The aim of the paper is to summarize the evidence of health impacts of occupational exposure to wildland fires. The authors searched 3 databases for relevant articles and screened the results. After full-text review, articles were included based on predetermined criteria. The authors identified 32 relevant articles. Occupational exposure to wildland fires affects lung function in the short term and may increase the risk of hypertension in the long term. Exposure to wildland fires is also associated with post-traumatic stress symptoms. There was insufficient evidence to comment on most longer-term risks, and in particular on respiratory disease or cancer risks. Further research is required to understand whether occupational exposure to wildland fires results in clinically significant impacts on respiratory function, and to further clarify the relationship between occupational exposure and blood pressure, mental health, and cancer outcomes.
Introduction:With increasing disaster risks from extreme weather, climate change, and emerging infectious diseases, the public health system plays a crucial role in community health protection. The disproportionate impacts of disaster risks demonstrate the need to consider ethics and values in public health emergency preparedness (PHEP) activities. Established PHEP frameworks from many countries do not integrate ethics into operational approaches.Aim:To explore the ethical dimensions of all-hazards public health emergency preparedness in Canada.Methods:A qualitative study design was employed to explore key questions relating to PHEP. Six focus groups, using the Structured Interview Matrix (SIM) format, were held across Canada with 130 experts from local, provincial, or federal levels, with an emphasis on local/regional public health. An inductive approach to content analysis was used to develop emergent themes, and iteratively examined based on the literature. This paper presents analyses examining the dimensions of ethics and values that emerged from the focus group discussions.Results:Thematic analysis resulted in the identification of four themes. The themes highlight the importance of proactive consideration of values in PHEP planning: challenges in balancing competing priorities, the need for transparency around decision-making, and consideration for how emergencies impact both individuals and communities.Discussion:Lack of consideration for the ethical dimensions of PHEP in operational frameworks can have important implications for communities. If decisions are made ad-hoc during an evolving emergency situation, the ethical implications may increase the risk for some populations, and lead to compromised trust in the PHEP system. The key findings from this study may be useful in influencing PHEP practice and policy to incorporate fairness and values at the core of PHEP to ensure readiness for emergencies with community health impacts.
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