Wildfire season opens as evidence of health risks rise

Scripps Howard News Service - June is usually prime time for Cindy Coopersmith to get out and enjoy the woods and wildlife around Fort Collins, Colo.

But last June heralded a summer of smoke. For nearly a month, the High Park fire west of the city generated thick plumes as it consumed more than 87,000 acres of brush, timber and 259 homes.

It drove the Coopersmiths and tens of thousands of others indoors or away from the area.

"People with respiratory issues were in trouble. If you looked outside, you knew it was not good. It was dreadful for so many people,'' said Coopersmith, a respiratory therapist at Poudre Valley Hospital. She and her husband, Howard, both in their 50s, have asthma, and she's co-founder of a local support group for parents of children with asthma and allergies.

Researchers at Colorado State University in Fort Collins said the particulate matter at the height of the June fire exceeded some of the worst air pollution days on record for cities with some of the worst air in the world -- Los Angeles, Mexico City and Beijing.

Like millions of Americans living in or near areas increasingly prone to wildfires - and often even hundreds of miles from those areas-- their lives were disrupted even though their homes were never in direct danger.

Government agencies ranging from the U.S. Forest Service and Interior Department to NASA, as well as climate scientists from the University of Alaska to the University of Maryland all agree that much of the U.S. can expect more large wildfires, generating more smoke that can affect larger areas during longer fire seasons in the years and decades ahead due to climate change.

At least a third of Americans have breathing or heart conditions that put them at risk from the soot from such fires, and even people with no health problems can be affected by the worst plumes, which can remain toxic over hundreds, even thousands of miles.

Researchers are working to better understand this toll. "The health consequences of forest fire smoke is of critical interest as fires are anticipated to occur more frequently, spread more rapidly and burn more intensely. Studies have shown health effects (from smoke) in communities far from fire sources,'' said Dr. Michelle Bell, a Yale researcher leading a two year study looking a health risks to communities from wildfires under a changing climate sponsored by the National Institutes of Health.

Wildfire smoke is what's left from incomplete combustion of whatever piece of landscape burns. It contains, among other things, carbon monoxide, nitric oxide, irritants like formaldehyde, carcinogens like benzene, and, most of all, particulate matter -- tiny bits of ash suspended in the air.

Many experts compare burning vegetation to tobacco smoke for its harmful effects. When nearly half a million acres burned outside Moscow in August, 2010, Dr. Alexander Chuchalin, Russia's chief pulmonologist, told a news conference the impact on residents' heart and lungs "equals the effect of two packs of cigarettes smoked within three or four hours."

And, scientists say, the smoke from wildfires is going to reach more and more of us. Experts project that large wildfires will, in coming decades, be more common, last longer and consume more acreage as the climate gets warmer and often drier, and with more tinder and lightning to feed and spark flames. Humans start most wildfires, but lightning strikes in remote areas produce some of the biggest and hardest to contain blazes.

Wildfires will also take a greater toll on people and their homes, as more of both move into fire-prone areas.

The overall number of fires per year has averaged about 74,000 over the past decade -- basically steady -- but the number of acres burned has been rising. More than 7 million acres burned in eight of the last 12 years.

Because of the growing threat of so-called mega-fires -- blazes that burn hundreds of thousands of acres and can go on for weeks until checked by changing weather -- scientists in the U.S. and elsewhere in the past decade or so have sped up research into how fires behave, generate smoke and affect health.

While wildfire danger, both from flames as well as from smoke, is expected to increase most in the U.S. Southeast, Southwest and West, all regions face some higher risk.

"We're sure fire season is getting worse and will continue to get worse in the future. It's pretty sobering when you look at the numbers. Some of those fires are going to have smoke affect a heavily populated area,'' said Michael Brauer, associate professor of environmental hygiene at the University of British Columbia.

Respiratory damage from wildfire smoke has been documented in dozens of studies. The main culprit is fine particulate matter, less than 2.5 micrometers in size

(a human hair is about 60 micrometers across). While larger particles can irritate the eyes, throat and lungs. it is the smallest that go deep into the lungs and cause inflammation.

Not only are people known to have asthma and other breathing problems affected, but many people who never had respiratory problems have suffered, too, many reports indicate.

"We see a lot of patients come into the ER or our clinic during major smoke events who have breathing problems that they've never encountered before,'' said Dr. Thomas Szwed, a pulmonologist at St. Vincent's Medical Center in Jacksonville, Fla.

"And we actually encourage our regular patients not to keep appointments during those events because they're really better off staying in their air conditioned homes and not being exposed to more smoke,'' he added.

In Fort Collins, the Coopersmith house has no central air conditioning. They installed a room air conditioner for their bedroom during a heat wave a few years ago.

"The bedroom became our safe room'' during last summer's fire. "We also have a HEPA (high efficiency particulate) filter that we ran most of the time. We both increased our medications within a few days. All we did for a month was sit at home and go to work.

"One of our friends with an 11-year old managed his asthma during the June fire, but when we got a second round of smoke from other fires later in the summer, they left for her father's in Utah," Cindy Coopersmith said.

Children, with smaller and more active lungs, and the elderly, with reduced lung capacity, are more susceptible to smoke than healthy adults.

"Even when there's no visible smoke, particulates in the air can make breathing difficult for kids,'' said Dr. Harold Farber, a pediatric pulmonologist at Texas Children's Hospital in Houston, who treated patients during and after major Texas wildfires two years ago.

