Abstract
In recent years, wildland fires have occurred more frequently and with increased intensity in many fire-prone areas. In addition to the direct life and economic losses attributable to wildfires, the emitted smoke is a major contributor to ambient air pollution, leading to significant public health impacts. Wildfire smoke is a complex mixture of particulate matter (PM), gases such as carbon monoxide, nitrogen oxide, and volatile and semi-volatile organic compounds. PM from wildfire smoke has a high content of elemental carbon and organic carbon, with lesser amounts of metal compounds. Epidemiological studies have consistently found an association between exposure to wildfire smoke (typically monitored as the PM concentration) and increased respiratory morbidity and mortality. However, previous reviews of the health effects of wildfire smoke exposure have not established a conclusive link between wildfire smoke exposure and adverse cardiovascular effects. In this review, we systematically evaluate published epidemiological observations, controlled clinical exposure studies, and toxicological studies focusing on evidence of wildfire smoke exposure and cardiovascular effects, and identify knowledge gaps. Improving exposure assessment and identifying sensitive cardiovascular endpoints will serve to better understand the association between exposure to wildfire smoke and cardiovascular effects and the mechanisms involved. Similarly, filling the knowledge gaps identified in this review will better define adverse cardiovascular health effects of exposure to wildfire smoke, thus informing risk assessments and potentially leading to the development of targeted interventional strategies to mitigate the health impacts of wildfire smoke.
Highlights
Wildland fires have been an important factor in shaping the landscape and controlling the biomes on Earth for millions of years [115]
Hein, and Abbreviations: CAD Coronary artery disease, CHD Congestive heart disease, cardiovascular disease (CVD) Cardiovascular disease, HF Heart failure, ischemic heart disease (IHD) Ischemic heart disease, myocardial infarction (MI) Myocardial infarction. “↑” indicates a positive association; “→” indicates a null association wildfire season in Victoria, Australia, was significantly associated with a 6.98% increase in risk of out-ofhospital cardiac arrests, with the strongest associations observed among men and older adults, and was associated with an increased risk for IHD-related emergency department (ED) visits (2.07%) and hospitalizations (1.86%), among women and the elderly [64]
This review finds that wildfire smoke contributes to high levels of air pollutants, including coarse and fine particulate matter (PM), gases, polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), during wildfire events
Summary
Wildland fires have been an important factor in shaping the landscape and controlling the biomes on Earth for millions of years [115]. Rapid growth of the wildland-urban interface and anthropogenic climate change have contributed to increased wildfire frequency and unprecedented intensity in many fire-prone regions [1, 22, 117, 163, 169]. In the western United States, summer wildfire frequency increased approximately eightfold between. Southeastern Australia is a densely populated region where large-scale wildfires have led to massive life and property loss [169]. Multiple forms of vegetation in wildlands, including trees, bushes, grass, and their partially decayed form “peat”, fuel these fires, and smoke emitted from the combustion of these vegetations are referred to as wildfire smoke, with alternative names including “landscape fire smoke”, “wildland fire smoke”, “peat fire smoke”, “forest fire smoke”, and “biomass smoke” [30, 75, 156]. Wildfire smoke contains many air pollutants known to be detrimental to human health, such as particulate matter (PM) and volatile organic compounds (VOCs) [4, 30]
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