Smoke Sense Initiative Leverages Citizen Science to Address the Growing Wildfire-Related Public Health Problem

Impacts of wildfire-season air quality on park and playground visitation in the Northwest United States

A significant cost of wildfires is the exposure of local and regional populations to air pollution from smoke, which can travel hundreds of miles from the source fire and is associated with significant negative health consequences. Wildfires are increasing in frequency and intensity in the United States, driven by historic fire management approaches and global climate change. These influences will take many decades or longer to reverse, so the main opportunities for mitigating health effects involve minimizing human exposure through changes in behavior or infrastructure. One key recommendation for reducing pollution exposures during wildfire smoke events is to limit time and physical activity outdoors, but there is limited evidence on the extent to which people make this change. We estimate how use of parks and playgrounds changes with air quality during wildfire season in the northwest United States. We find small reductions in park and playground visits on moderately polluted days, and large reductions, to 50-60% of baseline visits, when pollution levels are high. Disaggregating results by neighborhood characteristics, we find a significantly greater behavioral response to moderate levels of air pollution in neighborhoods with higher socio-economic status, although responses to high levels of pollution are similar across neighborhood types.

Knowledge, attitudes and practices about air pollution and its health effects in 6th to 11th-grade students in Colombia: a cross-sectional study

Introduction

Globally, air pollution is the leading environmental cause of disease and premature death. Raising awareness through environmental education and adequate communication on air quality could reduce the adverse effects. We aimed to assess the knowledge, attitudes, and practices (KAP) regarding air pollution and health and determine the factors associated with these KAP in children and adolescents.

Methods

In 2019-2020, a cross-sectional study was conducted on 6th-11th grade high school students in five municipalities in Colombia. Variables collected included: age, sex, private or public school, any medical history, emergency room visits due to respiratory symptoms in the last year, and whether students played sports. The main exposure was the School Environmental Project. The outcomes were the KAP scale [0% (the lowest score) to 100% (the highest score)]. The factors associated with KAP levels were evaluated with independent mixed regressions due to the multilevel structure of the study (level 1: student; level 2: school), and the exponential coefficients (95% confidence interval-CI) were reported.

Results

Among 1,676 students included, 53.8% were females. The median knowledge score about air pollution and its health effects was 33.8% (IQR: 24.0-44.9), 38.6% knew the air quality index, 30.9% knew the air quality alerts that occurred twice a year in these municipalities and 5.3% had high self-perceived knowledge. Positive attitudes, pro-environmental practices, being female, grade level, attending a private school, having respiratory diseases, and the school environmental project importance were associated with higher knowledge scores. The median attitudes score was 78.6% (IQR: 71.4-92.9). Pro-environmental attitudes were associated with knowledge-increasing, being female, attending a private school, and the school environmental project. The median pro-environmental practices score was 28.6% (IQR: 28.6-42.9). During air quality alerts, 11.6% had worn masks, 19% had reduced the opening time of windows and 15.9% avoided leaving home. Pro-environmental practices were associated with knowledge-increasing and attitudes-increasing, and lower practices with higher grade levels, visiting a doctor in the last year, and practicing sports.

Discussion

Children and adolescents have low knowledge scores and inadequate pro-environmental practices scores regarding air pollution. However, they demonstrate positive attitudes towards alternative solutions and express important concerns about the planet's future.

Climate Change, Landscape Fires, and Human Health: A Global Perspective

Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fire emerge from these interactions: remote area fires, wildfire disasters, savanna fires, Indigenous burning, prescribed burning, agricultural burning, and deforestation fires. All can have substantial impacts on human health and well-being directly and indirectly through (a) exposure to heat flux (e.g., injuries and destructive impacts), (b) emissions (e.g., smoke-related health impacts), and (c) altered ecosystem functioning (e.g., biodiversity, amenity, water quality, and climate impacts). Minimizing the adverse effects of landscape fires on population health requires understanding how human and environmental influences on fire impacts can be modified through interventions targeted at individual, community, and regional levels.

