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Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners of federal, state, and private forests is to craft ecosystem management plans that simultaneously optimize forest health and human health. Fire-a major forest management issue in the United States-complicates these goals. Wildfires are natural phenomena with unpredictable effects. Controlled fires, on the other hand, are often prescribed to reduce biomass fuels, reduce wildfire risks, and protect resource values. While fires can enhance the health of fire-adapted ecosystems, research on the human health impacts of smoke from forest fires is somewhat equivocal. This article synthesizes 30 years of research on the human health impacts of forest fires. It summarizes our current state of knowledge about the following: biophysical effects of environmental contamination resulting from forest fires; psychosocial impacts of forest fires; occupational exposure issues among fire crew; visibility impairment from forest fire smoke; and health care measures that address the impacts of forest fires. This article provides information that may be useful for land managers, researchers, policy makers, health care workers, and the general public in decision-making about forest management practices. It also recommends that future research use integrative health models and adopt ethnographic research methods. Fire Research in the South Forestry management practices can shape patterns of health, illness, and disease. A primary goal for federal, state, and private foresters is to craft ecosystem management plans that simultaneously optimize forest health and human health. Fire complicates these goals. Fire is a major forest management issue in the United States because of its frequency and its potential to damage natural and human resources. Wildfires are natural phenomena with unpredictable effects that occur across the continent at varying rates. Controlled fires, on the other hand, are often prescribed to reduce biomass fuels, reduce wildfire risks, and protect resource values. It is common for people who own forests in fire-adapted ecosystems to use prescribed (or controlled) burning as a means for creating healthy forest ecosystems. Many ecosystems in the southern United States are fireadapted; for example, evergreen shrub bogs, sandpine scrub, and flatwoods on the Coastal Plain; prairie grass savannas and pine forests in the Piedmont; and Table Mountain pine (Pinuspungens) and pitch pine (P. rigida) forests in the southern Appalachians. While fires can enhance the health of fireadapted ecosystems, research on the human health impacts of smoke from forest fires is somewhat equivocal. The health risks of smoke are particularly relevant in the southern United States, the region with the highest annual average prescribed burn area in the United States (Haines et al. 1998). Between 1985 and 1994, 424,119 hectares were submitted to prescribed fires (Haines et al. 1998). For most people in the South, smoke produced from forest fires has very little or no health impact. However, smoke is a very real concern for certain segments of the population. Young children, the elderly, people with pre-existing cardiopulmonary and psychiatric conditions, and smokers are particularly vulnerable to smoke-related health risks. People at greater risk of exposure to smoke from forest fires, for example residents of wildland-urban interfaces, outdoor enthusiasts, and firefighters, are also more vulnerable to health risks. This article synthesizes 30 years of research on the human health impacts of forest fires. Research on this topic is taking place in a variety of disciplines including forestry, pulmonary medicine, epidemiology, public health, clinical and animal toxicology, sociology, and anthropology. Epidemiologic studies on the health consequences of indoor air pollution created by the burning of bio mass fuel for cooking, heating and light offer insight into the health impacts of biomass smoke created by forest fires (Larson and Koenig 1994). …

Human Health Impacts of Forest Fires in the Southern United States: A Literature Review