Systematic Review of Haze Impact in Kalimantan: Meta-Analysis of PM2.5 Exposure on Non-Communicable Diseases
DOI:
https://doi.org/10.61843/jondpac.v3i2.1008Keywords:
PM2.5, Non-Communicable Diseases, Peatland fires, HazeAbstract
Background: Haze from peatland fires in Kalimantan represents a major public health threat contributing to increased non-communicable disease (NCD) burden via elevated PM2.5 exposure. This study aimed to conduct a systematic review of haze impacts in Kalimantan and a meta-analysis of PM2.5 exposure associations with NCD outcomes.
Methods: Systematic review followed PRISMA 2020 guidelines. Searches were conducted in PubMed, Scopus, Google Scholar, and Indonesian journals (2010-2025) using keywords related to haze, Kalimantan, PM2.5, and NCDs. Observational studies reporting associations between haze/PM2.5 exposure and health outcomes were included. Meta-analysis employed random-effects models using R (meta package). Study quality was assessed via Newcastle-Ottawa Scale.
Results: From 1,248 identified articles, 14 studies met inclusion criteria (8 for systematic review, 6 for meta-analysis). Haze exposure in Kalimantan increased respiratory clinic visits by 36.6% (95% CI: 10.2%-69.3%) during haze days. Meta-analysis revealed an 8.7% (95% CI: 6.2%-11.3%) increase in premature mortality risk and 12.4% (95% CI: 8.1%-17.0%) increase in cardiovascular hospitalization risk per 10 μg/m³ PM2.5 increment from fire sources. Moderate heterogeneity (I² = 58%). Annual burden estimates in Kalimantan: >3,200 excess deaths and >1,200 severe childhood asthma cases in Palangka Raya region alone during extreme fire years such as 2019.
Conclusion: Haze in Kalimantan significantly elevates NCD burden, particularly respiratory and cardiovascular diseases, through high PM2.5 exposure. Urgent policies for peatland fire prevention, ecosystem restoration, and early warning systems are needed to control NCDs in the region. Midwifery academies play a vital role in environmental health education for communities.
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References
Grosvenor MJ, Ardiyani V, Wooster MJ, et al. Catastrophic impact of extreme 2019 Indonesian peatland fires
on urban air quality and health. Community Earth Environment. 2024;5:123.doi:10.1038/s43247-024
01813-w
Kiely L, Spracklen DV, Wiedinmyer C, et al. New estimate of particulate emissions from Indonesian fires in
2015. Atmos Chem Phys. 2019;19:11105-11121.
Hein L, Spadaro JV, Ostro B, et al. The health impacts of Indonesian peatland fires. Environ Health.
2022;21:62. doi:10.1186/s12940-022-00872-w
Crippa P, Castruccio S, Archer-Nicholls S, et al. Population exposure to hazardous air quality due to the 2015
fires in Equatorial Asia. Sci Rep. 2016;6:37074.
Burnett R, Chen H, Szyszkowicz M, et al. Global estimates of mortality associated with long-term exposure
to outdoor fine particulate matter. Proc Natl Acad Sci USA. 2018;115(38):9592-9597.
Chen J, Hoek G. Long-term exposure to PM2.5 and mortality: a systematic review and meta-analysis. Environ
Int. 2020;143:105974.
Wooster MJ, Gaveau D, Salim MA, et al. New tropical peatland fire emissions factors and revised 2015
emissions estimates for Indonesia. Atmos Chem Phys. 2018;18:17679-17700.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting
systematic reviews. BMJ. 2021;372:n71.
Phung VLH, et al. Effects of smoke haze on respiratory clinic visits in Central Kalimantan, Indonesia. Int J
Epidemiol. 2025;54(6):dyaf169. doi:10.1093/ije/dyaf169
Marlier ME, et al. Indonesian Fires and Haze: Assessing Health Impacts and Prevention Strategies. RAND
Corporation Research Report. 2021. RR-A1314-1.
Brook RD, Rajagopalan S, Pope CA III, et al. Particulate matter air pollution and cardiovascular disease: an
update to the scientific statement from the American Heart Association. Circulation.
2010;121(21):2331-2378.
Haryanto B, et al. Associations Between Ambient PM2.5 Levels and Childhood Respiratory Diseases in
Greater Jakarta. Ann Glob Health. 2025;91(1):12.
Siregar S, et al. Association between long-term PM2.5 exposure and mortality in Indonesia. BMC Public
Health. 2024;24:1456.
Atkinson RW, Kang S, Anderson HR, et al. Epidemiological time series studies of PM2.5 and daily mortality
and hospital admissions: a systematic review and meta-analysis. Thorax. 2014;69(7):660-665.
World Health Organization. WHO Global Air Quality Guidelines: Particulate Matter (PM2.5 and PM10),
Ozone, Nitrogen Dioxide, Sulfur Dioxide and Carbon Monoxide. Geneva: WHO; 2021.
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