Wildfire smoke can be especially dangerous for some people. How to protect your health: Shots

Wildfire season is upon us again, and where there’s fire, there’s smoke, and studies show that smoke can be just as deadly as the flames themselves.

Recently, a group of scientists sought to quantify the long-term effects of exposure to smoke from California wildfires from 2008 to 2018. Their paper modeled statewide levels of fine particles called PM2.5 found in wildfire smoke and applied mortality data by zip code. They estimated that up to 55,710 premature deaths occurred due to wildfire-related PM2.5 in the air.

About 90% of wildfire smoke is made up of particles one-thirtieth the diameter of a human hair. “PM2.5 particles can penetrate deep into the lungs, from where they can enter the bloodstream and cause everything from inflammation to asthma attacks to sudden cardiac death,” says Mary Johnson, a research scientist at the Harvard T.H. Chan School of Public Health who studies the health effects of wildfires.

While the study on premature deaths focused on California, smoke from large fires can travel thousands of miles, putting people who don’t realize the danger at risk. “People in California and Texas are used to closing their windows, staying inside, and turning on their air purifiers during wildfires,” Johnson said. But as climate change makes large fires more frequent, everyone needs to be prepared to protect themselves.

Additionally, people with certain health conditions are at increased risk – here’s what you need to know, with specific guidance for high-risk groups.

Basic Prevention Measures: Beware of High AQI

If you hear about wildfires on the news or the sky looks hazy, check the Air Quality Index at AirNow.gov or PurpleAir.com. If your Air Quality Index is over 100, avoid outdoor exercise. If it’s over 150, wear a tight-fitting N95 mask when you’re outdoors. Run an air conditioner with a high-efficiency filter (EPA recommends MERV 13 or higher) or use a portable HEPA air purifier. (The EPA provides instructions here for making your own HEPA air purifier using a box fan.)

For high-risk groups

Consider taking additional precautions if you fall into a high-risk group, such as: Some experts recommend setting up a “clean room” with fewer windows and doors and a dedicated portable HEPA air purifier. Avoid activities that increase indoor air pollution, such as vacuuming, lighting candles, and using gas stoves, and repair drafty windows and doors. If the air quality is poor, try to do outdoor activities during times when the AQI is low. Also, ask your doctor what you should do to protect yourself. If possible, leave the area and move away from the smoke.

If you are pregnant

“When you’re pregnant, your breathing rate increases, so you inhale more smoke,” says Amy Padula, M.D., an associate professor in the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. “PM2.5 can enter the bloodstream, reach the placenta and potentially affect the fetus.”

In a study published earlier this year, she and her colleagues found that exposure to PM2.5 from wildfire smoke during pregnancy was associated with higher odds of premature birth, babies who were more likely to have immature lungs and delayed development, and were more likely to die within the first year of life.

Conclusion: If the AQI is above 100, stay indoors as much as possible with windows and doors closed and wear a NIOSH-certified N95 mask when outdoors.

For Children

“Children are more active and inhale more air relative to their body weight, leading to higher intakes of PM2.5, both of which put a strain on their immature lungs,” says Dr. Lisa Patel, member of the American Academy of Pediatrics’ Council on Environmental Health and Climate Change. “Lungs grow rapidly from birth to age 5 and continue to develop into the early 20s. Early exposure to wildfire smoke can lead to the development of asthma and can worsen asthma and cause pneumonia in children.”

A 2021 study found that wildfire-related PM2.5 is 10 times more harmful to children’s respiratory health than PM2.5 from other sources, such as air pollution. Exposure to fine particles has also been linked to an increased risk of ADHD, autism, and lower academic achievement.

Conclusion: “We need child-specific wildfire smoke guidelines,” says Dr. Patel, who has young children. In the absence of those, it makes sense to err on the side of caution for young children and those with asthma, who are especially sensitive. Dr. Patel says of her own family, “When the AQI is over 50, we turn on the air purifier and spend more time indoors. When it’s over 100, we don’t go outside.” Advice from the Icahn School of Medicine at Mount Sinai suggests spending less time outdoors, especially if the air has been smoky for more than a few days.

