Syed Amal, Basu Rupa
California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Sacramento, California, USA.
Paediatr Perinat Epidemiol. 2025 Jan;39(1):110-119. doi: 10.1111/ppe.13141.
With wildfires increasing globally due to climate change, children may be more behaviourally exposed and more physiologically vulnerable to adverse health outcomes.
To complete a comprehensive investigation of epidemiological studies examining respiratory and non-respiratory impacts of wildfires to identify research gaps and inform decision-making to protect children's health.
The databases searched were PubMed, Embase, Scopus and Google Scholar.
Global epidemiological studies that investigated individuals under the age of 18 and were published from January 2006 to July 2024 were eligible to be included. Studies were included if they had wildfire days, smoke, or pollutants as the main exposure and had an outcome related to children's health. Though a meta-analysis was not possible, results were reported qualitatively through summaries of evidence tables and noteworthy results and the magnitude of the associations for each outcome was reported.
Twenty-four studies were selected. Sixteen studies examined respiratory outcomes and 11 studies included non-respiratory outcomes. A meta-analysis was not conducted, and consistent conclusions could not be made due to the heterogeneity and the small number of studies. Most respiratory-related studies found positive associations between wildfire exposure and adverse respiratory outcomes. All non-respiratory outcomes, except physical activity, had positive associations with wildfire exposure. For most non-respiratory outcomes, only one study evaluated each outcome. Higher-risk children were asthmatic, obese, under the age of five, in low-income countries or with a low socio-economic status.
There is consistent evidence that wildfire exposure is associated with adverse respiratory health in children, globally. There is less consistent evidence for the effect of wildfire exposure on non-respiratory outcomes. Further long-term research on non-respiratory outcomes in children, specifically physical activity, academic success and mental health is needed, especially in high-risk populations.
由于气候变化，全球范围内野火不断增加，儿童可能在行为上更多地暴露于野火环境中，并且在生理上更容易受到不良健康后果的影响。
全面调查有关野火对呼吸和非呼吸影响的流行病学研究，以识别研究空白，并为保护儿童健康的决策提供依据。
检索的数据库包括PubMed、Embase、Scopus和谷歌学术。
纳入2006年1月至2024年7月发表的、调查18岁以下个体的全球流行病学研究。如果研究以野火日、烟雾或污染物作为主要暴露因素，且结果与儿童健康相关，则纳入研究。尽管无法进行荟萃分析，但通过证据表总结、值得注意的结果以及报告每个结果的关联强度进行了定性报告。
共选择了24项研究。16项研究考察了呼吸结局，11项研究纳入了非呼吸结局。未进行荟萃分析，由于研究的异质性和数量较少，无法得出一致结论。大多数与呼吸相关的研究发现野火暴露与不良呼吸结局之间存在正相关。除身体活动外，所有非呼吸结局均与野火暴露呈正相关。对于大多数非呼吸结局，每项结局仅有一项研究进行了评估。高危儿童包括哮喘患儿、肥胖儿童、五岁以下儿童、低收入国家儿童或社会经济地位较低的儿童。
有一致的证据表明，全球范围内野火暴露与儿童不良呼吸健康相关。关于野火暴露对非呼吸结局影响的证据则不太一致。需要对儿童的非呼吸结局，特别是身体活动、学业成绩和心理健康进行进一步的长期研究，尤其是在高危人群中。
