How to measure the economic health cost of wildfires – A systematic review of the literature for northern America

There has been an increasing interest in the economic health cost from smoke exposure from wildfires in thepast 20 years, particularly in the north-western USA that is reflected in an emergent literature. In this review, we provide anoverview and discussion of studies since 2006 on the health impacts of wildfire smoke and of approaches for the estimationof the associated economic cost. We focus on the choice of key variables such as cost estimators for determining theeconomic impact of mortality and morbidity effects. In addition, we provide an in-depth discussion and guidance on thefunctioning, advantages and challenges of BenMAP-CE, freely available software of the US Environmental ProtectionAgency (EPA) that has been used in a growing number of studies to assess cost from wildfire smoke. We highlight whatgenerates differences in outcomes between relevant studies and make suggestions for increasing the comparabilitybetween studies. All studies, however, demonstrate highly significant health cost from smoke exposure, in the millions orbillions of US dollars, often driven by increases in mortality. The results indicate the need to take health cost into accountfor a comprehensive analysis of wildfire impacts.