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Meta-Analysis of Heterogeneity in the Effects of Wildfire Smoke Exposure on Respiratory Health in North America

Author

Listed:
  • Michelle C. Kondo

    (Northern Research Station, USDA Forest Service, Baltimore, MA 21228, USA)

  • Anneclaire J. De Roos

    (School of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA)

  • Lauren S. White

    (School of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA)

  • Warren E. Heilman

    (Northern Research Station—Climate, Fire, and Carbon Cycle Sciences, USDA Forest Service, Lansing, MI 48910, USA)

  • Miranda H. Mockrin

    (Northern Research Station, USDA Forest Service, Baltimore, MA 21228, USA)

  • Carol Ann Gross-Davis

    (Office of Air Monitoring & Analysis (3AP40), Air Protection Division, US Environmental Protection Agency, Philadelphia, PA 19103, USA)

  • Igor Burstyn

    (School of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA)

Abstract

Epidemiological studies consistently show an association between wildfire-related smoke exposure and adverse respiratory health. We conducted a systematic review of evidence in published literature pertaining to heterogeneity of respiratory effects from this exposure in North America. We calculated the within-study ratio of relative risks (RRR) and 95% confidence intervals (CI) to examine heterogeneity of effect by population subgroup, and then summarized the RRRs using meta-analysis. We found evidence of a greater effect of wildfire smoke on respiratory health among females relative to males for asthma (RRR: 1.035, 95% CI: 1.013, 1.057) and chronic obstructive pulmonary disease (RRR: 1.018, 95% CI: 1.003, 1.032). There was evidence of a lower relative risk for all respiratory outcomes among youth compared to adults (RRR: 0.976, 95% CI: 0.963, 0.989). We also found wildfire smoke effects stratified by income, race, education, health behaviors, access to care, housing occupancy, geographic region, and urban/rural status. However, data were insufficient to quantitatively evaluate effect modification by these characteristics. While we found evidence that certain demographic subgroups of the population are more susceptible to respiratory health outcomes from wildfire smoke, it is unclear whether this information can be used to inform policy aimed to reduce health impact of wildfires.

Suggested Citation

  • Michelle C. Kondo & Anneclaire J. De Roos & Lauren S. White & Warren E. Heilman & Miranda H. Mockrin & Carol Ann Gross-Davis & Igor Burstyn, 2019. "Meta-Analysis of Heterogeneity in the Effects of Wildfire Smoke Exposure on Respiratory Health in North America," IJERPH, MDPI, vol. 16(6), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:6:p:960-:d:214767
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    Cited by:

    1. Marshall Burke & Sam Heft-Neal & Jessica Li & Anne Driscoll & Patrick Baylis & Matthieu Stigler & Joakim A. Weill & Jennifer A. Burney & Jeff Wen & Marissa L. Childs & Carlos F. Gould, 2022. "Exposures and behavioural responses to wildfire smoke," Nature Human Behaviour, Nature, vol. 6(10), pages 1351-1361, October.
    2. Claire L. Schollaert & Jihoon Jung & Joseph Wilkins & Ernesto Alvarado & Jill Baumgartner & Julien Brun & Tania Busch Isaksen & Jamie M. Lydersen & Miriam E. Marlier & Julian D. Marshall & Yuta J. Mas, 2024. "Quantifying the smoke-related public health trade-offs of forest management," Nature Sustainability, Nature, vol. 7(2), pages 130-139, February.
    3. Yufei Zou & Susan M. O’Neill & Narasimhan K. Larkin & Ernesto C. Alvarado & Robert Solomon & Clifford Mass & Yang Liu & M. Talat Odman & Huizhong Shen, 2019. "Machine Learning-Based Integration of High-Resolution Wildfire Smoke Simulations and Observations for Regional Health Impact Assessment," IJERPH, MDPI, vol. 16(12), pages 1-20, June.

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