Critical Review of Health Impacts of Wildfire Smoke Exposure

Wildland fire, air pollution and cardiovascular health: is it time to focus on the microvasculature as a risk assessment tool?

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.

Social Vulnerability in US Communities Affected by Wildfire Smoke, 2011 to 2021

Objectives. To describe demographic and social characteristics of US communities exposed to wildfire smoke. Methods. Using satellite-collected data on wildfire smoke with the locations of population centers in the coterminous United States, we identified communities potentially exposed to light-, medium-, and heavy-density smoke plumes for each day from 2011 to 2021. We linked days of exposure to smoke in each category of smoke plume density with 2010 US Census data and community characteristics from the Centers for Disease Control and Prevention's Social Vulnerability Index to describe the co-occurrence of smoke exposure and social disadvantage. Results. During the 2011-to-2021 study period, increases in the number of days of heavy smoke were observed in communities representing 87.3% of the US population, with notably large increases in communities characterized by racial or ethnic minority status, limited English proficiency, lower educational attainment, and crowded housing conditions. Conclusions. From 2011 to 2021, wildfire smoke exposures in the United States increased. As smoke exposure becomes more frequent and intense, interventions that address communities with social disadvantages might maximize their public health impact. (Am J Public Health. 2023;113(7):759-767. https://doi.org/10.2105/AJPH.2023.307286).

Wildfires and Older Adults: A Scoping Review of Impacts, Risks, and Interventions

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.

Wildfire smoke knows no borders: Differential vulnerability to smoke effects on cardio-respiratory health in the San Diego-Tijuana region

Exposure to fine particles in wildfire smoke is deleterious for human health and can increase cases of cardio-respiratory illnesses and related hospitalizations. Neighborhood-level risk factors can increase susceptibility to environmental hazards, such as air pollution from smoke, and the same exposure can lead to different health effects across populations. While the San Diego-Tijuana border can be exposed to the same wildfire smoke event, socio-demographic differences may drive differential effects on population health. We used the October 2007 wildfires, one the most devastating wildfire events in Southern California that brought smoke to the entire region, as a natural experiment to understand the differential effect of wildfire smoke on both sides of the border. We applied synthetic control methods to evaluate the effects of wildfire smoke on cardio-respiratory hospitalizations in the Municipality of Tijuana and San Diego County separately. During the study period (October 11th- October 26th, 2007), 2009 hospital admissions for cardio-respiratory diseases occurred in San Diego County while 37 hospital admissions were reported in the Municipality of Tijuana. The number of cases in Tijuana was much lower than San Diego, and a precise effect of wildfire smoke was detected in San Diego but not in Tijuana. However, social drivers can increase susceptibility to environmental hazards; the poverty rate in Tijuana is more than three times that of San Diego. Socio-demographics are important in modulating the effects of wildfire smoke and can be potentially useful in developing a concerted regional effort to protect populations on both sides of the border from the adverse health effects of wildfire smoke.

Neuroinflammatory and Metabolomic Temporal Dynamics Following Wood Smoke Inhalation

Smoke from wildland fires has been shown to produce neuroinflammation in preclinical models, characterized by neural infiltrations of neutrophils and monocytes, as well as altered neurovascular endothelial phenotypes. To address the longevity of such outcomes, the present study examined the neuroinflammatory and metabolomic temporal dynamics after inhalation exposures from biomass-derived smoke. 2-month-old female C57BL/6J mice were exposed to wood smoke every other day for two weeks at an average exposure concentration of 0.5mg/m 3 . Subsequent serial euthanasia occurred at 1-, 3-, 7-, 14-, and 28-days post-exposure. Flow cytometry of right hemispheres revealed two endothelial populations of PECAM (CD31), high and medium expressors, with wood smoke inhalation causing an increased proportion of PECAM Hi . These populations of PECAM Hi and PECAM Med were associated with an anti-inflammatory and pro-inflammatory response, respectively, and their inflammatory profiles were largely resolved by the 28-day mark. However, activated microglial populations (CD11b + /CD45 low ) remained higher in wood smoke-exposed mice than controls at day 28. Infiltrating neutrophil populations decreased to levels below controls by day 28. However, the MHC-II expression of the peripheral immune infiltrate remained high, and the population of neutrophils retained an increased expression of CD45, Ly6C, and MHC-II. Utilizing an unbiased approach examining the metabolomic alterations, we observed notable hippocampal perturbations in neurotransmitter and signaling molecules like glutamate, quinolinic acid, and 5-α-dihydroprogesterone. Utilizing a targeted panel designed to explore the aging-associated NAD + metabolic pathway, wood smoke exposure drove fluctuations and compensations across the 28-day time course, ending with decreased hippocampal NAD + abundance at day 28. Summarily, these results indicate a highly dynamic neuroinflammatory environment, with potential resolution extending past 28 days, the implications of which may include long-term behavioral changes, systemic and neurological sequalae directly associated wtith wildfire smoke exposure.

Quantifying the premature mortality and economic loss from wildfire-induced PM2.5 in the contiguous U.S

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.

Effect modification of the association between fine particulate air pollution during a wildfire event and respiratory health by area-level measures of socio-economic status, race/ethnicity, and smoking prevalence

Fine particulate air pollution (PM2.5) is decreasing in most areas of the United States, except for areas most affected by wildfires, where increasing trends in PM2.5 can be attributed to wildfire smoke. The frequency and duration of large wildfires and the length of the wildfire season have all increased in recent decades, partially due to climate change, and wildfire risk is projected to increase further in many regions including the western United States. Increasingly, empirical evidence suggests differential health effects from air pollution by class and race; however, few studies have investigated such differential health impacts from air pollution during a wildfire event. We investigated differential risk of respiratory health impacts during the 2008 northern California wildfires by a comprehensive list of socio-economic status (SES), race/ethnicity, and smoking prevalence variables. Regardless of SES level across nine measures of SES, we found significant associations between PM2.5 and asthma hospitalizations and emergency department (ED) visits during these wildfires. Differential respiratory health risk was found by SES for ED visits for chronic obstructive pulmonary disease where the highest risks were in ZIP codes with the lowest SES levels. Findings for differential effects by race/ethnicity were less consistent across health outcomes. We found that ZIP codes with higher prevalence of smokers had greater risk of ED visits for asthma and pneumonia. Our study suggests that public health efforts to decrease exposures to high levels of air pollution during wildfires should focus on lower SES communities.

Temperature and socioeconomic vulnerability: associations with cardiac event-induced posttraumatic stress symptoms

Background

Posttraumatic stress symptoms (PTSS) are common after acute coronary syndrome (ACS) and predict increased morbidity and mortality. Climate change contributes to worse mental and cardiovascular health outcomes, thus, PTSS represent a potential mechanism linking climate change to adverse cardiovascular outcomes. Because people living in areas with lower socioeconomic status (SES) experience greater climate vulnerability, have worse cardiovascular health, and may be more susceptible to PTSS, any effect of temperature on PTSS could be amplified in this population.

