exposure definitions. We found increases in respiratory hospitalizations ranging from 1.3 to up to 10% with a 10 μg m(-3) increase in wildfire-specific PM(2.5), compared to 0.67 to 1.3% associated with non-wildfire PM(2.5). Our conclusions point to the need for air quality policies to consider the variability in PM(2.5) impacts on human health according to the sources of emission.
Fire Influence on Regional to Global Environments and Air Quality was a NOAA/NASA collaborative campaign conducted during the summer of 2019. The objectives included identifying and quantifying wildfire composition, smoke evolution, and climate and health impacts of wildfires and agricultural fires in the United States. Ground based mobile sampling via sorbent tubes occurred at the Nethker and Williams Flats fires (2019) and Chief Timothy and Whitetail Loop fires (2020) in Idaho and Washington. Air samples were analyzed through thermal desorption-gas chromatography-mass spectrometry for a variety of volatile organic compounds to elucidate both composition and health impacts. Benzene, toluene, ethylbenzene, xylenes, butenes, phenol, isoprene and pinenes were observed in the wildfire smoke, with benzene ranging from 0.04 to 25 ppbv. Health risk was assessed for each fire by determining sub-chronic (wildfire event) and projected chronic inhalation risk exposure from benzene, a carcinogen, as well as other non-carcinogenic compounds including toluene, ethylbenzene, xylenes, and hexane. The cancer risk of benzene from sub-chronic exposure was 1 extra cancer per million people and ranged from 1 to 19 extra cancers per million people for the projected chronic scenarios, compared to a background level of 1 extra cancer per million people. The hazard index of non-carcinogenic compounds was less than one for all scenarios and wildfires sampled, which was considered low risk for non-cancer health events.
Exposure to wildfire smoke increases the risk of respiratory and cardiovascular hospital admissions. Health impact assessments, used to inform decision-making processes, characterize the health impacts of environmental exposures by combining preexisting epidemiological concentration-response functions (CRFs) with estimates of exposure. These two key inputs influence the magnitude and uncertainty of the health impacts estimated, but for wildfire-related impact assessments the extent of their impact is largely unknown. We first estimated the number of respiratory, cardiovascular, and asthma hospital admissions attributable to fire-originated PM2.5 exposure in central California during the October 2017 wildfires, using Monte Carlo simulations to quantify uncertainty with respect to the exposure and epidemiological inputs. We next conducted sensitivity analyses, comparing four estimates of fire-originated PM2.5 and two CRFs, wildfire and nonwildfire specific, to understand their impact on the estimation of excess admissions and sources of uncertainty. We estimate the fires accounted for an excess 240 (95% CI: 114, 404) respiratory, 68 (95% CI: -10, 159) cardiovascular, and 45 (95% CI: 18, 81) asthma hospital admissions, with 56% of admissions occurring in the Bay Area. Although differences between impact assessment methods are not statistically significant, the admissions estimates’ magnitude is particularly sensitive to the CRF specified while the uncertainty is most sensitive to estimates of fire-originated PM2.5. Not accounting for the exposure surface’s uncertainty leads to an underestimation of the uncertainty of the health impacts estimated. Employing context-specific CRFs and using accurate exposure estimates that combine multiple data sets generates more certain estimates of the acute health impacts of wildfires.
Wildfire smoke is one of the most significant concerns of human and environmental health, associated with its substantial impacts on air quality, weather, and climate. However, biomass burning emissions and smoke remain among the largest sources of uncertainties in air quality forecasts. In this study, we evaluate the smoke emissions and plume forecasts from 12 state-of-the-art air quality forecasting systems during the Williams Flats fire in Washington State, US, August 2019, which was intensively observed during the Fire Influence on Regional to Global Environments and Air Quality (FIREX-AQ) field campaign. Model forecasts with lead times within 1 d are intercompared under the same framework based on observations from multiple platforms to reveal their performance regarding fire emissions, aerosol optical depth (AOD), surface PM2.5, plume injection, and surface PM2.5 to AOD ratio. The comparison of smoke organic carbon (OC) emissions suggests a large range of daily totals among the models, with a factor of 20 to 50. Limited representations of the diurnal patterns and day-to-day variations of emissions highlight the need to incorporate new methodologies to predict the temporal evolution and reduce uncertainty of smoke emission estimates. The evaluation of smoke AOD (sAOD) forecasts suggests overall underpredictions in both the magnitude and smoke plume area for nearly all models, although the high-resolution models have a better representation of the fine-scale structures of smoke plumes. The models driven by fire radiative power (FRP)-based fire emissions or assimilating satellite AOD data generally outperform the others. Additionally, limitations of the persistence assumption used when predicting smoke emissions are revealed by substantial underpredictions of sAOD on 8 August 2019, mainly over the transported smoke plumes, owing to the underestimated emissions on 7 August. In contrast, the surface smoke PM2.5 (sPM(2.5)) forecasts show both positive and negative overall biases for these models, with most members presenting more considerable diurnal variations of sPM(2.5). Overpredictions of sPM(2.5) are found for the models driven by FRP-based emissions during nighttime, suggesting the necessity to improve vertical emission allocation within and above the planetary boundary layer (PBL). Smoke injection heights are further evaluated using the NASA Langley Research Center’s Differential Absorption High Spectral Resolution Lidar (DIAL-HSRL) data collected during the flight observations. As the fire became stronger over 38 August, the plume height became deeper, with a day-today range of about 2-9 km a.g.l. However, narrower ranges are found for all models, with a tendency of overpredicting the plume heights for the shallower injection transects and underpredicting for the days showing deeper injections. The misrepresented plume injection heights lead to inaccurate vertical plume allocations along the transects corresponding to transported smoke that is 1 d old. Discrepancies in model performance for surface PM2.5 and AOD are further suggested by the evaluation of their ratio, which cannot be compensated for by solely adjusting the smoke emissions but are more attributable to model representations of plume injections, besides other possible factors including the evolution of PBL depths and aerosol optical property assumptions. By consolidating multiple forecast systems, these results provide strategic insight on pathways to improve smoke forecasts.
Background: Recent increases in wildfire frequency and severity necessitate better understanding of health effects of wildfire smoke to protect affected populations. Objectives: We examined relationships between fine particulate matter (PM2.5) and morbidity during wildfires in California, and whether those relationships differed during the fire compared to a similar non-fire period. Methods: For nine San Francisco Bay Area counties, daily county- level diagnosis-specific counts of emergency department visits (EDVs) and hospitalizations were linked with county-level estimates of daily mean PM2.5 during the October 2017 Northern California wildfires and similar October days in 2015, 2016, and 2017. Associations were estimated using Poisson regression. Results: The median difference between county PM2.5 during the fire versus the non-fire period was 23.4 mu g/ m3, with days exceeding 80 mu g/m3 in some counties. Over the entire study period, PM2.5 was most consistently linked to EDVs for respiratory disease ( RREDV(lag0) per 23.4 mu g/ m3 increase: 1.25, 95% CI: 1.21, 1.30), asthma, chronic lower respiratory disease (CLRD; RREDV(lag0): 1.18, 95% CI: 1.10, 1.27), and acute myocardial infarction (RREDV(lag0): 1.14, 95% CI: 1.03, 1.25). Increases in acute upper respiratory infections and decreases in mental/behavioral EDVs were observed but were sensitive to model specification, specifically the inclusion of time-related covariates. Comparing fire and non-fire period EDV associations, we observed indications that PM2.5 during the fire was more strongly associated with asthma (RRlag0: 1.46, 95% CI: 1.38, 1.55) compared to non-fire period PM2.5 (RRlag0: 0.77, 95% CI: 0.55, 1.08), and the opposite observed for dysrhythmia, with the asthma difference being particularly robust to model choice. For hospitalizations, the most robust PM2.5 relationships were positive associations with respiratory, CLRD, and diabetes, and inverse associations with pneumonia. Respiratory and CLRD effect estimates were generally similar or smaller than for EDVs. Conclusions: Elevated short-term PM2.5 levels from wildfire smoke appears to impact respiratory and other health domains. (c) 2021 Elsevier B.V. All rights reserved.
BACKGROUND AND OBJECTIVES: Exposure to airborne fine particles with diameters <= 2.5 mu m (PM2.5) pollution is a well-established cause of respiratory diseases in children; whether wildfire-specific PM2.5 causes more damage, however, remains uncertain. We examine the associations between wildfire-specific PM2.5 and pediatric respiratory health during the period 2011-2017 in San Diego County, California, and compare these results with other sources of PM2.5. METHODS: Visits to emergency and urgent care facilities of Rady's Children Hospital network in San Diego County, California, by individuals (aged <= 19 years) with >= 1 of the following respiratory conditions: difficulty breathing, respiratory distress, wheezing, asthma, or cough were regressed on daily, community-level exposure to wildfire-specific PM2.5 and PM2.5 from ambient sources (eg, traffic emissions). RESULTS: A 10-unit increase in PM2.5 (from nonsmoke sources) was estimated to increase the number of admissions by 3.7% (95% confidence interval: 1.2% to 6.1%). In contrast, the effect of PM2.5 attributable to wildfire was estimated to be a 30.0% (95% confidence interval: 26.6% to 33.4%) increase in visits. CONCLUSIONS: Wildfire-specific PM2.5 was found to be similar to 10 times more harmful on children’s respiratory health than PM2.5 from other sources, particularly for children aged 0 to 5 years. Even relatively modest wildfires and associated PM2.5 resolved on our record produced major health impacts, particularly for younger children, in comparison with ambient PM2.5.
Major wildfires starting in the summer of 2020 along the west coast of the United States made PM2.5 concentrations in this region rank among the highest in the world. Washington was impacted both by active wildfires in the state and aged wood smoke transported from fires in Oregon and California. This study aims to estimate the magnitude and disproportionate spatial impacts of increased PM2.5 concentrations attributable to these wildfires on population health. Daily PM2.5 concentrations for each county before and during the 2020 Washington wildfire episode (September 7-19) were obtained from regulatory air monitors. Utilizing previously established concentration-response function (CRF) of PM2.5 (CRF of total PM2.5) and odds ratio (OR) of wildfire smoke days (OR of wildfire smoke days) for mortality, we estimated excess mortality attributable to the increased PM2.5 concentrations in Washington. On average, daily PM2.5 concentrations increased 97.1 mu g/m(3) during the wildfire smoke episode. With CRF of total PM2.5, the 13-day exposure to wildfire smoke was estimated to lead to 92.2 (95% CI: 0.0, 178.7) more all-cause mortality cases; with OR of wildfire smoke days, 38.4 (95% CI: 0.0, 93.3) increased all-cause mortality cases and 15.1 (95% CI: 0.0, 27.9) increased respiratory mortality cases were attributable to the wildfire smoke episode. The potential impact of avoiding elevated PM2.5 exposures during wildfire events significantly reduced the mortality burden. Because wildfire smoke episodes are likely to impact the Pacific Northwest in future years, continued preparedness and mitigations to reduce exposures to wildfire smoke are necessary to avoid excess health burden.
Increases in wildfire activity across the Western US pose a significant public health threat. While there is evidence that wildfire smoke is detrimental for respiratory health, the impacts on cardiovascular health remain unclear. This study evaluates the association between fine particulate matter (PM(2.5)) from wildfire smoke and unscheduled cardiorespiratory hospital visits in California during the 2004-2009 wildfire seasons. We estimate daily mean wildfire-specific PM(2.5) with Goddard Earth Observing System-Chem, a global three-dimensional model of atmospheric chemistry, with wildfire emissions estimates from the Global Fire Emissions Database. We defined a “smoke event day” as cumulative 0-1-day lag wildfire-specific PM(2.5) ≥ 98th percentile of cumulative 0-1 lag day wildfire PM(2.5). Associations between exposure and outcomes are estimated using negative binomial regression. Results indicate that smoke event days are associated with a 3.3% (95% CI: [0.4%, 6.3%]) increase in visits for all respiratory diseases and a 10.3% (95% CI: [2.3%, 19.0%]) increase for asthma specifically. Stratifying by age, we found the largest effect for asthma among children ages 0-5 years. We observed no significant association between exposure and overall cardiovascular disease, but stratified analyses revealed increases in visits for all cardiovascular, ischemic heart disease, and heart failure among non-Hispanic white individuals and those older than 65 years. Further, we found a significant interaction between smoke event days and daily average temperature for all cardiovascular disease visits, suggesting that days with high wildfire PM(2.5) concentrations and high temperatures may pose greater risk for cardiovascular disease. These results suggest substantial increases in adverse outcomes from wildfire smoke exposure and indicate the need for improved prevention strategies and adaptations to protect vulnerable populations.
This study proposes an approach to improve the spatial resolution of ground-level concentrations of PM2.5 that is required to assess health risks associated with exposure to pollutants released during wildfires. We use this approach to analyze the impact on air quality of the wildfire complex consisting of the Atlas, Nuns, Tubbs, Pocket, and Redwood Valley fires in northern California that started on October 8, 2017 and the Camp Fire in northern California that was first reported on November 8, 2018. The PM2.5 concentrations measured in populated areas downwind of these fires were well above the 24-h standard of 35 mu g/m3 during several days of both fires. To estimate health risks at locations where ground-based monitors did not provide sufficient spatial coverage we first estimate the emissions from the fires by fitting concentration estimates from two models, a Lagrangian model and a segmented plume dispersion model, to corresponding concentrations from ground monitors. We also use a power law model to fit the measured PM2.5 concentrations to the ratio of aerosol optical depth (AOD) to planetary boundary layer measured by the Moderate Resolution Imaging Spectroradiometer (MODIS) carried by NASA’s Terra and Aqua satellites. Dispersion model estimates are then combined with estimates from the AOD model to compute ground-level concentrations at a resolution of 1 km. Kriged residuals between estimates from the combined model and measured PM2.5 concentrations are then added to obtain high resolution maps that can be used for exposure studies.
Background: Wildfire smoke is responsible for around 20% of all particulate emissions in the U.S. and affects millions of people worldwide. Children are especially vulnerable, as ambient air pollution exposure during early childhood is associated with reduced lung function. Most studies, however, have focused on the short-term impacts of wildfire smoke exposures. We aimed to identify long-term baseline epigenetic changes associated with early-life exposure to wildfire smoke. We collected nasal epithelium samples for whole genome bisulfite sequencing (WGBS) from two groups of adult female rhesus macaques: one group born just before the 2008 California wildfire season and exposed to wildfire smoke during early-life (n = 8), and the other group born in 2009 with no wildfire smoke exposure during early-life (n = 14). RNA-sequencing was also performed on a subset of these samples. Results: We identified 3370 differentially methylated regions (DMRs) (difference in methylation ≥5%, empirical p < 0.05) and 1 differentially expressed gene (FLOT2) (FDR < 0.05, fold of change ≥ 1.2). The DMRs were annotated to genes significantly enriched for synaptogenesis signaling, protein kinase A signaling, and a variety of immune processes, and some DMRs significantly correlated with gene expression differences. DMRs were also significantly enriched within regions of bivalent chromatin (top odds ratio = 1.46, q-value < 3 x 10^(-6)) that often silence key developmental genes while keeping them poised for activation in pluripotent cells. Conclusions: These data suggest that early-life exposure to wildfire smoke leads to long-term changes in the methylome over genes impacting the nervous and immune systems. Follow-up studies will be required to test whether these changes influence transcription following an immune/respiratory challenge.
Objective: The California Emergency Medical Services Authority manages and deploys California Medical Assistance Teams (CAL-MAT) to disaster medical incidents in the state. This analysis reviews diagnoses for ambulatory medical visits at multiple wildland fire incident base camp field sites in California during the 2020 fire season. Methods: Clinical data without personal health information were extracted retrospectively from patient care records from all patients seen by a provider. Results were entered into Excel spreadsheets with calculation of summary statistics. Results: During the 2020 fire season, CAL-MAT teams deployed 21 times for a total of 327 days to base camps supporting large fire incidents and cared for 1756 patients. Impacts of heat and environmental smoke are a constant factor near wildfires; however, our most common medical problem was rhus dermatitis (54.5%) due to poison oak. All 2020 medical missions were further complicated by prevention and management of coronavirus disease (COVID-19). Conclusions: There is very little literature regarding the acute medical needs facing responders fighting wildland fires. Ninety-five percent of clinical conditions presenting to a field medical team at the wildfire incident base camp during a severe fire season in California can be managed by small teams operating in field tents.
Driven by climate change, wildfires are increasing in frequency, duration, and intensity across the Western United States. Outdoor workers are being exposed to increasing wildfire-related particulate matter and smoke. Recognizing this emerging risk, Washington adopted an emergency rule and is presently engaged in creating a permanent rule to protect outdoor workers from wildfire smoke exposure. While there are growing bodies of literature on the exposure to and health effects of wildfire smoke in the general public and wildland firefighters, there is a gap in knowledge about wildfire smoke exposure among outdoor workers generally and construction workers specifically-a large category of outdoor workers in Washington totaling 200,000 people. Several data sources were linked in this study-including state-collected employment data and national ambient air quality data-to gain insight into the risk of PM2.5 exposure among construction workers and evaluate the impacts of different air quality thresholds that would have triggered a new Washington emergency wildfire smoke rule aimed at protecting workers from high PM2.5 exposure. Results indicate the number of poor air quality days has increased in August and September in recent years. Over the last decade, these months with the greatest potential for particulate matter exposure coincided with an annual peak in construction employment that was typically 9.4-42.7% larger across Washington counties (one county was 75.8%). Lastly, the ‘encouraged’ threshold of the Washington emergency rule (20.5 mu g m(-3)) would have resulted in 5.5 times more days subject to the wildfire rule on average across all Washington counties compared to its ‘required’ threshold (55.5 mu g m(-3)), and in 2020, the rule could have created demand for 1.35 million N-95 filtering facepiece respirators among construction workers. These results have important implications for both employers and policy makers as rules are developed. The potential policy implications of wildfire smoke exposure, exposure control strategies, and data gaps that would improve understanding of construction worker exposure to wildfire smoke are also discussed.
