Air pollution in China and other parts of Asia poses large health risks and is an important contributor to global climate change. Almost half of Chinese homes use biomass and coal fuels for cooking and heating. China’s economic growth and infrastructure development has led to increased emissions from coal-fired power plants and an expanding fleet of motor vehicles. Black carbon (BC) from incomplete biomass and fossil fuel combustion is the most strongly light-absorbing component of particulate matter (PM) air pollution and the second most important climate-forcing human emission. PM composition and sources may also be related to its human health impact. We enrolled 280 women living in a rural area of northwestern Yunnan where biomass fuels are commonly used. We measured their blood pressure, distance from major traffic routes, and daily exposure to BC (pyrolytic biomass combustion), water-soluble organic aerosol (organic aerosol from biomass combustion), and, in a subset, hopane markers (motor vehicle emissions) in winter and summer. BC had the strongest association with systolic blood pressure (SBP) (4.3 mmHg; P < 0.001), followed by PM mass and water-soluble organic mass. The effect of BC on SBP was almost three times greater in women living near the highway [6.2 mmHg; 95% confidence interval (CI), 3.6 to 8.9 vs. 2.6 mmHg; 95% CI, 0.1 to 5.2]. Our findings suggest that BC from combustion emissions is more strongly associated with blood pressure than PM mass, and that BC’s health effects may be larger among women living near a highway and with greater exposure to motor vehicle emissions. Significance Air pollution is a leading health risk factor and important contributor to regional climate change in China and other parts of Asia. China’s particulate matter (PM) air pollution dramatically exceeds health guidelines and is impacted by industrial emissions, motor vehicles, and household use of biomass and coal fuels. Black carbon (BC) from biomass and fossil fuel burning is a major climate-forcing component of PM. We found that BC exposure from biomass smoke is more strongly associated with blood pressure than total PM mass, and that coexposure to motor vehicle emissions may strengthen BC’s impact. Air pollution mitigation efforts focusing on reducing combustion pollution are likely to have major benefits for climate and human health.

Purpose of Review: Increasing wildfire size and severity across the western United States has created an environmental and social crisis that must be approached from a transdisciplinary perspective. Climate change and more than a century of fire exclusion and wildfire suppression have led to contemporary wildfires with more severe environmental impacts and human smoke exposure. Wildfires increase smoke exposure for broad swaths of the US population, though outdoor workers and socially disadvantaged groups with limited adaptive capacity can be disproportionally exposed. Exposure to wildfire smoke is associated with a range of health impacts in children and adults, including exacerbation of existing respiratory diseases such as asthma and chronic obstructive pulmonary disease, worse birth outcomes, and cardiovascular events. Seasonally dry forests in Washington, Oregon, and California can benefit from ecological restoration as a way to adapt forests to climate change and reduce smoke impacts on affected communities.Recent Findings: Each wildfire season, large smoke events, and their adverse impacts on human health receive considerable attention from both the public and policymakers. The severity of recent wildfire seasons has state and federal governments outlining budgets and prioritizing policies to combat the worsening crisis. This surging attention provides an opportunity to outline the actions needed now to advance research and practice on conservation, economic, environmental justice, and public health interests, as well as the trade-offs that must be considered.Summary: Scientists, planners, foresters and fire managers, fire safety, air quality, and public health practitioners must collaboratively work together. This article is the result of a series of transdisciplinary conversations to find common ground and subsequently provide a holistic view of how forest and fire management intersect with human health through the impacts of smoke and articulate the need for an integrated approach to both planning and practice.

Household solid-fuel (biomass, coal) burning contributes to climate change and is a leading health risk factor. How and why households stop using solid-fuel stoves after adopting clean fuels has not been studied. We assessed trends in the uptake, use and suspension of household stoves and fuels in a multiprovincial cohort study of 753 Chinese adults and evaluated determinants of clean-fuel uptake and solid-fuel suspension. Over one-third (35%) and one-fifth (17%) of participants suspended use of solid fuel for cooking and heating, respectively, during the past 20 years. Determinants of solid-fuel suspension (younger age, widowed) and of earlier suspension (younger age, higher education and poor self-reported health status) differed from the determinants of clean-fuel uptake (younger age, higher income, smaller households and retired) and of earlier adoption (higher income). Clean-fuel adoption and solid-fuel suspension warrant joint consideration as indicators of household energy transition. Household energy research and planning efforts that more closely examine solid-fuel suspension may accelerate household energy transitions that benefit climate and human health.