Mahendran Rahini, Ju Ke, Yang Zhengyu, Gao Yuan, Huang Wenzhong, Yu Wenhua, Liu Yanming, Hundessa Samuel, Yu Pei, Xu Rongbin, Zhang Lei, Li Shanshan, Guo Yuming
Climate Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Melbourne Sexual Health Centre, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia.
ACS Environ Au. 2025 Apr 14;5(3):253-266. doi: 10.1021/acsenvironau.4c00087. eCollection 2025 May 21.
Amid the global rise in wildfire events, the health impacts of wildfire-related air pollution are increasingly scrutinized. While numerous reviews have examined the link between air pollution and infectious diseases, reviews specifically focusing on wildfire-related air pollution and infectious diseases remain scarce. To address this gap, we conducted a comprehensive search in MEDLINE, EMBASE, Scopus and Web of Science databases up to December 31, 2023, using PRISMA (Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines. Search terms included synonyms of wildfire and infectious diseases. Peer-reviewed epidemiological studies that reported any association or trend between wildfire air pollution and infectious diseases were selected against eligibility criteria. Risk of bias and quality of included studies were assessed using modified risk of bias and quality assessment tools. Our review included 30 studies, predominantly from developed countries including the United States (USA), Australia, and Canada. Most focused on respiratory infectious diseases ( = 29), including 9 specifically on the coronavirus disease 2019 (COVID-19). The majority examined short-term wildfire air pollution ( = 27) (exposure of one month or less). Twenty-three studies reported effect estimates for the meta-analysis. We found that a 10 μg/m increase in short-term wildfire PM (particulate matter with a diameter of 2.5 micrometer of less) exposure was associated with a 15% increase in COVID-19 infections (relative risk [RR] = 1.15; 95% confidence interval [CI]: 1.09-1.21; heterogeneity ( ): 83%), a 3% increase in respiratory diseases (RR = 1.03; 95% CI: 1.01-1.05; : 0%) and a 3% increase in acute upper respiratory infection combined with acute bronchitis (RR = 1.03; 95% CI: 1.02-1.05; : 62%). Medium-term exposure (more than a month but less than a year) to wildfire smoke was associated with 20% rising hospitalization for systemic fungal infections like coccidioidomycosis (95% CI: 5-38%). The current research exclusively examines respiratory infections in developed countries. Future high-quality primary studies should prioritize understanding the impact of wildfire-related air pollution on various infectious diseases.
在全球野火事件不断增加的背景下，野火相关空气污染对健康的影响受到了越来越多的审视。虽然已有众多综述探讨了空气污染与传染病之间的联系，但专门聚焦于野火相关空气污染与传染病的综述仍然较少。为了填补这一空白，我们按照PRISMA（系统评价与Meta分析的首选报告项目）指南，在截至2023年12月31日的MEDLINE、EMBASE、Scopus和Web of Science数据库中进行了全面检索。检索词包括野火和传染病的同义词。根据纳入标准，筛选出报告了野火空气污染与传染病之间任何关联或趋势的同行评审流行病学研究。使用改良的偏倚风险和质量评估工具评估纳入研究的偏倚风险和质量。我们的综述纳入了30项研究，主要来自包括美国、澳大利亚和加拿大在内的发达国家。大多数研究聚焦于呼吸道传染病（n = 29），其中9项专门针对2019冠状病毒病（COVID - 19）。大多数研究考察的是短期野火空气污染（n = 27）（暴露时间为一个月或更短）。23项研究报告了用于Meta分析的效应估计值。我们发现，短期野火细颗粒物（直径小于或等于2.5微米的颗粒物）暴露每增加10 μg/m³，与COVID - 19感染增加15%相关（相对风险[RR] = 1.15；95%置信区间[CI]：1.09 - 1.21；异质性（I²）：83%），与呼吸道疾病增加3%相关（RR = 1.03；95% CI：1.01 - 1.05；I²：0%），与急性上呼吸道感染合并急性支气管炎增加3%相关（RR = 1.03；95% CI：1.02 - 1.05；I²：62%）。中期（超过一个月但少于一年）暴露于野火烟雾与球孢子菌病等系统性真菌感染的住院率上升20%相关（95% CI：5 - 38%）。当前研究仅考察了发达国家的呼吸道感染情况。未来高质量的原发性研究应优先关注了解野火相关空气污染对各种传染病的影响。
