The mental health and well-being effects of wildfire smoke: a scoping review

Abstract

Background Smoke from wildfires is a growing public health risk due to the enormous amount of smoke-related pollution that is produced and can travel thousands of kilometers from its source. While many studies have documented the physical health harms of wildfire smoke, less is known about the effects on mental health and well-being. Understanding the effects of wildfire smoke on mental health and well-being is crucial as the world enters a time in which wildfire smoke events become more frequent and severe. We conducted a scoping review of the existing information on wildfire smoke’s impact on mental health and well-being and developed a model for understanding the pathways in which wildfire smoke may contribute to mental health distress. Methods We conducted searches using PubMed, Medline, Embase, Google, Scopus, and ProQuest for 1990–2022. These searches yielded 200 articles. Sixteen publications met inclusion criteria following screening and eligibility assessment. Three more publications from the bibliographies of these articles were included for a total of 19 publications. Results Our review suggests that exposure to wildfire smoke may have mental health impacts, particularly in episodes of chronic and persistent smoke events, but the evidence is inconsistent and limited. Qualitative studies disclose a wider range of impacts across multiple mental health and well-being domains. The potential pathways connecting wildfire smoke with mental health and well-being operate at multiple interacting levels including individual, social and community networks, living and working conditions, and ecological levels. Conclusions Priorities for future research include: 1) applying more rigorous methods; 2) differentiating between mental illness and emotional well-being; 3) studying chronic, persistent or repeated smoke events; 4) identifying the contextual factors that set the stage for mental health and well-being effects, and 5) identifying the causal processes that link wildfire smoke to mental health and well-being effects. The pathways model can serve as a basis for further research and knowledge synthesis on this topic. Also, it helps public health, community mental health, and emergency management practitioners mitigate the mental health and well-being harms of wildfire smoke.

Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States

“…In addition to cardiovascular and respiratory mortality, we found a strong association between smoke PM 2.5 and mortality from mental disorders. In a scoping review, the authors proposed a multi-level conceptual framework for understanding the pathways connecting wildfire smoke with mental health and well-being, which includes the interaction among individual, social and community networks, living and working conditions, and ecological levels (12). However, empirical evidence on this topic is still limited.…”

“…However, in addition to the physical health harms, mental health can also be potentially threatened by wildfire smoke. Some studies have linked wildfires to mental outcomes, such as anxiety, depression, poor sleep quality, and posttraumatic stress disorder (7, 12, 13), but the relationship between wildfire smoke and mental disorder mortality was rarely analyzed in previous studies.…”

“…and community networks, living and working conditions, and ecological levels (12). However, empirical evidence on this topic is still limited.…”

Health effects of wildfires

“…19 Wildfires can impact mental health through a variety of pathways at the individual, social and community level, in living and work conditions, and at the ecological level; for example, through reduced sleep duration and quality, reduced physical activity, increased perceptions of risk and anxiety, isolation from others, forced evacuations and/or relocations, reduced access to livelihoods, and loss of nature. 18,[22][23][24] Recent work has emphasized the need for broad measures of social impacts from wildfires -as opposed to more common outcomes like buildings burned and resources spent on suppression efforts -that provide more comprehensive pictures of the impact of wildfires on community health and well-being. 17 Given the vulnerability of some communities to impacts of environmental hazards, 25,26 community resilience can be considered a critical factor in mitigating the health effects of wildfires.…”

“…Recent literature has documented worsened cognitive outcomes, 88,89 declines in mental health, 24 and increased ED visits for headaches 90 associated with exposure to wildfire smoke. For example, Cleland et al 88 assessed cognitive performance among adults and found that wildfire smoke plumes was negatively associated with the estimated attention score on the same day and one week later.…”