LAUSR

There is increasing scientific consensus that climate change is the underlying cause of the prolonged dry and hot conditions that have increased the risk of extreme fire weather in Australia.1-3 With persistent droughts and record-breaking temperatures (2019 was Australia’s warmest and driest year on record, http://www.bom. gov.au/climate/current/annual/aus/), it is unlikely that the extreme bushfires and smoke haze in Australia during the “Black Summer” (at the end of 2019 and the beginning of 2020) will be a one-off event. In recent years, other parts of the world, including California, Southern Europe, Southeast Asia, and the Amazon, have also been affected by catastrophic wildfires. We should be better prepared for more frequent and intense bushfire and wildfire events.3,4 The immediate response to wildfires aims to prevent loss of life and may involve evacuation of people living in areas under threat. Although often necessary, evacuations can have health consequences for those who are displaced, particularly the poor and elderly, as was the case after the large-scale evacuations because of Hurricane Katrina in the US. Away from the forests and towns devastated by the fires, millions of people have been exposed to unprecedented levels of smoke blanketing large parts of eastern Australia over days and even weeks. Sydney, Melbourne, and Canberra, cities with typically good air quality, have experienced record levels of air pollution. The air pollution has been compared with that of the most polluted Asian megacities, and the hazards of personal exposure to bushfire smoke have been compared with the hazards of smoking tobacco. Although some of these comparisons are debatable, they illustrate the level of anxiety about the short-term and longer-term health effects of prolonged exposure to extremely high levels of smoke.4