Assessing the Risk of Respiratory-Related Healthcare Visits Associated with Wildfire Smoke Exposure in Children 0–18 Years Old: A Systematic Review

Abstract

Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children < 5 years old.

If We Destroy Nature – We Destroy Ourselves

“…The link between asthma exacerbations and smoke exposure is well established with a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in younger children (under 5 yr). 5 The results of this study reconfirm the link between a higher incidence of respiratory adverse events in children with airway hyperreactivity when exposed to wildfires. 5…”

Health effects of wildfire smoke during pregnancy and childhood

“…Health service use is defined mostly through hospital, or emergency department presentations or admissions, and or doctor or clinic visits in children during or related to a wildfire event or smoke exposure. These episodes of care are mostly related to respiratory causes, and health service use in general and specifically related to respiratory symptoms has been reported to increase during periods of wildfire smoke exposure and comes from a range of studies (Henry et al, 2021). A prospective cohort study of >6000 school-aged children, mostly aged 6 to 7 years, collected annual respiratory health data and included wildfire exposure following the 2003 Californian wildfires (Künzli et al, 2006).…”

The role of wildfires in a sustainable future

“…Air pollution is one of the causes of allergic diseases such as asthma. In particular, some people with asthma overuse cold medicines (Henry et al, 2021). In particular, some people with asthma overuse cold medicines (Haikerwal et al, 2016;Kiser et al, 2020;Shen et al, 2018).…”