Smoke health costs and the calculus for wildfires fuel management: a modelling study

<div>Background<div>Smoke from uncontrolled wildfires and deliberately set prescribed burns has the potential to produce substantial population exposure to fine particulate matter (PM_2.5). We aimed to estimate historical health costs attributable to smoke-related PM_2.5 from all landscape fires combined, and the relative contributions from wildfires and prescribed burns, in New South Wales, Australia.</div>Methods<div>We quantified PM_2.5 from all landscape fire smoke (LFS) and estimated the attributable health burden and daily health costs between July 1, 2000, and June 30, 2020, for all of New South Wales and by smaller geographical regions. We combined these results with a spatial database of landscape fires to estimate the relative total and per hectare health costs attributable to PM_2.5 from wildfire smoke (WFS) and prescribed burning smoke (PBS).</div>Findings<div>We estimated health costs of AU$ 2013 million (95% CI 718-3354; calculated with the 2018 value of the AU$). $1653 million (82.1%) of costs were attributable to WFS and $361 million (17.9%) to PBS. The per hectare health cost was of $105 for all LFS days ($104 for WFS and $477 for PBS). In sensitivity analyses, the per hectare costs associated with PBS was consistently higher than for WFS under a range of different scenarios.</div>Interpretation<div>WFS and PBS produce substantial health costs. Total health costs are higher for WFS, but per hectare costs are higher for PBS. This should be considered when assessing the trade-offs between prescribed burns and wildfires.</div></div>