Research on other health effects, such as heart disease, is less definitive, but one EPA study in North Carolina found a 37 percent increase in hospital admissions for heart failure during a 2008 peat fire.

Chemical reactions in smoke can increase ozone levels that impact people breathing hundreds of miles from a fire. Some studies show smoke worsens or brings on heart disease, others do not. A few studies indicate smoke can affect insulin resistance and diabetes. One recent report from the University of California,-Berkeley found that pregnant women exposed to smoke from fires in 2003 had babies with lower birth weights.

Yet unlike pollution in cities, which is monitored regularly, the impact of wildfire soot, even if on the rise, can vary widely from place to place and season to season and can only be assessed looking back.

"We're certain smoke is a serious public health threat, but we don't even know what all the long-term effects may be,'' said Janice Nolen, assistant vice president for national policy at the American Lung Association.

The effects of living amidst wildfire smoke that at times reached four times the level of particulates deemed hazardous by the U.S. Environmental Protection Agency were clear long after wildfires around Wenatchee, Wash., were contained last fall.

Restaurateur Mike Bendtsen was fighting "the worst cold I ever had" in early May, more than seven months after lightning-sparked fires in surrounding canyons left the valley with unhealthy air quality for 27 days last fall.

"I blame it on the fires, all the stuff we inhaled,'' said Bendtsen, 54. "You couldn't see across the street during the worst times."

As the fires grew to consume more than 56,000 acres, the Wenatchee Valley -- the lowest point in the eastern edge of the Cascade Mountains -- became a smoke sink. Many people left town.

Bendtsen used the Facebook page of his McGlinn's Public House restaurant as an interchange for people and groups that could help find housing, and channel food and other donations. The biggest effort focused on getting masks, in particular N-95 type respirators able to filter at least some of the soot.

"At first, there were no masks. No store in town had them, and no officials seemed to be dealing with this need, so we used money from donations and bought what we could. We gave out thousands of them outside the restaurant. The worst days, they'd be black in 24 hours and you had to change them out.'' 

The fires started Sept. 8.But it wasn't until about 10 days later that the state health department started shipping masks from a stockpile to local health departments in the fire region.

"We had this air emergency, and a lot of agencies fighting the fires and evacuating people, but we didn't seem to have a very coordinated effort at first to get word out to people about what to do to protect themselves from smoke,'' Bendtsen said. "We'll do better next time, but I wonder about other places that have to deal with a big smoke event.'' 

The National Weather Service, and state and local public health and emergency management officials do monitor weather conditions influencing fire and smoke extensively

and cooperate on warnings.

But great uncertainties remain about how fires will progress, and how to assess the risk from smoke for the young, elderly, infirm and otherwise healthy people. Most states and many local health departments in fire-prone regions have guidelines for issuing warnings, but residents and local officials have to use their best judgment in deciding when to shelter or evacuate, when to cancel outdoor events or close schools.

"Getting a forecast to people on the ground in enough time to plan a response is difficult because fire conditions can change so rapidly,'' Brauer said. "They want people to respond when they tell them to leave, and they don't have that many chances to mess up if they cry wolf.'' 

Health effects can also vary depending on what type of landscape is burning. Studies of fires in dry swamps and peat bogs, like those often seen in Florida, have found major impacts on breathing because the smoke is dense with particulate matter and tends to hang low to the ground. Another recent study found ponderosa pines -- common across the West -- release large amounts of potentially toxic alkaloids when they burn.

Gabriele Pfister, a researcher at the National Center for Atmospheric Research in Boulder, Colo., is working on new models using data from last year's fires to better understand fire dynamics.

"We're only beginning to understand wildfires' potential impacts on people and ecosystems, not only nearby but also potentially far downwind," Pfister said.

Wildfire smoke can travel great distances and still impact health. Satellites regularly plot smoke plumes moving hundreds and thousands of miles. Siberian fires send pollution to the Pacific Northwest, smoke from fires in Arizona and New Mexico drifted more than 1,000 miles to the Midwest two years ago; smoke from Central American fires frequently reaches Florida.

Pfister's is among several scientific teams working on new computer models to predict how wildfire smoke will move and affect health close to the fire and many miles away, particularly for areas that have no air quality monitors on the ground. In all, less than a third of all U.S. counties do.

In San Diego County, a team of researchers from Michigan Technological University, led by fire emissions expert Nancy French, just completed a two-year analysis of wildfires in the county in 2007, when more than 300,000 acres of grass and brush and more than 1,500 homes burned. A half million residents were ordered to evacuate.

The researchers found their fire models could predict more than a day in advance which areas would be most impacted by smoke -- predictions confirmed by a county network that tracked hospital emergency department visits.

"This is really useful in telling us who is most at risk during a major fire,'' said Jeffrey Johnson, a senior epidemiologist at the San Diego Health and Human Services Agency who also worked on the project. He said the model could help guide evacuations, shelter arrangements and a host of other decisions before, during and after fires.

The researchers think the modeling system could eventually be used in communities around the country to offer more precise, timely smoke warnings.

"I'm afraid fires are not going to get better anytime soon,'' Wenatchee restaurant owner Bendtsen said. "Communities need to have the tools to protect people. A lot of people around here aren't sure how much more smoke they can take."

(Reach Scripps health and science writer Lee Bowman at bowmanl@shns.com.)

(Distributed by Scripps Howard News Service, http://www.shns.com)

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