Frequent and widespread wildfires in the northwestern United States and Canada have become the “new normal” during the Northern Hemisphere summer months, which significantly degrades particulate matter air quality in the United States. Using the mid-visible Multi Angle Implementation of Atmospheric Correction (MAIAC) satellitederived aerosol optical depth (AOD) with meteorological information from the European Centre for Medium-Range Weather Forecasts (ECMWF) and other ancillary data, we quantify the impact of these fires on fine particulate matter concentration (PM2.5) air quality in the United States. We use a geographically weighted regression (GWR) method to estimate surface PM2.5 in the United States between low (2011) and high (2018) fire activity years. Our results indicate an overall leave-one-out cross-validation (LOOCV) R-2 value of 0.797 with root mean square error (RMSE) between 3 and 5 mu gm(-3). Our results indicate that smoke aerosols caused significant pollution changes over half of the United States. We estimate that nearly 29 states have increased PM2.5 during the fire-active year and that 15 of these states have PM2.5 concentrations more than 2 times that of the inactive year. Furthermore, these fires increased the daily mean surface PM2.5 concentrations in Washington and Oregon by 38 to 259 mu gm(-3), posing significant health risks especially to vulnerable populations. Our results also show that the GWR model can be successfully applied to PM2.5 estimations from wildfires, thereby providing useful information for various applications such as public health assessment.
Introduction: Wildfire smoke (WFS) exposure is a growing threat to human health, and lower socioeconomic position (SEP) has been shown to increase pollution susceptibility. Studies of SEP-related susceptibility, however, are often compromised due to spatial confounding between lower-SEP and pollution. Here we examine outdoorhoused nonhuman primates, living in natural social hierarchy in a common location, born during years of high vs. low WFS, to examine the separate and combined effects of WFS and social rank, an analog to SEP, on lung and immune function. Methods: Twenty-one females were born during extreme WFS events in summer 2008; 22 were born in summer 2009, during low WFS. Pulmonary function and circulating cytokines were measured three years later, in adolescence. We estimated fine particulate (PM2.5) and ozone exposures during each animal’s first 90 days and three years of age using regulatory data. Early-life social status was estimated using maternal rank at birth, as rank in females is relatively stable throughout life, and closely approximates mother’s rank. We tested associations among WFS exposure, rank, and endpoints using linear regression and ANOVA. Results: Higher WFS exposure in infancy was, on average, associated with lower functional residual capacity (FRC), residual volume (RV), tissue compliance (Ct), and IL-8 secretion in adolescence. Higher social rank conferred significantly higher expiratory reserve volume (ERV) and functional residual capacity (FRC) solely among those born in the high-WFS year (2008). Differences in effects of rank between years were not significant after adjustment for multiple comparisons. Conclusions: Exposure to WFS in infancy generally conferred lower adolescent respiratory volumes and inflammatory cytokines. Higher rank conferred higher respiratory volumes only among females born during WFS, suggesting the possibility that the health benefits of rank may be more apparent under environmental challenge.
BACKGROUND: Global climate change has led to an increase in the prevalence and severity of wildfires. Pollutants released into air, soil and groundwater from wildfires may impact embryo development leading to gastroschisis. OBJECTIVE: The objective of this study was to determine the association between wildfire exposure before and during pregnancy and the risk of foetal gastroschisis development. METHODS: This was a retrospective cohort study using The California Office of Statewide Health Planning and Development Linked Birth File linked to The California Department of Forestry and Fire Protection data between 2007 and 2010. Pregnancies complicated by foetal gastroschisis were identified by neonatal hospital discharge ICD-9 code. Pregnancies were considered exposed to wildfire if the mother’s primary residence zip code was within 15 miles to the closest edge of a wildfire. The exposure was further stratified by trimester or if exposed within 30 days prior to pregnancy. Multivariable log-binomial regression analyses were performed to estimate the association between wildfire exposure in each pregnancy epoch and foetal gastroschisis. RESULTS: Between 2007 and 2010, 844,348 (40%) births were exposed to wildfire in California. Compared with births without wildfire exposure, those with first-trimester exposure were associated with higher rates of gastroschisis, 7.8 vs. 5.7 per 10,000 births (adjusted relative risk [aRR] 1.28, 95% confidence interval [CI] 1.07, 1.54). Furthermore, those with prepregnancy wildfire exposure were also found to have higher rates of gastroschisis, 12.5 vs. 5.7 per 10,000 births, (aRR 2.17, 95% CI 1.42, 3.52). In contrast, second- and third-trimester wildfire exposures were not associated with foetal gastroschisis. CONCLUSIONS: Wildfire exposure within 30 days before pregnancy was associated with more than two times higher risk of foetal gastroschisis, whereas a 28% higher risk was demonstrated if exposure was in the first trimester.
The increased risk of wildfires and associated smoke exposure in the United States is a growing public health problem, particularly along the Wildland-Urban Interface (WUI). Using the measure of fire danger, the Energy Release Component, we define fire danger as the onset and duration of fire season, in the continental US, between 1979 and 2016. We then combine the measure of fire danger with census data to quantify changes in population fire exposure across the WUI. We determined that the largest increases in fire danger were observed in the Southwest, Intermountain, and Pacific Southwest regions. The increased fire danger, specifically during peak fire season, accounted for 6.1 more fires each year and 78,000 more acres burned each year, underscoring the link between fire danger and the risks of large fire occurrence and burn acreage. Finally, we observed significant population growth (121.2% between 1990 and 2010) within high-danger WUI areas, further implying significant increases in potential fire exposure.
Alaskan wildfires have major ecological, social, and economic consequences, but associated health impacts remain unexplored. We estimated cardiorespiratory morbidity associated with wildfire smoke (WFS) fine particulate matter with a diameter less than 2.5 μm (PM(2.5)) in three major population centers (Anchorage, Fairbanks, and the Matanuska-Susitna Valley) during the 2015-2019 wildfire seasons. To estimate WFS PM(2.5), we utilized data from ground-based monitors and satellite-based smoke plume estimates. We implemented time-stratified case-crossover analyses with single and distributed lag models to estimate the effect of WFS PM(2.5) on cardiorespiratory emergency department (ED) visits. On the day of exposure to WFS PM(2.5), there was an increased odds of asthma-related ED visits among 15-65 year olds (OR = 1.12, 95% CI = 1.08, 1.16), people >65 years (OR = 1.15, 95% CI = 1.01, 1.31), among Alaska Native people (OR = 1.16, 95% CI = 1.09, 1.23), and in Anchorage (OR = 1.10, 95% CI = 1.05, 1.15) and Fairbanks (OR = 1.12, 95% CI = 1.07, 1.17). There was an increased risk of heart failure related ED visits for Alaska Native people (Lag Day 5 OR = 1.13, 95% CI = 1.02, 1.25). We found evidence that rural populations may delay seeking care. As the frequency and magnitude of Alaskan wildfires continue to increase due to climate change, understanding the health impacts will be imperative. A nuanced understanding of the effects of WFS on specific demographic and geographic groups facilitates data-driven public health interventions and fire management protocols that address these adverse health effects.
Context: Wildfire events are increasing in prevalence and intensity in the Pacific Northwest. Effective communication of health risks and actions to reduce exposure to wildfire smoke is imperative. Objective: We assessed the content of wildfire smoke risk messages from government organizations and mainstream media during a major wildfire smoke event in August 2018. Design: We conducted a content analysis of wildfire smoke risk information communicated by local and state government organizations and the mainstream media. Setting: Eight Washington State counties during a statewide wildfire smoke event in August 2018. Main Outcome Measure: Leveraging the Extended Parallel Process Model and information in the existing literature on wildfire smoke and health, we assessed messages for the presence of information regarding health risk, personal interventions, administrative interventions, vulnerable populations, and trusted sources of information. Summary statistics were calculated to identify common messages about recommended interventions, vulnerable populations cited, and trusted sources of public health information. Results: Of the 273 identified government and media messages on wildfire smoke, the majority (71% and 66%) contained information about health risks. However, only 46% and 33% of government and media messages contained information about personal interventions to reduce risk, and 37% and 14% of government and media messages contained information about administrative interventions to reduce risk. Less than half of government and media messages (28% and 31%) contained information specific to vulnerable populations, and 58% and 46% of government and media messages contained any reference to a trusted source of information. Conclusions: While information about wildfire smoke and health risks was communicated during Washington’s August 2018 wildfire smoke event, there remains considerable opportunity to include additional information about interventions, vulnerable populations, and trusted sources of information. We recommend several opportunities to improve and evaluate risk communication and risk reduction before, during, and after future wildfire smoke events.
Background: The modular British Columbia Asthma Prediction System (BCAPS) is designed to reduce information burden during wildfire smoke events by automatically gathering, integrating, generating, and visualizing data for public health users. The BCAPS framework comprises five flexible and geographically scalable modules: (1) historic data on fine particulate matter (PM2.5) concentrations; (2) historic data on relevant health indicator counts; (3) PM2.5 forecasts for the upcoming days; (4) a health forecasting model that uses the relationship between (1) and (2) to predict the impacts of (3); and (5) a reporting mechanism. Methods: The 2018 wildfire season was the most extreme in British Columbia history. Every morning BCAPS generated forecasts of salbutamol sulfate (e.g., Ventolin) inhaler dispensations for the upcoming days in 16 Health Service Delivery Areas (HSDAs) using random forest machine learning. These forecasts were compared with observations over a 63-day study period using different methods including the index of agreement (IOA), which ranges from 0 (no agreement) to 1 (perfect agreement). Some observations were compared with the same period in the milder wildfire season of 2016 for context. Results: The mean province-wide population-weighted PM2.5 concentration over the study period was 22.0 mu g/m(3), compared with 4.2 mu g/m(3) during the milder wildfire season of 2016. The PM2.5 forecasts underpredicted the severe smoke impacts, but the IOA was relatively strong with a population-weighted average of 0.85, ranging from 0.65 to 0.95 among the HSDAs. Inhaler dispensations increased by 30% over 2016 values. Forecasted dispensations were within 20% of the observed value in 71% of cases, and the IOA was strong with a population-weighted average of 0.95, ranging from 0.92 to 0.98. All measures of agreement were correlated with HSDA population, where BCAPS performance was better in the larger populations with more moderate smoke impacts. The accuracy of the health forecasts was partially dependent on the accuracy of the PM2.5 forecasts, but they were robust to over- and underpredictions of PM2.5 exposure. Conclusions: Daily reports from the BCAPS framework provided timely and reasonable insight into the population health impacts of predicted smoke exposures, though more work is necessary to improve the PM2.5 and health indicator forecasts.
Wildfire smoke exposure is associated with a range of acute health outcomes, which can be more severe in individuals with underlying health conditions. Currently, there is limited information on the susceptibility of healthcare facilities to smoke infiltration. As part of a larger study to address this gap, a rehabilitation facility in Vancouver, Canada was outfitted with one outdoor and seven indoor low-cost fine particulate matter (PM2.5) sensors in Air Quality Eggs (EGG) during the summer of 2020. Raw measurements were calibrated using temperature, relative humidity, and dew point derived from the EGG data. The infiltration coefficient was quantified using a distributed lag model. Indoor concentrations during the smoke episode were elevated throughout the building, though non-uniformly. After censoring indoor-only peaks, the average infiltration coefficient (range) during typical days was 0.32 (0.22-0.39), compared with 0.37 (0.31-0.47) during the smoke episode, a 19% increase on average. Indoor PM2.5 concentrations quickly reflected outdoor conditions during and after the smoke episode. It is unclear whether these results will be generalizable to other years due to COVID-related changes to building operations, but some of the safety protocols may offer valuable lessons for future wildfire seasons. For example, points of building entry and exit were reduced from eight to two during the pandemic, which likely helped to protect the building from wildfire smoke infiltration. Overall, these results demonstrate the utility of indoor low-cost sensors in understanding the impacts of extreme smoke events on facilities where highly susceptible individuals are present. Furthermore, they highlight the need to employ interventions that enhance indoor air quality in such facilities during smoke events.
Wildfires can be detrimental to urban and rural communities, causing impacts in the form of psychological stress, direct physical injury, and smoke-related morbidity and mortality. This study examined the area burned by wildfires over the entire state of California from the years 2000 to 2020 in order to quantify and identify whether burned area and fire frequency differed across Census tracts according to socioeconomic indicators over time. Wildfire data were obtained from the California Fire and Resource Assessment Program (FRAP) and National Interagency Fire Center (NIFC), while demographic data were obtained from the American Community Survey. Results showed a doubling in the number of Census tracts that experienced major wildfires and a near doubling in the number of people residing in wildfire-impacted Census tracts, mostly due to an over 23,000 acre/year increase in the area burned by wildfires over the last two decades. Census tracts with a higher fire frequency and burned area had lower proportions of minority groups on average. However, when considering Native American populations, a greater proportion resided in highly impacted Census tracts. Such Census tracts also had higher proportions of older residents. In general, high-impact Census tracts tended to have higher proportions of low-income residents and lower proportions of high-income residents, as well as lower median household incomes and home values. These findings are important to policymakers and state agencies as it relates to environmental justice and the allocation of resources before, during, and after wildfires in the state of California.
The health impacts of wildfire smoke are an important and growing global issue, as extreme wildfire events are expected to increase in frequency and intensity throughout this century due to climate change. Research into individual protective health decision-making can elucidate how wildfire smoke exposure contributes to adverse health outcomes and aid in public health interventions to mitigate risks. In this study we investigate the role of psychological factors (threat and efficacy perceptions) and social processes (social norms and social support) in shaping protective behavior in response to wildfire smoke. Through semi-structured interviews of forty-five individuals in Northern California, we explore perceptions of threat and efficacy, social processes, and protective behaviors in response to wildfire smoke events between 2018 and 2020. We found that for many participants sensory experiences and engagement with wildfire smoke information were instrumental in forming perceptions of threat and efficacy. Three themes related to social processes emerged: interpreting information together, protecting vulnerable others, and questioning protective actions. Through these themes we show how social norms and social support interact in complex, non-linear ways to influence threat and efficacy perceptions, and directly affect protective health behavior. Finally, we propose a conceptual framework of wildfire smoke protective behavior. This study contributes to a growing body of knowledge within the disaster risk and protective health literatures related to wildfire smoke response. Our findings demonstrate how the study of psychological factors and social processes during natural hazards, like wildfire smoke events, is essential to understanding individual protective health decision-making pathways and ultimately, to developing a more comprehensive view of how individual actions affect exposure.
Background We studied the impact of fine particulate matter (PM2.5) exposure due to a remote wildfire event in the Pacific Northwest on daily outpatient respiratory and cardiovascular physician visits during wildfire (24-31 August, 2015) and post-wildfire period (1-30 September, 2015) relative to the pre-wildfire period (1-23 August, 2015) in the city of Calgary, Canada. Methods A quasi-Poisson regression model was used for modelling daily counts of physician visits due to PM2.5 while adjusting for day of the week (weekday versus weekend or public holiday), wildfire exposure period (before, during, after), methane, relative humidity, and wind direction. A subgroup analysis of those with pre-existing diabetes or hypertension was performed. Results An elevated risk of respiratory disease morbidity of 33% (relative risk: RR) [95% confidence interval (CI): 10%-59%] and 55% (95% CI: 42%-69%) was observed per 10 mu g/m(3) increase in PM2.5 level during and after wildfire, respectively, relative to the pre-wildfire time period. Increased risk was observed for children aged 0-9 years during (RR = 1.57, 95% CI: 1.21-2.02) and after the wildfire (RR = 2.11, 95% CI: 1.86-2.40) especially for asthma, acute bronchitis and acute respiratory infection. The risk of physician visits among seniors increased by 11% (95% CI: 3%-21%), and 19% (95% CI: 7%-33%) post-wildfire for congestive heart failure and ischaemic heart disease, respectively. Individuals with pre-existing diabetes had an increased risk of both respiratory and cardiovascular morbidity in the post-wildfire period (RR = 1.35, 95% CI: 1.09-1.67; RR = 1.22, 95% CI: 1.01-1.46, respectively). Conclusions Wildfire-related PM2.5 exposure led to increased respiratory condition-related outpatient physician visits during and after wildfires, particularly for children. An increased risk of physician visits for congestive heart failure and ischaemic heart disease among seniors in the post-wildfire period was also observed.
The increasing incidence of extreme wildfire is becoming a concern for public health. Although long-term exposure to wildfire smoke is associated with respiratory illnesses, reports on the association between short-term occupational exposure to wildfire smoke and lung function remain scarce. In this cross-sectional study, we analyzed data from 218 Royal Canadian Mounted Police officers (mean age: 38 & PLUSMN; 9 years) deployed at the Fort McMurray wildfires in 2016. Individual exposure to air pollutants was calculated by integrating the duration of exposure with the air quality parameters obtained from the nearest air quality monitoring station during the phase of deployment. Lung function was measured using spirometry and body plethysmography. Association between exposure and lung function was examined using principal component linear regression analysis, adjusting for potential confounders. In our findings, the participants were predominantly male (71%). Mean forced expiratory volume in 1 s (FEV1), and residual volume (RV) were 76.5 & PLUSMN; 5.9 and 80.1 & PLUSMN; 19.5 (% predicted). A marginal association was observed between air pollution and higher RV [beta: 1.55; 95% CI: -0.28 to 3.37 per interquartile change of air pollution index], but not with other lung function indices. The association between air pollution index and RV was significantly higher in participants who were screened within the first three months of deployment (2.80; 0.91 to 4.70) than those screened later (-0.28; -2.58 to 2.03), indicating a stronger effect of air pollution on peripheral airways. Acute short-term exposure to wildfire-associated air pollutants may impose subtle but clinically important deleterious respiratory effects, particularly in the peripheral airways.
Western North American fires have been increasing in magnitude and severity over the last few decades. The complex coupling of fires with the atmospheric energy budget and meteorology creates short-term feedbacks on regional weather altering the amount of pollution to which Americans are exposed. Using a combination of model simulations and observations, this study shows that the severe fires in the summer of 2017 increased atmospheric aerosol concentrations leading to a cooling of the air at the surface, reductions in sensible heat fluxes, and a lowering of the planetary boundary layer height over land. This combination of lower-boundary layer height and increased aerosol pollution from the fires reduces air quality. We estimate that from start of August to end of October 2017, ∼400 premature deaths occurred within the western US as a result of short-term exposure to elevated PM2.5 from fire smoke. As North America confronts a warming climate with more fires the short-term climate and pollution impacts of increased fire activity should be assessed within policy aimed to minimize impacts of climate change on society.
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 affordedpharmacy 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. (c) 2021 Elsevier Inc. All rights reserved.
