Uncertainty in Health Impact Assessments of Smoke From a Wildfire Event

Excess prenatal loss and respiratory illnesses of infant macaques living outdoors and exposed to wildfire smoke

Global climate change has transformed predictions of fire seasons in the near future, and record-breaking wildfire events have had catastrophic consequences in recent years. In September 2020, multiple wildfires subjected Oregon to hazardous air quality for several days. In this retrospective cohort study, we aimed to examine prenatal loss, morbidity, and mortality of rhesus (Macaca mulatta) and Japanese macaques (Macaca fuscata) exposed to poor air quality from the nearby wildfires. Detailed medical records from 2014 to 2020 of 580 macaques housed outdoors at a research facility in Beaverton, Oregon were used to evaluate the association between these health outcomes and wildfire smoke exposure. Logistic regression models estimated excess prenatal loss, hospitalization rates, respiratory problems, and mortality during and following the wildfire event, and Kruskal-Wallis statistics were used to determine if infant growth was affected by wildfire smoke exposure. Risk of pregnancy loss (relative risk = 4.1; p < 0.001) and odds of diagnosis with a respiratory problem (odds ratio = 4.47; p = 0.003) were higher in exposed infant macaques compared to nonexposed infants. Infant growth was not affected by poor air quality exposure. Our findings suggest wildfire smoke exposure poses a risk to the health of infants and pregnant individuals and should be monitored more closely in the future.

Performance of Vehicle Add-on Mobile Monitoring System PM2.5 measurements during wildland fire episodes

Fine particulate matter (PM2.5) resulting from wildland fire is a significant public health risk in the United States (U.S.). The existing stationary monitoring network and the tools used to alert the public of smoke conditions, such as the Air Quality Index or NowCast, are not optimized to capture actual exposure concentrations in impacted communities given that wildland fire smoke plumes have characteristically steep exposure concentration gradients that can vary over fine spatiotemporal scales. In response, we developed and evaluated a lightweight, universally attachable mobile PM2.5 monitoring system to provide supplemental, real-time air quality information during wildfire incidents and prescribed burning activities. We retroactively assessed the performance of the mobile monitor compared to nearby (100-1500 m) stationary low-cost sensors and regulatory monitors using 1 minute averaged data collected during two large wildfires in the western U.S. and during one small, prescribed burn in the Midwest. The mobile measurements were highly correlated (R 2 > 0.85) with the stationary network during the large wildfires. Further, 1 minute averaged mobile measurements differed from three collocated stationary instruments by <25% on average for fourteen out of fifteen total passages. For the small, prescribed burn, rapidly changing conditions near the fire border complicated the comparison of mobile and stationary measurements but the spatial maximum concentrations measured by both instruments were consistent. In general, this work highlights the value of using portable sensor technologies to address the monitoring challenges presented by dynamic wildland fire conditions and demonstrates the value in combining mobile monitoring with stationary data where possible.

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

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

Acute Health Effects of Wildfire Smoke Exposure During a Compound Event: A Case-Crossover Study of the 2016 Great Smoky Mountain Wildfires

In 2016, unprecedented intense wildfires burned over 150,000 acres in the southern Appalachian Mountains in the United States. Smoke from these fires greatly impacted the region and exposure to this smoke was significant. A bidirectional case-crossover design was applied to assess the relationship between PM2.5 (a surrogate for wildfire smoke) exposure and respiratory- and cardiovascular-related emergency department (ED) visits in Western North Carolina during these events. For 0-, 3-, and 7-day lags, findings indicated a significant increase in the odds of being admitted to the ED for a respiratory (ORs: 1.055, 95% CI: 1.048-1.063; 1.083, 1.074-1.092; 1.066, 1.058-1.074; respectively) or cardiovascular event (ORs: 1.052, 95% CI: 1.045-1.060; 1.074, 1.066-1.081; 1.067, 1.060-1.075; respectively) for every 5 μg/m3 increase in PM2.5 over a chosen cutpoint of 20.4 μg/m3. For all endpoints assessed except for emphysema, there were statistically significant increases in odds from 5.1% to 8.3%. In general, this increase was most pronounced 3 days after exposure. Additionally, individuals aged 55+ generally experience higher odds of heart disease at the 3- and 7-day lag points, and Black/African Americans generally experience higher odds of asthma at the 3-day lag point. In general, larger fires and increased numbers of fires within counties resulted in higher health burden at same day exposure. In a secondary analysis, the odds of an ED visit increased by over 40% in several cases among people exposed to days above the Environmental Protection Agency 24-hr PM2.5 standard of 35 μg/m3. Our findings provide new understanding on the health impacts of wildfires on rural populations in the southeastern US.

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.