Continent-based systematic review of the short-term health impacts of wildfire emissions

ABSTRACT

This review systematically gathers and provides an analysis of pollutants levels emitted from wildfire (WF) and their impact on short-term health effects of affected populations. The available literature was searched according to Population, Exposure, Comparator, Outcome, and Study design (PECOS) database defined by the World Health Organization (WHO) and a meta-analysis was conducted whenever possible. Data obtained through PECOS characterized information from the USA, Europe, Australia, and some Asian countries; South American countries were seldom characterized, and no data were available for Africa and Russia. Extremely high levels of pollutants, mostly of fine fraction of particulate matter (PM) and ozone, were associated with intense WF emissions in North America, Oceania, and Asia and reported to exceed several-fold the WHO guidelines. Adverse health outcomes include emergency department visits and hospital admissions for cardiorespiratory diseases as well as mortality. Despite the heterogeneity among exposure and health assessment methods, all-cause mortality, and specific-cause mortality were significantly associated with WF emissions in most of the reports. Globally, a significant association was found for all-cause respiratory outcomes including asthma, but mixed results were noted for cardiovascular-related effects. For the latter, estimates were only significant several days after WF emissions, suggesting a more delayed impact on the heart. Different research gaps are presented, including the need for the application of standardized protocols for assessment of both exposure and adverse health risks. Mitigation actions also need to be strengthened, including dedicated efforts to communicate with the affected populations, to engage them for adoption of protective behaviors and measures.

KEYWORDS:

• Climate changes
• forest fires
• general population
• air pollution
• particulate matter
• public health

Acknowledgments

The authors acknowledge the FCT support by projects UIDB/50006/2020, UIDP/50006/2020, LA/P/0008/2020, PCIF/SSO/0090/2019, and 2022.05381.PTDC through national funds. The authors thank to the CEEC Program Contract CEECIND/03666/2017 and the grant 2020.07394.BD supported by FCT and the European Union through Fundo Social Europeu.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10937404.2023.2236548

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Additional information

Funding

This investigation received financial support by the Fundação para a Ciência e a Tecnologia (FCT), Ministério da Ciência, Tecnologia e Ensino Superior, through national funds, under project BioFirEx: PCIF/SSO/0017/2018.