Data Linkages for Wildfire Exposures and Human Health Studies: A Scoping Review

Wildfires are increasing in frequency and intensity, with significant consequences that impact human health. A scoping review was conducted to: (a) understand wildfire-related health effects, (b) identify and describe environmental exposure and health outcome data sources used to research the impacts of wildfire exposures on health, and (c) identify gaps and opportunities to leverage exposure and health data to advance research. A literature search was conducted in PubMed and a sample of 83 articles met inclusion criteria. A majority of studies focused on respiratory and cardiovascular outcomes. Hospital administrative data was the most common health data source, followed by government data sources and health surveys. Wildfire smoke, specifically fine particulate matter (PM2.5), was the most common exposure measure and was predominantly estimated from monitoring networks and satellite data. Health data were not available in real-time, and they lacked spatial and temporal coverage to study health outcomes with longer latency periods. Exposure data were often available in real-time and provided better temporal and spatial coverage but did not capture the complex mixture of hazardous wildfire smoke pollutants nor exposures associated with non-air pathways such as soil, household dust, food, and water. This scoping review of the specific health and exposure data sources used to underpin these studies provides a framework for the research community to understand: (a) the use and value of various environmental and health data sources, and (b) the opportunities for improving data collection, integration, and accessibility to help inform our understanding of wildfires and other environmental exposures.

Clearing the air: evaluating institutions' social media health messaging on wildfire and smoke risks in the US Pacific Northwest

BACKGROUND

Wildfire smoke contributes substantially to the global disease burden and is a major cause of air pollution in the US states of Oregon and Washington. Climate change is expected to bring more wildfires to this region. Social media is a popular platform for health promotion and a need exists for effective communication about smoke risks and mitigation measures to educate citizens and safeguard public health.

METHODS

Using a sample of 1,287 Tweets from 2022, we aimed to analyze temporal Tweeting patterns in relation to potential smoke exposure and evaluate and compare institutions' use of social media communication best practices which include (i) encouraging adoption of smoke-protective actions; (ii) leveraging numeric, verbal, and Air Quality Index risk information; and (iii) promoting community-building. Tweets were characterized using keyword searches and the Linguistic Inquiry and Word Count (LIWC) software. Descriptive and inferential statistics were carried out.

RESULTS

44% of Tweets in our sample were authored between January-August 2022, prior to peak wildfire smoke levels, whereas 54% of Tweets were authored during the two-month peak in smoke (September-October). Institutional accounts used Twitter (or X) to encourage the adoption of smoke-related protective actions (82% of Tweets), more than they used it to disseminate wildfire smoke risk information (25%) or promote community-building (47%). Only 10% of Tweets discussed populations vulnerable to wildfire smoke health effects, and 14% mentioned smoke mitigation measures. Tweets from Washington-based accounts used significantly more verbal and numeric risk information to discuss wildfire smoke than Oregon-based accounts (p = 0.042 and p = 0.003, respectively); however, Tweets from Oregon-based accounts on average contained a higher percentage of words associated with community-building language (p < 0.001).

CONCLUSIONS

This research provides practical recommendations for public health practitioners and researchers communicating wildfire smoke risks on social media. As exposures to wildfire smoke rise due to climate change, reducing the environmental disease burden requires health officials to leverage popular communication platforms, distribute necessary health-related messaging rapidly, and get the message right. Timely, evidence-based, and theory-driven messaging is critical for educating and empowering individuals to make informed decisions about protecting themselves from harmful exposures. Thus, proactive and sustained communications about wildfire smoke should be prioritized even during wildfire "off-seasons."

