The study examined mortality following episodic wildfire smoke exposure across United States counties. Monthly county-level wildfire PM2.5 and death counts were used. Episodic exposure contrasts served to deconvolve overlapping responses and recover an impulse-response function. Excess mortality peaked about three years after an exposure pulse and subsided by five years. The authors estimate 1.7 million smoke-associated deaths during 2011-2023, about ten times the estimate from long-term ambient PM2.5 relative risks. Circulatory and respiratory causes contributed comparably, and responses were larger in adults aged 65 and over. The design is ecological, so exposure is assigned at county rather than individual level.
Why it is interesting: Deaths continue to accumulate for three years after exposure, giving a far larger burden than conventional ambient PM2.5 relative risks.
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