Hot, dry weather combined with high winds has led to the burning of more than 3.3 million acres in California, causing 22 reported deaths so far and destroying 4,100 structures, according to a report issued September 13 by the California Department of Forestry and Fire Protection. Five of the 20 largest wildfires in the state’s history have occurred in 2020, according to a tweet from the agency. Oregon’s Office of Emergency Management estimates that more than one million acres in the state have burned. Governor Kate Brown has put at least a half-million Oregonians under an evacuation notice. In Washington state, Governor Jay Inslee reported in a Facebook post that nearly 627,000 acres have burned. Both states have lost hundreds of homes, and a few towns have been completely leveled. “I live in Oregon and grew up here, and I can’t ever remember any wildfires being close to anything like this,” says 40-year-old David Blunck, PhD, a wildfire expert and an associate professor at the College of Engineering at Oregon State University in Corvallis. “These are unprecedented.” The National Interagency Fire Center (NIFC) partially blames multiday lightning events for sparking the fires, but human carelessness has also contributed. A smoke-emitting pyrotechnic device used for a gender-reveal party sparked the blaze that has destroyed more than 7,000 acres in San Bernardino County, according to the according to a September 7 story in the Los Angeles Times. Dr. Blunck adds that weather conditions in the area have allowed the fires to rage and continue. “High winds and low humidity have led to hotter fires that burn faster,” he says. Unfortunately, the fires may not be ending any time soon. NIFC is expecting “large fire-potential to increase” in October and November. Here’s what you need to know about how wildfires and wildfire smoke can affect your health — even for those living hundreds of miles from the flames.
How Close You Need to Be to Wildfires (and Wildfire Smoke) to Be at Risk
Blunck warns the public living within a few miles of the blazes to beware of embers that travel through the air and can start new fires. “Embers can land in a gutter or roof where there’s dry leaves or needles, which can then light and cause a house to burn down.” He advises homeowners to visit the National Fire Protection Association find out protective measures to reduce risks. Wildfires not only leave a trail of physical destruction, but they also generate a wave of health problems as harmful particulate matter and toxic gases are carried through the air, often hundreds of miles from the fire itself, according to a fact sheet from the Environmental Protection Agency (EPA). Skies over the Bay Area recently turned orange and dark enough to require streetlights to remain on in the middle of the afternoon — with much of the smoke coming from Mendocino, some 130 miles away, according to a September 10 report from ABC News. “Sometimes smoke from a wildfire can travel thousands of miles away,” says Mary Prunicki, MD, the director of air pollution and health research at Stanford University in California. “Even if it dissipates it can still raise pollution levels enough to impact your health.” When huge fires flare up and blanket vast areas, the public is advised to check air quality alerts (use sites such as IQAir and the EPA’s AirNow), which measure major pollutants, such as ground level ozone, particulate matter, carbon monoxide, and sulfur dioxide. A very unhealthy measure on the air quality index (AQI) is between 201 and 300, and anything about that is considered “hazardous.” Dr. Prunicki cautions that some areas near to the fires have topped 500 on the AQI.
Wildfire Complications Connected to COVID-19
Public health officials urge residents to stay indoors when air quality reaches unhealthy levels — and that has gotten more complicated during the COVID-19 pandemic. On KIRO News on September 9, Kathy Lofy, MD, a health officer with the Washington State Department of Health, warned: “If you’re indoors and you don’t have good ventilation and you’re with multiple other people, that can increase the risk of COVID transmission.” Prunicki notes that studies have also suggested that air pollution levels may increase the spread of coronavirus infection. Research from Harvard University found that even a slight rise in particulate matter in the air was linked with a 15 percent increase in the COVID-19 death rate (though it should be noted that the paper has not yet been published in a peer-reviewed journal). “We know that air pollution causes your immune system to become kind of dysfunctional and that’s going to make you more susceptible to any type of virus, including COVID-19,” Prunicki says. Some health experts (including the EPA) advise wearing an N95 mask to protect against smoke particles, but these masks may be in short supply due to a surge in demand caused by the pandemic. “The N95 masks are supposed to be reserved for healthcare workers,” says Prunicki. “It may be easier to get an N95 mask with exhalation valves, which are good at protecting for wildfire smoke but not at protecting others from your own exhalation when it comes to COVID.” Prunicki says to stay indoors as much as you can. If you have to go outdoors or in public spaces, wear a mask and practice social distancing guidelines. In addition, the fires have forced several coronavirus testing sites in the West to close, September 9 Bloomberg News report. RELATED: Study Links U.S. Air Quality to Higher Stroke Rate The EPA considers it safe to breathe in PM2.5 levels that don’t go over a concentration of 35 micrograms per cubic meter of air (mcg/m3) within a day, as long as the yearly daily average comes out to 12 mcg/m3 or less. Prunicki warns that it doesn’t take much of a rise in PM2.5 to ignite health problems. “With just a 10-unit increase in PM2.5, you’ll see an uptick in emergency room visits and hospital admissions for heart attacks, strokes, arrhythmias, and severe breathing problems related to asthma, COPD, or bronchitis,” she says. “The PM2.5 level here recently was 74 mcg/m3— so that’s well above what’s considered safe.” A study from the International Agency for Research on Cancer (IARCC) published in 2018 showed how extremely unhealthy these microparticles are when it labeled PM2.5 as a carcinogen for lung cancer. “When the level reaches 200 it’s like smoking almost 9 or 10 cigarettes a day, and that’s for everyone — babies and older people included,” says Prunicki. Some media outlets in Australia, where catastrophic wildfires raged earlier this year, use a “ciggie index,” which shows how bad the air is in comparison with smoking cigarettes. One “ciggie index” reading from Sydney in January said that inhaling the air there was the equivalent of smoking 19 cigarettes, according to a January 12, 2020 article in The Washington Post.