Methods

Spatial regression models were estimated to test the association of temperature and temperature variability (within-day variability, directed change over time, and absolute change over time), census tract-level SES, and their interaction with PTSS 1 month post-hospital discharge in a longitudinal cohort study comprising 956 patients evaluated for ACS at an urban U.S. academic medical center between November 2013-May 2017. PTSS were self-reported in relation to the ACS event that brought the patient to the hospital. Census tract-level was computed as a composite score from the CDC Social Vulnerability Index, with higher values indicating lower SES.

Results

No temperature or temperature variability metrics were associated with PTSS. Lower census tract-level SES was associated with greater PTSS at 1 month. There was a marginally significant interaction of SES with ACS status, such that we only observed evidence of an association among those with ACS.

Conclusion

Temperature exposures were not associated with acute CVD-induced PTSS, which could be a result of a small sample size, mismatched timescale, or lack of a true effect. Conversely, lower census tract-level SES was associated with developing worse PTSS 1 month after evaluation for an ACS. This association appeared stronger in individuals with a true ACS. Early interventions to prevent PTSS could promote better mental and CVD outcomes in this at-risk population.

Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians

BACKGROUND

People with HIV (PWH) are disproportionately vulnerable to the impacts of wildfires, given the need for frequent access to healthcare systems, higher burden of comorbidities, higher food insecurity, mental and behavioral health challenges, and challenges of living with HIV in a rural area. In this study, we aim to better understand the pathways through which wildfires impact health outcomes among PWH.

METHODS

From October 2021 through February 2022, we conducted individual semi-structured qualitative interviews with PWH impacted by the Northern California wildfires and clinicians of PWH who were impacted by wildfires. The study aims were to explore the influence of wildfires on the health of PWH and to discuss measures at the individual, clinic, and system levels that helped to mitigate these impacts.

RESULTS

We interviewed 15 PWH and 7 clinicians. While some PWH felt that surviving the HIV epidemic added to their resilience against wildfires, many felt that the wildfires compounded the HIV-related traumas that they have experienced. Participants outlined five main routes by which wildfires negatively impacted their health: (1) access to healthcare (medications, clinics, clinic staff), (2) mental health (trauma; anxiety, depression, or stress; sleep disturbances; coping strategies), (3) physical health (cardiopulmonary, other co-morbidities), (4) social/economic impacts (housing, finances, community), and (5) nutrition and exercise. The recommendations for future wildfire preparedness were at the (1) individual-level (what to have during evacuation), (2) pharmacy-level (procedural, staffing), and (3) clinic- or county-level (funds and vouchers; case management; mental health services; emergency response planning; other services such as telehealth, home visits, home laboratory testing).

CONCLUSIONS

Based on our data and prior research, we devised a conceptual framework that acknowledges the impact of wildfires at the community-, household-, and individual-level with implications for physical and mental health outcomes among PWH. These findings and framework can help in developing future interventions, programs, and policies to mitigate the cumulative impacts of extreme weather events on the health of PWH, particularly among individuals living in rural areas. Further studies are needed to examine health system strengthening strategies, innovative methods to improve access to healthcare, and community resilience through disaster preparedness.

TRIAL REGISTRATION

N/A.

The COVID-19-wildfire smoke paradox: Reduced risk of all-cause mortality due to wildfire smoke in Colorado during the first year of the COVID-19 pandemic

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.

Environmental influences on childhood asthma: Climate change

Climate change is a key environmental factor for allergic respiratory diseases, especially in childhood. This review describes the influences of climate change on childhood asthma considering the factors acting directly, indirectly and with their amplifying interactions. Recent findings on the direct effects of temperature and weather changes, as well as the influences of climate change on air pollution, allergens, biocontaminants and their interplays, are discussed herein. The review also focusses on the impact of climate change on biodiversity loss and on migration status as a model to study environmental effects on childhood asthma onset and progression. Adaptation and mitigation strategies are urgently needed to prevent further respiratory diseases and human health damage in general, especially in younger and future generations.

Spatial proximity to wildfires as a proxy for measuring PM2.5: A novel method for estimating exposures in rural settings

Background

Climate change impacts humans and society both directly and indirectly. Alaska, for example, is warming twice as fast as the global mean, and researchers are starting to grapple with the varied and inter-connected ways in which climate change affects the people there. With the number of wildfires increasing in Alaska as a result of climate change, the number of asthma cases has increased, driven by exposure to small particulate matter. However, it is not clear how far away smoke from wildfires can affect health. In this study, we hope to establish a relationship between proximity to wildfires and asthma in locations where direct PM2.5 measurement is not easily accomplished.

Methods

In this study, we examined whether proximity to wildfire exposure is associated with regional counts of adults with asthma, calculated using Behavioral Risk Factor Surveillance System (BRFSS) survey data and US Census data. We assigned "hotspots" around population centers with a range of various distances to wildfires in Alaska.

Results

We found that wildfires are associated with asthma prevalence, and the association is strongest within 25 miles of fires.

Conclusions

This study highlights the fact that proximity to wildfires has potential as a simple proxy for actual measured wildfire smoke, which has important implications for wildfire management agencies and for policy makers who must address health issues associated with wildfires, especially in rural areas.

Toxicological Effects of Secondary Air Pollutants

Secondary air pollutants, originating from gaseous pollutants and primary particulate matter emitted by natural sources and human activities, undergo complex atmospheric chemical reactions and multiphase processes. Secondary gaseous pollutants represented by ozone and secondary particulate matter, including sulfates, nitrates, ammonium salts, and secondary organic aerosols, are formed in the atmosphere, affecting air quality and human health. This paper summarizes the formation pathways and mechanisms of important atmospheric secondary pollutants. Meanwhile, different secondary pollutants' toxicological effects and corresponding health risks are evaluated. Studies have shown that secondary pollutants are generally more toxic than primary ones. However, due to their diverse source and complex generation mechanism, the study of the toxicological effects of secondary pollutants is still in its early stages. Therefore, this paper first introduces the formation mechanism of secondary gaseous pollutants and focuses mainly on ozone's toxicological effects. In terms of particulate matter, secondary inorganic and organic particulate matters are summarized separately, then the contribution and toxicological effects of secondary components formed from primary carbonaceous aerosols are discussed. Finally, secondary pollutants generated in the indoor environment are briefly introduced. Overall, a comprehensive review of secondary air pollutants may shed light on the future toxicological and health effects research of secondary air pollutants.