Public Health Benefits From Improved Identification of Severe Air Pollution Events With Geostationary Satellite Data

Despite improvements in ambient air quality in the US in recent decades, many people still experience unhealthy levels of pollution. At present, national-level alert-day identification relies predominately on surface monitor networks and forecasters. Satellite-based estimates of surface air quality have rapidly advanced and have the capability to inform exposure-reducing actions to protect public health. At present, we lack a robust framework to quantify public health benefits of these advances in applications of satellite-based atmospheric composition data. Here, we assess possible health benefits of using geostationary satellite data, over polar orbiting satellite data, for identifying particulate air quality alert days (24hr PM2.5 > 35 μg m-3) in 2020. We find the more extensive spatiotemporal coverage of geostationary satellite data leads to a 60% increase in identification of person-alerts (alert days × population) in 2020 over polar-orbiting satellite data. We apply pre-existing estimates of PM2.5 exposure reduction by individual behavior modification and find these additional person-alerts may lead to 1,200 (800-1,500) or 54% more averted PM2.5-attributable premature deaths per year, if geostationary, instead of polar orbiting, satellite data alone are used to identify alert days. These health benefits have an associated economic value of 13 (8.8-17) billion dollars ($2019) per year. Our results highlight one of many potential applications of atmospheric composition data from geostationary satellites for improving public health. Identifying these applications has important implications for guiding use of current satellite data and planning future geostationary satellite missions.

A cross-sectional study of inequalities in digital air pollution information access and exposure reducing behavior uptake in the UK

Air pollution is a pervasive global environmental challenge that presents substantial and differential risk across populations. Individual-level pollution exposure is a function of varying factors, including but not limited to geographic location, proximity to point sources, ventilation, and behavioral patterns. Mounting evidence suggests that informational interventions can play a substantial role in mediating exposures for specific population subgroups and reduce downstream adverse health outcomes. The literature has yet to address whether access to air quality information is sociodemographically stratified, and whether such access correlates with increased uptake of exposure reducing behaviors at the population level. This study represents a first step in answering these questions by analysing responses from the "Clean Air Public Insight Tracker" nationally representative survey (n = 1,993) of the UK population, administered by UK charity Global Action Plan. Results from logistic regression and zero-inflated negative binomial models estimate 28% of the population have accessed air pollution information, while the odds of younger individuals (ages 18-36), men, and non-white individuals of accessing digitally available air quality information are greater that those outside these categories. Additionally, the odds of behavior uptake is greater if an individual accesses digital information sources like the internet, mobile apps or social media, has a higher education qualification or cares for someone with a health condition. These findings contribute to the growing literature surrounding which population groups engage with environmental and health-relevant information channels, and what connects engagement with air quality channels and uptake of exposure reducing behaviors. These results reinforce the need for additional research around air pollution informational alerts and exploring causal links between specific exposure reducing behaviours and improved health outcomes. It can also help inform the flow of resources and targeting of informational campaigns towards sociodemographic groups that are less likely to engage with air quality information.

Feasibility and acceptability of home monitoring with portable spirometry in young adults with asthma

OBJECTIVE

Self-monitoring asthma control is a key component of asthma management. Few studies have reported usability and acceptability of portable spirometry among young adults with asthma. Portable spirometry offers a practical solution to monitoring airway narrowing at home. The purpose of this paper was to determine if self-administered spirometry is feasible and acceptable in young adults with asthma and whether regular monitoring resulted in improved airway function as measured by forced expiratory volume in one second (FEV1).

METHODS

Sixty-seven young adults (18-26 years) with self-reported asthma participated in a clinical trial during wildfire season which measured FEV1 as an outcome measure. Data was collected at baseline, week 4, and week 8 using a portable spirometer linked to a smartphone application. A subset of intervention participants completed spirometry twice daily. Acceptability of self-administered spirometry was evaluated after the trial among participants that volunteered to submit a survey and be interviewed.

RESULTS

At baseline, all 67 participants (100.0%) completed their scheduled spirometry readings which declined to 94.0% (n = 63) at week 4 and 86.6% (n = 58) at week 8. Daily readings were completed 83.2% of the time in the mornings and 84.3% of the time in the evenings. Mean FEV1 values were lower than predicted values, but above the lower limit of expected. FEV1 remained steady throughout the study period. Over two-thirds of participants used the notes feature in the application and described symptoms, asthma triggers, mitigating actions and test-taking issues.

