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Health risk associated with poor air quality caused by wildfire smoke 

This information is provided as a joint public service announcement by the Chelan-Douglas Health District, Confluence Health and Columbia Valley Community Health, to ensure that the residents of the Wenatchee Valley and surrounding areas have access to accurate and consistent information about the health risks and precautions people should take during this time of poor air quality, due to area wildfires.    

1. What is in the smoke? 

The smoke is made up of two elements: gases and particulate matter.  The smoke you “see” is the “Particulate Matter”, which is made up primarily of vegetation that has burned.  Particulate matter is categorized as coarse, fine and ultra fine.  The smoke you “can’t see” are the gases, which include carbon monoxide, nitrogen dioxide, VOC-such as benzene, and aldehydes like formaldehyde and acrolein.  Although you can’t see the gases, you may be able to smell and taste them. 

2. What are the effects of smoke that people should watch out for?

In general, the current level of air pollution from the wildfires in the region can cause you to have eye irritation, nasal irritation, headaches, dizziness and a feeling of nausea and respiratory problems.  Additionally, it can disrupt your sleep, and a lack of sleep can potentially lead to other health issues, such as migraine headaches.
 
The particulate matter can have several effects on you. If you breathe primarily through your nose, the large particles of matter are trapped in your mucus and you can sneeze it out.  Any particulate matter that gets past your nose or comes in via your mouth should be collected and cleared by the mucus made by bronchial tubes make, so that you can cough it up.  Essentially, your lungs are designed for exactly this purpose – to get rid of the foreign particulate matter. However, if your lungs don’t work “normally” you will have more problems. If the material is not “digestible” by the defensive cells in your lungs (for example the dust at the World Trade Center), then it can result in long term injury.
 
Some of the gases produced by wildfires can irritate the lining of the nasal passages, throat and lungs.  Your body’s response to this irritation can be cough and excessive mucus production, as with the particulate matter. It can also cause constriction of the muscle tissue in the airways, leading to a temporary narrowing, which is an asthma-like response and can make you short of breath.   The gases can also cause irritation of your eyes, headaches, dizziness and make you feel nauseated.  While wearing eye protection (sunglasses or regular glasses) will provide some protection for your eyes, unless they are form fitting some gas will still get around them. Wearing contacts can make your eyes even more irritated. 

3. What precautions should people take? 

The best advice is to follow common sense, by minimizing your exposure to the smoke and staying indoors  as much as possible.  Following are 5 simple precautions you can take.

  • If you must go outside, try to avoid any activity that causes you to breathe more rapidly and/or deeply (exercise, mowing the yard and so forth).  This increased breathing can result in the particulate matter and gases being pulled deeper into your lungs, which makes it harder for your body to get rid of it. 
  • If you need to be outside, consider wearing an N-95 mask, to filter out the particular matter.   
  • Increase your fluid intake.  Drinking more water will help your body’s mucus defenses clear the smoke out of your airway. 
  • If you do go out in your car, use the “Recirculate” instead of the “Fresh Air” intake as the air outside isn’t fresh! 
  • If you can enter your house through the garage, don’t open the door to the house until the garage door is closed. Then take your shoes off so you don’t track “particulate matter” inside.  Some of the gaseous chemicals are going to get in your house even with the best precautions so you may still smell the smoke at home.

If you have purchased a carbon monoxide monitor for your home, a word of caution is that many monitors immediately go to the maximum reading first, as a way of calibrating, then gradually reduce to the correct level.  Therefore, the initial reading may not be accurate and we encourage you to wait a few moments to allow the monitor to adjust itself.  Similarly, be cautious with air purifiers, as some generate ozone and can actually make the situation worse. 

4. Are the smoke levels in Wenatchee Valley dangerous, and if so, how dangerous? 

This is best answered by focusing on two distinct groups of people: 

  • For people with chronic lung and heart problems – like asthma, COPD or emphysema, and cardiovascular disease – the effects can be dangerous. Anyone with such health problems should take this situation seriously. Talk to your health care provider for advice or medication to get you through this.  If you notice a change in the color of your sputum or you can’t control the coughing, this is an indication you should call your provider.  You may want to consider leaving the area for a few days if you are having smoke-related problems.  
  • For other people, who do not already have such problems, there is no clear evidence of long term health effects from a week or two of wildfire smoke exposure. That is not to say it is pleasant or completely harmless. Even otherwise healthy people can have burning eyes and nose, cough, headache and other symptoms from smoke exposure day after day. For everyone, it makes sense to do all you can to minimize your exposure, especially for children. People with hay fever may notice more problems than those who don’t have hay fever. But for most people this is a matter of short term discomfort rather than long term health problems.  