Indirect Methods to Determine the Risk of Damage to the Health of Firefighters and Children Due to Exposure to Smoke Emission from Burning Wood/Coal in a Controlled Environment

People are constantly exposed to particulate matter and chemicals released during fires. However, there are still few studies on gas and particulate emissions related to exposure to burning firewood and charcoal during forest fires, making it difficult to understand the effects on the health of the population. The objective of this study was to quantify the metal(loid)s present in the smoke from wood and charcoal fires through the deposition of metals in beef topside and pork loin, considering the routes of skin exposure, inhalation, and ingestion, contributing to the understanding of metals in the increase of the risks of cancer and mortality associated with firefighting and children. The concentrations of metals [aluminum (Al), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), molybdenum (Mo), vanadium (V), zinc (Zn)] and metalloids arsenic (As) were determined by inductively coupled plasma-mass spectrometry (ICP OES) after microwave digestion. Moreover, we assessed the associated risk regarding the elemental intake of these elements through the smoke, using the hazard quotient (HQ), hazard index (HI), Total Hazard Index (HIt), and carcinogenic risk (CR). All samples had results for HQ and HIt < 1, indicating a non-potential health risk. However, the carcinogenic risks posed by As and Cr via the three exposure pathways (except for inhalation exposure to children and adults, and by Cr via ingestion and inhalation for children and adults) exceeded the standard threshold. In conclusion, continuous exposure of firefighters or children to smoke from fires containing high concentrations of heavy metals such as As and Cr can be harmful to health. The study used animal tissues; thus, new methods must be developed to quantify the concentration of heavy metals deposited in human tissue when humans are exposed to smoke from fires.

Emission factors for polycyclic aromatic hydrocarbons from laboratory biomass-burning and their chemical transformations during aging in an oxidation flow reactor

Atmospheric polycyclic aromatic hydrocarbons (PAHs) can be emitted from different combustion sources including domestic biomass burning, internal combustion engines, and biomass burning (BB) in wild, prescribed, and agricultural fires. With climate warming and consequent global increases in frequency and severity of wildfires, BB is a dominant source of PAHs emitted into the atmosphere. In this study, six globally and regionally important and representative fuels (Alaskan peat, Moscow peat, Pskov peat, eucalyptus, Malaysian peat, and Malaysian agricultural peat) were burned under controlled conditions in the combustion chamber facility at the Desert Research Institute (DRI, Reno, NV, USA). Gas- and particle-phase BB emissions were aged in an oxidation flow reactor (OFR) to mimic five to sevendays of atmospheric aging. To sample gas- and particle-phase BB emissions, fresh and OFR-aged biomass-burning aerosols were collected on Teflon-impregnated glass fiber filters (TIGF) in tandem with XAD resin media for organic carbon speciation. The objectives of this study were to i) quantify the emission factors for 113 PAHs emitted from the combustion of the six selected fuels, ii) characterize the distribution of PAH compounds between gas and particle phases for these fuels, iii) identify the changes in PAHs during OFR-aging, and iv) evaluate toxicity potential with characterized compounds. We found that combustion emissions of gas-phase PAHs were more abundant (>80 % by mass) than particle-phase PAHs, for emissions from all combusted fuels. The mass fraction of substituted napthalenes in Moscow peat and Malaysian peat emissions were ∼70 % & 84 %, respectively, whereas in Eucalyptus the same fraction was <50 %, which indicates that these substituted compounds can be used as tracers for peat emissions. Mass concentrations of gas- and particle-phase PAHs were reduced by ∼70 % after OFR oxidation. However, the understanding of the fate of PAHs during OFR oxidation requires further investigations. Our results also indicate that the PAH toxicity of BB samples would be underestimated by 10-100 times if only the BaPeq for the 16 US EPA priority PAHs in the particle phase are included.

Long-term impact of the 2014 Hazelwood coal mine fire on emergency department presentations in Australia

BACKGROUND

In 2014, wildfires ignited a coal mine in Australia, burning for 6 weeks, releasing large amounts of fine particulate matter ≤2.5 μm in diameter (PM_2.5). We investigated the association between individual PM_2.5 exposure and emergency department presentations (EDPs) within 5 years post-fire.

METHODS

Survey and exposure data for 2725 residents from an exposed and unexposed town were linked with ED administrative data from 2009 to 2019. The association between individual PM_2.5 and EDPs was assessed using recurrent survival analysis.

RESULTS

A 10 μg/m³ increase in PM_2.5 was associated with a 10% increase in respiratory EDPs (HR = 1.10; 95%CI:1.00-1.22) over 5 years post-fire. Increased risks of EDPs for ischaemic heart disease (HR = 1.39; 95%CI:1.12-1.73), atherothrombotic disease (HR = 1.27; 95%CI:1.08-1.50), and cardiovascular disease (HR = 1.10, 95%CI:0.99-1.22) were evident within 2.5 years.

CONCLUSION

PM_2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory conditions. An increased risk of CVD within 2.5 years post-fire subsided after this time.

Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires

Occupational exposure as a firefighter has recently been classified as a carcinogen to humans by International Agency for Research on Cancer (IARC). Biomonitoring has been increasingly used to characterize exposure of firefighting forces to contaminants. However, available data are dispersed and information on the most relevant and promising biomarkers in this context of firefighting is missing. This review presents a comprehensive summary and critical appraisal of existing biomarkers of exposure including volatile organic compounds such as polycyclic aromatic hydrocarbons, several other persistent other organic pollutants as well as heavy metals and metalloids detected in biological fluids of firefighters attending different fire scenarios. Urine was the most characterized matrix, followed by blood. Firefighters exhaled breath and saliva were poorly evaluated. Overall, biological levels of compounds were predominantly increased in firefighters after participation in firefighting activities. Biomonitoring studies combining different biomarkers of exposure and of effect are currently limited but exploratory findings are of high interest. However, biomonitoring still has some unresolved major limitations since reference or recommended values are not yet established for most biomarkers. In addition, half-lives values for most of the biomarkers have thus far not been defined, which significantly hampers the design of studies. These limitations need to be tackled urgently to improve risk assessment and support implementation of better more effective preventive strategies.

Wildfires and the Changing Landscape of Air Pollution-related Health Burden in California

Rationale: Wildfires are a growing source of pollution including particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5), but associated trends in health burden are not well characterized. Objectives: We investigated trends and disparities in PM2.5-related cardiorespiratory health burden (asthma, chronic obstructive pulmonary disease, and all-cause respiratory and cardiovascular emergency department [ED] visits and hospital admissions) for all days and wildfire smoke-affected days across California from 2008 to 2016. Methods: Using residential Zone Improvement Plan code and daily PM2.5 exposures, we estimated overall and subgroup-specific (age, gender, race and ethnicity) associations with cardiorespiratory outcomes. Health burden trends and disparities were evaluated on the basis of relative risk, attributable number, and attributable fraction by demographic and geographic factors and over time. Measurements and Main Results: PM2.5-attributed burden steadily decreased, whereas the fraction attributed to wildfire smoke varied by fire season intensity, constituting up to 15% of the annual PM2.5-burden. The highest relative risk and PM2.5-attributed burden (92 per 100,000 people) was observed for respiratory ED visits, accounting for 2.2% of the respiratory annual burden. Disparities in overall morbidity in the oldest age, Black, and "other" race groups were also reflected in PM2.5-attributed burden, whereas Asian populations had the highest risk rate in respiratory outcomes and thus the largest fraction of the total burden attributed to the exposure. In contrast, high wildfire PM2.5-attributed burden rates in rural, central, and northern California populations occurred because of differential exposure. Conclusions: In California, wildfires' impact on air quality offset the public health gains achieved through reductions in nonsmoke PM2.5. Disproportionate effects could be attributed to differences in subpopulation susceptibility, relative risk, and differential exposure.

