Growing wildfire smoke represents a substantial threat to air quality and human health. However, the impact of wildfire smoke on human health remains imprecisely understood due to uncertainties in both the measurement of exposure of population to wildfire smoke and dose-response functions linking exposure to health. Here, we compare daily wildfire smoke-related surface fine particulate matter (PM2.5) concentrations estimated using three approaches, including two chemical transport models (CTMs): GEOS-Chem and the Community Multiscale Air Quality (CMAQ) and one machine learning (ML) model over the contiguous US in 2020, a historically active fire year. In the western US, compared against surface PM2.5 measurements from the US Environmental Protection Agency (EPA) and PurpleAir sensors, we find that CTMs overestimate PM2.5 concentrations during extreme smoke episodes by up to 3-5 fold, while ML estimates are largely consistent with surface measurements. However, in the eastern US, where smoke levels were much lower in 2020, CTMs show modestly better agreement with surface measurements. We develop a calibration framework that integrates CTM- and ML-based approaches to yield estimates of smoke PM2.5 concentrations that outperform individual approach. When combining the estimated smoke PM2.5 concentrations with county-level mortality rates, we find consistent effects of low-level smoke on mortality but large discrepancies in effects of high-level smoke exposure across different methods. Our research highlights the differences across estimation methods for understanding the health impacts of wildfire smoke and demonstrates the importance of bench-marking estimates with available surface measurements.
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