CONCLUSIONS

Young adults in our sample were highly compliant with regular, self-administered spirometry.

Health Research in the Wake of Disasters: Challenges and Opportunities for Sensor Science

BACKGROUND

Disaster events adversely affect the health of millions of individuals each year. They create exposure to physical, chemical, biological, and psychosocial hazards while simultaneously exploiting community and individual-level vulnerabilities that allow such exposures to exert harm. Since 2013, the National Institute of Environmental Health Sciences (NIEHS) has led the development of the Disaster Research Response (DR2) program and infrastructure; however, research exploring the nature and effects of disasters on human health is lacking. One reason for this research gap is the challenge of developing and deploying cost-effective sensors for exposure assessment during disaster events.

OBJECTIVES

The objective of this commentary is to synergize the consensus findings and recommendations from a panel of experts on sensor science in support of DR2.

METHODS

The NIEHS convened the workshop, "Getting Smart about Sensors for Disaster Response Research" on 28 and 29 July 2021 to discuss current gaps and recommendations for moving the field forward. The workshop invited full discussion from multiple viewpoints, with the goal of identifying recommendations and opportunities for further development of this area of research. The panel of experts included leaders in engineering, epidemiology, social and physical sciences, and community engagement, many of whom had firsthand experience with DR2.

DISCUSSION

The primary finding of this workshop is that exposure science in support of DR2 is severely lacking. We highlight unique barriers to DR2, such as the need for time-sensitive exposure data, the chaos and logistical challenges that ensue from a disaster event, and the lack of a robust market for sensor technologies in support of environmental health science. We highlight a need for sensor technologies that are more scalable, reliable, and versatile than those currently available to the research community. We also recommend that the environmental health community renew efforts in support of DR2 facilitation, collaboration, and preparedness. https://doi.org/10.1289/EHP12270.

Evaluating User Preferences, Comprehension, and Trust in Apps for Environmental Health Hazards: Qualitative Case Study

BACKGROUND

Climate change is projected to increase environmental health hazard risks through fire-related air pollution and increased airborne pollen levels. To protect vulnerable populations, it is imperative that evidence-based and accessible interventions are available. The environmental health app, AirRater, was developed in 2015 in Australia to provide information on multiple atmospheric health hazards in near real time. The app allows users to view local environmental conditions, and input and track their personal symptoms to enable behaviors that protect health in response to environmental hazards.

OBJECTIVE

This study aimed to develop insights into users' perceptions of engagement, comprehension, and trust in AirRater to inform the future development of environmental health apps. Specifically, this study explored which AirRater features users engaged with, what additional features or functionality needs users felt they required, users' self-perception of understanding app information, and their level of trust in the information provided.

METHODS

A total of 42 adult AirRater users were recruited from 3 locations in Australia to participate in semistructured interviews to capture location- or context-specific experiences. Participants were notified of the recruitment opportunity through multiple avenues including newsletter articles and social media. Informed consent was obtained before participation, and the participants were remunerated for their time and perspectives. A preinterview questionnaire collected data including age range, any preexisting conditions, and location (postcode). All participant data were deidentified. Interviews were recorded, transcribed, and analyzed using thematic analysis in NVivo 12 (QSR International).

RESULTS

Participants discussed app features and functionality, as well as their understanding of, and trust in, the information provided by the app. Most (26/42, 62%) participants used and valued visual environmental hazard features, especially maps, location settings, and hazard alerts. Most (33/42, 78%) found information in the app easy to understand and support their needs, irrespective of their self-reported literacy levels. Many (21/42, 50%) users reported that they did not question the accuracy of the data presented in the app. Suggested enhancements include the provision of meteorological information (eg, wind speed or direction, air pressure, UV rating, and humidity), functionality enhancements (eg, forecasting, additional alerts, and the inclusion of health advice), and clarification of existing information (eg, symptom triggers), including the capacity to download personal summary data for a specified period.

