Assessing the Risk of Respiratory-Related Healthcare Visits Associated with Wildfire Smoke Exposure in Children 0-18 Years Old: A Systematic Review.

Shelby Henry,Liz Dennett,Anne Hicks,Maria B Ospina

doi:10.3390/ijerph18168799

Shelby Henry, Liz Dennett + Show 2 more

Open Access

https://doi.org/10.3390/ijerph18168799

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Abstract

Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children < 5 years old.

Highlights

Climate change influences extreme weather events, contributing to global natural disasters, including wildfires
Of the 65 studies included in full-text screening, 10 were excluded due to no respiratory or healthcare outcomes, 12 due to no pediatric data, 8 due to prescribed burn or other non-wildfire exposure, 9 due to study methodology, 3 because no full text was available, 1 only assessed birth outcomes and 5 repeated data presented in included studies
One of the 17 remaining studies was excluded for high risk of bias [29] in all domains

Summary

Introduction

Climate change influences extreme weather events, contributing to global natural disasters, including wildfires. Changes to precipitation leading to increased incidence of flooding and drought, as well as increased intensity of windstorms all increase the risk of uncontrolled fires [1]. Wildfires have been increasing in frequency, size and intensity [3], with the number of unmanageable crown fires projected to continue increasing throughout the remainder of the 21st century [4,5,6]. The wildfire burning season is expected to increase, with more days of uncontrolled burning in which the intensity exceeds the ability to suppress the fire [4]. Identify the report as a systematic review.

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