Evidence map›Paper›PMID 30889810›Full record

SynthesisInternational journal of environmental research and public health2019

Meta-Analysis of Heterogeneity in the Effects of Wildfire Smoke Exposure on Respiratory Health in North America.

Michelle C Kondo, Anneclaire J De Roos, Lauren S White, Warren E Heilman, Miranda H Mockrin, Carol Ann Gross-Davis, Igor Burstyn

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of environmental research and public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Wildfire smoke-related PMEnvironment international · 2026
    Article
  5. Wildfire-Specific PMGeoHealth · 2026
    Article
  6. Article
  7. Wildfire and asthma - The prospective interventions.The World Allergy Organization journal · 2025
    Review
  8. Article
  9. Article
  10. Impacts of wildfire-season air quality on park and playground visitation in the Northwest United States.Ecological economics : the journal of the International Society for Ecological Economics · 2024
    Article
  11. Long-term exposure to wildland fire smoke PMProceedings of the National Academy of Sciences of the United States of America · 2024
    Article
  12. Long-term exposure to wildland fire smoke PMmedRxiv : the preprint server for health sciences · 2024
    Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Michelle C KondoNorthern Research Station, USDA Forest Service, Baltimore, MA 21228, USA. michelle.c.kondo@usda.gov.
Anneclaire J De RoosSchool of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA. aderoos@drexel.edu.
Lauren S WhiteSchool of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA. laurenswhite@gmail.com.
Warren E HeilmanNorthern Research Station-Climate, Fire, and Carbon Cycle Sciences, USDA Forest Service, Lansing, MI 48910, USA. wheilman@fs.fed.us.ORCID 0000-0003-4217-5100
Miranda H MockrinNorthern Research Station, USDA Forest Service, Baltimore, MA 21228, USA. mhmockrin@fs.fed.us.
Carol Ann Gross-DavisOffice of Air Monitoring & Analysis (3AP40), Air Protection Division, US Environmental Protection Agency, Philadelphia, PA 19103, USA. gross-davis.carolann@epa.gov.
Igor BurstynSchool of Public Health, Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA. Igor.Burstyn@drexel.edu.ORCID 0000-0002-7153-4478

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Epidemiological studies consistently show an association between wildfire-related smoke exposure and adverse respiratory health. We conducted a systematic review of evidence in published literature pertaining to heterogeneity of respiratory effects from this exposure in North America. We calculated the within-study ratio of relative risks (RRR) and 95% confidence intervals (CI) to examine heterogeneity of effect by population subgroup, and then summarized the RRRs using meta-analysis. We found evidence of a greater effect of wildfire smoke on respiratory health among females relative to males for asthma (RRR: 1.035, 95% CI: 1.013, 1.057) and chronic obstructive pulmonary disease (RRR: 1.018, 95% CI: 1.003, 1.032). There was evidence of a lower relative risk for all respiratory outcomes among youth compared to adults (RRR: 0.976, 95% CI: 0.963, 0.989). We also found wildfire smoke effects stratified by income, race, education, health behaviors, access to care, housing occupancy, geographic region, and urban/rural status. However, data were insufficient to quantitatively evaluate effect modification by these characteristics. While we found evidence that certain demographic subgroups of the population are more susceptible to respiratory health outcomes from wildfire smoke, it is unclear whether this information can be used to inform policy aimed to reduce health impact of wildfires.

Indexed as

WildfiresEnvironmental ExposureFemaleHumansMaleNorth AmericaRespiratory Tract DiseasesRiskRural PopulationSex FactorsSmokeSmokeheterogeneity of effectsratio of relative riskrespiratory healthwildfire smoke

Identifiers

PMID30889810
PMCPMC6466235

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.