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Wildfire smoke can cause health problems, even death

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When smoke from massive wildfires in the Canadian province of Quebec descended on the U.S. Northeast in early June 2023, lung-related health problems quickly followed.

Researchers reviewing data from 53 hospital emergency departments in New York City found that asthma-related ER visits increased nearly 44% over those smoky few days, peaking on June 7, the city’s worst air quality day from the Canadian smoke.

Dr. Lawrence MacDonald, chief of pulmonary medicine at DMC Huron Valley Sinai Hospital in Commerce Township, Michigan, a suburb of Detroit, said his emergency room saw more patients with lung distress as well last summer when Canadian wildfire smoke blanketed the area for days at a time.

“There was a noticeable increase in asthma exacerbations — needing steroids, needing to increase treatments, needing to go to the ER,” he said. “Absolutely, the presence of this stuff in the air increases the chance that you’re going to get sick, you’re going to be symptomatic, you’re going to end up in the ER.”

According to the World Health Organization, wildfire smoke can contain a mixture of hazardous air pollutants such as fine particulate matter known as PM2.5, nitrogen dioxide, ozone, aromatic hydrocarbons and lead. In addition to contaminating the air with toxic pollutants, wildfires simultaneously impact the climate by releasing large quantities of carbon dioxide and other greenhouse gases into the atmosphere.

Wildfire smoke can be deadly: Here’s why

Perhaps the most insidious of the pollutants is PM2.5, particles 2.5 microns in size or smaller — so tiny that the width of a human hair is about 30 times larger. The body’s defense systems: moist tissue with immune cells in the nose and throat, and mucous in the lung’s airways, are designed to trap particles, with coughing and sneezing working to expel them, MacDonald said. But PM2.5 is so small it can move past those defenses to lodge deep within the lungs and their tiny air sacs.

“Our lungs are built to protect us from stuff like this, but the really small particles can avoid and evade the protective system that we have built into us,” he said.

Children, elderly people, pregnant women and those with preexisting medical conditions such as asthma and COPD are most susceptible to health complications from wildfire smoke. The WHO notes that PM2.5 from wildfire smoke is associated with premature deaths and can cause and exacerbate diseases of the lungs, heart, brain and nervous system, skin, gut, kidney, eyes, nose and liver. It has also been shown to lead to cognitive impairment and memory loss.

What can be done about it? Stay inside.

A new study out of the Yale School of Public Health investigated the association between long-term exposure to wildland fire smoke PM2.5 and deaths across the contiguous U.S. from 2007 to 2020. Factoring out PM2.5 exposures from other types of air pollution and other potential factors, the study found that when the wildfire smoke PM2.5 concentration in an area was 5 or more micrograms per cubic meter over a 12-month moving average, nonaccidental deaths per month increased by just over 2 per 100,000 people exposed. The mortality rate also increased by a fraction per month when the average air concentration was between 0.1 and 5 micrograms per cubic meter, the study found.

“Certainly, across the Midwest and the East, we saw some of the worst air quality impairment that we’ve ever seen from wildfire smoke” in 2023, said Vijay Lemaye, an environmental epidemiologist based in Wisconsin who is director of applied research initiatives at the nonprofit environmental organization Natural Resources Defense Council.

“From a public health perspective, that’s really worrying. As much as we can see the smoggy air, these microscopic particles are dangerous to us at levels far lower than what we experienced.”

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There’s not much the public can do when wildfire smoke descends on their community except try to avoid it. The U.S. Environmental Protection Agency recommends staying inside with doors and windows closed, operating an air conditioning system with high-efficiency filters if possible. Portable air cleaners are also recommended.

Those without such amenities should consider seeking shelter elsewhere from the smoke, if possible, the EPA recommends. Also avoid adding to indoor air pollution through things such as burning candles, using gas, propane or wood-burning stoves or fireplaces, running vacuum cleaners or using aerosol sprays.

Those with asthma or other known heart or lung conditions should work closely with their doctor on a plan for stepped-up response should wildfire smoke cause increased difficulty with breathing, MacDonald said.

“A lot of people will come in who don’t have a doctor, or maybe have a doctor but don’t have a plan,” he said.

“If you end up in the ER, it’s a failure of therapy.”

Contact Keith Matheny: kmatheny@freepress.com. This story was supported by the Pulitzer Center.

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