The increased frequency of wildfires in the Western United States has raised public awareness of the impact of wildfire smoke on air quality and human health. Exposure to wildfire smoke has been linked to an increased risk of cancer and cardiorespiratory morbidity. Evidence-driven interventions can alleviate the adverse health impact of wildfire smoke. During wildfires, public health guidance is based on regional air quality data with limited spatiotemporal resolution. Recently, low-cost air quality sensors have been used in air quality studies, given their ability to capture high-resolution spatiotemporal data. We demonstrate the use of a network of low-cost particulate matter (PM) sensors to gather indoor and outdoor PM2.5 data from seven locations in the urban Seattle area, along with a personal exposure monitor worn by a resident living in one of these locations during the 2020 Washington wildfire event. The data were used to determine PM concentration indoor/outdoor (I/O) ratios, PM reduction, and personal exposure levels. The result shows that locations equipped with high-efficiency particulate air (HEPA) filters and HVAC filtration systems had significantly lower I/O ratios (median I/O = 0.43) than those without air filtration (median I/O = 0.82). The median PM2.5 reduction for the locations with HEPA is 58% compared to 20% for the locations without HEPA. The outdoor PM sensor showed a high correlation to the nearby regional air quality monitoring stations (pre-calibration R-2 = 0.92). The personal monitor showed higher variance in PM measurements as the user moved through different microenvironments and could not be fully characterized by the network of indoor or outdoor monitors. The findings imply that evidence-based interventions can be developed to reduce pollution exposure when combining data from indoor and outdoor sensors. Personal exposure monitoring captured temporal spikes in PM exposure.
Exceptional events occur when air pollution in a specific location exceeds the National Ambient Air Quality Standards (NAAQS) due to an event that cannot be reasonably attributed to human activities, such as a wildland fire. Ground-level ozone (O-3) and particulate matter (PM) are Environmental Protection Agency (EPA) criteria pollutants regulated under the NAAQS. Smoke from wildland fires can increase PM and O-3 concentrations downwind of fire and impact air quality, visibility, and health. Our analysis shows that the frequency of exceptional event reporting for PM with aerodynamic diameters smaller than 2.5 mu m or 10 mu m (PM2.5 and PM10) had increased since 2007 when the air quality standards became more stringent. We also show that wildland fires and windblown dust drive many exceptional events in several EPA regions. We note the importance of growth in the number of exceptional event days due to wildfire smoke in the future due to climate change and point to possible changes to the NAAQS and implementations.
Increased wildland fire activity is producing extreme fine particulate matter (PM2.5) concentrations impacting millions of people every year, especially in the western United States (US). Recommendations for limiting exposure to PM2.5 and associated adverse health outcomes focus on staying inside, closing windows and doors, and increasing filtration; however, relatively little is known about indoor air quality (IAQ) during major smoke events. Indoor and outdoor hourly PM2.5 (µg m–3) measurements from the publicly available PurpleAir sensor (PAS) network were analyzed for 42 sites (26 residential, 6 school, 10 commercial) across the western US during a September 2020 period of heavy wildfire smoke influence. The fraction of ambient PM2.5 that penetrates indoors and remains airborne (Fin), as well as the ratio (I/O) and correlation coefficient (R2) of indoor to outdoor PM2.5 concentrations, were lower in residential compared to commercial and school buildings. Interventions to improve IAQ were highly influential in PM2.5 infiltration in residential case studies, with multiple, continuously run filter units associated with lower Fin, I/O, and R2. A low-cost PM2.5 filtration method consisting of a Minimum Efficiency Rating Value-13 (MERV-13) filter attached to a box fan is evaluated as an alternative for improving IAQ during wildland fire smoke events. The MERV-13 fan filter unit proved highly effective at reducing indoor PM2.5 and particles 0.3–1.0 µm measured by PAS and a particle counter, respectively, when recirculating air in a single room. Low-cost filtration methods can have significant benefit for filtering submicron smoke particles and may reduce exposure to PM2.5 during wildfire smoke events.
Objective(s): This study explored the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during wildfire season. Design: Three-arm, 8-week randomized clinical trial. Sample: Sixty-seven young adults with asthma were enrolled. Measurements: The Asthma Control Test, forced expiratory volume in one second (FEV1) and the System Usability Scale were measured at baseline, 4, and 8 weeks. The Research Attitude Scale was administered at 8 weeks. Twenty participants from the two intervention arms completed an optional survey and six were interviewed after completing the study. Intervention: Both intervention arms could access Smoke Sense Urbanova, an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova Plus arm also monitored their daily FEV1, received air quality notifications, and accessed preventive tips and a message board. Results: Most participants agreed the app and spirometer were usable and their privacy and confidentiality were maintained. No adverse events were reported. Conclusions: Participant-identified recommendations will support intervention refinement and testing. This research supports asthma self-management tools that public health nurses and community health workers can recommend for at-risk populations.
Wildland fires are diminishing air quality on a seasonal and regional basis, raising concerns about respiratory health risks to the public and occupational groups. This American Thoracic Society (ATS) workshop was convened in 2019 to meet the growing health threat of wildland fire smoke. The workshop brought together a multidisciplinary group of 19 experts, including wildland fire managers, public health officials, epidemiologists, toxicologists, and pediatric and adult pulmonologists. The workshop examined the following four major topics: 1) the science of wildland fire incidence and fire management, 2) the respiratory and cardiovascular health effects of wildland fire smoke exposure, 3) communication strategies to address these health risks, and 4) actions to address wildland fire health impacts. Through formal presentations followed by group discussion, workshop participants identified top priorities for fire management, research, communication, and public policy to address health risks of wildland fires. The workshop concluded that short-term exposure to wildland smoke causes acute respiratory health effects, especially among those with asthma and chronic obstructive pulmonary disease. Research is needed to understand long-term health effects of repeated smoke exposures across fire seasons for children, adults, and highly exposed occupational groups (especially firefighters). Other research priorities include fire data collection and modeling, toxicology of different fire fuel sources, and the efficacy of health protective measures to prevent respiratory effects of smoke exposure. The workshop committee recommends a unified federal response to the growing problem of wildland fires, including investment in fire behavior and smoke air quality modeling, research on the health impacts of smoke, and development of robust clinical and public health communication tools.
Recent dramatic and deadly increases in global wildfire activity have increased attention on the causes of wildfires, their consequences, and how risk from wildfire might be mitigated. Here we bring together data on the changing risk and societal burden of wildfire in the United States. We estimate that nearly 50 million homes are currently in the wildland-urban interface in the United States, a number increasing by 1 million houses every 3 y. To illustrate how changes in wildfire activity might affect air pollution and related health outcomes, and how these linkages might guide future science and policy, we develop a statistical model that relates satellite-based fire and smoke data to information from pollution monitoring stations. Using the model, we estimate that wildfires have accounted for up to 25% of PM (2.5) (particulate matter with diameter <2.5 μm) in recent years across the United States, and up to half in some Western regions, with spatial patterns in ambient smoke exposure that do not follow traditional socioeconomic pollution exposure gradients. We combine the model with stylized scenarios to show that fuel management interventions could have large health benefits and that future health impacts from climate-change-induced wildfire smoke could approach projected overall increases in temperature-related mortality from climate change-but that both estimates remain uncertain. We use model results to highlight important areas for future research and to draw lessons for policy.
Smoke impacts from large wildfires are mounting, and the projection is for more such events in the future as the one experienced October 2017 in Northern California, and subsequently in 2018 and 2020. Further, the evidence is growing about the health impacts from these events which are also difficult to simulate. Therefore, we simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling with WRF-CMAQ, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses. To demonstrate these analyses, we estimated the health impacts from smoke impacts during wildfires in October 8-20, 2017, in Northern California, when over 7 million people were exposed to Unhealthy to Very Unhealthy air quality conditions. We investigated using the 5-min available GOES-16 fire detection data to simulate timing of fire activity to allocate emissions hourly for the WRF-CMAQ system. Interestingly, this approach did not necessarily improve overall results, however it was key to simulating the initial 12-hr explosive fire activity and smoke impacts. To improve these results, we applied one data fusion and three machine learning algorithms. We also had a unique opportunity to evaluate results with temporary monitors deployed specifically for wildfires, and performance was markedly different. For example, at the permanent monitoring locations, the WRF-CMAQ simulations had a Pearson correlation of 0.65, and the data fusion approach improved this (Pearson correlation = 0.95), while at the temporary monitor locations across all cases, the best Pearson correlation was 0.5. Overall, WRF-CMAQ simulations were biased high and the geostatistical methods were biased low. Finally, we applied the optimized PM2.5 exposure estimate in an exposure-response function. Estimated mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% CI: 0, 196) with 47% attributable to wildland fire smoke.Implications: Large wildfires in the United States and in particular California are becoming increasingly common. Associated with these large wildfires are air quality and health impact to millions of people from the smoke. We simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses from the October 2017 Northern California wildfires. Temporary monitors deployed for the wildfires provided an important model evaluation dataset. Total estimated regional mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% confidence interval: 0, 196) with 47% of these deaths attributable to the wildland fire smoke. This illustrates the profound effect that even a 12-day exposure to wildland fire smoke can have on human health.
Wildland fire smoke contains hazardous levels of fine particulate mat-ter (PM2.5), a pollutant shown to adversely effect health. Estimating fire at-tributable PM2.5 concentrations is key to quantifying the impact on air quality and subsequent health burden. This is a challenging problem since only to-tal PM2.5 is measured at monitoring stations and both fire-attributable PM2.5 and PM2.5 from all other sources are correlated in space and time. We propose a framework for estimating fire-contributed PM2.5 and PM2.5 from all other sources using a novel causal inference framework and bias-adjusted chemical model representations of PM2.5 under counterfactual scenarios. The chemical model representation of PM2.5 for this analysis is simulated using Commu-nity Multiscale Air Quality Modeling System (CMAQ), run with and without fire emissions across the contiguous U.S. for the 2008-2012 wildfire seasons. The CMAQ output is calibrated with observations from monitoring sites for the same spatial domain and time period. We use a Bayesian model that ac-counts for spatial variation to estimate the effect of wildland fires on PM2.5 and state assumptions under which the estimate has a valid causal interpreta-tion. Our results include estimates of the contributions of wildfire smoke to PM2.5 for the contiguous U.S. Additionally, we compute the health burden associated with the PM2.5 attributable to wildfire smoke.
Wildfire smoke is a growing public health concern in the United States. Numerous studies have documented associations between ambient smoke exposure and severe patient outcomes for single-fire seasons or limited geographic regions. However, there are few national-scale health studies of wildfire smoke in the United States, few studies investigating Intensive Care Unit (ICU) admissions as an outcome, and few specifically framed around hospital operations. This study retrospectively examined the associations between ambient wildfire-related PM2.5 at a hospital ZIP code with total hospital ICU admissions using a national-scale hospitalization data set. Wildfire smoke was characterized using a combination of kriged PM2.5 monitor observations and satellite-derived plume polygons from National Oceanic and Atmospheric Administration’s Hazard Mapping System. ICU admissions data were acquired from Premier, Inc. and encompass 15%-20% of all U.S. ICU admissions during the study period. Associations were estimated using a distributed-lag conditional Poisson model under a time-stratified case-crossover design. We found that a 10 mu g/m(3) increase in daily wildfire PM2.5 was associated with a 2.7% (95% CI: 1.3, 4.1; p = 0.00018) increase in ICU admissions 5 days later. Under stratification, positive associations were found among patients aged 0-20 and 60+, patients living in the Midwest Census Region, patients admitted in the years 2013-2015, and non-Black patients, though other results were mixed. Following a simulated severe 7-day 120 mu g/m(3) smoke event, our results predict ICU bed utilization peaking at 131% (95% CI: 43, 239; p < 10(-5)) over baseline. Our work suggests that hospitals may need to preposition vital critical care resources when severe smoke events are forecast. Plain Language Summary Wildfire smoke negatively affects people's health. Heavy smoke has been linked to higher rates of hospital admissions, emergency room, admissions, and death. However, we do not know the impact of smoke on Intensive Care Unit (ICU) admissions or on limited hospital resources like ICU beds. To fill this knowledge gap, we linked hospital ICU admissions to smoke levels near those hospitals. We also predicted how many ICU admissions would occur during a simulated severe week-long smoke event and how many ICU beds would be needed to care for the patients. We found that the link between smoke and ICU admissions was relatively modest, but a severe smoke event could more than double the number of ICU beds needed.
Wildfires are natural ecological processes that generate high levels of fine particulate matter (PM2.5) that are dispersed into the atmosphere. PM2.5 could be a potential health problem due to its size. Having adequate numerical models to predict the spatial and temporal distribution of PM2.5 helps to mitigate the impact on human health. The compositional data approach is widely used in the environmental sciences and concentration analyses (parts of a whole). This numerical approach in the modelling process avoids one common statistical problem: the spurious correlation. PM2.5 is a part of the atmospheric composition. In this way, this study developed an hourly spatio-temporal PM2.5 model based on the dynamic linear modelling framework (DLM) with a compositional approach. The results of the model are extended using a Gaussian-Mattern field. The modelling of PM2.5 using a compositional approach presented adequate quality model indices (NSE = 0.82, RMSE = 0.23, and a Pearson correlation coefficient of 0.91); however, the correlation range showed a slightly lower value than the conventional/traditional approach. The proposed method could be used in spatial prediction in places without monitoring stations.
We developed daily maps of surface fine particulate matter (PM(2.5)) for the western United States. We used geographically weighted regression fit to air quality station observations with Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol optical depth (AOD) data, and meteorological data to produce daily 1-kilometer resolution PM(2.5) concentration estimates from 2003-2020. To account for impacts of stagnant air and inversions, we included estimates of inversion strength based on meteorological conditions, and inversion potential based on human activities and local topography. Model accuracy based on cross-validation was R(2) = 0.66. AOD data improve the model in summer and fall during periods of high wildfire activity while the stagnation terms capture the spatial and temporal dynamics of PM(2.5) in mountain valleys, particularly during winter. These data can be used to explore exposure and health outcome impacts of PM(2.5) across spatiotemporal domains particularly in the intermountain western United States where measurements from monitoring station data are sparse. Furthermore, these data may facilitate analyses of inversion impacts and local topography on exposure and health outcome studies.
We estimated cardiopulmonary morbidity and mortality associated with wildfire smoke (WFS) fine particulate matter (PM2.5) in the Front Range of Colorado from 2010 to 2015. To estimate WFS PM2.5, we developed a daily kriged PM2.5 surface at a 15 x 15 km resolution based on the Environmental Protection Agency Air Quality System monitors for the western United States; we subtracted out local seasonal-average PM2.5 of nonsmoky days, identified using satellite-based smoke plume estimates, from the local daily estimated PM2.5 if smoke was identified by National Oceanic and Atmospheric Administration’s Hazard Mapping System. We implemented time-stratified case-crossover analyses to estimate the effect of a 10 mu g/m(3) increase in WFS PM2.5 with cardiopulmonary hospitalizations and deaths using single and distributed lag models for lags 0-5 and distinct annual impacts based on local and long-range smoke during 2012, and long-range transport of smoke in 2015. A 10 mu g/m(3) increase in WFS was associated with all respiratory, asthma, and chronic obstructive pulmonary disease hospitalizations for lag day 3 and hospitalizations for ischemic heart disease at lag days 2 and 3. Cardiac arrest deaths were associated with WFS PM2.5 at lag day 0. For 2012 local wildfires, asthma hospitalizations had an inverse association with WFS PM2.5 (OR: 0.716, 95% CI: 0.517-0.993), but a positive association with WFS PM2.5 during the 2015 long-range transport event (OR: 1.455, 95% CI: 1.093-1.939). Cardiovascular mortality was associated with the 2012 long-range transport event (OR: 1.478, 95% CI: 1.124-1.944).
Wildfire activity in the western United States (US) has been increasing, a trend that has been correlated with changing patterns of temperature and precipitation associated with climate change. Health effects associated with exposure to wildfire smoke and fine particulate matter (PM(2.5)) include short- and long-term premature mortality, hospital admissions, emergency department visits, and other respiratory and cardiovascular incidents. We estimate PM(2.5) exposure and health impacts for the entire continental US from current and future western US wildfire activity projected for a range of future climate scenarios through the 21st century. We use a simulation approach to estimate wildfire activity, area burned, fine particulate emissions, air quality concentrations, health effects, and economic valuation of health effects, using established and novel methodologies. We find that climatic factors increase wildfire pollutant emissions by an average of 0.40% per year over the 2006-2100 period under Representative Concentration Pathway (RCP) 4.5 (lower emissions scenarios) and 0.71% per year for RCP8.5. As a consequence, spatially weighted wildfire PM(2.5) concentrations more than double for some climate model projections by the end of the 21st century. PM(2.5) exposure changes, combined with population projections, result in a wildfire PM2.5-related premature mortality excess burden in the 2090 RCP8.5 scenario that is roughly 3.5 times larger than in the baseline period. The combined effect of increased wildfire activity, population growth, and increase in the valuation of avoided risk of premature mortality over time results in a large increase in total economic impact of wildfire-related PM(2.5) mortality and morbidity in the continental US, from roughly $7 billion per year in the baseline period to roughly $36 billion per year in 2090 for RCP4.5, and $43 billion per year in RCP8.5. The climate effect alone accounts for a roughly 60% increase in wildfire PM2.5-related premature mortality in the RCP8.5 scenario, relative to baseline conditions.
Pollution from wildfires constitutes a growing source of poor air quality globally. To protect health, governments largely rely on citizens to limit their own wildfire smoke exposures, but the effectiveness of this strategy is hard to observe. Using data from private pollution sensors, cell phones, social media posts and internet search activity, we find that during large wildfire smoke events, individuals in wealthy locations increasingly search for information about air quality and health protection, stay at home more and are unhappier. Residents of lower-income neighbourhoods exhibit similar patterns in searches for air quality information but not for health protection, spend less time at home and have more muted sentiment responses. During smoke events, indoor particulate matter (PM(2.5)) concentrations often remain 3-4× above health-based guidelines and vary by 20× between neighbouring households. Our results suggest that policy reliance on self-protection to mitigate smoke health risks will have modest and unequal benefits.
