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

Michelle C. Kondo, Anneclaire J. De Roos, Lauren S. White, Warren E. Heilman, Miranda H. Mockrin, Carol Ann Gross-Davis and Igor Burstyn
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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

IJERPH, 2019, vol. 16, issue 6, 1-15

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.

Keywords: wildfire smoke; respiratory health; heterogeneity of effects; ratio of relative risk (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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