August 21, 2018 - With nearly 1 million acres already burned, this year’s wildfire season in California is off to a hot start. Yet as the well-known Mendocino, Carr, and Holy fires round out the list of almost two dozen wildfires currently raging across the state, the September-October peak of fire season is looming ominously in the near future.
While the obvious dangers to health and property from the blazes are of immediate concern to nearby residents, long-term impacts from the exposure to smoke and airborne particulate poses an often-overlooked risk to human health across the whole region. The haze from these fires can be seen for thousands of miles, and air quality alerts have started to be issued all over the state, warning of hazardous breathing conditions, especially for sensitive populations.
Since we still have much to learn about the long-term effects of chronic inhalation of wildfire smoke, it can be difficult to predict the long-term impact that these fires may have on the health of the exposed residents. What we do know, however, is that the smoke typically produced by wildfires contains a wide range of mild to severe respiratory irritants from volatile organic carbons, to carbon monoxide, to polyaromatic hydrocarbons – the latter being a broad class of known carcinogens.
The EPA has a standard method of measuring toxicity and the associated risks from an exposure, using a dose-response curve. While certain noncarcinogens do not pose a tangible health risk if dosage is kept below a certain threshold (based on intrinsic properties and the height, weight, and age of the exposed individual), carcinogenic compounds are treated as having a non threshold effect. That is to say, any exposure to carcinogens will, to some degree, initiate development of cancer.
(In this way we can think of an individuals’ long-term risk for cancer as an aggregate of all their lifetime exposures to carcinogens.)
Since longitudinal studies on the issue are difficult, it is hard to be certain of the impact that these fires may have on the health of a population being repeatedly exposed to them. We can, however, reasonably extrapolate that the repeated exposure to hazardous air pollution will bring at least a nontrivial increase in the vulnerability of patients in these regions.
Wildfires already cause disruptions to the health system, mainly by destroying structures, blocking access to facilities, and by causing acute burns and smoke inhalation injuries. The likely consequences of the associated health risks from wildfire smoke include potential dependence on oxygen tanks, nebulizers, chemotherapy drugs, and other medications for respiratory conditions.
Healthcare Ready has seen these types of patients and the difficulties they face when their access to their medication and healthcare supplies is threatened. We know from our involvement in countless disaster responses that any event affecting chronically ill patients or those with dependence on medications or healthcare equipment requires forward thinking and innovative collaboration to prevent and respond to tragedies.
Perhaps then, this ever-increasing trend in wildfires underscores the need for Healthcare Ready and our partners to continue pushing the cutting edge of innovative health solutions forward and bolster resilience for any and all patients exposed to a disaster.
 Mihelcic, James R, and Julie Beth Zimmerman. Environmental Engineering: Fundamentals, Sustainability, Design. John Wiley & Sons Inc, 2014.