Wildfire-related PM2.5 and health economic loss of mortality in Brazil

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.

Long-range transport of CO and aerosols from Siberian biomass burning over northern Japan during 18-20 May 2016

High CO concentration and dense aerosol layers at 1-6 km altitude in the free troposphere were observed over Rikubetsu, Japan, in ground-based Fourier transform spectrometer (FTS) and lidar measurements during 18-20 May 2016, days after intense wildfires east of Lake Baikal, Siberia. The column-averaged dry-air mole fraction of CO (XCO) was observed to be ∼150 ppb from 11:15 to 13:50 JST on 19 May, and peak aerosol optical depths (AODs) of 1.41 and 1.28 were observed at 15:40 JST 18 May and 11:20 JST 19 May, respectively. We used the HYSPLIT model to calculate five-day backward trajectories from Rikubetsu on May 18, 2016 at 2, 3 and 5 km altitude. The results show that the air parcels passed over the Siberian wildfires during 16-17 May. It was found that the high CO concentrations originated from forest fires were transported to the upper layers of Hokkaido. This will contribute to the understanding of the regional effects of air pollution in northern Japan due to air masses originating from forest fires. By combining these independent datasets such as AERONET aerosol optical thickness (AOT), MODIS fire data, and Infrared Atmospheric Sounding Interferometer (IASI) total CO columns, we confirmed that the lidar measurements of enhanced aerosol concentrations and FTS measurements of maximum XCO over Rikubetsu resulted from a persistent smoke plume transported from Siberian wildfires. Relatively large-scale forest fires have been frequently occurring in Siberia recently. However, the effects of CO and other gases released from them over northern Japan are not well known. We observed high concentrations of CO over the TCCON station in Rikubetsu, Japan, which we believe to be of forest fire origin. Therefore, we analyzed it as a case study to confirm its origin and impact on the upper atmosphere over northern Japan.

UAV-Based Wildland Fire Air Toxics Data Collection and Analysis

Smoke plumes emitted from wildland-urban interface (WUI) wildfires contain toxic chemical substances that are harmful to human health, mainly due to the burning of synthetic components. Accurate measurement of these air toxics is necessary for understanding their impacts on human health. However, air pollution is typically measured using ground-based sensors, manned airplanes, or satellites, which all provide low-resolution data. Unmanned Aerial Vehicles (UAVs) have the potential to provide high-resolution spatial and temporal data due to their ability to hover in specific locations and maneuver with precise trajectories in 3-D space. This study investigates the use of an octocopter UAV, equipped with a customized air quality sensor package and a volatile organic compound (VOC) air sampler, for the purposes of collecting and analyzing air toxics data from wildfire plumes. The UAV prototype developed has been successfully tested during several prescribed fires conducted by the California Department of Forestry and Fire Protection (CAL FIRE). Data from these experiments were analyzed with emphasis on the relationship between the air toxics measured and the different types of vegetation/fuel burnt. BTEX compounds were found to be more abundant for hardwood burning compared to grassland burning, as expected.

Long-term impacts of non-occupational wildfire exposure on human health: A systematic review

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.

The impact of the 2019/2020 Australian landscape fires on infant feeding and contaminants in breast milk in women with asthma

BACKGROUND

The 2019/2020 Australian landscape fires (bushfires) resulted in prolonged extreme air pollution; little is known about the effects on breastfeeding women and their infants. This study aimed to examine the impact of prolonged landscape fires on infant feeding methods and assess the concentration of polycyclic aromatic hydrocarbons (PAHs) and elements in breast milk samples.

METHODS

From May - December 2020, women with asthma, who were feeding their infants during the fires, were recruited from an existing cohort. Data on infant feeding and maternal concern during the fires were retrospectively collected. Breast milk samples were collected from a sample of women during the fire period and compared with samples collected outside of the fire period for levels of 16 PAHs (gas chromatography coupled with mass spectrometry), and 20 elements (inductively coupled plasma-mass spectrometry).

RESULTS

One-hundred-and-two women who were feeding infants completed the survey, and 77 provided 92 breast milk samples. Two women reported concern about the impact of fire events on their infant feeding method, while four reported the events influenced their decision. PAHs were detected in 34% of samples collected during, versus no samples collected outside, the fire period (cross-sectional analysis); specifically, fluoranthene (median concentration 0.015 mg/kg) and pyrene (median concentration 0.008 mg/kg) were detected. Women whose samples contained fluoranthene and pyrene were exposed to higher levels of fire-related fine particulate matter and more fire days, versus women whose samples had no detectable fluoranthene and pyrene. Calcium, potassium, magnesium, sodium, sulphur, and copper were detected in all samples. No samples contained chromium, lead, nickel, barium, or aluminium. No statistically significant difference was observed in the concentration of elements between samples collected during the fire period versus outside the fire period.

CONCLUSIONS

Few women had concerns about the impact of fire events on infant feeding. Detection of fluoranthene and pyrene in breast milk samples was more likely during the 2019/2020 Australian fire period; however, levels detected were much lower than levels expected to be related to adverse health outcomes.

Evaluation of Model-Based PM2.5 Estimates for Exposure Assessment during Wildfire Smoke Episodes in the Western U.S

Investigating the health impacts of wildfire smoke requires data on people's exposure to fine particulate matter (PM2.5) across space and time. In recent years, it has become common to use machine learning models to fill gaps in monitoring data. However, it remains unclear how well these models are able to capture spikes in PM2.5 during and across wildfire events. Here, we evaluate the accuracy of two sets of high-coverage and high-resolution machine learning-derived PM2.5 data sets created by Di et al. and Reid et al. In general, the Reid estimates are more accurate than the Di estimates when compared to independent validation data from mobile smoke monitors deployed by the US Forest Service. However, both models tend to severely under-predict PM2.5 on high-pollution days. Our findings complement other recent studies calling for increased air pollution monitoring in the western US and support the inclusion of wildfire-specific monitoring observations and predictor variables in model-based estimates of PM2.5. Lastly, we call for more rigorous error quantification of machine-learning derived exposure data sets, with special attention to extreme events.

