Wildfire Exposure and Respiratory Health: A Comprehensive Review of Emerging Evidence.

Abstract

In January 2025, a catastrophic wildfire in Los Angeles, California, resulted in extensive economic losses and created a substantial risk to public respiratory health. With the progression of climate change, the increasing frequency and severity of wildfires have become a critical global issue due to their substantial impact on respiratory health. Wildfire smoke comprises elevated levels of ambient air pollutants, such as particulate matter (PM2.5, PM10), carbon monoxide (CO), nitrogen oxides (NOx), ozone (O3), and a range of toxic substances. Notably, wildfire-related PM is especially detrimental because it can penetrate deeply into the lower respiratory tract and alveoli, provoking stronger oxidative and inflammatory responses, and leading to both the development and worsening of respiratory conditions, including asthma and chronic obstructive pulmonary disease (COPD). Research indicates that short-term exposure to wildfire smoke is linked to acute exacerbations of asthma, COPD, and pneumonia, contributing to higher mortality rates and increased demands on healthcare utilization. Long-term exposure may increase the risk of developing COPD, accelerate disease progression, and is potentially linked to a heightened risk of lung cancer and mortality. Collectively, these data underscore the substantial threat posed by wildfire smoke, escalating morbidity, mortality, and socioeconomic burdens. This review systematically summarizes recent advances in our understanding of respiratory health impacts linked with wildfire smoke exposure. By aggregating current evidence, the review seeks to guide healthcare practitioners and public health officials, thereby promoting evidence-based interventions for clinical management, health communication, and disaster response amid the escalating risk associated with wildfires.