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

Authors :
Kondo MC
De Roos AJ
White LS
Heilman WE
Mockrin MH
Gross-Davis CA
Burstyn I
Source :
International journal of environmental research and public health [Int J Environ Res Public Health] 2019 Mar 18; Vol. 16 (6). Date of Electronic Publication: 2019 Mar 18.
Publication Year :
2019

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.

Details

Language :
English
ISSN :
1660-4601
Volume :
16
Issue :
6
Database :
MEDLINE
Journal :
International journal of environmental research and public health
Publication Type :
Academic Journal
Accession number :
30889810
Full Text :
https://doi.org/10.3390/ijerph16060960