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

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.

A scoping review of wildfire smoke risk communications: issues, gaps, and recommendations

BACKGROUND

Wildfire smoke exposure has become a growing public health concern, as megafires and fires at the wildland urban interface increase in incidence and severity. Smoke contains many pollutants that negatively impact health and is linked to a number of health complications and chronic diseases. Communicating effectively with the public, especially at-risk populations, to reduce their exposure to this environmental pollutant has become a public health priority. Although wildfire smoke risk communication research has also increased in the past decade, best practice guidance is limited, and most health communications do not adhere to health literacy principles: readability, accessibility, and actionability. This scoping review identifies peer-reviewed studies about wildfire smoke risk communications to identify gaps in research and evaluation of communications and programs that seek to educate the public.

METHODS

Four hundred fifty-one articles were identified from Web of Science and PubMed databases. After screening, 21 articles were included in the final sample for the abstraction process and qualitative thematic analysis. Ten articles were based in the US, with the other half in Australia, Canada, Italy, and other countries. Fifteen articles examined communication materials and messaging recommendations. Eight papers described communication delivery strategies. Eleven articles discussed behavior change. Six articles touched on risk communications for vulnerable populations; findings were limited and called for increasing awareness and prioritizing risk communications for at-risk populations.

RESULTS

This scoping review found limited studies describing behavior change to reduce wildfire smoke exposure, characteristics of effective communication materials and messaging, and communication delivery strategies. Literature on risk communications, dissemination, and behavior change for vulnerable populations was even more limited.

CONCLUSIONS

Recommendations include providing risk communications that are easy-to-understand and adapted to specific needs of at-risk groups. Communications should provide a limited number of messages that include specific actions for avoiding smoke exposure. Effective communications should use mixed media formats and a wide variety of dissemination strategies. There is a pressing need for more intervention research and effectiveness evaluation of risk communications about wildfire smoke exposure, and more development and dissemination of risk communications for both the general public and vulnerable populations.

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.

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.

Bushfire Smoke and Children's Health-Exploring a Communication Gap

The "Black Summer" bushfires of 2019/2020 in Australia generated smoke that persisted for over three months, mainly affecting Eastern Australia. Most communication strategies focused on the fire itself, revealing a knowledge gap in effective communication of the impact of bushfire smoke on health, especially for children and those living in non-English speaking minority groups. To address this, semi-structured qualitative interviews were undertaken with sixteen adults with caring (n = 11) or educational (n = 5) responsibilities for primary-school aged children (5-12 years, with some also having children up to 16 years) who had direct experience of the "Black Summer" bushfires. Overall, 43% (n = 7) of the sample spoke English as a first language, 25% (n = 4) spoke Turkish, with the remainder speaking Persian, Arabic, and Spanish. Thematic inductive qualitative content analysis revealed predominant themes of the role of parents and caregivers as conduits and curators of information. Air quality apps were the most common source of information. Language barriers and the lack of child-friendly methods of communication were highlighted as particular challenges. This qualitative study provides evidence for future development of communication strategies to better serve culturally and linguistically diverse individuals and the children in their care.