Q&A: What to Know About Exposure to Smoke and Debris From Wildfire

Karen Selby, RN, patient advocate at the Mesothelioma Center at Asbestos.com, discusses the health risks associated with exposure to wildfire smoke and debris, including eye irritation, minor respiratory irritation, and long-term effects like permanent lung damage and cancer. People with pre-existing lung conditions, young children, the elderly, and individuals with compromised immune systems are particularly vulnerable. She talks about how to minimize exposure to wildfire smoke and debris, including avoiding disturbed ash and debris, wearing an N95 mask or a respirator with certain filters, and staying indoors with windows and doors sealed tight. Finally, Selby discusses how communities and health care professionals can help by providing education and resources for people to protect themselves against harmful smoke inhalation.

California Wildfire, Debris and Smoke, Health Risks, Pharmacists | Image Credit: Jennifer J. Taylor | stock.adobe.com

Pharmacy Times®: What are some of the most significant health risks due to exposure to wildfire smoke and debris?

Karen Selby, RN: Wildfire smoke can contain a complex mixture of many pollutants, including chemicals, gases, synthetic materials, and cancer-causing fibers such as asbestos. Smoke inhalation from wildfires has been known to cause a multitude of health issues. Most are short-term, like eye irritation and minor respiratory irritation, but potential long-term illness may affect both young and old individuals, with many risks being primarily respiratory related.

Wildfire smoke is particularly dangerous because it contains particle pollutants. The smoke can be highly concentrated, and the lungs often struggle to expel the inhaled particles.

Pharmacy Times: Are there any populations that would be most vulnerable to various health risks of wildfire smoke?

Selby: Yes, people with pre-existing lung conditions such as asthma, [chronic obstructive pulmonary disease], or pulmonary fibrosis can have acute exacerbated effects from inhaling smoke. Also, young children and the elderly are particularly vulnerable to long-term effects from wildfire smoke. Individuals with already compromised immune systems may have issues with inhaling contaminated air.

Pharmacy Times: How can exposure to arsenic, lead, and asbestos through wildfire smoke and debris post significant health risks?

Selby: Inhaling contaminated smoke can result in long-term effects like permanent lung damage and cancer. It typically takes heavy concentrations of exposure for extended periods of time to be at risk for cancer-related effects. According to the [National Institutes of Health], lead-containing paint is common in structures built before 1977. Heated lead in burning paint can be aerosolized and absorbed directly into the bloodstream through the lungs. Acute lead intoxication has been reported in this setting.

Pharmacy Times: Asbestos exposure can cause long-term health implications. Can you discuss the risk of mesothelioma and lung cancer in association with wildfire smoke?

Selby: As wildfires burn through older homes and buildings, asbestos-containing materials become brittle and damaged. Asbestos fibers are fire-resistant, and they can survive extreme temperatures up to 1,600 degrees fahrenheit. When fire damages old building materials, it can release asbestos fibers, which are microscopic and easily inhaled. Asbestos exposure poses health risks to residents, firefighters, first responders and cleanup crews during and after wildfires.

According to the California Department of Forestry and Fire Protection, about 73% of all structures in the Palisades area alone were built before 1980. With that many buildings at risk of containing asbestos, there’s significant potential for asbestos to become airborne and travel by wind throughout the area.

Pharmacy Times: How can patients minimize their exposure to wildfire smoke and debris?

Selby: Avoid disturbing ash and debris because they may contain asbestos fibers. Keep children and pets away from affected areas. Wet debris lightly with water to reduce airborne dust, but avoid using high-pressure sprays. Do not sweep or vacuum the ash because it can release asbestos fibers into the air. Do not handle or dispose of contaminated materials. Once emergency officials declare that the area is safe, federal and state debris removal teams will move into the affected areas. Cleanup happens in 2 phases: hazardous waste removal in phase 1 and structural debris removal in phase 2.

While wearing an N95 mask can prevent inhalation of fine particles in smoke, it cannot prevent asbestos exposure. Respirators with certain filters, including N100, R100 or P100 filters, can prevent exposure to both smoke and asbestos. If you’re returning to an area that sustained significant damage and may encounter asbestos-contaminated debris, you may consider wearing an appropriately rated respirator, gloves, goggles and protective clothing.

Pharmacy Times: How can communities and health care professionals provide health needs to those affected by the wildfires?

Selby: Provide education and resources for people to protect themselves against harmful smoke inhalation. Encourage staying indoors with windows and doors sealed tight and to stay hydrated. Have safety masks readily available for the community. Encourage a well-fitted N95 mask if you need to go outside. Do not ignore severe symptoms like chest pain, persistent cough or difficulty breathing, see your [physicians].