The increasing number and severity of wildfires is negatively impacting air quality for millions of California residents each year. Community exposure to PM(2.5) in two main population centers (San Francisco Bay area and Los Angeles County area) was assessed using the low-cost PurpleAir sensor network for the record-setting 2020 California wildfire season. Estimated PM(2.5) concentrations in each study area were compared to census tract-level environmental justice vulnerability indicators, including environmental, health, and demographic data. Higher PM(2.5) concentrations were positively correlated with poverty, cardiovascular emergency department visits, and housing inequities. Sensors within 30 km of actively burning wildfires showed statistically significant increases in indoor (~800 %) and outdoor (~540 %) PM(2.5) during the fires. Results indicate that wildfire emissions may exacerbate existing health disparities as well as the burden of pollution in disadvantaged communities, suggesting a need to improve monitoring and adaptive capacity among vulnerable populations.
As wildfires increase in prevalence and intensity across California and globally, it is anticipated that more children will be exposed to wildfire smoke, and thus face associated adverse health outcomes. Here, we provide a concise summary of the respiratory effects of California’s wildfires on pediatric healthcare utilization, examine global examples of wildfire smoke exposure within the pediatric population and associated physiological effects, and assess the efficacy of metrics used to measure and communicate air quality during wildfires within the United States and elsewhere.
Climate change and human activities have drastically altered the natural wildfire balance in the Western US and increased population health risks due to exposure to pollutants from fire smoke. Using dynamically downscaled climate model projections, we estimated additional asthma emergency room visits and hospitalizations due to exposure to smoke fine particulate matter (PM2.5) in the Western US in the 2050s. Isolating the amount of PM2.5 from wildfire smoke is both difficult to estimate and, thus, utilized by relatively few studies. In this study, we use a sophisticated modeling approach to estimate future increase in wildfire smoke exposure over the reference period (2003-2010) and subsequent health care burden due to asthma exacerbation. Average increases in smoke PM2.5 during future fire season ranged from 0.05 to 9.5 mu g m(-3) with the highest increases seen in Idaho, Montana, and Oregon. Using the Integrated Climate and Land-Use Scenarios (ICLUS) A2 scenario, we estimated the smoke-related asthma events could increase at a rate of 15.1 visits per 10 000 persons in the Western US, with the highest rates of increased asthma (25.7-41.9 per 10 000) in Idaho, Montana, Oregon, and Washington. Finally, we estimated healthcare costs of smoke-induced asthma exacerbation to be over $1.5 billion during a single future fire season. Here we show the potential future health impact of climate-induced wildfire activity, which may serve as a key tool in future climate change mitigation and adaptation planning.
Biomass burning emits a wide range of carbona-ceous particles into the atmosphere and has negative impacts on human health and the Earth’s radiative balance. Nonvolatile spherical organic aerosol particles, commonly known as tar balls, represent one of the most abundant particles in aged biomass burning smoke. However, the detailed molecular level composition of ambient tar balls is largely unknown but critical to assess their environmental impacts. Ambient aerosol samples collected during a wildfire event, which were similar to 90% tar balls by number fraction, were analyzed using ultrahigh-resolution Orbitrap Elite mass spectrometry with four complementary ionization modes. Our results show the molecular composition of tar balls to be complex, composed of over 10,000 molecular formulas. Model estimated saturation mass concentrations and relative humidity-dependent glass-transition temperatures were consistent with low volatility and solid morphology as expected for tar balls. Room-temperature evaporation kinetics showed that these particles retained similar to 90% of their volume after 24 h of evaporation. The molecular complexity detected here signifies a continuum of carbonaceous species, ranging from C-3 to C-45 with continuous ranges of oxygenation and hydrogen saturation for each Cn. Approximately 24% of molecular formulas were estimated to be highly aromatic, which could indicate chemical compounds with negative health effects and which may contribute to visible light absorption. The carbon continuum observed here has significant implications for the molecular characterization of atmospheric organic matter. The level of complexity detected here should not be ignored in future studies, and we demonstrate that multiple analytical methods may be required to suitably interpret this complexity on a molecular level.
This paper presents findings from an online survey that explored public experiences of wildfire smoke, public health advisory information, risk perceptions, and protective actions in response to wildfire smoke in western Canada. Most respondents had wildfire smoke experiences lasting several days with decreased visibility, and many had difficulty breathing and changes to their health. While a majority of respondents were aware of the Air Quality Health Index and how to respond on a high risk day, some did not. Most respondents perceived the risk from wildfire smoke during their most recent experience to be extreme, severe, or moderate, with only 20% perceiving low risk from wildfire smoke. Wildfire smoke experiences affected risk perceptions, and female respondents perceived the risk from wildfire smoke to be higher in comparison to male respondents. Most respondents took protective actions during their most recent exposure to wildfire smoke, with the most popular measures including keeping windows and doors shut, and limiting time spent outdoors. Perceptions of wildfire smoke risks, experiencing health impacts from wildfire smoke, sex and highest level of education, and firefighting experience influenced protective actions. Recommendations to improve public health during wildfire smoke events and future research are included.
First Nation reserves in Canada are at high risk from wildfires, with many evacuated every year. There is a need to understand how First Nations are affected by wildfire evacuations to identify ways to reduce negative impacts. The First Nations Wildfire Evacuation Partnership has conducted research to explore evacuation experiences of seven First Nations in three Canadian provinces. This paper presents findings from research across the seven First Nations. Results show that few participating First Nations had an up to date emergency plan tailored to their community, which contributed to challenges during the evacuation. Family separation, insufficient information, and worries about losing their house caused considerable distress for evacuees. Wildfire smoke health impacts occurred, particularly for those who had pre-existing health conditions. Social and financial support, if available, helped evacuees during and after their evacuation. Several years after First Nations return home after a wildfire evacuation, lingering distress continues and some First Nations were still experiencing fiscal challenges as a result of the evacuation. Recommendations for reducing negative impacts of wildfire evacuations on First Nations people are discussed.
BACKGROUND: Long-term exposure to fine particles ≤2.5 μm in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016. METHODS AND FINDINGS: Nationwide cancer death records were collected during 2010-2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM2.5 concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 μg/m3, and the annual non-wildfire-related PM2.5 concentration was 8.20 μg/m3. The RR for mortality from all cancers was 1.02 (95% CI 1.01-1.03, p < 0.001) per 1-μg/m3 increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-μg/m3 increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00-1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04-1.16], p = 0.002), esophagus (1.05 [95% CI 1.01-1.08], p = 0.012), stomach (1.03 [95% CI 1.01-1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05-1.11], p < 0.001), larynx (1.06 [95% CI 1.02-1.11], p = 0.003), skin (1.06 [95% CI 1.00-1.12], p = 0.003), breast (1.04 [95% CI 1.01-1.06], p = 0.007), prostate (1.03 [95% CI 1.01-1.06], p = 0.019), and testis (1.10 [95% CI 1.03-1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders. CONCLUSIONS: Exposure to wildfire-related PM2.5 can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources.
We quantified the impacts of wildfire-related PM2.5 on 2 million hospital admissions records due to cardiorespiratory diseases in Brazil between 2008 and 2018. The national analysis shows that wildfire waves are associated with an increase of 23% (95%CI: 12%-33%) in respiratory hospital admissions and an increase of 21% (95%CI: 8%-35%) in circulatory hospital admissions. In the North (where most of the Amazon region is located), we estimate an increase of 38% (95%CI: 30%-47%) in respiratory hospital admissions and 27% (95%CI: 15%-39%) in circulatory hospital admissions. Here we report epidemiological evidence that air pollution emitted by wildfires is significantly associated with a higher risk of cardiorespiratory hospital admissions. Brazil is a wildfire-prone region, and few studies have investigated the health impacts of wildfire exposure. Here, the authors show that wildfire waves are associated with an increase of 23% in respiratory hospital admissions and an increase of 21% in circulatory hospital admissions in Brazil.
Background Birth defects are a major cause of poor health outcomes during both childhood and adulthood. A growing body of evidence demonstrated associations between air pollution exposure during pregnancy and birth defects. To date, there is no study looking at birth defects and exposure to wildfire-related air pollution, which is suggested as a type of air pollution source with high toxicity for reproductive health. Objective Our study addresses this gap by examining the association between birth defects and wildfire smoke exposure in Brazil between 2001 and 2018. Based on known differences of impacts of wildfires across different regions of Brazil, we hypothesized differences in risks of birth defects for different regions. Methods We used a logistic regression model to estimate the odds ratios (ORs) for individual birth defects (12 categories) associated with wildfire exposure during each trimester of pregnancy. Results Among the 16,825,497 birth records in our study population, there were a total of 7595 infants born in Brazil between 2001 and 2018 with birth defects in any of the selected categories. After adjusting for several confounders in the primary analysis, we found statistically significant OR for three birth defects, including cleft lip/cleft palate [OR: 1.007 (95% CI: 1.001; 1.013)] during the second trimester of exposure, congenital anomalies of the respiratory system [OR: 1.013 (95% CI: 1.002; 1.023)] in the second trimester of exposure, and congenital anomalies of the nervous system [OR: 1.002 (95% CI: 1.001; 1.003)] during the first trimester of exposure for the regions South, North, and Midwest, respectively. Significance Our results suggest that maternal exposure to wildfire smoke during pregnancy may increase the risk of an infant being born with some congenital anomaly. Considering that birth defects are associated with long-term disability, impacting families and the healthcare system (e.g., healthcare costs), our findings should be of great concern to the public health community. Impact statement Our study focused on the association between maternal exposure to wildfire smoke in Brazil during pregnancy and the risk of an infant being born with congenital anomalies, which presents serious public health and environmental challenges.
Air pollution from Amazon fires has adverse impacts on human health. The number of fires in the Amazon has increased in recent years, but whether this increase was driven by deforestation or climate has not been assessed. We analyzed relationships between fire, deforestation, and climate for the period 2003 to 2019 among selected states across the Brazilian Legal Amazon (BLA). A statistical model including deforestation, precipitation and temperature explained ∼80% of the variability in dry season fire count across states when totaled across the BLA, with positive relationships between fire count and deforestation. We estimate that the increase in deforestation since 2012 increased the dry season fire count in 2019 by 39%. Using a regional chemistry-climate model combined with exposure-response associations, we estimate this increase in fire resulted in 3,400 (95UI: 3,300-3,550) additional deaths in 2019 due to increased exposure to particulate air pollution. If deforestation in 2019 had increased to the maximum recorded during 2003-2019, the number of active fire counts would have increased by an additional factor of 2 resulting in 7,900 (95UI: 7,600-8,200) additional premature deaths. Our analysis demonstrates the strong benefits of reduced deforestation on air quality and public health across the Amazon.
BACKGROUND: In the context of climate change and deforestation, Brazil is facing more frequent and unprecedented wildfires. Wildfire-related PM(2·5) is associated with multiple adverse health outcomes; however, the magnitude of these associations in the Brazilian context is unclear. We aimed to estimate the association between daily exposure to wildfire-related PM(2·5) and cause-specific hospital admission and attributable health burden in the Brazilian population using a nationwide dataset from 2000 to 2015. METHODS: In this nationwide time-series analysis, data for daily all-cause, cardiovascular, and respiratory hospital admissions were collected through the Brazilian Unified Health System from 1814 municipalities in Brazil between Jan 1, 2000, and Dec 31, 2015. Daily concentrations of wildfire-related PM(2·5) were estimated using the 3D chemical transport model GEOS-Chem at a 2·0° latitude by 2·5° longitude resolution. A time-series analysis was fitted using quasi-Poisson regression to quantify municipality-specific effect estimates, which were then pooled at the regional and national levels using random-effects meta-analyses. Analyses were stratified by sex and ten age groups. The attributable fraction and attributable cases of hospital admissions due to wildfire-related PM(2·5) were also calculated. FINDINGS: At the national level, a 10 μg/m(3) increase in wildfire-related PM(2·5) was associated with a 1·65% (95% CI 1·51-1·80) increase in all-cause hospital admissions, a 5·09% (4·73-5·44) increase in respiratory hospital admissions, and a 1·10% (0·78-1·42) increase in cardiovascular hospital admissions, over 0-1 days after the exposure. The effect estimates for all-cause hospital admission did not vary by sex, but were particularly high in children aged 4 years or younger (4·88% [95% CI 4·47-5·28]), children aged 5-9 years (2·33% [1·77-2·90]), and people aged 80 years and older (3·70% [3·20-4·20]) compared with other age groups. We estimated that 0·53% (95% CI 0·48-0·58) of all-cause hospital admissions were attributable to wildfire-related PM(2·5), corresponding to 35 cases (95% CI 32-38) per 100 000 residents annually. The attributable rate was greatest for municipalities in the north, south, and central-west regions, and lowest in the northeast region. Results were consistent for all-cause and respiratory diseases across regions, but remained inconsistent for cardiovascular diseases. INTERPRETATION: Short-term exposure to wildfire-related PM(2·5) was associated with increased risks of all-cause, respiratory, and cardiovascular hospital admissions, particularly among children (0-9 years) and older people (≥80 years). Greater attention should be paid to reducing exposure to wildfire smoke, particularly for the most susceptible populations. FUNDING: Australian Research Council and Australian National Health and Medical Research Council.
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
During wildfire smoke events public health agencies release advisories to stay indoors, close doors and windows, and operate a portable air cleaner (PAC). The do-it-yourself (DIY) air cleaner consisting of a box fan and a furnace filter is a widely used low-cost alternative to commercial PACs because of its increased accessibility. In this study, we evaluate the clean air delivery rate (CADR) of different DIY air cleaner designs for reducing simulated wildfire smoke and identify operating parameters that may impact their performance and use. The simplest formulation of a DIY air cleaner (box fan with taped on minimum effectiveness reporting value – [MERV] 13 furnace filter) had a CADR of 111.2 ± 1.3 ft(3) /min (CFM). Increasing the fan flow by changing the fan type, increasing the fan setting, or reducing the pressure drop across the filtering surface increased the CADR. Large increases in CADR could be obtained by using a shroud (40%), using a 4″ thick filter (123%) using two filters in a wedge shape (137%), or using four filters in a Corsi-Rosenthal (CR) box design (261%). The CADR was greatly reduced with filters heavily loaded with smoke, pointing to the need for frequent filter changes during smoke events.
In recent years, wildland fires have occurred more frequently and with increased intensity in many fire-prone areas. In addition to the direct life and economic losses attributable to wildfires, the emitted smoke is a major contributor to ambient air pollution, leading to significant public health impacts. Wildfire smoke is a complex mixture of particulate matter (PM), gases such as carbon monoxide, nitrogen oxide, and volatile and semi-volatile organic compounds. PM from wildfire smoke has a high content of elemental carbon and organic carbon, with lesser amounts of metal compounds. Epidemiological studies have consistently found an association between exposure to wildfire smoke (typically monitored as the PM concentration) and increased respiratory morbidity and mortality. However, previous reviews of the health effects of wildfire smoke exposure have not established a conclusive link between wildfire smoke exposure and adverse cardiovascular effects. In this review, we systematically evaluate published epidemiological observations, controlled clinical exposure studies, and toxicological studies focusing on evidence of wildfire smoke exposure and cardiovascular effects, and identify knowledge gaps. Improving exposure assessment and identifying sensitive cardiovascular endpoints will serve to better understand the association between exposure to wildfire smoke and cardiovascular effects and the mechanisms involved. Similarly, filling the knowledge gaps identified in this review will better define adverse cardiovascular health effects of exposure to wildfire smoke, thus informing risk assessments and potentially leading to the development of targeted interventional strategies to mitigate the health impacts of wildfire smoke.
Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
BACKGROUND: Fine particulate matter (PM(2.5)) produced by landscape fires is thought to be more toxic than that from non-fire sources. However, the effects of “fire-sourced” PM(2.5) on acute respiratory infection (ARI) are unknown. METHODS: We combined Demographic and Health Survey (DHS) data from 48 countries with gridded global estimates of PM(2.5) concentrations from 2003 to 2014. The proportions of fire-sourced PM(2.5) were assessed by a chemical transport model using a variety of PM(2.5) source data. We tested for associations between ARI and short-term exposure to fire- and “non-fire-sourced” PM(2.5) using a bidirectional case-crossover analysis. The robustness and homogeneity of the associations were examined by sensitivity analyses. We also established a nonlinear exposure-response relationship between fire- and non-fire-sourced PM(2.5) and ARI using a two-dimensional spline function. RESULTS: The study included 36,432 children under 5 years who reported ARI symptoms. Each 1 µg/m(3) increment of fire-sourced PM(2.5) was associated with a 3.2 % (95 % confidence interval [CI] 0.2, 6.2) increment in the risk of ARI. This effect was comparable to that of each ∼5 µg/m(3) increment in PM(2.5) from non-fire sources (3.1 %; 95 % CI 2.4, 3.7). The association between ARI and total PM(2.5) concentration was significantly mediated by the proportion of fire-sourced particles. Nonlinear analysis showed that the risk of ARI was increased by both fire- and non-fire-sourced PM(2.5), but especially by the former. CONCLUSIONS: PM(2.5) produced by landscape fire was more strongly associated to ARI among children under 5 years than that from non-fire sources.
Wildland fires release substantial amounts of hazardous contaminants, contributing to a decline in air quality and leading to serious health risks. Thus, this study aimed to understand the contributions of the 2017 extreme wildland fires in Portugal on children health, compared to 2016 (with burned area, in accordance with the average of the previous 15 years). The impact of long-term exposure to PM(10) and NO(2) concentrations, associated with wildland fires, on postneonatal mortality, bronchitis prevalence, and bronchitis symptoms in asthmatic children was estimated, as well as the associated costs. The excess health burden in children attributable to exposure to PM(10) and NO(2), was calculated based on WHO HRAPIE relative risks. Fire emissions were obtained from the Fire INventory from NCAR (FINN). The results obtained indicate that the smoke from wildfires negatively impacts children’s lung function (PM(10) exposure: increase of 320 and 648 cases of bronchitis in 2016 and 2017; NO(2) exposure: 24 and 40 cases of bronchitis symptoms in asthmatic children in 2016 and 2017) and postneonatal mortality (PM(10) exposure: 0.2 and 0.4 deaths in 2016 and 2017). Associated costs were increased in 2017 by around 1 million € for all the evaluated health endpoints, compared to 2016.
