Quantifying the short-term mortality effects of wildfire smoke in Europe: a multicountry epidemiological study in 654 contiguous regions

Year: 2025

Type: article

Abstract: Background Fine particulate matter (PM 2·5 ) from wildfire smoke could be more harmful to human health than that from other sources. Evidence of the short-term association between wildfire-related PM 2·5 and mortality in Europe remains sparse, leading to uncertainties in the fire-related PM 2·5 mortality burden. Methods In this retrospective, multicountry epidemiological study, we used the EARLY-ADAPT database to obtain daily mortality records in 654 contiguous subnational regions from 32 European countries, representing a population of 541 million individuals. We combined these data with daily estimates of fire-related and non-fire-related PM 2·5 from the System for Integrated Modelling of Atmospheric Composition model during 2004–22. Regional and pooled associations between daily fire-related PM 2·5 and all-cause and cause-specific mortality were quantified using quasi-Poisson regression. We compared deaths attributable to fire-related PM 2·5 using relative risks (RRs) specific to fire-related PM 2·5 versus total PM 2·5 . Findings Our study data included 95⸱3 million daily deaths for all-cause mortality, 19⸱5 million daily deaths for cardiovascular mortality, and 3⸱9 million daily deaths for respiratory mortality from Jan 1, 2004, until the latest available year in each country. Pooled cumulative (lags 0–7) RRs associated with a 1 μg per m 3 increase in fire-related PM 2·5 were 1⸱007 (95% CI 1⸱004–1⸱010) for all-cause mortality, 1⸱009 (1⸱006–1⸱013) for cardiovascular mortality, and 1⸱013 (1⸱008–1⸱019) for respiratory mortality. RRs were larger for fire-related PM 2·5 than for non-fire-related PM 2·5 . Using RRs for total (fire-related and non-fire-related) PM 2·5 underestimated the fire-related PM 2·5 attributable mortality by 93%. Interpretation Associations with all-cause and cause-specific mortality were larger for fire-related compared with non-fire-related PM 2·5 . Assuming wildfire PM 2·5 has the same effect as total PM 2·5 substantially underestimates the mortality burden of wildfire smoke. Funding The European Commission, EU Horizon Europe, the European Research Council, and the Research Council of Finland.

Source: The Lancet Planetary Health

DOI: 10.1016/j.lanplh.2025.101296

Authors: Anna Alari, Joan Ballester, Carles Milà, Tarik Benmarhnia, Mikhail Sofiev, Andreas Uppstu, Risto Hänninen, Cathryn Tonne

Institutions: Universitat Pompeu Fabra, Barcelona Institute for Global Health, Scripps Institution of Oceanography, Inserm, University of California San Diego, Institut de Recherche en Santé, Environnement et Travail, Université de Rennes, Finnish Meteorological Institute

Language: English

Topic: Air Quality and Health Impacts

Subfield: Health, Toxicology and Mutagenesis

Field: Environmental Science

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $6,680

Funders: Centres de Recerca de Catalunya, European Commission, Academy of Finland, Generalitat de Catalunya, Ministerio de Ciencia e Innovación, HORIZON EUROPE Framework Programme, European Research Council, Socialstyrelsen, Agencia Estatal de Investigación, Norwegian Institute of Public Health, HORIZON EUROPE European Research Council

OpenAlex ID: W4413152831