CONCLUSIONS

Participants' perspectives can inform the future development of environmental health apps. Specifically, participants' insights support the identification of key elements for the optimal development of environmental health app design, including streamlining, capacity for users to customize, use of real time data, visual cues, credibility, and accuracy of data. The results also suggest that, in the future, iterative collaboration between developers, environmental agencies, and users will likely promote better functional design, user trust in the data, and ultimately better population health outcomes.

"When people see me, they know me; they trust what I say": characterizing the role of trusted sources for smoke risk communication in the Okanogan River Airshed Emphasis Area

INTRODUCTION

As wildfire smoke events increase in intensity and frequency in the Pacific Northwest, there is a growing need for effective communication on the health risks of smoke exposure. Delivery through a trusted source or intermediary has been shown to improve reception of risk communication messages. This is especially salient in rural and tribal communities who may be hesitant to trust information from state and federal agency sources. This study aims to identify and characterize trusted sources for smoke risk information in the Okanogan River Airshed Emphasis Area (ORAEA), a rural region of North Central Washington state that is heavily impacted by smoke from wildfires and prescribed fire.

METHODS

The research team conducted a qualitative study using data collected through key informant interviews and focus groups to assess the role of various sources and intermediaries in disseminating smoke risk information. We used a consensual coding approach in NVivo Qualitative Analysis Software to sort data into preliminary categories, which were grouped into themes using a thematic analysis approach. We used member checking and iterative feedback processes with local project partners throughout the project to ensure credibility of results.

RESULTS

Through the analysis, we identified three themes characterizing trusted sources for smoke risk communication in the ORAEA. These themes were: (1) local and tribal sources of information are perceived as more trustworthy than state and federal government sources, (2) trustworthiness is determined by an evaluation of multiple factors, in particular, perceived credibility, quality of information, and relationship with the source, and (3) conservative political ideology and perceived parallels with COVID-19 communication influence perception of trust. Within each theme, we identified several sub-themes, which contributed additional nuance to our analysis.

CONCLUSION

This study provides insights into which sources of information are trusted by rural and tribal community members in the ORAEA and why. Results from our study emphasize the importance of relationships and collaboration with local and tribal partners in smoke risk communication. In this paper, we discuss implications for state and federal agency practitioners and present recommendations for how to work with local and tribal partners on smoke risk communication.

Exposures and behavioural responses to wildfire smoke

Pollution from wildfires constitutes a growing source of poor air quality globally. To protect health, governments largely rely on citizens to limit their own wildfire smoke exposures, but the effectiveness of this strategy is hard to observe. Using data from private pollution sensors, cell phones, social media posts and internet search activity, we find that during large wildfire smoke events, individuals in wealthy locations increasingly search for information about air quality and health protection, stay at home more and are unhappier. Residents of lower-income neighbourhoods exhibit similar patterns in searches for air quality information but not for health protection, spend less time at home and have more muted sentiment responses. During smoke events, indoor particulate matter (PM2.5) concentrations often remain 3-4× above health-based guidelines and vary by 20× between neighbouring households. Our results suggest that policy reliance on self-protection to mitigate smoke health risks will have modest and unequal benefits.

Machine learning-based observation-constrained projections reveal elevated global socioeconomic risks from wildfire

Reliable projections of wildfire and associated socioeconomic risks are crucial for the development of efficient and effective adaptation and mitigation strategies. The lack of or limited observational constraints for modeling outputs impairs the credibility of wildfire projections. Here, we present a machine learning framework to constrain the future fire carbon emissions simulated by 13 Earth system models from the Coupled Model Intercomparison Project phase 6 (CMIP6), using historical, observed joint states of fire-relevant variables. During the twenty-first century, the observation-constrained ensemble indicates a weaker increase in global fire carbon emissions but higher increase in global wildfire exposure in population, gross domestic production, and agricultural area, compared with the default ensemble. Such elevated socioeconomic risks are primarily caused by the compound regional enhancement of future wildfire activity and socioeconomic development in the western and central African countries, necessitating an emergent strategic preparedness to wildfires in these countries.