If your child has asthma, make sure to have medication on hand and stay in close contact with your pediatrician, adds Patel.

Adults with asthma and COPD

“Chronic lung disease is caused in part by inflammation in the airways, and wildfire smoke induces inflammation, exacerbating these diseases,” explains Dr. John Balmes, a pulmonologist and professor emeritus of environmental health sciences at the University of California, Berkeley. Numerous studies have shown that people with asthma and COPD are more likely to visit the emergency room or be hospitalized when exposed to wildfire smoke.

For some people, the decline in lung function can last for a long time: Researchers looked at data from patients at an allergy clinic in North Carolina and found that peak respiratory flow was reduced a year after two separate fires had hit the area.

Conclusion: N95 masks can make it difficult to breathe, so Balmes recommends opting for one with an exhalation valve. If the AQI is over 100, in addition to staying indoors, monitor your breathing with a peak flow meter. If you’re in the red zone and taking rescue bronchodilators, Balmes recommends going to the emergency room or ER. If you’re checking your oxygen saturation with a pulse oximeter, go to the ER if it’s below 84%. (Note: it doesn’t work well on darker skin tones.)

If you’re over 65: be aware of your pulmonary and cardiovascular risks

“Older people are more likely to have high blood pressure, heart disease and other medical conditions that make them more susceptible to the toxic effects of wildfire smoke,” Harvard’s Johnson said. Journal of the American Heart Association A 2018 study found that people over the age of 65 were more likely to visit emergency rooms for a variety of cardiovascular conditions, including heart attack, arrhythmia, pulmonary embolism, and stroke, on or after smoky days. Older women and black people may be especially vulnerable to respiratory illnesses when exposed to wildfire smoke, research has found.

Conclusion: If you have heart or lung problems, ask a neighbor to pick up your mail, take out the trash or run errands when the Air Quality Index (AQI) is above 150, and if you must go out, wear a well-fitting N95 mask, Balmes says.

If you work outdoors

Farm workers. Construction workers. Bike messengers. Landscapers. Millions of people work outdoors and can’t take time off because of smoky air. The work is often heavy, which means they breathe in more PM2.5. There are few studies evaluating the health effects on outdoor workers, but it’s safe to assume that regular exposure to unhealthy air has negative effects. According to the Occupational Safety and Health Administration, federal law gives workers the right to a safe workplace, and they have the right to speak up about dangers or refuse to work in unsafe conditions.

The Centers for Disease Control and Prevention suggests all employers reschedule or shift work to areas and times with less smoke and encourage workers to take frequent breaks. Oregon, California and Washington are the only states that have adopted rules to help employers limit employee exposure, such as providing workers with N95 masks. But a 2021 investigation in California by KQED and California Newsroom found that compliance is patchy at best.

Conclusion: Even if your employer doesn’t provide you with a mask, wear an N95 mask with an exhalation valve when you’re outdoors in smoky air.

Household pets

“If you’re feeling the effects of smoke, your pets are too,” says Lori Teller, a veterinarian and clinical professor at Texas A&M University College of Veterinary Medicine. “Coughing and vomiting are signs they’re affected. Wildfire smoke can injure the lungs and damage other organs if particles enter the bloodstream.” Birds are highly sensitive to smoke because they breathe in nearly twice as much oxygen as mammals. Brachycephalic breeds such as French bulldogs, pugs and Persian cats may be more susceptible to the effects of smoke because their respiratory tract is compressed.

Conclusion: An AQI above 100 is dangerous for puppies and kittens, older animals and those with heart or lung problems. If it’s above 150, keep your pets indoors except for brief trips to the bathroom, and “keep them entertained by playing ball in the hallway or teaching them new tricks,” says Dr Teller. “If your pet is having difficulty breathing and has red, watery eyes, contact your vet – they may need supplemental oxygen.”

Ginny Graves is a freelance journalist specializing in science, health, and psychology based in the San Francisco Bay Area.