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Once again, the pharmacist’s role proves to be essential in times of crisis as the wildfires across Los Angeles County, California, continue to grow. As of January 10, at 11:15 am, there are 5 major fires—Palisades, Eaton, Kenneth, Hurst, and Lidia—across a combined 36,560 acres and the 2 largest fires are a combined 11% contained.1
The National Weather Service has reported that smoke coverage is severe and wind gusts could reach around 20 mph, with the potential to accelerate the fires further.2
According to the National Community Pharmacists Association (NCPA), there are more than 50 independent community pharmacies affected by the wildfires. Patients are advised to stay in contact with their health care providers, pharmacists, and other medical professionals to strategize the best ways for uninterrupted medical treatment.3,4
Furthermore, the NCPA Foundation’s Disaster Relief Fund will be utilized to assist independent community pharmacists affected by the wildfires.4
Wildfires' Affect On Lungs, Cardiovascular Health
The authors of a 2019 study stated that the largest forest fires at that time were nearly 5 times more frequent annually compared with 1990. Fires reportedly last much longer and cover more land area than in the past. For California specifically, the wildfire season typically ends in October. Wildfire smoke contains a complex mixture of acrolein, benzene, carbon dioxide, carbon monoxide, formaldehyde, polycyclic aromatic hydrocarbons, and fine and respirable particulate matter, all of which pose risks to patients.5
In a study published by the US Department of Agriculture’s Forest Service, exposure to wood smoke could affect the lungs and cardiovascular health of those who are exposed. Specifically, the study measured the risk for wildland firefighters, who have a 43% increased risk of lung cancer mortality and 30% increased risk of cardiovascular disease mortality.5
In another study published in January 2025, patients who were exposed to wildfire disaster declarations during radiation treatment for lung cancer had worse overall survival compared with those who were unexposed to wildfire. In previous research, exposure to hurricane disasters were also associated with worse survival among patients with non–small cell lung cancer due to exposure and interruption of treatment. The authors added that understanding exposure to climate–driven disasters and mortality can help develop disaster preparedness and response strategies for patients undergoing cancer treatments.6
The Pharmacist's Role During Times Of Crisis
Due to the rapid nature of the wildfires, President Biden has approved Governor Gavin Newsom’s request for a Presidential Major Disaster Declaration to support the response efforts in California. With the declaration, federal assistance funding is available to help state, tribal, and local governments cover emergency response costs and initiates the Individual Assistance program for affected citizens and businesses. The approval also provides support through the US Forest Service, including 5 large air tankers, 10 helicopters, and dozens of engines.7
Emergency Evacuation Documents
1. Identification: Driver's License, State ID, Passport, Birth Certificates, Photos of family members
2. Important Documents: Proof of address, insurance documents, financial records, medical records
3. Personal: Custody documents, legal documents
NCPA Foundation. Wildfires Devastate Southern California, Impacting Many in the Pharmacy Community. January 9, 2025. Accessed January 10, 2025. https://ncpafoundation.substack.com/p/wildfires-devastate-southern-california
"The situation in Los Angeles is highly dangerous and rapidly evolving. President Biden’s swift action is a huge lift for California as we throw everything we can into protecting residents with substantial state, local, and federal resources. To all those in Southern California, please continue to listen to local authorities and don’t wait, evacuate if asked,” Governor Newsom stated in a news release.7
In times of declared state of emergency, the California State Board of Pharmacy’s California Business and Professions Code section 4062(b) goes into effect. Through this the Board “permits pharmacies to provide care by waiving requirements that may be impossible to meet during an emergency, including requirements for prescription forms, record-keeping, labeling, and other standard pharmacy practices and duties.” However, pharmacists should be documenting dispensing related to this section on the prescription form in case of audit by either the Board or insurance company.8
In addition, section 4064 authorizes pharmacists to use professional judgement to refill prescriptions of drugs or devices deemed dangerous, even without prescriber’s authorization, if failure to refill could interrupt ongoing care or have adverse impacts on the patient’s well-being.8
The American Red Cross issued a checklist and reminders about what patients should take if they need to leave home quickly and safely. They suggest gathering food, water, and medications in advance due to any potential store closures, and learning emergency skills such as first aid and CPR. Further, patients should have plans in place for electronic medical equipment if power outages occur.9
In addition to medication preparedness, pharmacists can also serve as educators about protecting patients' lungs and preventing cardiovascular disease due to wildfire inhalation. Respirators are very valuable because they can cover the nose and mouth and filter out smoke and ash particles. However, the most effective protection is to stay indoors if possible, especially for patients with asthma, known heart or lung diseases, and those at increased risk of adverse health effects.10
REFERENCES
1. Cal Fire. Current Emergency Incidents. January 10, 2025. Accessed January 10, 2025. https://www.fire.ca.gov/Incidents
2. National Weather Service. Los Angeles/Oxnard, CA. January 10, 2025. Accessed January 10, 2025. https://forecast.weather.gov/MapClick.php?lat=34.052238&lon=-118.243344
3. US Environmental Protection Agency. Wildfire smoke factsheet. 2025. Accessed January 10, 2025. https://www.epa.gov/sites/default/files/2018-11/documents/respiratory_protection-no-niosh-5081.pdf
4. NCPA Foundation. Wildfires Devastate Southern California, Impacting Many in the Pharmacy Community. January 9, 2025. Accessed January 10, 2025. https://ncpafoundation.substack.com/p/wildfires-devastate-southern-california
5. Navarro KM, Kleinman MT, Mackay CE, et al. Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality. Environ Res. 2019;173:462-468. doi:10.1016/j.envres.2019.03.060
6. Lichter KE, Larson B, Pagadala M, Mohamad O, Nogueira L. Impact of declared wildfire disasters on survival of lung cancer patients undergoing radiation. Cancer Causes Control. Published online January 9, 2025. doi:10.1007/s10552-024-01949-2
7. Governor Newsom quickly secures Major Disaster Declaration from President Biden for Los Angeles Fires. News release. Governor Gavin Newsom. January 8, 2024. Accessed January 10, 2025. https://www.gov.ca.gov/2025/01/08/governor-newsom-quickly-secures-major-disaster-declaration-from-president-biden-for-los-angeles-fires/
8. California State Board of Pharmacy. Important information for licensees during declared states of emergency. August 2021. Accessed January 10, 2025. https://www.pharmacy.ca.gov/licensees/declared_disasters.pdf
9. American Red Cross. What should you do before a wildfire starts. 2025. Accessed January 10, 2025. https://www.redcross.org/get-help/how-to-prepare-for-emergencies/types-of-emergencies/wildfire.html?srsltid=AfmBOopLT0cPzn8jcsbP_0sN4udAlUAQkh0YJq21NFt8kRjJMLwIwQqi
10. Antrim A. Emergency Prescription Assistance Program Deployed in North Carolina Following Hurricane Helene. Pharmacy Times. October 7, 2024. Accessed January 10, 2025. https://www.pharmacytimes.com/view/emergency-prescription-assistance-program-deployed-in-north-carolina-following-hurricane-helene