Wildland fires, increasing in recent decades in the Mediterranean region due to climate change, can contribute to PM levels and composition. This study aimed to investigate biological effects of PM(2.5) (Ø < 2.5 µm) and PM(10) (Ø < 10 µm) collected near a fire occurred in the North-West of Italy in 2017 and in three other areas (urban and rural areas). Organic extracts were assessed for mutagenicity using Ames test (TA98 and TA100 strains), cell viability (WST-1 and LDH assays) and genotoxicity (Comet assay) with human bronchial cells (BEAS-2B) and estrogenic activity using a gene reporter assay (MELN cells). In all sites, high levels of PM(10) and PM(2.5) were measured during the fire suggesting that near and distant sites were influenced by fire pollutants. The PM(10) and PM(2.5) extracts induced a significant mutagenicity in all sites and the mutagenic effect was increased with respect to historical data. All extracts induced a slight increase of the estrogenic activity but a possible antagonistic activity of PM samples collected near fire was observed. No cytotoxicity or DNA damage was detected. Results confirm that fires could be relevant for human health, since they can worsen the air quality increasing PM concentrations, mutagenic and estrogenic effects.
Uncontrolled wildfires have a substantial impact on the environment, the economy and local populations. According to the European Forest Fire Information System (EFFIS), between 2000 and 2013 wildfires burned up to 740 000 ha of land annually in the south of Europe, Portugal being the country with the highest percentage of burned area per square kilometre. However, there is still a lack of knowledge regarding the impacts of the wildfire-related pollutants on the mortality of the country’s population. All wildfires occurring during the fire season (June-July-AugustSeptember) from 2001 and 2016 were identified, and those with a burned area above 1000 ha (large fires) were considered for the study. During the studied period (2001-2016), more than 2 million ha of forest (929 766 ha from June to September alone) were burned in mainland Portugal. Although large fires only represent less than 1% of the number of total fires, in terms of burned area their contribution is 46% (53% from June to September). To assess the spatial impact of the wildfires, burned areas in each region of Portugal were correlated with PM10 concentrations measured at nearby background air quality monitoring stations. Associations between PM10 and all-cause (excluding injuries, poisoning and external causes) and cause-specific mortality (circulatory and respiratory) were studied for the affected populations using Poisson regression models. A significant positive correlation between burned area and PM10 was found in some regions of Portugal, as well as a significant association between PM10 concentrations and mortality, these being apparently related to large wildfires in some of the regions. The north, centre and inland of Portugal are the most affected areas. The high temperatures and long episodes of drought expected in the future will increase the probabilities of extreme events and therefore the occurrence of wildfires.
INTRODUCTION: Fine particulate matter with an aerodynamic diameter < 2.5 μm (PM(2.5)) in the ambient air has been associated with increased blood pressure (BP) levels and new-onset hypertension. However, the association of BP with a sudden upsurge of PM(2.5) in extreme conditions has not yet been demonstrated. AIM: To evaluate the association between PM(2.5) pollutants the week before, during, and the week after the 2021 wildfires in Athens (Greece) and home BP measurements. METHODS: Home BP measurements were performed, and the readings were transferred to the doctor's office through a telemonitoring system on the patient's Smartphone application. Data from a calibrated, sensor-based PM(2.5) monitoring network assessed PM(2.5) exposure. RESULTS: PM(2.5) pollutants demonstrated a gradual surge while the particle concentration was not different in the selected air pollution measurement stations. A total of 20 consecutive patients with controlled hypertension, mean age 61 ± 9 years, were included in the analysis. For one unit in μg/m(3) increase of PM(2.5) particle concentration, an average of 2.1 mmHg increment in systolic BP was observed after adjustment for confounders (P = 0.023). CONCLUSIONS: Our findings raise the hypothesis that short-term exposure to raised PM(2.5) concentrations in the air appears to be associated with increases in systolic home BP." Telemonitoring systems of home BP recordings may provide important information for the clinical management of hypertensive patients, at least in conditions of major environmental disturbances, such as wildfires.
Wildfires are a complex environmental problem worldwide. The ashes produced during the fire bear metals and PAHs with high toxicity and environmental persistence. These are mobilized into downhill waterbodies, where they can impair water quality and human health. In this context, the present study aimed at assessing the toxicity of mimicked wildfire runoff to human skin cells, providing a first view on the human health hazardous potential of such matrices. Human keratinocytes (HaCaT) were exposed to aqueous extracts of ashes (AEA) prepared from ash deposited in the soil after wildfires burned a pine or a eucalypt forest stand. Cytotoxicity (MTT assay) and changes in cell cycle dynamics (flow cytometry) were assessed. Cell viability decreased with increasing concentrations of AEA, regardless of the ash source, the extracts preparation method (filtered or unfiltered to address the dissolved or the total fractions of contaminants, respectively) or the exposure period (24 and 48 h). The cells growth was also negatively affected by the tested AEA matrices, as evidenced by a deceleration of the progress through the cell cycle, namely from phase G0/G1 to G2. The cytotoxicity of AEA could be related to particulate and dissolved metal content, but the particles themselves may directly affect the cell membrane. Eucalypt ash was apparently more cytotoxic than pine ash due to differential ash metal burden and mobility to the water phase. The deceleration of the cell cycle can be explained by the attempt of cells to repair metal-induced DNA damage, while if this checkpoint and repair pathways are not well coordinated by metal interference, genomic instability may occur. Globally, our results trigger public health concerns since the burnt areas frequently stand in slopes of watershed that serve as recreation sites and sources of drinking water, thus promoting human exposure to wildfire-driven contamination.
Extreme heat and poor air quality arising from landscape fires are an increasing global concern driven by anthropogenic climate change. Previous studies have shown these environmental conditions are associated with negative health outcomes for vulnerable people. Managing and adapting to these conditions in a warming climate can present substantial difficulties, especially in climates already challenging for human habitation. This study was set in the tropical city of Darwin, Australia. We recruited individuals from population groups vulnerable to outdoor hazards: outdoor workers, teachers and carers, and sportspeople, to participate in focus group discussions. We aimed to gain an understanding of the impacts of extreme heat and poor air quality and how individuals perceived and managed these environmental conditions. We identified a number of key themes relating to impacts on health, work and activity, and adaptive behaviors, while identifying gaps in policy and infrastructure that could improve the lives and protect the health of vulnerable people living, working, and playing in this region. In addition, these outcomes potentially provide direction for other regions with similar environmental challenges. Extreme heat and poor air quality place an additional burden on the lives of people in high-risk settings, such as outdoor workers, teachers and carers, and sportspeople.
Biomass burning and dust storm have significant impacts on air pollution, aerosol properties and potential human health. In order to investigate the influences of them on the chemical component and sources of aerosols, PM2.5 are collected in spring and summer in Beijing. There are two special periods in the whole campaign. (1) Event I, from 16 to 18 April. Air quality is extremely poor during this period mainly affected by biomass burning. (2) Event II, from 4 to 5 May, the biggest dust storm happened on 4 May. In addition, we choose a relative clean period as (3) Event III, from 24 to 29 July, with the lowest PM2.5 levels (16-31 mu g m(-3)) in the whole campaign. Contributions of NO3, SO42-, and NH4+ to PM2.5 in Event I are 22.1%, 11.3%, and 8.3%, respectively, and decreased dramatically to 2.4%, 5.4%, and 0.9% in Event II, suggesting secondary aerosols are more significant in haze period. Both ratios of phytane & pristane and PAHs to OC in Event I and II are comparable, indicating contribution of local primary organic aerosols from fossil fuel combustions to PM2.5 are not significant differences between polluted and dust period. In contrast, ratio of levoglucosan to OC is much higher in Event I and ratio of trehalose to OC is much higher in Event II, suggesting the contribution of regional primary organic aerosols from biomass burning to PM2.5 is important during polluted period, while contribution of regional primary organic aerosols from dust to PM2.5 is significant in dust storm. Based on the organic markers, this work also estimates the source apportionment of PM2.5. Dust and biomass burning are the main contributors in polluted period, while vehicle and cooking are the main contributors in clean period.
PURPOSE: The characteristic topography and climate often affect the occurrence of large-scale wildfires in the Eastern Gangwon-do region of Korea. However, there are no studies on the health effects of these wildfires in Korea. This study aimed to analyze the differences in medical use between a wildfire-affected area and an adjacent non-affected area before and after a wildfire in 2019 in Gangwon-do, Korea. MATERIALS AND METHODS: We used medical usage data from the Korean National Health Insurance Corporation. Rates of medical use were determined for citizens of a wildfire-affected area in the Eastern Yeongdong region and a non-affected area in the Western Yeongseo region. Logistic regression analysis was performed considering an increase in medical use per individual as a dependent variable; age, sex, income, smoking, drinking, and exercise were included as confounding variables. RESULTS: The odds ratio for medical use in Yeongdong region increased significantly after 3 days, 3 months, and 1 year after a fire occurred, compared with Yeongseo region. CONCLUSION: The results of this study confirmed that the use of medical care increased for residents of a wildfire-affected area, compared with those of an adjacent non-affected area. This is the first study on the relationship between wildfires and inpatient medical use in Korea.
OBJECTIVES: In April 2000, a series of wildfires occurred simultaneously in five adjacent small cities located on the eastern coast of Korea. These wildfires burned approximately 23,794 hectares of forestland over several days. We investigated the effects of prenatal exposure to the by-products generated by wildfire disasters on birth weight. METHODS: Birth weight data were obtained for 1999-2001 from the birth registration database of the Korean National Statistical Office and matched with the zip code and exposed/unexposed pregnancy week for days of the wildfires. Generalized linear models were then used to assess the associations between birth weight and exposure to wildfires after adjusting for fetal sex, gestational age, parity, maternal age, maternal education, paternal education, and average exposed atmospheric temperature. RESULTS: Compared with unexposed pregnancies before and after the wildfires, mean birth weight decreased by 41.4 g (95% confidence interval [CI], -72.4 to -10.4) after wildfire exposure during the first trimester, 23.2 g (95% CI, -59.3 to 13.0) for exposure during the second trimester, and 27.0 g (95% CI, -63.8 to 9.8) during the third trimester. In the adjusted model for infants exposed in utero during any trimester, the mean birth weight decreased by 32.5 g (95% CI, -53.2 to -11.7). CONCLUSIONS: We observed a 1% reduction in birth weight after wildfire exposure. Thus, exposure to by-products generated during a wildfire disaster during pregnancy may slow fetal growth and cause developmental delays.
BACKGROUND: Studies on the association between smoke haze (hereafter ‘haze’) and adverse health effects have increased in recent years due to extreme weather conditions and the increased occurrence of vegetation fires. The possible adverse health effects on under-five children (U5Y) is especially worrying due to their vulnerable condition. Despite continuous repetition of serious haze occurrence in Southeast Asia, epidemiological studies in this region remained scarce. Furthermore, no study had examined the association accounting for three important aspects (time lag, duration and intensity) concurrently. OBJECTIVE: This study aimed to examine the association between haze and U5Y mortality in Malaysia, considering time lag, duration and intensity of exposure. METHODS: We performed a time-stratified case-crossover study using a generalized additive model to examine the U5Y mortality related to haze in 12 districts in Malaysia, spanning from 2014 to 2016. A ‘haze day’ was characterized by intensity [based on concentrations of particulate matter (PM)] and duration (continuity of haze occurrence, up to 3 days). RESULTS: We observed the highest but non-significant odds ratios (ORs) of U5Y mortality at lag 4 of Intensity-3. Lag patterns revealed the possibility of higher acuteness at prolonged and intensified haze. Stratifying the districts by the 95th-percentile of PM distribution, the ‘low’ category demonstrated marginal positive association at Intensity-2 Duration-3 [OR: 1.210 (95% confidence interval: 1.000, 1.464)]. CONCLUSIONS: We found a null association between haze and U5Y mortality. The different lag patterns of the association observed over different duration and intensity suggest consideration of these aspects in future studies.
Interactions between climate change and anthropogenic activities result in increasing numbers of open fires, which have been shown to harm maternal health. However, few studies have examined the association between open fire and pregnancy loss. We conduct a self-comparison case-control study including 24,876 mothers from South Asia, the region with the heaviest pregnancy-loss burden in the world. Exposure is assessed using a chemical transport model as the concentrations of fire-sourced PM(2.5) (i.e., fire PM(2.5)). The adjusted odds ratio (OR) of pregnancy loss for a 1-μg/m(3) increment in averaged concentration of fire PM(2.5) during pregnancy is estimated as 1.051 (95% confidence intervals [CI]: 1.035, 1.067). Because fire PM(2.5) is more strongly linked with pregnancy loss than non-fire PM(2.5) (OR: 1.014; 95% CI: 1.011, 1.016), it contributes to a non-neglectable fraction (13%) of PM(2.5)-associated pregnancy loss. Here, we show maternal health is threaten by gestational exposure to fire smoke in South Asia.
Wildfires are increasing and cause health effects. The immediate and ongoing health impacts of prolonged wildfire smoke exposure in severe asthma are unknown. This longitudinal study examined the experiences and health impacts of prolonged wildfire (bushfire) smoke exposure in adults with severe asthma during the 2019/2020 Australian bushfire period. Participants from Eastern/Southern Australia who had previously enrolled in an asthma registry completed a questionnaire survey regarding symptoms, asthma attacks, quality of life and smoke exposure mitigation during the bushfires and in the months following exposure. Daily individualized exposure to bushfire particulate matter (PM(2.5)) was estimated by geolocation and validated modelling. Respondents (n = 240) had a median age of 63 years, 60% were female and 92% had severe asthma. They experienced prolonged intense PM(2.5) exposure (mean PM(2.5) 32.5 μg/m(3) on 55 bushfire days). Most (83%) of the participants experienced symptoms during the bushfire period, including: breathlessness (57%); wheeze/whistling chest (53%); and cough (50%). A total of 44% required oral corticosteroid treatment for an asthma attack and 65% reported reduced capacity to participate in usual activities. About half of the participants received information/advice regarding asthma management (45%) and smoke exposure minimization strategies (52%). Most of the participants stayed indoors (88%) and kept the windows/doors shut when inside (93%), but this did not clearly mitigate the symptoms. Following the bushfire period, 65% of the participants reported persistent asthma symptoms. Monoclonal antibody use for asthma was associated with a reduced risk of persistent symptoms. Intense and prolonged PM(2.5) exposure during the 2019/2020 bushfires was associated with acute and persistent symptoms among people with severe asthma. There are opportunities to improve the exposure mitigation strategies and communicate these to people with severe asthma.
Objective: Adults born either extremely preterm (EP, <28 weeks gestation) or extremely low birthweight (ELBW, <1000 g birthweight) have more obstructive airflow than controls of normal birthweight (>2499 g). We compared self-reported adverse respiratory health outcomes in young adults born EP/ELBW with controls following smoke exposure from the 2019/2020 wildfires in the Australian state of Victoria, and explored if any effects were mediated by airway obstruction, reflected in the forced expiratory volume in 1 second (FEV1). Methods: EP/ELBW participants were derived from all survivors born in the state of Victoria in 1991–92. Contemporaneous controls of normal birthweight (>2499 g) were recruited in the newborn period and matched for sociodemographic variables. Both groups had been assessed at intervals through childhood and into adulthood. Those who participated in the most recent follow-up assessment at 25 years of age, when FEV1 had been measured, were sent a survey when they were approximately 28 years of age asking about respiratory health related outcomes (respiratory symptoms, health services usage, medication uptake) following wildfire smoke exposure over the southern hemisphere summer of 2019–20. Results: A total of 296 participants (166 EP/ELBW; 130 controls) were sent the survey; 44% of the EP/ELBW group and 47% of the control group responded. Compared with controls, EP/ELBW respondents reported more overall respiratory problems (30%vs 20%) and specific respiratory symptoms (breathlessness, wheezing, cough and chest tightness) following wildfire smoke exposure, as well as higher health services usage (e.g. local health clinic, hospital emergency department) and medication uptake for respiratory-related problems. Higher FEV1 values were associated with lower odds of most self-reported respiratory symptoms; adjusting for FEV1 attenuated the differences between EP/ELW and control groups. Conclusion: Survivors born EP/ELBW may be at an increased risk of adverse respiratory health outcomes following wildfire smoke exposure in early adulthood, in part related to worse expiratory airflows.
We investigated the association between respiratory symptoms and psychological distress in the context of a prolonged smoke event, and evaluated whether smoke exposure, or pre-existing respiratory and mental health conditions, influenced the association. Three thousand ninety-six residents of a rural town heavily exposed to smoke from the 6-week Hazelwood coal mine fire, and 960 residents of a nearby unexposed town, completed Kessler’s psychological distress questionnaire (K10) and a modified European Community Respiratory Health Survey. Logistic regression models evaluated associations between distress and respiratory symptoms, with interactions fitted to evaluate effect modification. Smoke exposed participants reported higher levels of distress than those unexposed, and participants reporting respiratory symptoms recorded higher levels of distress than participants without respiratory symptoms, irrespective of exposure. 5-unit increments in K10 scores were associated with 21%-48% increases in the odds of reporting respiratory symptoms. There were significant interactions with pre-existing asthma, chronic obstructive pulmonary disease and mental health conditions, but not with smoke exposure. Although participants with pre-existing conditions were more likely to report respiratory symptoms, increasing distress was most strongly associated with respiratory symptoms among those without pre-existing conditions. Communities exposed to landscape fire smoke could benefit from interventions to reduce both psychological and respiratory distress.
A sense of psychological connectedness with the natural world has important benefits for global health. In a time of environmental crisis, however, it may also be accompanied by mental health risks. We used national survey data collected after a severe Australian bushfire season (N = 3,875) to test a path model of the relationships between nature connectedness, worry about climate change, individual and collective climate action, and psychological distress (depression, anxiety, stress). We found that nature connectedness was positively associated with climate worry that, in turn, was positively associated with climate action and psychological distress. Whereas taking individual climate action was associated with reduced psychological distress, taking collective climate action had the opposite effect. Our findings provide new insights into potential processes underlying the association between nature connectedness and mental health in the climate change context and point to an urgent need to protect the well-being of people engaging in collective climate action.
This paper presents new evidence of the causal effect of air pollution on Australian health outcomes, using the Black Saturday bushfires (BSB) in 2009 as a natural experiment. This event was one of the largest bushfires in Australian history and emitted approximately four million tonnes of CO(2) into the atmosphere. We use data from the Household Income and Labour Dynamic Australia (HILDA) panel and compare the health status of individuals who were living in affected and unaffected regions before and after the event. Using a triple differences procedure, we further examine whether a difference in vulnerability to bushfire smoke exists comparing people living in urban or regional areas. We find that ambient air pollution had significant negative effects on health and that the magnitudes were actually larger for individuals residing in urban areas.