A new study develops a machine learning framework to observationally constrain CMIP6-simulated fire carbon emissions, finding a weaker increase in 21st-century global fires but higher increase in their socioeconomic risks than previously thought.

Promoting risk reduction among young adults with asthma during wildfire smoke: A feasibility study

OBJECTIVE(S)

This study explored the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during wildfire season.

DESIGN

Three-arm, 8-week randomized clinical trial.

SAMPLE

Sixty-seven young adults with asthma were enrolled.

MEASUREMENTS

The Asthma Control Test, forced expiratory volume in one second (FEV₁ ) and the System Usability Scale were measured at baseline, 4, and 8 weeks. The Research Attitude Scale was administered at 8 weeks. Twenty participants from the two intervention arms completed an optional survey and six were interviewed after completing the study.

INTERVENTION

Both intervention arms could access Smoke Sense Urbanova, an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova Plus arm also monitored their daily FEV₁ , received air quality notifications, and accessed preventive tips and a message board.

RESULTS

Most participants agreed the app and spirometer were usable and their privacy and confidentiality were maintained. No adverse events were reported.

CONCLUSIONS

Participant-identified recommendations will support intervention refinement and testing. This research supports asthma self-management tools that public health nurses and community health workers can recommend for at-risk populations.

Socio-demographic and health vulnerability in prescribed-burn exposed versus unexposed counties near the National Forest System

Prescribed fire is an increasingly important tool in restoring ecological conditions and reducing uncontrolled wildfire. Prescribed burn techniques could reduce public health impacts associated with wildfire smoke exposure. However, there have been few assessments of the health impacts of prescribed burning, and potential vulnerabilities among populations exposed to smoke from prescribed fires. Our study area focused on counties in and near U.S. National Forests - a set of lands distributed across the U.S. In county-level analyses, we compared the sociodemographic and health characteristics of areas that were exposed with those that were not exposed to prescribe burns during the years 2010-2019 on a national level and within three regions. In addition, using spatial error regression models, we looked for associations between prescribed fire exposure and health behaviors and outcomes while controlling for spatial autocorrelation. On a national level, we found disproportionate prescribed fire exposure in rural counties with higher percentage mobile home and vacant housing units, and higher percentage African-American and white populations. Regionally, we found evidence of disproportionate exposure to prescribed burns among counties with lower percentage white population, higher percentage Hispanic population and mobile homes in the southern region, and to high poverty counties with high vacancy in the western region. These findings could indicate that vulnerable populations face potential health risks from prescribed burning smoke exposure, but also that they are not missing out on the benefits of prescribed burning, which could involve considerably lower smoke exposure compared to uncontrolled wildfire. In addition, in regression analyses, we found no evidence of disproportionate health burden in exposed compared to unexposed counties. Awareness of these patterns could influence both large-scale or institutional polices about prescribed burning practice, and could be used to build decision-making factors into modeling tools and smoke management plans, as well as community-engagement around wildfire risk reduction.

Communication channels for receiving air quality alerts among adults in the United States

