EPA Researchers Contribute to American Thoracic Society Workshop Report on Wildland Fire Smoke Research, Respiratory and Cardiovascular Health Effects
Published May 4, 2021
In recent years, the U.S. has experienced some of the most severe wildfires on record, ravaging massive swaths of land, destroying homes and businesses, and polluting the air with dangerous smoke. As climate change contributes to a warmer, drier environment, and as areas near forests become more populated, wildfires grow more frequent and more damaging, raising concerns for the health of populations exposed to wildfire smoke.
To assess current research on wildland fire smoke and its health effects in the U.S., the American Thoracic Society (ATS) Environmental Health Policy Committee and Assembly on Environmental, Occupational, and Population Health, and partners, have released “Respiratory Impacts of Wildland Fire Smoke: Future Challenges and Policy Opportunities: An Official American Thoracic Society Workshop Report.” The report details the results of a 2019 workshop, hosted by ATS and partially funded by EPA, in which a diverse group of wildland fire experts, scientists, researchers, and clinicians convened to discuss and present current knowledge on wildland fires and their impacts on human health. The group also identified challenges in communication and policy strategies, as well as developed ideas for managing the effects of wildland fires. The report was authored by several multi-disciplinary collaborators including EPA scientists Dr. Wayne Cascio, Dr. Ana Rappold, and Dr. M. Ian Gilmour.
Air pollution, including wildland fire smoke, is the fourth leading risk factor for global mortality resulting from heart and blood vessel diseases, according to 2019 statistics from the Institute for Health Metrics and Evaluation. About half of global deaths associated with air pollution result from cardiovascular diseases, and about 20 percent of cardiovascular disease deaths result from air pollution. Furthermore, short- and long-term exposure to airborne particulate matter (PM), especially fine particulate matter (PM2.5), which is less than 2.5 microns in width, is associated with a range of adverse health effects, including cardiovascular and pulmonary diseases. In the U.S., more than a third of airborne PM2.5 originates from wildfires, leading experts to observe the relationship between wildfire smoke exposure and health.
“In the U.S., as man-made causes of PM2.5 fall over time, local PM2.5 concentrations related to wildfire emissions are making up a larger proportion of air particle pollution. In parts of the U.S., wildfire-related PM makes up 30 percent of annual ambient PM, and during wildfire season in the West, it can be as much as 90 percent,” Dr. Cascio explains. This indicates that many of the illnesses, hospitalizations, and deaths associated with air pollution may result from exposure to wildfire related PM. Additionally, some evidence discussed in the ATS workshop indicates that wildfire-related PM may lead to more hospitalizations for asthmatic children and older adults than non-wildfire-related PM possibly due to wildfire smoke’s different chemical makeup.
In assessing the health effects of wildland fire smoke, Dr. Cascio, a cardiologist describes the populations most vulnerable to the adverse cardiovascular health effects associated with wildland fire smoke, and why effectively educating communities about these vulnerable groups is critical. “We know that the effects of wildfire smoke are greater in those who are older,” Cascio states.
Cascio adds that those with underlying conditions such as heart disease and lung disease are also more susceptible to smoke-related health issues. “Adults with chronic obstructive pulmonary disease (COPD) are also at risk from wildfire smoke exposure, and nearly 50% of adults diagnosed with COPD also have cardiovascular disease. Therefore, actions to increase awareness of the health effects of wildfire smoke among at risk patients will need to be directed to primary care physicians as well as their patients,” says Cascio.
According to Cascio and Rappold, communication and education are key in protecting cardiovascular and overall human health from the effects of wildland fire smoke. As discussed in the ATS workshop and its resulting report, communicating the health risks of wildland fire smoke can pose significant challenges, including a lack of educational resources and coordination among public health officials, clinicians, and communities at large. To address the gaps in public knowledge, there is a growing need for training public health officials with wildfire-specific knowledge and communication strategies, wildfire counseling between healthcare providers and patients, and greater collaboration among public health agencies and wildfire scientists to better predict and prepare for health risks in vulnerable communities.
Going forward, EPA continues to make strides in the assessment of wildland fire smoke and its health impacts to protect the environment and health of communities most affected by fires. Cascio and Rappold seek to promote the results of the ATS workshop through outreach, public health guides, and collaboration with other researchers and organizations.
Currently, Cascio is taking part in an ongoing project, led by EPA epidemiologist Jason Sacks, comparing the health effects of prescribed fires and wildfires, in collaboration with EPA’s Office of Air and Radiation, the U.S. Forest Service, and the Department of the Interior. This research aims to promote the use of controlled fires for land management, while assessing health effects using EPA strategies for evidence-based decision making. Overall, EPA and its collaborators are calling for further research on the health effects of wildland fire smoke, and development of strategies for communicating these health risks and preparing vulnerable communities for future wildfire events.