Impact of Wildfire Smoke on Acute Illness
Climate change increases wildfire smoke exposure. Inhaled smoke causes inflammation, oxidative stress, and coagulation, which exacerbate cardiovascular and respiratory disease while worsening obstetric and neonatal outcomes.
Subject Tags
- Fire management
- Forest
- Social Sciences
Abstract
Climate change is increasing the frequency and severity of wildfires, expanding population exposure to harmful smoke. Wildfire smoke contains fine particulate matter and toxic gases that trigger inflammation, oxidative stress, and coagulation abnormalities, contributing to cardiovascular, respiratory, obstetric, and neonatal morbidity. Although wildfire‑related air pollution is a growing global health threat, its perioperative implications remain poorly characterized, and no clinical guidelines exist for managing exposed patients. Wildfire smoke now accounts for more than half of U.S. days with elevated PM₂.₅, with some communities experiencing extreme concentrations far above World Health Organization recommendations. Vulnerable groups—including children, older adults, pregnant individuals, and those with cardiopulmonary disease—face disproportionate risk. Subclinical exposure may increase perioperative complications such as major adverse cardiac events and postoperative respiratory compromise, while prenatal exposure contributes to prematurity and low birth weight, with long‑term health consequences. As wildfire smoke affects populations both near and far from burn areas, there is an urgent need to develop perioperative protocols that recognize and mitigate the risks associated with overt and silent smoke exposure.
Citation
Hughes, F., Parsons, L., Levy, J.H., Shindell, D., Alhanti, B., Ohnuma, T., Kasibhatla, P., Montgomery, H. and Krishnamoorthy, V., 2024. Impact of wildfire smoke on acute illness. Anesthesiology, 141(4), pp.779-789. 10.1097/ALN.0000000000005115
TNC Authors
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Luke Parsons
Applied Climate Modeling Scientist
The Nature Conservancy
Email: luke.parsons@tnc.org