BACKGROUND: Bushfire smoke is a major ongoing environmental hazard in Australia. In the summer of 2019-2020 smoke from an extreme bushfire event exposed large populations to high concentrations of particulate matter (PM) pollution. In this study we aimed to estimate the effect of bushfire-related PM of less than 2.5 μm in diameter (PM(2.5)) on the risk of mortality in Sydney, Australia from 2010 to 2020. METHODS: We estimated concentrations of PM(2.5) for three subregions of Sydney from measurements at monitoring stations using inverse-distance weighting and cross-referenced extreme days (95th percentile or above) with satellite imagery to determine if bushfire smoke was present. We then used a seasonal and trend decomposition method to estimate the Non-bushfire PM(2.5) concentrations on those days. Daily PM(2.5) concentrations above the Non-bushfire concentrations on bushfire smoke days were deemed to be Bushfire PM(2.5). We used distributed-lag non-linear models to estimate the effect of Bushfire and Non-bushfire PM(2.5) on daily counts of mortality with sub-analyses by age. These models controlled for seasonal trends in mortality as well as daily temperature, day of week and public holidays. RESULTS: Within the three subregions, between 110 and 134 days were identified as extreme bushfire smoke days within the subregions of Sydney. Bushfire-related PM(2.5) ranged from 6.3 to 115.4 µg/m(3). A 0 to 10 µg/m(3) increase in Bushfire PM(2.5) was associated with a 3.2% (95% CI 0.3, 6.2%) increase in risk of all-cause death, cumulatively, in the 3 days following exposure. These effects were present in those aged 65 years and over, while no effect was observed in people under 65 years. CONCLUSION: Bushfire PM(2.5) exposure is associated with an increased risk of mortality, particularly in those over 65 years of age. This increase in risk was clearest at Bushfire PM(2.5) concentrations up to 30 µg/m(3) above background (Non-bushfire), with possible plateauing at higher concentrations of Bushfire PM(2.5).
We examine 512 Australian newspaper articles published over a five-year period (2016-2021) that report on air pollution due to bushfire smoke and resulting human health impacts. We analyze to what extent these articles provide information on the possible range of negative health impacts due to bushfire smoke pollution, and to what extent they report on climate change as a driver behind increased bushfire risk. A temporary surge in articles in our sample occurs during the unusually severe 2019/2020 Black Summer bushfires. However, most articles are limited to general statements about the health impacts of bushfire smoke, with only 50 articles in the sample (9%) mentioning an explicit link between bushfire smoke inhalation and cardiovascular and respiratory problems or increases in mortality risk. About 148 of the 512 articles in the sample (29%) established a connection between bushfire risk and climate change. We carry out a further keyword analysis to identify differences in reporting by Australia’s two main publishing groups (News Corp Australia and Nine Entertainment), which shows that articles in News Corp Australia outlets offered the lowest climate change coverage. We suggest that more detailed communication strategies are needed to strengthen public preparedness for future impacts.
Smoke from forest fires can reach hazardous levels for extended periods of time. We aimed to determine if there is an association between particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5) and living in a forest fire–prone province and cognitive function. We used data from the Indonesian Family and Life Survey. Cognitive function was assessed by the Ravens Colored Progressive Matrices (RCPM). We used regression models to estimate associations between PM2.5 and living in a forest fire–prone province and cognitive function. In multivariable models, we found very small positive relationships between PM2.5 levels and RCPM scores (PM2.5 level at year of survey: β = 0.1%; 95% confidence interval (CI) [0.01, 0.19%]). There were no differences in RCPM scores for children living in forest fire–prone provinces compared with children living in non-forest fire–prone provinces (mean difference = −1.16%, 95% CI [–2.53, 0.21]). RCPM scores were lower for children who had lived in a forest fire–prone province all their lives compared with children who lived in a non-forest fire–prone province all their life (β = −1.50%; 95% CI [–2.94, –0.07]). Living in a forest fire–prone province for a prolonged period of time negatively affected cognitive scores after adjusting for individual factors.
Smoke haze due to vegetation and peatland fires in Southeast Asia is a serious public health concern. Several approaches have been applied in previous studies; however, the concepts and interpretations of these approaches are poorly understood. In this scoping review, we addressed issues related to the application of epidemiology (EPI), health burden estimation (HBE), and health risk assessment (HRA) approaches, and discussed the interpretation of findings, and current research gaps. Most studies reported an air quality index exceeding the ‘unhealthy’ level, especially during smoke haze periods. Although smoke haze is a regional issue in Southeast Asia, studies on its related health effects have only been reported from several countries in the region. Each approach revealed increased health effects in a distinct manner: EPI studies reported excess mortality and morbidity during smoke haze compared to non-smoke haze periods; HBE studies estimated approximately 100,000 deaths attributable to smoke haze in the entire Southeast Asia considering all-cause mortality and all age groups, which ranged from 1,064-260,000 for specified mortality cause, age group, study area, and study period; HRA studies quantified potential lifetime cancer and non-cancer risks due to exposure to smoke-related chemicals. Currently, there is a lack of interconnection between these three approaches. The EPI approach requires extensive effort to investigate lifetime health effects, whereas the HRA approach needs to clarify the assumptions in exposure assessments to estimate lifetime health risks. The HBE approach allows the presentation of health impact in different scenarios, however, the risk functions used are derived from EPI studies from other regions. Two recent studies applied a combination of the EPI and HBE approaches to address uncertainty issues due to the selection of risk functions. In conclusion, all approaches revealed potential health risks due to smoke haze. Nonetheless, future studies should consider comparable exposure assessments to allow the integration of the three approaches.
Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM(2.5)) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM(2.5) exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM(2.5) from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults.
The 2019-20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia’s capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experientially different from many natural disasters, it nevertheless poses a significant public health threat. As the impact of extended bushfire smoke in an urban setting is relatively unexplored we aimed to capture the individual and community-level experiences of the event and their importance for community and social functioning. We responded rapidly by conducting semi-structured interviews with a range of Canberra residents who, due to their personal or social circumstances, were potentially vulnerable to the effects of the smoke. Three major themes emerging from the narratives depicted disruption to daily life, physical and psychological effects, and shifting social connectedness. This study highlighted the ambiguous yet impactful nature of a bushfire smoke event, and identified four simple key messages that may be critically relevant to policy making in preparation for similar smoke events in the future.
The 2019-2020 summer wildfire event on the east coast of Australia was a series of major wildfires occurring from November 2019 to end of January 2020 across the states of Queensland, New South Wales (NSW), Victoria and South Australia. The wildfires were unprecedent in scope and the extensive character of the wildfires caused smoke pollutants to be transported not only to New Zealand, but also across the Pacific Ocean to South America. At the peak of the wildfires, smoke plumes were injected into the stratosphere at a height of up to 25 km and hence transported across the globe. The meteorological and air quality Weather Research and Forecasting with Chemistry (WRF-Chem) model is used together with the air quality monitoring data collected during the bushfire period and remote sensing data from the Moderate Resolution Imaging Spectroradiometer (MODIS) and Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellites to determine the extent of the wildfires, the pollutant transport and their impacts on air quality and health of the exposed population in NSW. The results showed that the WRF-Chem model using Fire Emission Inventory (FINN) from National Center for Atmospheric Research (NCAR) to simulate the dispersion and transport of pollutants from wildfires predicted the daily concentration of PM2.5 having the correlation (R-2) and index of agreement (IOA) from 0.6 to 0.75 and 0.61 to 0.86, respectively, when compared with the ground-based data. The impact on health endpoints such as mortality and respiratory and cardiovascular diseases hospitalizations across the modelling domain was then estimated. The estimated health impact on each of the Australian Bureau of Statistics (ABS) census districts (SA4) of New South Wales was calculated based on epidemiological assumptions of the impact function and incidence rate data from the 2016 ABS and NSW Department of Health statistical health records. Summing up all SA4 census district results over NSW, we estimated that there were 247 (CI: 89, 409) premature deaths, 437 (CI: 81, 984) cardiovascular diseases hospitalizations and 1535 (CI: 493, 2087) respiratory diseases hospitalizations in NSW over the period from 1 November 2019 to 8 January 2020. The results are comparable with a previous study based only on observation data, but the results in this study provide much more spatially and temporally detailed data with regard to the health impact from the summer 2019-2020 wildfires.
Persistent and intensive wildland dense-fires (DFs) release substantial amounts of airborne pollutants, resulting in a sharp increase in emissions and leading to serious impacts on the environment and human health over extensive geographical areas. It is challenging to thoroughly investigate patterns of fire occurrence and fire distribution for predicting wildfire behaviour, and it is especially difficult to distinguish the characteristics of human-caused and climate-driven fires. Here, we identify and assess dense-fire (DF) from the perspective of spatiotemporally integrated processes using a machine-learning method based on a density-based clustering algorithm with noise constraint ratio. DFs represent collections of fires with homogenous behaviour and therefore allow the study of their internal features, which can reveal fixed patterns of fire occurrence and dis-tribution as well as the evolution of fires over time. We estimated and labelled thousands of fire clusters on the Indochina Peninsula between 2010 and 2020, most of which occurred between December and May. For large-scale DFs, the number of fires contained and amount of atmospheric pollutants emitted were accounted for throughout most of the region, and the time, location and scale of their occurrence each year were relatively stable and predictable. Furthermore, the results of a secondary cluster analysis of fire interactions over the past decade showed two extreme fire events, labelled “north ” and “south ” groups, whose activities significantly impacted the atmospheric environment of the Indochina Peninsula. Additionally, we predicted their start/end dates and daily emissions. The study also found that the recurrence of high-density fires and the correlation between the DF edge and administrative border suggested a positive anthropogenic influence. To the authors’ knowledge, this study is the first to analyze fires in a spatiotemporal Euclidean space by using density-based clustering, with high-density fires as independent subjects to study fire behaviour. The method proposed in this study can provide a reference for wildfire prediction and emission forecasting and fire control work.
Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events.
Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children < 5 years old.
Air quality impacts from wildfires have been dramatic in recent years, with millions of people exposed to elevated and sometimes hazardous fine particulate matter (PM2.5) concentrations for extended periods. Fires emit particulate matter (PM) and gaseous compounds that can negatively impact human health and reduce visibility. While the overall trend in U.S. air quality has been improving for decades, largely due to implementation of the Clean Air Act, seasonal wildfires threaten to undo this in some regions of the United States. Our understanding of the health effects of smoke is growing with regard to respiratory and cardiovascular consequences and mortality. The costs of these health outcomes can exceed the billions already spent on wildfire suppression. In this critical review, we examine each of the processes that influence wildland fires and the effects of fires, including the natural role of wildland fire, forest management, ignitions, emissions, transport, chemistry, and human health impacts. We highlight key data gaps and examine the complexity and scope and scale of fire occurrence, estimated emissions, and resulting effects on regional air quality across the United States. The goal is to clarify which areas are well understood and which need more study. We conclude with a set of recommendations for future research. Implications In the recent decade the area of wildfires in the United States has increased dramatically and the resulting smoke has exposed millions of people to unhealthy air quality. In this critical review we examine the key factors and impacts from fires including natural role of wildland fire, forest management, ignitions, emissions, transport, chemistry and human health.
Wildland firefighters work on wildfire incidents all over the United States and perform arduous work under extreme work conditions, including exposure to smoke. Wildland fire smoke is a mixture of hazardous air pollutants. For assessing wildland firefighter exposure to smoke, most studies measured carbon monoixde (CO) and particulate matter and reported changes in lung health by measured lung function, airway responsiveness, and respiratory symptoms across individual work shifts and single fire seasons. All fire personnel should understand the hazards of smoke and develop ways to mitigate exposure to smoke.
Catastrophic wildfires are increasing around the globe as climate change continues to progress. Another risk factor for large wildfires in the western United States is a legacy of fire suppression that has allowed overgrowth of underbrush and small trees in forests where periodic lightning-sparked wildfires are part of the natural ecosystem. Wildfire smoke contains CO(2), CO, NOx, particulate matter, complex hydrocarbons (including polycyclic aromatic hydrocarbons), and irritant gases, including many of the same toxic and carcinogenic substances as cigarette smoke. The public need clear and consistent messaging to understand that wildland fire smoke poses a health risk.
Since air pollutants are difficult and expensive to control, a strong scientific underpinning to policies is needed to guide mitigation aimed at reducing the current burden on public health. Much of the evidence concerning hazard identification and risk quantification related to air pollution comes from epidemiological studies. This must be reinforced with mechanistic confirmation to infer causality. In this review we focus on data generated from four contrasting sources of particulate air pollution that result in high population exposures and thus where there remains an unmet need to protect health: urban air pollution in developing megacities, household biomass combustion, wildfires and desert dust storms. Taking each in turn, appropriate measures to protect populations will involve advocating smart cities and addressing economic and behavioural barriers to sustained adoption of clean stoves and fuels. Like all natural hazards, wildfires and dust storms are a feature of the landscape that cannot be removed. However, many efforts from emission containment (land/fire management practices), exposure avoidance and identifying susceptible populations can be taken to prepare for air pollution episodes and ensure people are out of harm’s way when conditions are life-threatening. Communities residing in areas affected by unhealthy concentrations of any airborne particles will benefit from optimum communication via public awareness campaigns, designed to empower people to modify behaviour in a way that improves their health as well as the quality of the air they breathe.
Wildfire smoke is an increasing environmental health threat to which children are particularly vulnerable, for both physiologic and behavioral reasons. To address the need for improved public health messaging this review summarizes current knowledge and knowledge gaps in the health effects of wildfire smoke in children, as well as tools for public health response aimed at children, including consideration of low-cost sensor data, respirators, and exposures in school environments. There is an established literature of health effects in children from components of ambient air pollution, which are also present in wildfire smoke, and an emerging literature on the effects of wildfire smoke, particularly for respiratory outcomes. Low-cost particulate sensors demonstrate the spatial variability of pollution, including wildfire smoke, where children live and play. Surgical masks and respirators can provide limited protection for children during wildfire events, with expected decreases of roughly 20% and 80% for surgical masks and N95 respirators, respectively. Schools should improve filtration to reduce exposure of our nation’s children to smoke during wildfire events. The evidence base described may help clinical and public health authorities provide accurate information to families to improve their decision making.
Wildfire smoke harms health. We add to this literature by evaluating the health effects of California’s 2018 Carr Fire and preceding wildfire seasons in Shasta County. METHODS: With data from the Shasta County Health and Human Services Agency, we examined the link between weekly wildfire fine particulate matter (PM(2.5)) exposure estimated using a spatiotemporal multiple imputation approach and emergency department (ED) visits and mortality using time-series models that controlled for temporal trends and temperature. RESULTS: Between 2013 and 2018, Shasta County experienced 19 weeks with average wildfire PM(2.5) ?5.5 ?g/m(3) (hereafter, “high wildfire PM(2.5) concentration”). Among all Shasta County Zip Code Tabulation Areas (ZCTAs; n = 36), we detected no association between high wildfire PM(2.5) concentrations and respiratory or circulatory disease-related ED visits or mortality. Subsequent analyses were confined to valley ZCTAs (n = 11, lower elevation, majority of population, worse air quality in general). In valley ZCTAs, high wildfire PM(2.5) was associated with a 14.6% (95% confidence interval [CI] = 4.2, 24.9) increase in same-week respiratory disease-related ED visits but no increase in the subsequent 2 weeks nor on circulatory disease-related mortality or ED visits or all-cause mortality. Two weeks after high wildfire PM(2.5) weeks, respiratory disease-related deaths decreased (-31.5%, 95% CI = -64.4, 1.5). The 2018 Carr Fire appeared to increase respiratory disease-related ED visits by 27.0% (95% CI = 4.0, 50.0) over expectation and possibly reduce circulatory disease-related deaths (-18.2%, 95% CI = -39.4, 2.9). CONCLUSIONS: As climate change fuels wildfire seasons, studies must continue to evaluate their health effects, particularly in highly exposed populations.
The 2018 Camp Fire caused significant damages to the education and healthcare systems in the town of Paradise, CA. This paper presents the findings of a qualitative case study about disaster impacts and disparities, interdependencies, and recovery strategies of schools and hospitals in Paradise. Four major themes of findings emerged from the qualitative analysis of interviews with teachers, counselors, and administrators in Paradise education and healthcare systems and extensive archival research. First, complex and long-standing mental health challenges are the dominant impact on the educational system. Second, educational and healthcare impacts are shaped by social vulnerability. Third, educational and healthcare systems play a critical role for recovery of socially vulnerable groups due to the interconnectedness of community components. Fourth, adapting to new communication norms and technologies is effective for supporting educational and community recovery. Several specific recommendations are provided based on the findings for building back more resilient and equitable education and healthcare services.
Natural disasters are potentially traumatic events due to their disruptive nature and high impact on social and physical environments, particularly for children and adolescents. The present study aimed to examine the psychometric properties of the Children’s Revised Impact of Event Scale (CRIES-13) in a sample of Portuguese children and adolescents exposed to a specific type of natural disaster (i.e., wildfire). The sample was recruited at six school units of the Central region of Portugal following wildfires in the summer of 2017 and included children and adolescents without a clinical diagnosis of a psychopathological condition associated with exposure to the traumatic event (i.e., nonclinical sample, n = 486) and those with a clinical diagnosis of a trauma- and/or stress-related disorder (i.e., posttraumatic stress disorder [PTSD], adjustment disorder, separation anxiety disorder, or grief; clinical sample, n = 54). Confirmatory factor analyses indicated that a two-factor model (i.e., Intrusion/Arousal and Avoidance) provided a better fit than a three-factor model (i.e., Intrusion, Arousal, and Avoidance) and was found to be invariant across gender and age groups. The CRIES-13 showed good reliability for all subscales, with Cronbach’s alpha s > .79. Higher CRIES-13 scores were associated with poorer health and well-being and more internalizing and externalizing problems. The clinical sample presented with significantly higher CRIES-13 scores than the nonclinical sample, eta(2)(p) = .13. These results contribute to the cross-cultural validation of the CRIES-13 and support its use as a reliable and valid measure for assessing posttraumatic symptoms in children and adolescents.