Wildland-urban interface fire ashes as a major source of incidental nanomaterials

Although metal and metalloid concentrations in wildfire ashes have been documented, the nature and concentrations of incidental nanomaterials (INMs) in wildland-urban interface (WUI) fire ashes have received considerably less attention. In this study, the total metal and metalloid concentrations of 57 vegetation, structural, and vehicle ashes and underlying soils collected at the WUI following the 2020 fire season in northern California - North Complex Fire and LNU Lightning Complex Fire - were determined using inductively coupled plasma-time of flight-mass spectrometry after microwave-assisted acid digestion. The concentrations of Ti, Zn, Cu, Ni, Pb, Sn, Sb, Co, Bi, Cr, Ba, As, Rb, and W are generally higher in structural/vehicle-derived ashes than in vegetation-derived ashes and soils. The concentrations of Ca, Sr, Rb, and Ag increased with increased combustion completeness (e.g., black ash < gray ash < white ash), whereas those of C, N, Zn, Pb, and In decreased with increased combustion completeness. The concentration of anthropogenic Ti - determined by mass balance calculations and shifts in Ti/Nb above the natural background ratios - was highest in vehicle ash (median: 30.8 g kg^-1, range: 4.5-41.0 g kg^-1) followed by structural ash (median: 5.5 g kg^-1, range: of 0-77.4 g kg^-1). Various types of carbonaceous INM (e.g., amorphous carbon, turbostratic-like carbon, and carbon associated with zinc oxides) and metal-bearing INMs (e.g., Ti, Cu, Fe, Zn, Mn, Pb, and Cr) with sizes between few nanometers to few hundreds of nanometers were evidenced in ashes using transmission electron microscopy, including energy dispersive X-ray spectroscopy. Overall, this study demonstrates the abundance of a variety of metals and metalloids in the form of INMs in WUI fire ashes. This study also highlights the need for further research into the formation, transformation, reactivity, fate, and effects of INMs during and following fires at the WUI.

Rethinking the focus on forest fires in federal wildland fire management: Landscape patterns and trends of non-forest and forest burned area

For most of the 20th century and beyond, national wildland fire policies concerning fire suppression and fuels management have primarily focused on forested lands. Using summary statistics and landscape metrics, wildfire spatial patterns and trends for non-forest and forest burned area over the past two decades were examined across the U.S, and federal agency jurisdictions. This study found that wildfires burned more area of non-forest lands than forest lands at the scale of the conterminous and western U.S. and the Department of Interior (DOI). In an agency comparison, 74% of DOI burned area occurred on non-forest lands and 78% of U.S. Forest Service burned area occurred on forested lands. Landscape metrics revealed key differences between forest and non-forest fire patterns and trends in total burned area, burned patch size, distribution, and aggregation over time across the western U.S. Opposite fire patterns emerged between non-forest and forest burns when analyzed at the scale of federal agency jurisdictions. In addition, a fire regime departure analysis comparing current large fire probability with historic fire trends identified certain vegetation types and locations experiencing more fire than historically. These patterns were especially pronounced for cold desert shrublands, such as sagebrush where increases in annual area burned, and fire frequency, size, and juxtaposition have resulted in substantial losses over a twenty-year period. The emerging non-forest fire patterns are primarily due to the rapid expansion of non-native invasive grasses that increase fuel connectivity and fire spread. These invasions promote uncharacteristic frequent fire and loss of native ecosystems at large-scales, accelerating the need to place greater focus on managing invasive species in wildland fire management. Results can be used to inform wildfire management and policy aimed at reducing uncharacteristic wildfire processes and patterns for both non-forest and forest ecosystems as well as identify differing management strategies needed to address the unique wildfire issues each federal agency faces.

Housing: Fragile buffer to wildfire smoke in pregnancy

Living near or migrating to areas at high risk for wildfires may result in health consequences and increased disparities for pregnant people and their children.

Tuberculosis Diagnoses Following Wildfire Smoke Exposure in California

Rationale: 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/m³ (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.

Exercise in bushfire smoke for high performance athletes: A Position Statement from the Australian Institute of SportEndorsed by Australasian College of Sport and Exercise Physicians (ACSEP) and Sport Medicine Australia (SMA)

OBJECTIVES

The frequency of bushfires in Australia is increasing and it is expected bushfire smoke will become a more prevalent phenomenon impacting air quality. The objective of this position statement is to provide guidance to the sport sector regarding exercise in air affected by bushfire smoke.

DESIGN

This is position statement from the Australian Institute of Sport, based on a narrative review of the literature regarding bushfire smoke and its effects on health and exercise performance.

METHODS

A narrative review of scientific publications regarding the effects of bushfire smoke on health and exercise performance.

RESULTS

Bushfire smoke has negative impacts on health and performance. Athletes exercising at high intensity over a prolonged duration will increase their exposure to air pollutants. Athletes with a history of elevated airway responsiveness are likely to be at increased risk of an adverse response to bushfire smoke exposure.

CONCLUSIONS

Athletes, coaches, support staff and sport organisations should monitor air quality (PM2.5 concentration) and make appropriate adjustments to training duration and intensity.

Race and Street-Level Firework Legalization as Primary Determinants of July 4th Air Pollution across Southern California

Air pollution is a major public health threat that is associated with asthma, cardiovascular disease, respiratory disease and all-cause mortality. Among the most important acute air pollution events occurring each year are celebrations involving fireworks, such as the 4th of July holiday in the United States. In this community-engaged study, academic partners and residents collaborated to collect indoor and outdoor PM2.5 concentration measurements in the disadvantaged city of Santa Ana, California, using low-cost AtmoTube sensor devices before, during and after the July 4th firework celebration, while also examining July 4th data extracted from the PurpleAir sensor network across over a hundred other cities in southern California. Average outdoor PM2.5 concentrations on July 4th were found to be three-to-five times higher than baseline, with hourly concentrations exceeding 160 μg/m3. Outdoor averages were roughly 30% to 100% higher than indoor levels. The most polluted cities exhibited 15-times higher PM2.5 levels compared with the least contaminated cities and were often those where household-level fireworks were legal for sale and use. Race/ethnicity was found to be the leading predictor of July 4th-related air pollution across three counties in southern California, with greater PM2.5 being associated with higher proportions of Hispanic residents and lower proportions of White residents. The findings from this study underscore the importance of environmental justice as it relates to firework-related air pollution exposure, and the critical role city- and county-level firework policies play in determining exposure.

The impact of fire-specific PM2.5 calibration on health effect analyses

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) R² of 0.79 compared to CMAQ-based PM_2.5 estimates with R² 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.

Environmental justice analysis of wildfire-related PM2.5 exposure using low-cost sensors in California

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.

Modeling Human Lung Cells Exposure to Wildfire Uncovers Aberrant lncRNAs Signature

Emissions generated by wildfires are a growing threat to human health and are characterized by a unique chemical composition that is tightly dependent on geographic factors such as fuel type. Long noncoding RNAs (lncRNAs) are a class of RNA molecules proven to be critical to many biological processes, and their condition-specific expression patterns are emerging as prominent prognostic and diagnostic biomarkers for human disease. We utilized a new air-liquid interface (ALI) direct exposure system that we designed and validated in house to expose immortalized human tracheobronchial epithelial cells (AALE) to two unique wildfire smokes representative of geographic regions (Sierra Forest and Great Basin). We conducted an RNAseq analysis on the exposed cell cultures and proved through both principal component and differential expression analysis that each smoke has a unique effect on the LncRNA expression profiles of the exposed cells when compared to the control samples. Our study proves that there is a link between the geographic origin of wildfire smoke and the resulting LncRNA expression profile in exposed lung cells and also serves as a proof of concept for the in-house designed ALI exposure system. Our study serves as an introduction to the scientific community of how unique expression patterns of LncRNAs in patients with wildfire smoke-related disease can be utilized as prognostic and diagnostic tools, as the current roles of LncRNA expression profiles in wildfire smoke-related disease, other than this study, are completely uncharted.

