Policy Implications for Protecting Health from the Hazards of Fire Smoke. A Panel Discussion Report from the Workshop Landscape Fire Smoke: Protecting Health in an Era of Escalating Fire Risk

Personal strategies to reduce the effects of landscape fire smoke on asthma-related outcomes: a protocol for systematic review and meta-analysis

INTRODUCTION

Landscape fire smoke (LFS) contains several hazardous air pollutants that are known to be detrimental to human health. People with asthma are more vulnerable to the health impact of LFS than general populations. The aim of this review is to investigate the effectiveness of personal strategies to reduce the effect of LFS on asthma-related outcomes.

METHODS AND ANALYSIS

We will electronically search databases such as Medline, Embase, CINAHL and Cochrane Clinical Trials Register to identify eligible articles for the review. Screening of search results and data extraction from included studies will be completed by two independent reviewers. The risk of bias (RoB 2) will be assessed using the Risk of Bias Assessment Tool for Non-Randomised Studies for observational studies, the Cochrane Collaboration tool for assessing the RoB 2 for randomised controlled trials (RCTs) and the Risk Of Bias In Nonrandomized Studies of Interventions tool for non-RCTs. A random-effect meta-analysis will be performed to determine the pooled summary of findings of the included studies. If meta-analysis is not possible, we will conduct a narrative synthesis. Findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

ETHICS AND DISSEMINATION

This study will synthesise the available evidence obtained from published studies and as such, no ethical approval is required. The review will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42022341120.

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.

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.

Wildfire, Smoke Exposure, Human Health, and Environmental Justice Need to be Integrated into Forest Restoration and Management

PURPOSE OF REVIEW

Increasing wildfire size and severity across the western United States has created an environmental and social crisis that must be approached from a transdisciplinary perspective. Climate change and more than a century of fire exclusion and wildfire suppression have led to contemporary wildfires with more severe environmental impacts and human smoke exposure. Wildfires increase smoke exposure for broad swaths of the US population, though outdoor workers and socially disadvantaged groups with limited adaptive capacity can be disproportionally exposed. Exposure to wildfire smoke is associated with a range of health impacts in children and adults, including exacerbation of existing respiratory diseases such as asthma and chronic obstructive pulmonary disease, worse birth outcomes, and cardiovascular events. Seasonally dry forests in Washington, Oregon, and California can benefit from ecological restoration as a way to adapt forests to climate change and reduce smoke impacts on affected communities.

RECENT FINDINGS

Each wildfire season, large smoke events, and their adverse impacts on human health receive considerable attention from both the public and policymakers. The severity of recent wildfire seasons has state and federal governments outlining budgets and prioritizing policies to combat the worsening crisis. This surging attention provides an opportunity to outline the actions needed now to advance research and practice on conservation, economic, environmental justice, and public health interests, as well as the trade-offs that must be considered. Scientists, planners, foresters and fire managers, fire safety, air quality, and public health practitioners must collaboratively work together. This article is the result of a series of transdisciplinary conversations to find common ground and subsequently provide a holistic view of how forest and fire management intersect with human health through the impacts of smoke and articulate the need for an integrated approach to both planning and practice.

Bushfire Smoke in Our Eyes: Community Perceptions and Responses to an Intense Smoke Event in Canberra, Australia

The 2019–20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia's capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experientially different from many natural disasters, it nevertheless poses a significant public health threat. As the impact of extended bushfire smoke in an urban setting is relatively unexplored we aimed to capture the individual and community-level experiences of the event and their importance for community and social functioning. We responded rapidly by conducting semi-structured interviews with a range of Canberra residents who, due to their personal or social circumstances, were potentially vulnerable to the effects of the smoke. Three major themes emerging from the narratives depicted disruption to daily life, physical and psychological effects, and shifting social connectedness. This study highlighted the ambiguous yet impactful nature of a bushfire smoke event, and identified four simple key messages that may be critically relevant to policy making in preparation for similar smoke events in the future.