As climate change increases the frequency and severity of disasters, and population and social changes raise the public’s vulnerability to disaster events, societies face additional risk of multiple disaster events or other hazards occurring simultaneously. Such hazards involve significant uncertainty, which must be translated into concrete plans able to be implemented by disaster workers. Little research has explored how disaster managers incorporate different forms of knowledge and uncertainty into preparations for simultaneous hazards or disaster events, or how front-line disaster workers respond to and implement these plans. In this paper I draw on ethnographic research working as a wildland firefighter, interviews with firefighters and fire managers, and state and agency planning documents to examine preparations for two events occurring in Central Oregon in August 2017: (1) the height of wildfire season and (2) hundreds of thousands of anticipated visitors for a total solar eclipse. I find that different qualities of risk, hazard, and uncertainty across these two events were central to the development and implementation of disaster plans. Agency leaders devised worst-case scenario plans for the eclipse based on uncertain predictions regarding hazards from the eclipse and the occurrence of severe wildfires, aiming to eliminate the potential for unknown hazards. These plans were generally met with skepticism by front-line disaster workers. Despite the uncertainties that dominated eclipse-planning rhetoric, firefighters largely identified risks from the eclipse that were risks they dealt with in their daily work as firefighters. I conclude by discussing implications of these findings for conceptual understandings of disaster planning as well as contemporary concerns about skepticism and conspiracy theories directed at government planning and response to disaster events.
During the summer of 2018 Sweden experienced a high occurrence of wildfires, most intense in the low-densely populated Jämtland Härjedalen region. The aim of this study was to investigate any short-term respiratory health effects due to deteriorated air quality generated by the smoke from wildfires. For each municipality in the region Jämtland Härjedalen, daily population-weighted concentrations of fine particulate matter (PM(2.5)) were calculated through the application of the MATCH chemistry transport model. Modelled levels of PM(2.5) were obtained for two summer periods (2017, 2018). Potential health effects of wildfire related levels of PM(2.5) were examined by studying daily health care contacts concerning respiratory problems in each municipality in a quasi-Poisson regression model, adjusting for long-term trends, weekday patterns and weather conditions. In the municipality most exposed to wildfire smoke, having 9 days with daily maximum 1-h mean of PM(2.5) > 20 ?g/m(3), smoke days resulted in a significant increase in daily asthma visits the same and two following days (relative risk (RR) = 2.64, 95% confidence interval (CI): 1.28-5.47). Meta-estimates for all eight municipalities revealed statistically significant increase in asthma visits (RR = 1.68, 95% CI: 1.09-2.57) and also when grouping all disorders of the lower airways (RR = 1.40, 95% CI: 1.01-1.92).
In recent years, the frequency, intensity, and severity of wildfires have been on the rise due to various environmental factors. Several studies show that the strategic application of fuel treatments is effective at altering fire behavior and its spread patterns. Effective planning for mitigating future expected losses under wildfire risk is a complex challenge that requires the integration of fire spread, simulation, and optimization models as well as the inclusion of multiple objectives into a unified framework. Previous works simplify the analysis by valuing the landscape regions using a unique objective (e.g., minimize the average expected area burned) or a predefined objective function. However, such an assumption is a simplification of the real system as multiple parts of the landscape have different values based on factors such as the presence of human settlements and infrastructure, availability of environmental services, and forest health. In this work, we expand these previous attempts by providing an integrated framework to naturally include and weight multiple objectives into the optimization model and analyze the trade-off between present objectives and future protection against wildfire risk. We study three key regions based on their recent fire history, landscape diversity, and demographic variety to quantify the impact of multiple objectives in landscape management. We obtain treatment plans using various combinations of these layers reflecting how different priorities of the decision-makers could affect treatment policies.
People experiencing homelessness during the 2017-2018 California wildfires faced significant risks of disruption. Homeless service organizations (HSOs) are an essential safety net for this population. To learn about how HSOs performed during the wildfires, this study interviewed U.S. Department of Veterans Affairs (VA) staff overseeing HSOs providing transitional housing under the VA’s Grant and Per Diem (GPD) program to Veterans experiencing homelessness. We employed a comparative case study approach exploring GPD organizations’ disaster response actions, including evacuating Veterans from wildfire-affected areas or taking in disaster-displaced Veterans. This article presents three themes in the GPD organizations’ disaster response: (1) Organizations benefitted from close collaboration and communication with the VA during the disaster, creating a safety net to ensure Veterans’ well-being and enact rapid re-housing to prevent homelessness; (2) Organization staff performed heroically under stressful disaster conditions; and (3) Organizations benefitted from the written disaster plans that VA requires them to create, but were not as well-prepared for wildfires as they had been for earthquakes. As emergent threats such as the COVID-19 pandemic, wildfires, and a very active 2020 hurricane season amplify the importance of mitigating risks, comprehensive disaster planning is needed to ensure the safety and support of people experiencing homelessness.
In Fort McMurray, Alberta, Canada, the wildfire of May 2016 forced the population of 88,000 to rapidly evacuate in a traumatic and chaotic manner. Ten percentage of the homes in the city were destroyed, and many more structures were damaged. Since youth are particularly vulnerable to negative effects of natural disasters, we examined possible long-term psychological impacts. To assess this, we partnered with Fort McMurray Public and Catholic Schools, who surveyed Grade 7-12 students (aged 11-19) in November 2017, 2018, and 2019-i.e., at 1.5, 2.5, and 3.5 years after the wildfire. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, drug use, alcohol use, tobacco use, quality of life, self-esteem, and resilience. Data analysis was done on large-scale anonymous surveys including 3,070 samples in 2017; 3,265 samples in 2018; and 3,041 samples in 2019. The results were unexpected and showed that all mental health symptoms increased from 2017 to 2019, with the exception of tobacco use. Consistent with this pattern, self-esteem and quality of life scores decreased. Resilience scores did not change significantly. Thus, mental health measures worsened, in contrast to our initial hypothesis that they would improve over time. Of note, we observed higher levels of mental health distress among older students, in females compared to male students, and in individuals with a minority gender identity, including transgender and gender-non-conforming individuals. These findings demonstrate that deleterious mental health effects can persist in youth for years following a wildfire disaster. This highlights the need for multi-year mental health support programs for youth in post-disaster situations. The indication that multi-year, post-disaster support is warranted is relatively novel, although not unknown. There is a need to systematically investigate factors associated with youth recovery following a wildfire disaster, as well as efficacy of psychosocial strategies during later phases of disaster recovery relative to early post-disaster interventions.
INTRODUCTION: Climate change presents unprecedented health threats. It is imperative that medical trainees understand the implications of climate change/planetary health on the physical and mental health and well-being of their patients. Medical professionals generally are not trained to consider climate change impacts in patient encounters. Hence, there is a need to train climate-aware providers who will be at the forefront of patient care in managing these current and emerging health impacts. METHODS: We created a standardized patient (SP) case enhanced with details of risks and health impacts due to exposure to wildfire smoke. This session was deployed to 11 internal medicine clerkship students as part of a standard OSCE already included in our curriculum to evaluate core clinical and communication skills. Two cohorts, a group activity, and a one-on-one encounter were deployed and followed with a faculty debrief and learner assessments. RESULTS: Students had increased awareness and knowledge of health impacts of climate change and potential actions for adaptation and mitigation. The improvements were statistically significant for the one-on-one cohort (p = .006). Postsimulation comments were favorable; students were more inclined to consider health impacts, risks, and vulnerabilities exacerbated by climate change. DISCUSSION: Students had an increased recognition of climate change as a force impacting their patients’ health which should be considered in patient care. This format allowed retention of well established curricular content, but also the inclusion of other crucial emerging issues that will impact public health locally and globally and foster the development of climate-aware health care providers.
IMPORTANCE Air pollution is a worldwide public health issue that has been exacerbated by recent wildfires, but the relationship between wildfire-associated air pollution and inflammatory skin diseases is unknown. OBJECTIVE To assess the associations between wildfire-associated air pollution and clinic visits for atopic dermatitis (AD) or itch and prescribed medications for AD management. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional time-series study assessed the associations of air pollution resulting from the California Camp Fire in November 2018 and 8049 dermatology clinic visits (4147 patients) at an academic tertiary care hospital system in San Francisco, 175 miles from the wildfire source. Participants included pediatric and adult patients with AD or itch from before, during, and after the time of the fire (October 2018 through February 2019), compared with those with visits in the same time frame of 2015 and 2016, when no large wildfires were near San Francisco. Data analysis was conducted from November 1, 2019, to May 30, 2020. EXPOSURES Wildfire-associated air pollution was characterized using 3 metrics: fire status, concentration of particulate matter less than 2.5 mu m in diameter (PM2.5), and satellite-based smoke plume density scores. MAIN OUTCOMES AND MEASURES Weekly clinic visit counts for AD or itch were the primary outcomes. Secondary outcomes were weekly numbers of topical and systemic medications prescribed for AD in adults. RESULTS Visits corresponding to a total of 4147 patients (mean [SD] age, 44.6 [21.1] years; 2322 [56%] female) were analyzed. The rates of visits for AD during the Camp Fire for pediatric patients were 1.49 (95% CI, 1.07-2.07) and for adult patients were 1.15 (95% CI, 1.02-1.30) times the rate for nonfire weeks at lag 0, adjusted for temperature, relative humidity, patient age, and total patient volume at the clinics for pediatric patients. The adjusted rate ratios for itch clinic visits during the wildfire weeks were 1.82 (95% CI, 1.20-2.78) for the pediatric patients and 1.29 (95% CI, 0.96-1.75) for adult patients. A 10-mu g/m(3) increase in weekly mean PM2.5 concentration was associated with a 7.7% (95% CI, 1.9%-13.7%) increase in weekly pediatric itch clinic visits. The adjusted rate ratio for prescribed systemic medications in adults during the Camp Fire at lag 0 was 1.45 (95% CI, 1.03-2.05). CONCLUSIONS AND RELEVANCE This cross-sectional study found that short-term exposure to air pollution due to the wildfire was associated with increased health care use for patients with AD and itch. These results may provide a better understanding of the association between poor air quality and skin health and guide health care professionals’ counseling of patients with skin disease and public health practice.
We estimate the effects of wildfire smoke exposure on infant health. Exposure to wildfire smoke is determined using the latitude and longitude coordinates corresponding to each infant’s home address and a fine-scaled spatial dataset of wildfire smoke plumes constructed in GIS from satellite images of the landscape. Using a difference-in-differences estimation strategy, model estimates show that exposure to wildfire smoke leads to a .034 increase in the probability of low birthweight.
Objective: The study examines how wildfire smoke exposure may impact health and safety in the agricultural workplace. Methods: Semi-structured interviews were conducted with agricultural employers and focus group discussions were held with farmworkers in three regions of California. Results: Agricultural employers had varying knowledge about and experience responding to poor air quality due to wildfire smoke. Respirators or masks were not mentioned as a potential protective measure when describing their safety practices. Farmworkers reported experiencing poor air quality due to wildfire smoke, although knowledge of safety precautions varied. Farmworkers reported employer and supervisors’ attitudes toward safety as having the greatest impact on the implementation of workplace safety measures. Conclusion: Adapting health promotion and workplace safety strategies to meet the multiple vulnerabilities and diverse needs of farmworkers is critical to successful implementation of workplace protection and safety measures. Given limited familiarity with the topic, wildfire smoke exposure resources are needed to assist employers and supervisors in their compliance with a new wildfire smoke safety regulation in California. To the best of our knowledge, this is the first study to explore agricultural employer and farmworker perceptions of the health and safety impacts of wildfire smoke and workplace exposure.
The air quality and human health impacts of wildfires depend on fire, meteorology, and demography. These properties vary substantially from one region to another in China. This study compared smoke from more than a dozen wildfires in Northeast, North, and Southwest China to understand the regional differences in smoke transport and the air quality and human health impacts. Smoke was simulated using the Hybrid Single Particle Lagrangian Integrated Trajectory Model (HYSPLIT) with fire emissions obtained from the Global Fire Emission Database (GFED). Although the simulated PM2.5 concentrations reached unhealthy or more severe levels at regional scale for some largest fires in Northeast China, smoke from only one fire was transported to densely populated areas (population density greater than 100 people/km(2)). In comparison, the PM2.5 concentrations reached unhealthy level in local densely populated areas for a few fires in North and Southwest China, though they were very low at regional scale. Thus, individual fires with very large sizes in Northeast China had a large amount of emissions but with a small chance to affect air quality in densely populated areas, while those in North and Southwest China had a small amount of emissions but with a certain chance to affect local densely populated areas. The results suggest that the fire and air quality management should focus on the regional air quality and human health impacts of very large fires under southward/southeastward winds toward densely populated areas in Northeast China and local air pollution near fire sites in North and Southwest China.
The relationship between the fires occurrences and diseases is an essential issue for making public health policy and environment protecting strategy. Thanks to the Internet, today, we have a huge amount of health data and fire occurrence reports at our disposal. The challenge, therefore, is how to deal with 4 Vs (volume, variety, velocity and veracity) associated with these data. To overcome this problem, in this paper, we propose a method that combines techniques based on Data Mining and Knowledge Discovery from Databases (KDD) to discover spatial and temporal association between diseases and the fire occurrences. Here, the case study was addressed to Malaria, Leishmaniasis and respiratory diseases in Brazil. Instead of losing a lot of time verifying the consistency of the database, the proposed method uses Decision Tree, a machine learning-based supervised classification, to perform a fast management and extract only relevant and strategic information, with the knowledge of how reliable the database is. Namely, States, Biomes and period of the year (months) with the highest rate of fires could be identified with great success rates and in few seconds. Then, the K-means, an unsupervised learning algorithms that solves the well-known clustering problem, is employed to identify the groups of cities where the fire occurrences is more expressive. Finally, the steps associated with KDD is perfomed to extract useful information from mined data. In that case, Spearman’s rank correlation coefficient, a nonparametric measure of rank correlation, is computed to infer the statistical dependence between fire occurrences and those diseases. Moreover, maps are also generated to represent the distribution of the mined data. From the results, it was possible to identify that each region showed a susceptible behaviour to some disease as well as some degree of correlation with fire outbreak, mainly in the drought period.
This study aimed to examine the psychometric properties of the Child Post-Traumatic Cognitions Inventory (CPTCI) in a sample of Portuguese children and adolescents, following the exposition to a wildfire disaster. The sample included 533 children and adolescents living in regions exposed to the wildfire disaster (non-clinical sample: n = 483; clinical sample: n = 50). The short form of the instrument (CPTCI-SF) including two correlated factors (‘Sense of Disturbing and Permanent Change’ and ‘Sense of Being a Fragile Person in a Scary World’) showed good model fit and was invariant across gender and age-groups. Good internal consistency (> .70) was found, and higher CPTCI scores were associated with poorer adjustment indicators. The clinical sample presented significantly higher CPTCI scores than the non-clinical sample. These results contribute to the cross-cultural validation of the CPTCI and support the adequacy of its short form as a reliable and valid measure to be used with Portuguese children and adolescents.
The Cognitive Emotion Regulation Questionnaire-Kids (CERQ-Kids) is a self-report questionnaire that assesses cognitive emotional regulation strategies that children may employ when they face traumatic or stressful events. However, its psychometric properties were only analyzed among participants from the general community. The goal of this study is to examine the factor structure of the Portuguese CERQ-Kids and to explore its psychometric properties in a sample of children/adolescents exposed to a potentially traumatic event (wildfires). The sample included 488 children/adolescents (Mage = 13.02, SD = 2.5, range = 8-17) who lived in the areas affected by the 2017 Portugal wildfires and who did not receive a diagnosis of a mental disorder, and a clinical group of 50 children/adolescents (Mage = 12, SD = 2.62, range = 8-16) who lived in the same areas and who were diagnosed with a mental disorder. All participants completed the CERQ-Kids and measures of emotion regulation strategies, mental health, and quality of life. The best fitting model was the original nine-factor correlated model. This model was invariant across gender and age groups. With the exception of the Acceptance subscale, the remaining subscales presented adequate internal consistency. Participants from the clinical group scored higher on Self-blame, Rumination, Catastrophizing, and Acceptance than participants from the non-clinical group. Significant correlations were found between the CERQ-Kids subscales and measures of cognitive reappraisal, expressive suppression, prosocial behavior, mental health, and quality of life. The Portuguese version of the CERQ-Kids proved to be a psychometrically adequate measure of cognitive emotion regulation strategies that children and adolescents may use when exposed to a potentially traumatic event.
In October 2017, hundreds of wildfires ravaged the forests of the north and centre of Portugal. The fires were fanned by strong winds as tropical storm Ophelia swept the Iberian coast, dragging up smoke (together with Saharan dust from north-western Africa) into higher western European latitudes. Here we analyse the long-range transport of particulate matter (PM(10)) and study associations between PM(10) and short-term mortality in the Portuguese population exposed to PM(10) due to the October 2017 wildfires, the worst fire sequence in the country over the last decades. We analysed space- and ground-level observations to track the smoke plume and dust trajectory over Portugal and Europe, and to access PM(10) concentrations during the wildfires. The effects of PM(10) on mortality were evaluated using satellite data for exposure and Poisson regression models. The smoke plume covered most western European countries (including Spain, France, Belgium and the Netherlands), and reached the United Kingdom, where the population was exposed in average to an additional PM(10) level of 11.7 µg/m(3) during seven smoky days (three with dust) in relation to the reference days (days without smoke or dust), revealing the impact of the wildfires on distant populations. In Portugal, the population was exposed in average to additional PM(10) levels that varied from 16.2 to 120.6 µg/m(3) in smoky days with dust and from 6.1 to 20.9 µg/m(3) in dust-free smoky days. Results suggest that PM(10) had a significant effect on the same day natural and cardiorespiratory mortalities during the month of October 2017. For every additional 10 µg/m(3) of PM(10), there was a 0.89% (95% confidence interval, CI, 0-1.77%) increase in the number of natural deaths and a 2.34% (95% CI, 0.99-3.66%) increase in the number of cardiorespiratory-related deaths. With rising temperatures and a higher frequency of storms due to climate change, PM from Iberian wildfires together with NW African dust will tend to be more often transported into Northern European countries, which may carry health threats to areas far from the ignition sites.