Reaction of HOCl with Wood Smoke Aerosol: Impacts on Indoor Air Quality and Outdoor Reactive Chlorine

High loadings of biomass burning (BB) aerosol particles from wildfire or residential heating sources can be present in both outdoor and indoor environments, where they deposit onto surfaces such as walls and furniture. These pollutants can interact with oxidants in both the aerosol and deposited forms. Hypochlorous acid (HOCl), a strong oxidant emitted during cleaning with chlorine-cleaning agents such as bleach, can attain mixing ratios of hundreds of ppbv indoors; moreover, lower mixing ratios are naturally present outdoors. Here, we report the heterogeneous reactivity of HOCl with wood smoke aerosol particles. After exposure to gas-phase HOCl, the particle chlorine content increased reaching chlorine-to-organic mass ratios of 0.07 with the chlorine covalently bound as organochlorine species, many of which are aromatic. Investigating individual potential BB components, we observed that unsaturated species such as coniferaldehyde and furfural react efficiently with HOCl. These observations indicate that organochlorine pollutants will form indoors when bleach cleaning a wildfire impacted space. The chlorine component of particles internally mixed with BB material and chloride initially increased, upon HOCl exposure, indicating that active chlorine recycling in the outdoor environment will be suppressed in the presence of BB emissions.

Physicochemical and toxicological properties of wood smoke particulate matter as a function of wood species and combustion condition

Wood burning is a major source of ambient particulate matter (PM) and has been epidemiologically linked to adverse pulmonary health effects, however the impact of fuel and burning conditions on PM properties has not been investigated systematically. Here, we employed our recently developed integrated methodology to characterize the physicochemical and biological properties of emitted PM as a function of three common hardwoods (oak, cherry, mesquite) and three representative combustion conditions (flaming, smoldering, incomplete). Differences in PM and off-gas emissions (aerosol number/mass concentrations; carbon monoxide; volatile organic compounds) as well as inorganic elemental composition and organic carbon functional content of PM0.1 were noted between wood types and combustion conditions, although the combustion scenario exerted a stronger influence on the emission profile. More importantly, flaming combustion PM0.1 from all hardwoods significantly stimulated the promoter activity of Sterile Alpha Motif (SAM) pointed domain containing ETS (E-twenty-six) Transcription Factor (SPDEF) in human embryonic kidney 293 (HEK-293 T) cells, a biomarker for mucin gene expression associated with mucus production in pulmonary diseases. However, no bioactivity was observed for smoldering and incomplete combustion, which was likely driven by differences in the organic composition of PM0.1. Detailed chemical speciation of organic components of wood smoke is warranted to identify the individual compounds that drive specific biological responses.

Evaluation of the efficiency of a Venturi scrubber in particulate matter collection smaller than 2.5 µm emitted by biomass burning

Energy demand has increased worldwide, and biomass burning is one of the solutions most used by industries, especially in countries that have a great potential in agriculture, such as Brazil. However, these energy sources generate pollutants, consisting of particulate matter (PM) with a complex chemical composition, such as sugarcane bagasse (SB) burning. Controlling these emissions is necessary; therefore, the aim was to evaluate PM collection using a rectangular Venturi scrubber (RVS), and its effects on the composition of the PM emitted. Considering the appropriate use of biomass as an industrial fuel and the emerging need for a technique capable of efficiently removing pollutants from biomass burning, this study shows the control of emissions as an innovation in a situation such as the industrial one with the use of a Venturi scrubber in fine particle collection, in addition to using portable and representative isokinetic sampling equipment of these particles. The pilot-scale simulation of the biomass burning process, the representative sampling of fine particles and obtaining parameters to control pollutant emissions for a Venturi scrubber, meets the current situation of concern about air quality. The average collection efficiency values were 96.6% for PM_{> 2.5}, 85.5% for PM_1.0-2.5, and 66.9% for PM_{< 1.0}. The ionic analysis for PM_{< 1.0} filters showed potassium, chloride, nitrate, and nitrite at concentrations ranging from 20.12 to 36.5 μg/m³. As the ethanol and sugar plants will continue to generate electricity with sugarcane bagasse burning, emission control technologies and cost-effective and efficient portable samplers are needed to monitor particulate materials and improve current gas cleaning equipment projects.

Association between temperature variability and global meningitis incidence

BACKGROUND

Meningitis can cause devastating epidemics and is susceptible to climate change. It is unclear how temperature variability, an indicator of climate change, is associated with meningitis incidence.

METHODS

We used global meningitis incidence data along with meteorological and demographic data over 1990-2019 to identify the association between temperature variability and meningitis. We also employed future (2020-2100) climate data to predict meningitis incidence under different emission levels (SSPs: Shared Socioeconomic Pathways).

RESULTS

We found that the mean temperature variability increased by almost 3 folds in the past 30 years. The largest changes occurred in Australasia, Tropical Latin America, and Central Sub-Saharan Africa. With a logarithmic unit increase in temperature variability, the overall global meningitis risk increases by 4.8 %. Australasia, Central Sub-Saharan Africa, and High-income North America are the most at-risk regions. Higher statistical differences were identified in males, children, and the elderly population. Compared to high-emission (SSP585) scenario, we predicted a median reduction of 85.8 % in meningitis incidence globally under the low-emission (SSP126) climate change scenario by 2100.

CONCLUSION

Our study provides evidence for temperature variability being in association with meningitis incidence, which suggests that global actions are urgently needed to address climate change and to prevent meningitis occurrence.

Assessment of indoor air quality and their inter-association in hospitals of northern India-a cross-sectional study

This study was commenced to evaluate the indoor and outdoor air quality concentrations of PM_2.5, sub-micron particles (PM_>2.5, PM_1.0-2.5, PM_{0.50 -1.0}, PM_0.25-0.50, and PM_<0.25), heavy metals, and microbial contaminants along with their identification in three different hospitals of Lucknow City. The study was conducted from February 2022 to April 2022 in hospitals situated in the commercial, residential, and industrial belts of the city. The indoor concentration trend of particulate matter as observed during the study suggested that most of the highest concentrations belonged to the hospital situated in an industrial area. The highest obtained indoor and outdoor concentrations for PM_1.0-2.5, PM_0.50-1.0, PM_0.25-0.50, and PM_<0.25 are 40.44 µg/m³, 56.08 µg/m³, 67.20 µg/m³, 74.50 µg/m³, 61.9 µg/m³, 79.3 µg/m³, 82.0 µg/m³, and 93.9 µg/m³, respectively, which belonged to hospital C situated in the industrial belt. However, for PM_>2.5, the highest indoor concentration obtained belonged to hospital B, i.e., 30.7 µg/m³, which is situated in the residential belt of the city. Regarding PM_2.5, the highest indoor and outdoor concentrations obtained are 149.41 µg/m³ and 227.45 µg/m³, which were recorded at hospital A and hospital C, respectively. The present study also observed that a high bacterial load of 1389.21 CFU/m³ is recorded in hospital B, and the fungi load was highest in hospital C with 786.34 CFU/m³. Henceforth, the present study offers thorough information on the various air pollutants in a crucial indoor setting, which will further aid the researchers in the field to identify and mitigate the same more precisely.