Symptoms You Might Experience From Wildfire Smoke, and Who Is at Heightened Risk
Wildfire smoke can cause irritation and inflammation from small-particle lung pollution, and Prunicki says indications include watery eyes, a bit of a sore throat, coughing, or a burning sensation in the nose. “What this means is that allergens, pollutants, and irritants that normally cannot get deep into your lungs can aerosolize into smaller particles because of smoke and lodge deep into the lung tissue, causing inflammation, which then may cause cough, wheezing, shortness of breath, and trouble breathing,” says Purvi Parikh, MD, an allergist and immunologist with NYU Langone Health in New York City and a spokesperson for the Allergy and Asthma Network. “Not to mention, carbon monoxide is often given off at dangerous levels around fires as well, and can lead to carbon monoxide poisoning with poor ventilation.” The Centers for Disease Control and Prevention (CDC) warns that adults over 65, children (with developing lungs), and pregnant women are most susceptible to smoke. “Also, those with underlying lung issues, such as COPD, asthma, and bronchitis are at higher risk, as this is adding insult to already injured lungs,” says Dr. Parikh. Irritation in the airways of people with these respiratory problems can make symptoms of the conditions worse and increase risk of additional respiratory infections, like bacterial pneumonia, according to the Allergy and Asthma Network. In addition, smoke can pose a threat to individuals with chronic cardiovascular issues. “If you have heart disease, you have to watch for signs of having a heart attack and you must be aware if your heart is arrhythmic,” says Prunicki. If individuals are feeling the effects of the smoke, they are advised to see a healthcare provider right away. Otis Brawley, MD, a professor of oncology and epidemiology at Johns Hopkins University in Baltimore, warns: “Damage to heart, vasculature, and lungs can be permanent, and it can be fatal.” Few studies have delved into the long-term health outcomes from wildfire smoke exposure, but IARC research has concluded that air pollution can cause cancer, according to Cancer Research UK. While not an exact parallel, long-term health effects seen in people exposed to particulates after 9/11 may offer clues. A study published in the February 2020 issue of NCI Cancer Spectrum, for example, shows that 9/11 responders have higher rates of leukemia than those not exposed to World Trade Center dust. This corresponds with other research showing higher cancer rates in this population, according to the Leukemia and Lymphoma Society. “It’s hard to know what long-term health effects from wildfires may be, but there’s certainly reason to be concerned,” says Prunicki. Parikh adds that wildfires can wreak havoc on mental health as well. “There is a sense of despair, depression, suicidality, and hopelessness, especially if you have lost your home or loved ones, or your health has become compromised by these fires,” she says. “If you feel it is affecting your mental health or someone around you, please seek assistance from a mental health professional as soon as possible.”
What You Can Do to Protect Your Health if the Air Is Not Clean
When air quality alerts veer into the danger zone, people can take steps to protect themselves:
Avoid going outside. One of the easiest actions to minimize smoky air intake is to stay indoors. The CDC instructs people to keep windows and doors shut, and run an air-conditioner, but keep the fresh-air intake closed and the filter clean to prevent outdoor smoke from getting inside. Those without air-conditioning may want to seek out an air-conditioned community center.Keep exercise indoors and to a minimum. Physical activity increases breathing and heart rates, so when air quality levels go into the red, exercise inside and at a moderate (rather than high-intensity) pace. “Overexertion should be avoided,” says Dr. Brawley.Skip surgical masks and dust masks for protection from smoke. Some people seek out dust masks sold at hardware stores thinking these might help prevent damage from wildfire smoke, but these masks only block out large particles, such a sawdust, not the micro elements that can really damage the lungs. Do still wear a face mask or other type of face covering when in public or around those you don’t live with to help stop the spread of COVID-19. But when it comes to protection from wildfire smoke, Prunicki says: “Staying indoors is still the best option.”
If you have an underlying health condition and have questions about how wildfire smoke might affect your health, contact your doctor. “If an issue is severe, you should see a physician as soon as possible and not take breathing lightly — asthma attacks, COPD flares, and carbon monoxide poisoning can be deadly,” says Parikh.
