Potential impacts of prescribed fire smoke on public health and socially vulnerable populations in a Southeastern U.S. state.

Prescribed fire is an essential tool for wildfire risk mitigation and ecosystem restoration in the Southeastern United States. It is also one of the region's largest sources of atmospheric emissions. The public health impacts of prescribed fire smoke, however, remain uncertain. Here, we use digital burn permit records, reduced-complexity air quality modeling, and epidemiological associations between fine particulate matter concentrations and multiple health endpoints to assess the impacts of prescribed burning on public health across Georgia. Additionally, we examine the social vulnerability of populations near high prescribed burning activity using a demographic- and socioeconomic-based index. The analysis identifies spatial clusters of burning activity in the state and finds that areas with intense prescribed fire have levels of social vulnerability that are over 25% higher than the state average. The results also suggest that the impacts of burning in Georgia can potentially include hundreds of annual morbidity and mortality cases associated with smoke pollution. These health impacts are concentrated in areas with higher fractions of low socioeconomic status, elderly, and disabled residents, particularly vulnerable to air pollution. Estimated smoke-related health incidence rates are over 3 times larger than the state average in spatial clusters of intense burning activity, and over 40% larger in spatial clusters of high social vulnerability. Spatial clusters of low social vulnerability experience substantially lower negative health effects from prescribed burning relative to the rest of the state. The health burden of smoke from prescribed burns in the state is comparable to that estimated for other major emission sectors, such as vehicles and industrial combustion. Within spatial clusters of socially-vulnerable populations, the impacts of prescribed fire considerably outweigh those of other emission sectors. These findings call for greater attention to the air quality impacts of prescribed burning in the Southeastern U.S. and the communities most exposed to fire-related smoke.