Assessing community response to wildfire smoke: A multimethod study using social media

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 (PM2.5 ) 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. PM2.5 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.

A novel ensemble-based statistical approach to estimate daily wildfire-specific PM2.5 in California (2006-2020)

Though fine particulate matter (PM2.5) has decreased in the United States (U.S.) in the past two decades, the increasing frequency, duration, and severity of wildfires significantly (though episodically) impairs air quality in wildfire-prone regions and beyond. Increasing PM2.5 concentrations derived from wildfire smoke and associated impacts on public health require dedicated epidemiological studies. Main sources of PM2.5 data are provided by government-operated monitors sparsely located across U.S., leaving several regions and potentially vulnerable populations unmonitored. Current approaches to estimate PM2.5 concentrations in unmonitored areas often rely on big data, such as satellite-derived aerosol properties and meteorological variables, apply computationally-intensive deterministic modeling, and do not distinguish wildfire-specific PM2.5 from other sources of emissions such as traffic and industrial sources. Furthermore, modelling wildfire-specific PM2.5 presents a challenge since measurements of the smoke contribution to PM2.5 pollution are not available. Here, we aim to use statistical methods to isolate wildfire-specific PM2.5 from other sources of emissions. Our study presents an ensemble model that optimally combines multiple machine learning algorithms (including gradient boosting machine, random forest and deep learning), and a large set of explanatory variables to, first, estimate daily PM2.5 concentrations at the ZIP code level, a relevant spatiotemporal resolution for epidemiological studies. Subsequently, we propose a novel implementation of an imputation approach to estimate the wildfire-specific PM2.5 concentrations that could be applied geographical regions in the US or worldwide. Our ensemble model achieved comparable results to previous machine learning studies for PM2.5 prediction while avoiding processing larger, computationally intensive datasets. Our study is the first to apply a suite of statistical models using readily available datasets to provide daily wildfire-specific PM2.5 at a fine spatial scale for a 15-year period, thus providing a relevant spatiotemporal resolution and timely contribution for epidemiological studies.

Wildfire smoke exposure and emergency department visits for headache: A case-crossover analysis in California, 2006-2020

OBJECTIVE

To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM2.5 ) and wildfire-specific PM2.5 with emergency department (ED) visits for headache.

BACKGROUND

Studies have reported associations between PM2.5 exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM2.5 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 PM2.5 to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM2.5 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 PM2.5 (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95-1.44 per 10 μg/m3 increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM2.5 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 PM2.5 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 PM2.5 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.

Assessing Perception of Wildfires and Related Impacts among Adult Residents of Southern California

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.

Mechanisms of Lung Damage and Development of COPD Due to Household Biomass-Smoke Exposure: Inflammation, Oxidative Stress, MicroRNAs, and Gene Polymorphisms

Chronic exposure to indoor biomass smoke from the combustion of solid organic fuels is a major cause of disease burden worldwide. Almost 3 billion people use solid fuels such as wood, charcoal, and crop residues for indoor cooking and heating, accounting for approximately 50% of all households and 90% of rural households globally. Biomass smoke contains many hazardous pollutants, resulting in household air pollution (HAP) exposure that often exceeds international standards. Long-term biomass-smoke exposure is associated with Chronic Obstructive Pulmonary Disease (COPD) in adults, a leading cause of morbidity and mortality worldwide, chronic bronchitis, and other lung conditions. Biomass smoke-associated COPD differs from the best-known cigarette smoke-induced COPD in several aspects, such as a slower decline in lung function, greater airway involvement, and less emphysema, which suggests a different phenotype and pathophysiology. Despite the high burden of biomass-associated COPD, the molecular, genetic, and epigenetic mechanisms underlying its pathogenesis are poorly understood. This review describes the pathogenic mechanisms potentially involved in lung damage, the development of COPD associated with wood-derived smoke exposure, and the influence of genetic and epigenetic factors on the development of this disease.

The choice of message and messenger to drive behavior change that averts the health impacts of wildfires: an online randomized controlled experiment

BACKGROUND

To reduce the negative health effects from wildfire smoke exposure, effective risk and health communication strategies are vital. We estimated the behavioral effects from changes in message framing and messenger in public health messages about wildfire smoke on Facebook.

METHODS

During September and October 2021, we conducted a preregistered online randomized controlled experiment in Facebook. Adult Facebook users (n = 1,838,100), living in nine wildfire-prone Western U.S. states, were randomly assigned to see one of two ad versions (narrative frame vs. informational frame) from one of two messengers (government vs. academic). We estimated the effects of narrative framing, the messenger, and their interactions on ad click-through rates, a measure of recipient information-seeking behavior.

RESULTS

Narrative frame increased click-through rates by 25.3% (95% CI = 22.2, 28.4%), with larger estimated effects among males, recipients in areas with less frequent exposure to heavy wildfire smoke, and in areas where predominant political party affiliation of registered voters was Republican (although not statistically different from predominantly-Democrat areas). The estimated effect from an academic messenger compared to a government messenger was small and statistically nonsignificant (2.2%; 95% CI = - 0.3, 4.7%). The estimated interaction effect between the narrative framing and the academic messenger was also small and statistically nonsignificant (3.9%; 95% CI = - 1.1, 9.1%).

CONCLUSIONS

Traditional public service announcements rely heavily on communicating facts (informational framing). Shifting from a fact-focused, informational framing to a story-focused, narrative framing could lead to more effective health communication in areas at risk of wildfires and in public health contexts more broadly.

TRIAL REGISTRATION

Date registered: August 19, 2021; Registration DOI: https://doi.org/10.17605/OSF.IO/JMWUF.

The impact of prolonged landscape fire smoke exposure on women with asthma in Australia

BACKGROUND

Little is known about the physical and mental health impact of exposure to landscape fire smoke in women with asthma. This study examined the health impacts and information-seeking behaviours of women with asthma exposed to the 2019/2020 Australian fires, including women who were pregnant.

METHODS

Women with asthma were recruited from the Breathing for Life Trial in Australia. Following the landscape fire exposure period, self-reported data were collected regarding symptoms (respiratory and non-respiratory), asthma exacerbations, wellbeing, quality of life, information seeking, and landscape fire smoke exposure mitigation strategies. Participants' primary residential location and fixed site monitoring was used to geolocate and estimate exposure to landscape fire-related fine Particulate Matter (PM_2.5).