Background The natural cycle of large-scale wildfires is accelerating, increasingly exposing both rural and populous urban areas to wildfire emissions. While respiratory health effects associated with wildfire smoke are well established, cardiovascular effects have been less clear. Methods and Results We examined the association between out-of-hospital cardiac arrest and wildfire smoke density (light, medium, heavy smoke) from the National Oceanic Atmospheric Association’s Hazard Mapping System. Out-of-hospital cardiac arrest data were provided by the Cardiac Arrest Registry to Enhance Survival for 14 California counties, 2015-2017 (N=5336). We applied conditional logistic regression in a case-crossover design using control days from 1, 2, 3, and 4 weeks before case date, at lag days 0 to 3. We stratified by pathogenesis, sex, age (19-34, 35-64, and >= 65 years), and socioeconomic status (census tract percent below poverty). Out-of-hospital cardiac arrest risk increased in association with heavy smoke across multiple lag days, strongest on lag day 2 (odds ratio, 1.70; 95% CI, 1.18-2.13). Risk in the lower socioeconomic status strata was elevated on medium and heavy days, although not statistically significant. Higher socioeconomic status strata had elevated odds ratios with heavy smoke but null results with light and medium smoke. Both sexes and age groups 35 years and older were impacted on days with heavy smoke. Conclusions Out-of-hospital cardiac arrests increased with wildfire smoke exposure, and lower socioeconomic status appeared to increase the risk. The future trajectory of wildfire, along with increasing vulnerability of the aging population, underscores the importance of formulating public health and clinical strategies to protect those most vulnerable.
Background Wildfire events are increasing in prevalence in the western United States. Research has found mixed results on the degree to which exposure to wildfire smoke is associated with an increased risk of mortality. Methods We tested for an association between exposure to wildfire smoke and non-traumatic mortality in Washington State, USA. We characterized wildfire smoke days as binary for grid cells based on daily average PM2.5 concentrations, from June 1 through September 30, 2006-2017. Wildfire smoke days were defined as all days with assigned monitor concentration above a PM2.5 value of 20.4 mu g/m(3), with an additional set of criteria applied to days between 9 and 20.4 mu g/m(3). We employed a case-crossover study design using conditional logistic regression and time-stratified referent sampling, controlling for humidex. Results The odds of all-ages non-traumatic mortality with same-day exposure was 1.0% (95% CI: – 1.0 – 4.0%) greater on wildfire smoke days compared to non-wildfire smoke days, and the previous day’s exposure was associated with a 2.0% (95% CI: 0.0-5.0%) increase. When stratified by cause of mortality, odds of same-day respiratory mortality increased by 9.0% (95% CI: 0.0-18.0%), while the odds of same-day COPD mortality increased by 14.0% (95% CI: 2.0-26.0%). In subgroup analyses, we observed a 35.0% (95% CI: 9.0-67.0%) increase in the odds of same-day respiratory mortality for adults ages 45-64. Conclusions This study suggests increased odds of mortality in the first few days following wildfire smoke exposure. It is the first to examine this relationship in Washington State and will help inform local and state risk communication efforts and decision-making during future wildfire smoke events.
Background Wildfires are increasingly a significant source of fine particulate matter (PM2.5), which has been linked to adverse health effects and increased mortality. ESKD patients are potentially susceptible to this environmental stressor. Methods We conducted a retrospective time-series analysis of the association between daily exposure to wildfire PM2.5 and mortality in 253 counties near a major wildfire between 2008 and 2012. Using quasi-Poisson regression models, we estimated rate ratios (RRs) for all-cause mortality on the day of exposure and up to 30 days following exposure, adjusted for background PM2.5, day of week, seasonality, and heat. We stratified the analysis by causes of death (cardiac, vascular, infectious, or other) and place of death (clinical or nonclinical setting) for differential PM2.5 exposure and outcome classification. Results We found 48,454 deaths matched to the 253 counties. A 10-mu g/m(3) increase in wildfire PM2.5 associated with a 4% increase in all-cause mortality on the same day (RR, 1.04; 95% confidence interval [95% CI], 1.01 to 1.07) and 7% increase cumulatively over 30 days following exposure (RR, 1.07; 95% CI, 1.01 to 1.12). Risk was elevated following exposure for deaths occurring in nonclinical settings (RR, 1.07; 95% CI, 1.02 to 1.12), suggesting modification of exposure by place of death. “Other” deaths (those not attributed to cardiac, vascular, or infectious causes) accounted for the largest portion of deaths and had a strong same-day effect (RR, 1.08; 95% CI, 1.03 to 1.12) and cumulative effect over the 30-day period. On days with a wildfire PM2.5 contribution >10 mu g/m(3), exposure accounted for 8.4% of mortality. Conclusions Wildfire smoke exposure was positively associated with all-cause mortality among patients receiving in-center hemodialysis.
The effects of atmospheric black carbon (BC) on climate and public health have been well established, but large uncertainties remain regarding the extent of the impacts of BC at different temporal and spatial scales. These uncertainties are largely due to the heterogeneous nature of BC in terms of its spatiotemporal distribution, mixing state, and coating composition. Here, we seek to further understand the size and mixing state of BC emitted from various sources and aged over different timescales using field measurements in the Los Angeles region. We measured refractory black carbon (rBC) with a single-particle soot photometer (SP2) on Catalina Island, California (similar to 70 km southwest of downtown Los Angeles) during three different time periods. During the first campaign (September 2017), westerly winds were dominant and measured air masses were representative of wellaged background over the Pacific Ocean. In the second and third campaigns (December 2017 and November 2018, respectively), atypical Santa Ana wind conditions allowed us to measure biomass burning rBC (BCbb) from air masses dominated by large biomass burning events in California and fossil fuel rBC (BCff) from the Los Angeles Basin. We observed that the emissions source type heavily influenced both the size distribution of the rBC cores and the rBC mixing state. BCbb had thicker coatings and larger core diameters than BBff. We observed a mean coating thickness (CTBc) of similar to 40-70 nm and a count mean diameter (CMD) of similar to 120 nm for BCbb. For BCff, we observed a CTBc of similar to 5-15 nm and a CMD of similar to 100 nm. Our observations also provided evidence that aging led to an increased CTBc for both BCbb and BCff . Aging timescales < similar to 1 d were insufficient to thickly coat freshly emitted BCff. However, CTBc for aged B-ff within aged background plumes was similar to 35 nm thicker than CTBc for fresh BCff. Likewise, we found that CTBc for aged BCbb was similar to 18 nm thicker than CTBc for fresh BCbb. The results presented in this study highlight the wide variability in the BC mixing state and provide additional evidence that the emissions source type and aging influence rBC microphysical properties.
Central to public health risk communication is understanding the perspectives and shared values among individuals who need the information. Using the responses from a Smoke Sense citizen science project, we examined perspectives on the issue of wildfire smoke as a health risk in relation to an individual’s preparedness to adopt recommended health behaviors. The Smoke Sense smartphone application provides wildfire-related health risk resources and invites participants to record their perspectives on the issue of wildfire smoke. Within the app, participants can explore current and forecasted daily air quality, maps of fire locations, satellite images of smoke plumes, and learn about health consequences of wildfire smoke. We used cluster analysis to identify perspective trait-clusters based on health status, experience with fire smoke, risk perception, self-efficacy, access to exposure-reducing resources, health information needs, and openness to health risk messaging. Differences between traits were examined based on demographics, health status, activity level and engagement with the app. We mapped these traits to the Precaution Adoption Process Model (PAPM) to indicate where each trait lies in adopting recommended health behaviors. Finally, we suggest messaging strategies that may be suitable for each trait. We determined five distinct perspective traits which included individuals who were Protectors and have decided to engage on the issue by adopting new behaviors to protect their health; Cautious, Proactive, and Susceptible individuals who were at a Deciding stage but differed based on risk perceptions and information needs; and the Unengaged who did not perceive smoke as a health issue and were unlikely to change behavior in response to messaging. Across all five traits, the level of engagement and information needs differed substantially, but were not defined by demographics. Individuals in the Susceptible trait had the highest level of engagement and the highest information needs. Messaging that emphasizes self-efficacy and benefits of reducing exposure may be effective in motivating individuals from the deciding stage to taking health protective action. Shared perspectives define an individual’s propensity for acting on recommended health behaviors, therefore, health risk message content should be tailored based on these perspectives.
Objectives To assess the likely prevalence rates of Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD) in staff of Fort McMurray School Districts eighteen months after a May 2016 wildfire, and to determine possible predictors. Methods A quantitative cross-sectional survey was used to collect data through self-administered online questionnaires to determine likely MDD, GAD and PTSD using well validated self-report questionnaires. Results Of 1,446 staff who were sent the online survey link in an e-mail, 197 completed the survey, of which there were 168 females (85%) and 29 males (15%). The one-month prevalence rates for likely MDD, GAD and PTSD among the school staff were 18.3, 15.7 and 10.2% respectively. There were statistically significant associations between multiple socio-demographic and clinical variables likely MDD, GAD and PTSD among respondents. Conclusion Knowledge of key factors for MDD, GAD and PTSD may be helpful for policy makers when formulating population level social and clinical programs, to mitigate the mental health effects of future natural disasters.
Rationale: There is significant evidence of increased healthcare utilization from cardiopulmonary causes in adults from exposure to wildfire smoke, but evidence in pediatric age groups is limited.Objectives: To quantify and examine the healthcare utilization effects of the December 2017 Lilac Fire in San Diego County among pediatric patients at the Rady Children’s Hospital (RCH) emergency department and urgent care (UC) clinics.Methods: Using data from 2011 to 2017, including data on daily particulate matter <2.5 ?m (PM(2.5)) in an inverse-distance interpolation model and RCH electronic medical records, we retrospectively analyzed pediatric respiratory visits at the RCH emergency department and UC clinics during the Santa Ana wind (SAW)-driven Lilac Fire from December 7 to 16, 2017. An interrupted time series study design was applied as our primary analysis to compare the observed pediatric respiratory visits from December 7 to 16, 2017 to what would have occurred in a counterfactual situation, namely, if the Lilac Fire had not occurred. A complementary descriptive spatial analysis was also used to evaluate the geographic distribution of respiratory visits in relationship to satellite imaging of the Lilac Fire and the associated wind pattern.Results: The Lilac Fire was associated with 16.0 (95% confidence interval [CI], 11.2-20.9) excess respiratory visits per day at the RCH emergency department across all pediatric age groups. Children aged 0 to 5 years had the highest absolute excess respiratory visits per day with 7.3 (95% CI, 3.0-11.7), whereas those aged 6 to 12 years had the highest relative increase in visits, with 3.4 (95% CI, 2.3-4.6). RCH UC clinics had similar results. The top five ZIP codes in San Diego County with the highest standard deviations of age-adjusted respiratory visits were all located generally downwind of the fire perimeter, as expected for the SAW pattern.Conclusions: We have demonstrated an increase in pediatric respiratory visits during the SAW-driven Lilac Fire in San Diego County in a patterned geographic distribution that is attributable to an increase in PM(2.5) exposure. Younger children were particularly affected. Climate change is expected to result in more frequent and extensive wildfires in the region and will require greater preparedness and adaptation efforts to protect vulnerable populations, such as young children.
Background: Air pollution is a global problem and also linked to respiratory diseases. Wildfire smog is a major cause of air pollution in the upper northern area of Thailand. Thus, in the current study, we examined whether long-term exposure to wildfire smog induces lung function changes in a population from the upper northern area of Thailand. Methods: The lung function of 115 participants with long-term exposure smog was determined using peak flow meter. Results: Long-term smoke exposure participants decreased FEV1 (forced expiratory volume in 1 second)/FVC (forced vital capacity) ratio (56.49 +/- 23.88 in males and 56.29 +/- 28.23 in females) compared with general Thai population. Moreover, the reduction of FVC, FEV1, and peak expiratory flow rate (PEFR) values also showed in both male and female subjects. These results suggest that long-term smoke exposure induces obstructive lung abnormality. Moreover, itchy/watery nose, cough, phlegm, and chest pain also reported in these subjects. Conclusion: Wildfire smog could be induced respiratory pathway inflammation and easily collapsible respiratory airways.
The worst disaster of natural origin in recent Canadian history occurred in May 2016 in the northern Alberta community of Fort McMurray Wood Buffalo (FMWB). Among the 88,000 people abruptly evacuated amidst a raging wildfire were approximately 1850 pregnant or pre-conception women. Based on the Allostatic Load and Preterm Birth Conceptual Framework (Olson et al., 2015) [1], a simple, cost-effective expressive writing intervention following Pennebaker’s work (Pennebaker and Beall, 1986; Pennebaker et al., 2007) [2,3] was implemented in a primary study to help mitigate the negative effects of stress on a sample of these women and their unborn children. Journal writing served as an intervention in the primary study while the contents of the journal entries became the data analyzed in this qualitative study. This study utilized both inductive and deductive thematic analysis of journal entries completed by 54 women over four consecutive days (15 min/day). Deductive analysis followed a coding structure that was generated from two resilience scales. Themes that emerged during inductive analysis were also coded. The main themes that emerged described the women’s challenging experiences: fears for themselves and their offspring, fire-related and past trauma, and relationship changes. Resilience characteristics and practices also emerged from the writings and mirrored those found in the literature: (a) posttraumatic growth, (b) adaptability, (c) emotional/social connectedness, (d) composure, and (e) reasoning. This paper highlights the challenging experiences of pregnant women exposed to a disaster and the resilience they demonstrated in the face of the tragedy.
Wildfires have a significant adverse impact on air quality in the United States (US). To understand the potential health impacts of wildfire smoke, many epidemiology studies rely on concentrations of fine particulate matter (PM) as a smoke tracer. However, there are many gas-phase hazardous air pollutants (HAPs) identified by the Environmental Protection Agency (EPA) that are also present in wildfire smoke plumes. Using observations from the Western Wildfire Experiment for Cloud Chemistry, Aerosol Absorption, and Nitrogen (WE-CAN), a 2018 aircraft-based field campaign that measured HAPs and PM in western US wildfire smoke plumes, we identify the relationships between HAPs and associated health risks, PM, and smoke age. We find the ratios between acute, chronic noncancer, and chronic cancer HAPs health risk and PM in smoke decrease as a function of smoke age by up to 72% from fresh (<1 day of aging) to old (>3 days of aging) smoke. We show that acrolein, formaldehyde, benzene, and hydrogen cyanide are the dominant contributors to gas-phase HAPs risk in smoke plumes. Finally, we use ratios of HAPs to PM along with annual average smoke-specific PM to estimate current and potential future smoke HAPs risks.
Smoke from wildfires contains many air pollutants of concern and epidemiological studies have identified associations between exposure to wildfire smoke PM(2.5) and mortality and respiratory morbidity, and a possible association with cardiovascular morbidity. For this study, a retrospective analysis of air quality modelling was performed to quantify the exposure to wildfire-PM(2.5) across the Canadian population. The model included wildfire emissions from across North America for a 5-month period from May to September (i.e. wildfire season), between 2013 and 2015 and 2017-2018. Large variations in wildfire-PM(2.5) were noted year-to-year, geospatially, and within fire season. The model results were then used to estimate the national population health impacts attributable to wildfire-PM(2.5) and the associated economic valuation. The analysis estimated annual premature mortalities ranging from 54-240 premature mortalities attributable to short-term exposure and 570-2500 premature mortalities attributable to long-term exposure, as well as many non-fatal cardiorespiratory health outcomes. The economic valuation of the population health impacts was estimated per year at $410M-$1.8B for acute health impacts and $4.3B-$19B for chronic health impacts for the study period. The health impacts were greatest in the provinces with populations in close proximity to wildfire activity, though health impacts were also noted across many provinces indicating the long-range transport of wildfire-PM(2.5). Understanding the population health impacts of wildfire smoke is important as climate change is anticipated to increase wildfire activity in Canada and abroad.
Exposure to wildfire smoke causes adverse health outcomes, suggesting the importance of accurately estimating smoke concentrations. Geostatistical methods can combine observed, modeled, and satellite-derived concentrations to produce accurate estimates. Here, we estimate daily average ground-level PM2.5 concentrations at a 1 km resolution during the October 2017 California wildfires, using the Constant Air Quality Model Performance (CAMP) and Bayesian Maximum Entropy (BME) methods to bias-correct and fuse three concentration datasets: permanent and temporary monitoring stations, a chemical transport model (CTM), and satellite-derived estimates. Four BME space/time kriging and data fusion methods were evaluated. All BME methods produce more accurate estimates than the standalone CTM and satellite products. Adding temporary station data increases the R-2 by 36%. The data fusion of observations with the CAMP-corrected CTM and satellite-derived concentrations provides the best estimate (R-2 = 0.713) in fire-impacted regions, emphasizing the importance of combining multiple datasets. We estimate that approximately 65,000 people were exposed to very unhealthy air (daily average PM2.5 >= 150.5 mu g/m(3)).
Wildfires are an important ecological threat in Cote d’Ivoire with the northern half the most affected zone. This study assessed farmers’ perception of wildfire occurrence in the N’Zi River Watershed and compared this perception to remotely sensed fire data trends. To this end, 259 farmers were individually interviewed and 18 farmers were involved in three focus group discussions in three agro-ecological zones. A combination of descriptive statistics and regression analysis was used for data analysis. Results showed that 78.75% of farmers observed the upward trend in the annual wildfire activity identified by remote sensing data during 2001-2016. Most of the respondents identified hunting (65.83%), farm establishment (50%) and firebreaks establishment (46.67%) as main causes of wildfires. The perceived impacts of wildfires included immediate crop burning, crop growth delaying, mid-term post-fire crop destruction, destruction of material goods and loss of human life. Local population developed endogenous strategies to cope with this scourge. Amongst identified coping strategies, firebreaks establishment and maintenance around new clearings and farms and prohibition of fire-hunting during the dry season were highlighted. Therefore, policies and institutions that support local wildfires management initiatives must take advantage of the strong community knowledge and networks to strengthen their effectiveness and sustainability.
Wildfires, which are becoming more frequent and intense in many countries, pose serious threats to human health. To determine health impacts and provide public health messaging, satellite-based smoke plume data are sometimes used as a proxy for directly measured particulate matter levels. We collected data on particulate matter <2.5 mu m in diameter (PM2.5) concentration from 16 ground-level monitoring stations in the San Francisco Bay Area and smoke plume density from satellite imagery for the 2017-2018 California wildfire seasons. We tested for trends and calculated bootstrapped differences in the median PM2.5 concentrations by plume density category on a 0-3 scale. The median PM2.5 concentrations for categories 0, 1, 2, and 3 were 16, 22, 25, and 63 mu g/m(3), respectively, and there was much variability in PM2.5 concentrations within each category. A case study of the Camp Fire illustrates that in San Francisco, PM2.5 concentrations reached their maximum many days after the peak for plume density scores. We found that air pollution characterization by satellite imagery did not precisely align with ground-level PM2.5 concentrations. Public health practitioners should recognize the need to combine multiple sources of data regarding smoke patterns when developing public guidance to limit the health effects of wildfire smoke.
