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Wildfire Smoke - Gets In Your Lungs

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

Picture of Wildfire Smoke in Southern California

The fires raging in California are the lead story on every news outlet in the country. The number of people evacuated and the number of homes destroyed are hard to comprehend. But as the fires die down, the television cameras will move to the next story, and the stories from Southern California will be replaced by the next catastrophe.

In the medical world, the fallout from the fires may be exactly that...fallout. Ash and soot are covering thousands of square miles of land, and my expectation is that those people with asthma and emphysema will soon be affected. While California has been the leader in this country in trying to limit secondhand smoke exposure, Mother Nature hasn't read the laws. Smoking is illegal in public buildings, but just going outside may be too dangerous for many.

The small particles of soot and ash from the fires will continue to rain down on the area for many days to come, and depending on atmospheric conditions, the area of pollution will extend well beyond the range of the fires. These particles can act as irritants and trigger lung ailments in those already prone: asthmatics, those with COPD and emphysema, or people with heart disease.

We breathe like a bellows. The ribs swing out, the diaphragm pushes down, and air is sucked into the lungs. If the breathing tubes, called the bronchioles, get narrow, it's much harder to suck air in. Think of breathing through a straw and the harder you try to suck in, the more the straw collapses. Soot and ash can cause the small, involuntary muscles that surround the bronchioles to go into spasm and cause those tubes to narrow. As well, the same particles can cause direct swelling inside the bronchiole, and further narrowing occurs. Sucking in air through the narrow tubes causes the wheezing sound, but sometimes if there isn't enough air moving, the patient may be too tight to wheeze.

Inhalers are used to treat acute episodes, and sometimes steroids, like prednisone, are prescribed to decrease the swelling. But prevention is always better than not being able to breathe. When smoke and smog are fouling the air, staying inside may be a better option. Air conditioner air filters can help keep home air clean, but the filters need to be maintained or replaced if they are to work. Paper dust masks, available at hardware stores (think of surgeons' face masks) will help filter out the big particles of soot and ash, but won't work on smoke.

When the media and news people leave, the stories will be just beginning. The clean up will put people in the middle of the dirt, dust, ash, and soot. Hospital emergency departments will start to see the number of people suffering from respiratory problems rise and there will be nobody to report the story. Years from now, a medical journal will publish studies about how large scale fires affected the need for medical care in 2007. And sadly, nobody will report that story either.


Last Editorial Review: 10/24/2007







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