RESULTS

The survey was completed by 81 pregnant, 70 breastfeeding and 232 non-pregnant and non-breastfeeding women with asthma. Participants had a median daily average of 17 μg/m³ PM_2.5 and 105 μg/m³ peak PM_2.5 exposure over the fire period (October 2019 to February 2020). Over 80% of participants reported non-respiratory and respiratory symptoms during the fire period and 41% reported persistent symptoms. Over 82% reported asthma symptoms and exacerbations of asthma during the fire period. Half the participants sought advice from a health professional for their symptoms. Most (97%) kept windows/doors shut when inside and 94% stayed indoors to minimise exposure to landscape fire smoke. Over two in five (43%) participants reported that their capacity to participate in usual activities was reduced due to prolonged smoke exposure during the fire period. Participants reported greater anxiety during the fire period than after the fire period (mean (SD) = 53(13) versus 39 (13); p < 0.001). Two in five (38%) pregnant participants reported having concerns about the effect of fire events on their pregnancy.

CONCLUSION

Prolonged landscape fire smoke exposure during the 2019/2020 Australian fire period had a significant impact on the health and wellbeing of women with asthma, including pregnant women with asthma. This was despite most women taking actions to minimise exposure to landscape fire smoke. Effective and consistent public health messaging is needed during landscape fire events to guard the health of women with asthma.

The mental health and well-being effects of wildfire smoke: a scoping review

BACKGROUND

Smoke from wildfires is a growing public health risk due to the enormous amount of smoke-related pollution that is produced and can travel thousands of kilometers from its source. While many studies have documented the physical health harms of wildfire smoke, less is known about the effects on mental health and well-being. Understanding the effects of wildfire smoke on mental health and well-being is crucial as the world enters a time in which wildfire smoke events become more frequent and severe. We conducted a scoping review of the existing information on wildfire smoke's impact on mental health and well-being and developed a model for understanding the pathways in which wildfire smoke may contribute to mental health distress.

METHODS

We conducted searches using PubMed, Medline, Embase, Google, Scopus, and ProQuest for 1990-2022. These searches yielded 200 articles. Sixteen publications met inclusion criteria following screening and eligibility assessment. Three more publications from the bibliographies of these articles were included for a total of 19 publications.

RESULTS

Our review suggests that exposure to wildfire smoke may have mental health impacts, particularly in episodes of chronic and persistent smoke events, but the evidence is inconsistent and limited. Qualitative studies disclose a wider range of impacts across multiple mental health and well-being domains. The potential pathways connecting wildfire smoke with mental health and well-being operate at multiple interacting levels including individual, social and community networks, living and working conditions, and ecological levels.

CONCLUSIONS

Priorities for future research include: 1) applying more rigorous methods; 2) differentiating between mental illness and emotional well-being; 3) studying chronic, persistent or repeated smoke events; 4) identifying the contextual factors that set the stage for mental health and well-being effects, and 5) identifying the causal processes that link wildfire smoke to mental health and well-being effects. The pathways model can serve as a basis for further research and knowledge synthesis on this topic. Also, it helps public health, community mental health, and emergency management practitioners mitigate the mental health and well-being harms of wildfire smoke.

Climate change and cardiovascular disease: implications for global health

Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth's weather and air conditions owing to anthropogenic activity. Climate change has resulted not only in extreme temperatures, but also in an increase in the frequency of droughts, wildfires, dust storms, coastal flooding, storm surges and hurricanes, as well as multiple compound and cascading events. The interactions between climate change and health outcomes are diverse and complex and include several exposure pathways that might promote the development of non-communicable diseases such as cardiovascular disease. A collaborative approach is needed to solve this climate crisis, whereby medical professionals, scientific researchers, public health officials and policymakers should work together to mitigate and limit the consequences of global warming. In this Review, we aim to provide an overview of the consequences of climate change on cardiovascular health, which result from direct exposure pathways, such as shifts in ambient temperature, air pollution, forest fires, desert (dust and sand) storms and extreme weather events. We also describe the populations that are most susceptible to the health effects caused by climate change and propose potential mitigation strategies, with an emphasis on collaboration at the scientific, governmental and policy levels.

The Canadian Optimized Statistical Smoke Exposure Model (CanOSSEM): A machine learning approach to estimate national daily fine particulate matter (PM2.5) exposure

Exposure to biomass smoke has been associated with a wide range of acute and chronic health outcomes. Over the past decades, the frequency and intensity of wildfires has increased in many areas, resulting in longer smoke episodes with higher concentrations of fine particulate matter (PM_2.5). There are also many communities where seasonal open burning and residential wood heating have short- and long-term impacts on ambient air quality. Understanding the acute and chronic health effects of biomass smoke exposure requires reliable estimates of PM_2.5 concentrations during the wildfire season and throughout the year, particularly in areas without regulatory air quality monitoring stations. We have developed a machine learning approach to estimate PM_2.5 across all populated regions of Canada from 2010 to 2019. The random forest machine learning model uses potential predictor variables integrated from multiple data sources and estimates daily mean (24-hour) PM_2.5 concentrations at a 5 km × 5 km spatial resolution. The training and prediction datasets were generated using observations from National Air Pollution Surveillance (NAPS) network. The Root Mean Squared Error (RMSE) between predicted and observed PM_2.5 concentrations was 2.96 μg/m³ for the entire prediction set, and more than 96 % of the predictions were within 5 μg/m³ of the NAPS PM_2.5 measurements. The model was evaluated using 10-fold, leave one-region-out, and leave-one-year-out cross-validations. Overall, CanOSSEM performed well but performance was sensitive to removal of large wildfire events such as the Fort McMurray interface fire in May 2016 or the extreme 2017 and 2018 wildfire seasons in British Columbia. Exposure estimates from CanOSSEM will be useful for epidemiologic studies on the acute and chronic health effects associated with PM_2.5 exposure, especially for populations affected by biomass smoke where routine air quality measurements are not available.

Assessing Vertical Allocation of Wildfire Smoke Emissions Using Observational Constraints From Airborne Lidar in the Western U.S

Wildfire emissions are a key contributor of carbonaceous aerosols and trace gases to the atmosphere. Induced by buoyant lifting, smoke plumes can be injected into the free troposphere and lower stratosphere, which by consequence significantly affects the magnitude and distance of their influences on air quality and radiation budget. However, the vertical allocation of emissions when smoke escapes the planetary boundary layer (PBL) and the mechanism modulating it remain unclear. We present an inverse modeling framework to estimate the wildfire emissions, with their temporal and vertical evolution being constrained by assimilating aerosol extinction profiles observed from the airborne Differential Absorption Lidar-High Spectral Resolution Lidar during the Fire Influence on Regional to Global Environments and Air Quality field campaign. Three fire events in the western U.S., which exhibit free-tropospheric injections are examined. The constrained smoke emissions indicate considerably larger fractions of smoke injected above the PBL (f _>PBL, 80%-94%) versus the column total, compared to those estimated by the WRF-Chem model using the default plume rise option (12%-52%). The updated emission profiles yield improvements for the simulated vertical structures of the downwind transported smoke, but limited refinement of regional smoke aerosol optical depth distributions due to the spatiotemporal coverage of flight observations. These results highlight the significance of improving vertical allocation of fire emissions on advancing the modeling and forecasting of the environmental impacts of smoke.