Busier ERs in Bay Area, Sacramento
This month’s Camp Fire — the deadliest and largest in California history — was more than four times bigger than the Tubbs Fire. Throughout much of the Bay Area and Sacramento area, the smoke was so intense and widespread that many people wore masks, stayed indoors and bought air purifiers. At least two Northern California hospitals have reported busier ERs due to smoke from the fire, which burned 153,000 acres in the foothills of the Sierra Nevada. Robin Scott, director of the emergency department at Adventist Health Clear Lake, reported a 43 percent increase in respiratory diagnoses when the smoke hung over the region compared with the two previous weeks. In Berkeley, 160 miles from the fire, Sutter Health’s Alta Bates Summit Medical Center treated “increasing numbers of patients with chief complaints that appear to be connected to the poor air quality,” including “asthma, eczema, respiratory illness — as well as worsening heart conditions like congestive heart failure and chest pain,” said Ronn Berrol, medical director of the emergency department. Other hospitals in the region, however, reported small increases, while some, including Kaiser Permanente in Oakland, reported no increases. “There has been a slight uptick in terms of patients coming through our ER with respiratory issues. Most have been quickly treated and discharged,” said William Hodges, director of communications at Dignity Health in Sacramento. “I would say the impact has been minimal at most.” Francesca Dominici, a biostatistics professor at Harvard University’s T.H. Chan School of Public Health, said understanding the health effects is critical because climate change is making fires more frequent, ferocious, erratic, and long lasting. Dominici was on a team of researchers that published a study last year that collected data from wildfires across the West between 2004 and 2009 and compared it with hospitalizations of elderly residents. About 22 percent more African Americans 65 and older were hospitalized for respiratory problems on smoky days than on non-smoky days. For elderly women of all races, respiratory hospitalizations increased more than 10 percent on smoky days, and for elderly men, 4 percent. Five of the 10 largest wildfires in California history have occurred in the last two years, and many of the state’s largest population centers have been exposed to smoke repeatedly. Dominici said the impacts are likely cumulative. “More people are becoming susceptible to air pollution because they have been breathing bad air from previous wildfires,” she said. “For these people, the risk of adverse health effects is going to be even larger than the rest of the population.” U.S. Environmental Protection Agency researchers, in a study published in April, examined more than a million emergency room visits during California’s 2015 fire season and found a 42 percent increase in heart attacks among adults over 65 on days with dense wildfire smoke. They also found increases in strokes and other cardiovascular effects. The EPA researchers expressed a willingness to speak about their research, but the agency would not grant permission.Tiny particles harm hearts, lungs
A major health concern is the makeup of the smoke. Fires emit clouds of fine particles known as PM2.5. For decades, researchers have shown that whenever these tiny particles — which largely come from vehicles and other sources of fuel combustion — increase in the air, deaths and hospitalizations from heart attacks and respiratory problems rise. The particles can irritate airways, travel deep into the lungs and disrupt the heart. In addition, fires can emit toxic gases from a variety of sources, including oil, metals, and pesticides. Among the estimated 19,000 buildings destroyed in the Camp Fire were gas stations, two grocery stores, eight schools, and a hotel. “When you’re breathing smoke from that wildfire,” said Stanford’s Nadeau, “you’re breathing paint thinner, Drano, plastics, heavy metals, and burned leaves, which are very similar to tobacco.” The long-term effects of breathing this cocktail are unknown. In Palo Alto, 200 miles from the Camp Fire, pediatrician Kellen Glinder said he has seen a marked increase in number of children with breathing problems during each of California’s recent wildfires. On Friday, after rain cleared much of the wildfire smoke, the waiting room at the Palo Alto Medical Foundation, a clinic where Glinder works, wasn’t as busy as it was in previous days. Several children sat or crawled around as a television played Toy Story overhead. But Glinder said he still was treating kids affected by the smoke. About one third of the 20 children he treated each day during the fires — six to eight kids per day — had conditions the smoke exacerbated, Glinder said. “We (saw) a lot of things hidden under the guise of a cold that wouldn’t have gotten worse unless the air quality was so bad,” he said. In August, when the Mendocino Complex Fire blazed through the state, Glinder treated more patients with asthma and other conditions. And last year, the Santa Rosa fires brought similar health concerns. “Each forest fire is going to have its own particular combination of chemicals, depending on what’s getting incinerated and blowing our way,” he said. “With this particular fire, I saw a lot more … skin irritation, headaches, and nausea than I had seen in prior forest fires.” The waiting room had a box of miniature paper masks for the kids, decorated with Mickey Mouse heads. Glinder, however, said such flimsy masks are ineffective at protecting people from smoke’s particles and gases; they are designed to contain germs from colds and flu. Like the elderly, children are particularly sensitive to soot and smoke. “Children’s lungs are still growing, their nervous systems are still growing,” Glinder said. “That makes them more susceptible to these pollutants.”This story was originally published by Grist with the headline The smoke’s gone, but hearts and lungs still may be in danger months after wildfires on Dec 3, 2018.