Wildfire smoke and health impacts: a narrative review

Air pollution emission associated with wildfires is a global concern, contributing to air quality deterioration and severely impacting public health. This narrative review aims to provide an overview of wildfire smoke (WFS) characteristics and associated impacts on adults' and children's health. Literature review based on a bibliographic survey in PubMed (National Library of Medicine, United States), SciELO (Scientific Electronic Library Online), and Google Scholar databases. Observational, cross-sectional, longitudinal, and review studies were considered, prioritizing peer-reviewed articles published in the last 10 years (2014-2024). Wildfire smoke (WFS) contributes to the deterioration of air quality, resulting in increased exposure to air pollution especially in wildland-urban interfaces. WFS contains particulate matter (PM) in a range of sizes and chemical compositions, as well as multiple toxic gasses. The health impacts of WFS are systemic, affecting the respiratory, cardiovascular, and neurological systems. Exposure to WFS is associated with inflammatory and oxidative stress, DNA damage, epigenetic modulations, and stress-disorders in adults and children. Children may be at an increased risk of WFS respiratory impacts, due to their smaller airways and developing lungs. Wildfires are increasing in frequency and intensity, resulting in thousands of premature deaths and hospitalizations worldwide, each year. Preventive measures against wildfire spread must be reinforced, considering the increasing trends of global warming and extreme weather events. Adaptation strategies should be undertaken especially in wildland-urban interface regions, including the improvement of early warning systems, improvement of health care facilities and household preparedness and promotion of risk communication campaigns.