Smoke exposure from California fires could kill some

As the California fires rage, the smoke blanketing the state is putting nearly 1.6 million residents of three counties at risk for lung and heart problems.

The fine particles of burned materials in smoke embed themselves into our lungs, causing burning and irritation in the short term, but exposure to fire smoke is insidious, and has been linked to serious diseases and even premature death.

Poor quality air from fire smoke can aggravate heart, lung, and inflammatory diseases, causing acute symptoms and hospitalizations.

For healthy people, the effects of smoke inhalation include milder problems like burning, wheezing and irritation, but could develop into more serious respiratory infections in the coming weeks.

At least one person has died in the California fires, but homes like this one are shrouded in smoke that could be lethal to some of the 1.6 million residents breathing the toxic air

More than 230,000 acres in Southern California have been scorched, at least one person has died, and the Thomas fire is not expected to be contained until Christmas Eve. 

The Thomas Fire is now the fifth largest in history and smoke from it has filled the air in Ventura, San Jaoquin and Santa Barbara counties with levels of smoke that air quality regulators deem ‘unhealthy.’

Smoke contains carbon monoxide, carbon dioxide and particulate matter.

Inhaling heavy smoke temporarily changes the way that our lungs work as we breath, which causes the sensations of burning, chest tightness and difficulty breathing. 

‘The main pollutant we’re concerned about is PM2.5, very small particles that can get into the deepest parts of the lungs and cause not only lung, but heart issues,’ says Lyz Hoffman, public information officer at the Santa Barbara County Air Pollution Control District. 

To try to mitigate these risks, Santa Barbara county has handed out more than 300,000 N-95 face masks. The masks can effectively block toxic particles in ways that scarves and even surgical masks cannot. 

These very tiny toxins get into the air sacs within the lungs that allow us to quickly exchange oxygen for carbon dioxide as we breath. The particulate matter (PM) can damage the walls of those air sacs. 

‘When that happens, it can impair the oxygen exchange, and that’s why people might feel short of breath, especially those with underlying cardiovascular diseases,’ says Dr Charity Dean, public health officer for Santa Barbara county. 

The air in Santa Barbara is worse right now – after five days of smoke exposure – than it has been ever since the county started documenting pollution levels in 1999. 

Though most otherwise healthy adults are quite resilient and recover form the effects of smoke inhalation, nearly 450,000 residents there have been exposed. 

Dr Dean says that when she went to a clinic to pick up an inhaler yesterday, the facility was ‘slammed. It was full and everybody was wheezing and coughing.’ 

She says that each of the local hospitals have estimated they are seeing about 50 patients related to fire smoke inhalation daily, but ‘I think that’s a real underestimate.’ 

Previous research has shown consistent overall increases in hospitalizations during wild fires. 

Those with cardiovascular and respiratory conditions are the most vulnerable and smoke inhalation can pose very serious, even deadly, risks to them.  

‘For asthma sufferers, [symptoms] worsen by five percent for every 10 micrograms of PM, but during fires, exposure can be ten times that, even reaching several hundred micrograms during wild fires,’ says Dr Ana Rappold, an Environmental Protection Agency scientist who researchers air pollution. 

The air pollution can affect those ‘hundreds, even thousands of miles away from the fires’ she says.   

For people with underlying heart conditions, a smoky day can be deadly. 

A Satellite image shows the vast plume of smoke blowing North and West from fires that have destroyed more than 230,000 acres of land in Southern California

A Satellite image shows the vast plume of smoke blowing North and West from fires that have destroyed more than 230,000 acres of land in Southern California

‘People with underlying cardiovascular or vascular disease – people who have had a heart attack, a stroke, or have a stent in their heart, for example – have low blood profusion to their heart or brain. For them, a slight drop in their oxygenation level can have a real impact,’ says Dr Dean. 

As particles from smoke inhalation damage the air sacs in their lungs, they also cause an inflammatory response, so mucus builds up. 

Oxygen is carried throughout the body in blood. Those have underlying heart conditions have constricted vessels, and, therefore, less blood flow and oxygen reaching their hearts any way. 

‘All that combined is a perfect storm to drop oxygen levels. In someone very sensitive to oxygen levels because they already get less profusion [of oxygen] into their heart due to cardiac disease, that can lead to a serious health event,’ such as heart failure, says Dr Dean.  

The mucus build up that happens with smoke inhalation is part of an inflammatory response, which can worsen the conditions of people who already have inflammatory conditions like obesity and diabetes. 

It can also make people more susceptible to bacterial pneumonia, the symptoms of which may not appear for weeks after the fires are out and the smoke has dissipated. 

This is particularly true for people with Asthma, ‘whose lungs are vulnerable, it can cause them to be more susceptible to pneumonia because of the increase in mucus and the inability to clear that mucus,’ says Dr Dean. 

Research on the long term effects of smoke exposure is inconclusive, but suggests that it may be linked for greater risks of developing heart and lung diseases. 

In extreme circumstances, the exposure may be able to cause ‘long-term scarring,’ though ‘most healthy adults can clear these particles from their lungs if their exposure is limited and they have a break form the smoke so their lungs have a chance to recover,’ Dr Dean says. 

She added: ‘Chronic, day after day exposure can cause lung damage in the long run.’

She, along with other experts, says that the best way to protect yourself is to get out of town, away from the smoke. 

Barring that, creating clean rooms for sleeping by installing a special HEPA air filter, and sealing off windows and openings. A cheaper option is to run an air conditioner on recirculation mode. And if you must go outside, wear a heavy-duty N-95 mask.