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home : columns : ask the doctors January 27, 2021

11/2/2020 8:08:00 AM
Smoke from western fires can strain lungs thousands of miles away

Dear Doctors: We're in central Oregon, and even though the wildfires aren't right next to our town, we've had bad air quality all summer. My husband and I and our kids are feeling irritation in our lungs and sinuses, like when you're catching a cold. Can this happen even when you're not close enough to see the smoke?

Dear Reader: The numerous wildfires in the western United States this season have created dangerous conditions far from the reach of the flames. You don't have to be able to see or smell the smoke for it to present a health hazard. The danger from wildfire smoke comes from the billions of particulates that it contains. As the smoke rises, these minute particles become suspended in the air, where they can drift for many miles. This year, scientists were startled to discover that pollution from the West's multiple wildfires reached the jet stream, which carried it across the Atlantic Ocean to Europe.

Wildfire smoke is a mix of gases created by combustion and the fine particles that those gases contain. The particles come from everything that has been incinerated, including homes, vegetation, trees, plastics, polymers, chemicals and the host of other materials in our built environment. The particulates carried by wildfire smoke make breathing more difficult for everyone. This is especially true for people living with respiratory problems such as allergies, asthma and chronic obstructive pulmonary disease, also known as COPD, whose airways are chronically inflamed. This leaves them especially vulnerable to the effects of outside irritants.

One of the reasons wildfire particulates are potentially so damaging is their tiny size. They're measured in microns, with 1 micron about 1/70th the width of a human hair. Particles that small can travel into the deepest recesses of the lungs. There, they cause the immune system to set off a protective inflammation response, which interferes with normal breathing.

Symptoms from inhaling wildfire particulates can include coughing, wheezing, sneezing, throat irritation, itchy or watery eyes, a runny nose, congestion, chest discomfort and shortness of breath. Some people report that it feels like having a mild to moderate flu, but without fever or body aches. Smoke can also be dangerous for people living with chronic heart disease, and can result in symptoms such as rapid heartbeat, chest pain and exhaustion.

To protect yourself and your family, keep track of the air quality in your immediate area. Whenever it drops, take steps to minimize exposure. Stay indoors and keep the windows and doors closed. If your home has either air conditioning or a HEPA filter, use them. Safeguard your indoor air quality by avoiding the use of candles or aerosol sprays. Don't kick up indoor particulates through activities such as vacuuming or dusting. Everyone, of any age or state of health, should avoid unnecessary exertion. Individuals who use a rescue inhaler should have one available, as well as a spare. Check regularly to see whether anyone is experiencing adverse symptoms, and be willing to seek medical help if it should be needed.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to Owing to the volume of mail, personal replies cannot be provided.

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