Exposure to air pollution is associated with respiratory and cardiovascular effects, particularly among people with underlying respiratory and heart disease. It is therefore important for individuals with respiratory and heart disease to be aware of air quality. However, information about the most effective communication channels for disseminating air quality alerts is limited. We assessed communication channels used for receiving air quality alerts among U.S. adults using data from the summer 2020 wave of ConsumerStyles, a nationally representative survey of U.S. adults (n = 4053). We calculated weighted percentages of respondents who received air quality alerts from six communication channels and stratified by demographic and health characteristics. We calculated weighted prevalence ratios (PRs) adjusted for sex, age, race/ethnicity, and education to assess if communication channel use varied by presence of respiratory or heart disease. Sixty-four percent of U.S. adults had heard or read about air quality alerts. Television was the most commonly reported communication channel for receiving alerts (57.5%), followed by app on mobile phone or device (30.2%) and internet or social media (26.4%). Communication channels differed most prominently by age. The proportion of adults receiving alerts from specific communication channels did not notably vary by presence of heart disease. Adults with respiratory disease more often reported receiving alerts from their doctor’s office than adults without respiratory disease (PR: 3.10, 95% confidence interval: 1.49, 6.45). These findings can be used by public health officials to increase awareness of poor air quality days and improve the reach of alerts to target populations.

Health protection messaging for populations susceptible to air pollution during landscape fire smoke events: an integrative review

Public health communication strategies to protect against the health impacts of air pollution due to landscape fire are becoming increasingly urgent in Australia. How well the public, particularly susceptible populations, are receiving, understanding and acting upon health protection messages related to smoke events is poorly understood. This integrative review sought literature relevant to health protection messaging for smoke events, including appropriate message content and suitable message delivery, with a focus on vulnerable and sensitive populations. Using an exhaustive search strategy of databases and grey literature, 26 relevant articles were identified and thematically analysed to produce a synthesis of findings on key themes. Findings indicated that a variety of traditional and modern communication channels are needed to ensure health messages are received by those most at-risk and should consider locally relevant information. A key theme to emerge in this review was the need for health messaging to susceptible populations to commence in advance of bushfire seasons to facilitate health protective actions being taken. During the acute-phase of smoke events, messages that were short with non-technical advice, were recalled and complied with more often. The need to improve the consistency of message content was a recurrent theme in the literature and suggested a need for greater interagency collaboration and communication. Preliminary evidence from smartphone app studies show promising results for targeted communication, however, more robust research is needed on the efficacy of these communication channels. Further research is also needed on the health impacts of smoke events, related compounding issues and strategies to reduce health risks, to better inform health protection messaging to susceptible populations.

Efficacy of Communication Techniques and Health Outcomes of Bushfire Smoke Exposure: A Scoping Review

Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events.

A Systematic Literature Review on the Participation Aspects of Environmental and Nature-Based Citizen Science Initiatives

It is commonly argued that, despite the tremendous resonance Citizen Science (CS) has shown in recent years, there is still lack of understanding of important aspects defining citizens’ participation and engagement in CS initiatives. While CS initiatives could provide a vehicle to foster forms of participation contributing to the democratization of science, there is still limited attention paid to the “Citizen” component of the Citizen Science term. For the purpose of this work, we systematically reviewed the available literature for empirical studies in respect to citizens’ participation in environmental and nature-based CS initiatives established during the last two decades, using the PRISMA methodology. The participatory facet of the retrieved 119 CS initiatives was analysed on the basis of: (a) exclusion and inclusion demographic factors, (b) CS models and practices, (c) facilitators and constraints of citizen’s participation, and (d) environmental citizenship. Our findings show that the majority of the CS initiatives did not place restrictions on gender participation; however, we have identified that mostly highly educated adults participated in the reviewed initiatives. In addition, most of the CS initiatives reported in the literature were situated in the EU and USA, were mostly limited to the local scale, and primarily followed the contributory model. Academic institutions were found to coordinate the majority of the CS initiatives examined. By using digital technologies, academic scientists were able to control and increase data quality, as well as to engage a broader audience, even though they were mostly treating volunteers as “data collectors”, desiring their long-term engagement. Therefore, it will be of CS benefit to be better aligned with the mentality and needs of citizens. In this direction CS initiatives should trigger citizens’ learning gains and interpersonal/social benefits and personal, environmental, and social motivations, but also to shift their goals towards contributing to science and citizens’ connection with nature. On the other hand, there is a need to overcome any design and implementation barriers, and to enhance democratization through a more participative engagement of active and aware citizens, thus promoting environmental citizenship.

