Wildfire, health effects and solution (WHES) - ABSTRACT Wildfire pollution is an increasingly serious public health concern in California, USA. Wildfire smoke mainly consists of fine particulate matters (PM2.5) that can exert greater toxicity than ambient urban air pollutants. Pregnant people and newborns are particularly vulnerable to the negative effects of wildfire smoke exposure. Currently, scientific evidence on the effects of maternal exposure to wildfire PM2.5 on adverse pregnancy and infant outcomes (hereby abbreviated as APOs), particularly concerning the toxic chemicals in PM2.5, is elusive. Additionally, there is a limited understanding of how human behavior changes affect wildfire smoke exposure and APOs. Furthermore, few studies have focused on developing and evaluating practical proactive strategies, such as prescribed burning and land management solutions, to mitigate wildfire emissions at the source and minimize future smoke exposure, with the aim of improving pregnancy and infant health. To address these knowledge gaps, we propose an integrated framework with the overarching goal to study the complex interactions between wildfire smoke exposure, human behavioral responses, and pregnancy and infant health; and to evaluate innovative solutions for mitigating wildfire smoke and protect women and infant health during and after pregnancy. We hypothesize wildfire air pollution increases health risks for pregnant people and infants, particularly for those with existing chronic health conditions (e.g., hypertension, diabetes) and those residing in communities with inadequate protective measures against wildfire pollution. Furthermore, we also hypothesize that incorporating public health response and community vulnerability in fire and land management solutions may have great potential to improve pregnancy and infant health related to wildfire air pollution. Our research project comprises three specific aims. First, we will apply advanced wildfire air pollution modeling, combined with comprehensive birth cohort data (linked birth and death certificates) spanning from 2016 to 2027, to assess the effects of wildfire PM2.5 and its constituents (black carbon, organic carbon, nitrate, sulfate, ammonium) on APOs in fire-impacted areas of California (Aim 1). Second, we will develop novel community-scale indices to evaluate changes in human behavior, such as patterns of human mobility and air infiltration, in response to wildfire exposure, and assess their impacts on differentiating the health effects of wildfires on APOs (Aim 2). Third, we will perform scenario simulations using an integrated vegetation-fire- health model to assess whether practical proactive strategies such as optimization of prescribed burning or alteration of wildland vegetation can reduce future wildfire air pollution exposure and the burden of APOs until 2100 (Aim 3). Our findings will advance our understanding of multifactorial human behaviors and their role in pregnancy health outcomes related to wildfire exposure, and will inform evidence-based policies as well as guide interventions to improve the health and well-being of pregnant people and their babies.