5. Aside from people with chronic respiratory and cardiac conditions, in anyone in the general population at higher risk?

Children are especially vulnerable, as their lungs are still developing, and should be monitored closely.  Some people who have never had an asthma attack may have one in these conditions.  If that happens to you or your child, call or visit a doctor immediately.  It will also be important for children and adults to get vaccinated against the flu, because the more time spent cooped up indoors with others can potentially lead to an increased risk of a flu outbreak. 

6. Will a mask protect me from the smoke? 

A mask will reduce the particulate matter, but unless it has special filters, will not prevent inhaling the gases.  Additionally, wearing a mask is most beneficial if it fits properly.  Even the most expensive mask is of limited benefit if it isn’t worn right.  It’s important to note that the useful life of a mask if 8-12 hours, unless it gets wet, in which case you should replace it.  If your mask is dirty, it should be replaced because it is probably no longer doing a good job of filtering the air.

7. Should people be concerned about long-term health effects from experiencing high levels of poor air quality for this extended amount of time? 

Unless you have prolonged exposure for hours on a daily basis like the firefighters, the long term risk is limited.  Available studies of wildfire smoke exposure in communities have shown no detectable long-term increase in deaths afterward.  We’ve already discussed the seriousness of the situation for those with health problems. For the rest of us, there are two levels of concern. There is the immediate discomfort, and each of us decides for him/herself how bad that is. Then there is the fear of the unknown, especially for our loved ones. No one can say for certain that there is absolutely no risk for anyone. Science has its limitations, and the best we can do is to tell you what is known so far. But if there is a longer term risk, it is a relatively small one, since a really big risk would have shown up already in studies.
 
Of course it is always possible that there is a small effect, so small that it didn’t show up in the studies. But if it is that small, it is in the neighborhood of many risks we experience daily (like driving to Seattle) and is a proper subject for common sense rather than fear or panic.  Thinking about small risks can be tricky, so it helps to have an everyday comparison. It’s a lot like deciding to drive to Seattle to get out of the bad air. The risks of car travel are small, but there is always the risk of a collision or other accident.  Our best evidence suggests any long-term risk related to the smoke (for people without those health problems) is similar.  

8. Is it true that this is more harmful to people’s health than Mt. Saint Helens, 9/11 or other similar events?  

Those types of examples are neither helpful nor relevant to this situation, because they are an apples and oranges comparison.  It’s important to realize that not all smoke and ash is the same. People have heard about risks from other kinds of smoke and ash, and may be confusing them with our situation. For example, Mount St. Helens ash had a lot of silica in it. Unlike wildfire particles, silica particles are very jagged and tend to stick in the lungs, causing irritation and damage for a long time. 
 
People have also heard about respiratory health risks for the 9-11 responders. Much of what they inhaled in New York was concrete dust from the collapsed buildings. Concrete dust also has a lot of silica and other minerals in it, and the resulting diseases include silicosis and other related illness. Again, even a day of that dust is much worse than wildfire smoke.
 
An earlier Wenatchee World article referred to a notorious air pollution incident in London, 1952, when according to WenWorld 4,000 to 12,000 people died. At the time the weekly death rate in London was 4,000 people in a city of 8.6 million people. For one thing, their smoke was even thicker than ours. At some points pedestrians could not see their own feet. For another, it was a very different kind of pollution, leaving a black acidic slime on exposed surfaces caused by hydrogen sulfide.  Finally, it happened in a population that had already been exposed for years to bad air pollution. Our population usually breathes good air. It is a good historic example of the dangers of bad air, but not a very good guide to our situation today. 

9. Should people leave the area? 

It is certainly an option for people who are sick from the smoke and other measures are not helping them enough. Others may want to leave (if they can) because of the discomfort, even if they have no serious illness. One thing is certain – going to an area with clean air for a while is the most effective way of avoiding health problems from the smoke. 

10. What are the top five tips you hope people will take away from this? 

  • If you use a mask while outside, remember the useful life is 8-12 hours.  Plan accordingly and make it last.
  • Stay hydrated, as that is essential to help your body’s natural defenses clear away the smoke particles. 
  • Stay indoors when practical. 
  • Do not tape over dryer and stove vents, in an effort to “secure” your home from the smoke. 
  • People with asthma, COPD or other chronic respiratory and cardiac conditions should consider creating a clean room or start using a purifier.

More information: Precautions Against Poor Air Quality