Wildfire Smoke Is Associated With an Increased Risk of Cardiorespiratory Emergency Department Visits in Alaska

Alaskan wildfires have major ecological, social, and economic consequences, but associated health impacts remain unexplored. We estimated cardiorespiratory morbidity associated with wildfire smoke (WFS) fine particulate matter with a diameter less than 2.5 μm (PM2.5) in three major population centers (Anchorage, Fairbanks, and the Matanuska-Susitna Valley) during the 2015-2019 wildfire seasons. To estimate WFS PM2.5, we utilized data from ground-based monitors and satellite-based smoke plume estimates. We implemented time-stratified case-crossover analyses with single and distributed lag models to estimate the effect of WFS PM2.5 on cardiorespiratory emergency department (ED) visits. On the day of exposure to WFS PM2.5, there was an increased odds of asthma-related ED visits among 15-65 year olds (OR = 1.12, 95% CI = 1.08, 1.16), people >65 years (OR = 1.15, 95% CI = 1.01, 1.31), among Alaska Native people (OR = 1.16, 95% CI = 1.09, 1.23), and in Anchorage (OR = 1.10, 95% CI = 1.05, 1.15) and Fairbanks (OR = 1.12, 95% CI = 1.07, 1.17). There was an increased risk of heart failure related ED visits for Alaska Native people (Lag Day 5 OR = 1.13, 95% CI = 1.02, 1.25). We found evidence that rural populations may delay seeking care. As the frequency and magnitude of Alaskan wildfires continue to increase due to climate change, understanding the health impacts will be imperative. A nuanced understanding of the effects of WFS on specific demographic and geographic groups facilitates data-driven public health interventions and fire management protocols that address these adverse health effects.

Leveraging risk communication science across US federal agencies

Many US federal agencies apply principles from risk communication science across a wide variety of hazards. In so doing, they identify key research and practice gaps that, if addressed, could help better serve the nation’s communities and greatly enhance practice, research, and policy development.

Knowing Your Audience: A Typology of Smoke Sense Participants to Inform Wildfire Smoke Health Risk Communication

Central to public health risk communication is understanding the perspectives and shared values among individuals who need the information. Using the responses from a Smoke Sense citizen science project, we examined perspectives on the issue of wildfire smoke as a health risk in relation to an individual's preparedness to adopt recommended health behaviors. The Smoke Sense smartphone application provides wildfire-related health risk resources and invites participants to record their perspectives on the issue of wildfire smoke. Within the app, participants can explore current and forecasted daily air quality, maps of fire locations, satellite images of smoke plumes, and learn about health consequences of wildfire smoke. We used cluster analysis to identify perspective trait-clusters based on health status, experience with fire smoke, risk perception, self-efficacy, access to exposure-reducing resources, health information needs, and openness to health risk messaging. Differences between traits were examined based on demographics, health status, activity level and engagement with the app. We mapped these traits to the Precaution Adoption Process Model (PAPM) to indicate where each trait lies in adopting recommended health behaviors. Finally, we suggest messaging strategies that may be suitable for each trait. We determined five distinct perspective traits which included individuals who were Protectors and have decided to engage on the issue by adopting new behaviors to protect their health; Cautious, Proactive, and Susceptible individuals who were at a Deciding stage but differed based on risk perceptions and information needs; and the Unengaged who did not perceive smoke as a health issue and were unlikely to change behavior in response to messaging. Across all five traits, the level of engagement and information needs differed substantially, but were not defined by demographics. Individuals in the Susceptible trait had the highest level of engagement and the highest information needs. Messaging that emphasizes self-efficacy and benefits of reducing exposure may be effective in motivating individuals from the deciding stage to taking health protective action. Shared perspectives define an individual's propensity for acting on recommended health behaviors, therefore, health risk message content should be tailored based on these perspectives.