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Meta-Analysis
. 2024 Jan 29:75:277-292.
doi: 10.1146/annurev-med-052422-020909. Epub 2023 Sep 22.

Health Effects of Wildfire Smoke Exposure

Carlos F Gould  1 , Sam Heft-Neal  2 , Mary Johnson  3 , Juan Aguilera  4 , Marshall Burke  1   2   5 , Kari Nadeau  3
Affiliations
Meta-Analysis

Health Effects of Wildfire Smoke Exposure

Carlos F Gould et al. Annu Rev Med. .

Abstract

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.

Keywords: air pollution; environmental health; epidemiology; public health.

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Figures

Figure 1.
Figure 1.
Meta-analysis of the associations between ambient wildfire-specific fine particulate matter and same-day health outcomes per 1 μg m–3. Pooled responses are derived from random effects meta-analysis and estimated via restricted maximum likelihood.
Figure 2.
Figure 2.
Differing response of daily zip code–level ED visit rates to wildfire PM2.5 concentrations according to modeling linear and nonlinear effects and lagged effects in California, 2006–2017. Curves measure the percentage change in ED visits for a given daily smoke PM2.5 concentration. Annotations indicate the total number of ED visits to public facilities attributable to wildfire smoke, with positives indicating excess ED visits and negatives indicating averted ED visits. Panels a–b show estimates under linear or nonlinear models; panels c–d show nonlinear estimates with and without lagged effects. Histograms in panels a and c indicate the distribution of zip code–smoke days on days with any wildfire smoke in that zip code. Abbreviations: ED, emergency department; PM, particulate matter; RTI, respiratory tract infection.
See this image and copyright information in PMC

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