Implications of the California Wildfires for Health, Communities, and Preparedness Proceedings of a Workshop (2020) / Chapter Skim
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4 Effects of Wildfires on Human Health
4 Effects of Wildfires on Human Health
Pages 33-56
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From page 33... ...
(Riden) • In particular, wildland firefighters experience smoke exposures that can cause a wide variety of negative health outcomes.
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Some of the smallest particles can even cross into the bloodstream and travel throughout the body. Almost every study that has investigated associations between smoke exposure and respiratory health outcomes has found significant associations with asthma exacerbation.
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More research should be done to look at the background concentrations of ozone, the precursors of ozone, and a fire's impact on ozone, she said, because the impacts of other fires on ozone concentrations, and thus health, could differ from what was found in this one study. Most studies have found mental health impacts of wildfire smoke exposure, including posttraumatic stress disorder (PTSD)
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From page 36... ...
"We need to look at this more." Reid listed several pressing research questions: • The long-term health impacts of repeated exposures to wildfires • Other health endpoints related to wildfire smoke that have not been studied, including metabolic disorders, cognitive decline, child development, and maternal health • Why findings differ across studies, particularly for cardiovascular disease • Effects on vulnerable populations • Impacts of other air pollutants in wildfire smoke, not just particu late matter • The health impacts from ozone based on a wider variety of wildfires • The effectiveness of public health interventions CHALLENGES AND LIMITATIONS OF WILDFIRE SMOKE EXPOSURE RESEARCH Reid also discussed some of the difficulties of ascertaining the effects of wildfire smoke on health. First, studying wildfires inevitably poses epidemiological challenges.
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The health effects caused by an increased PM2.5 exposure cannot be calculated with certainty if the exposure is uncertain. To quantify smoke exposure, "the first place to turn is monitoring data, and there's a lot of this available," said Reid.
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To counter the uncertainties in satellite data, monitoring data, and air-quality models, exposure assessment researchers are increasingly using blended models that combine satellite data and monitoring data, and sometimes air-quality models and other data. For example, Gan et al.
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"If they are highly correlated then it would be hard to disentangle that. I do not think any studies have tried to do so." "We are only getting the tip of the iceberg in terms of the health impacts from smoke exposure." -- Colleen Reid OCCUPATIONAL EXPOSURE TO WILDFIRE SMOKE AMONG AGRICULTURAL WORKERS "You have the foundation of health effects in people," said Heather Riden, manager of the Western Center for Agricultural Health and Safety at the University of California (UC)
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From page 40... ...
Many also said that they would continue to work in unsafe conditions because, as one put it, "rent had to be paid" and "food has to be bought." Riden said, "It is in that context that we need to be thinking about public policies and how to protect those people who have no choice but to work despite unsafe conditions." Farmworkers had varying knowledge of protective measures. Some were aware of respirators and how they could use masks to protect themselves.
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From page 41... ...
We make individual accommodations." At the time of the workshop, the California Occupational Safety and Health Standards Board was considering a petition for an emergency regulation on wildfire smoke exposure for outdoor workers. Employers would be required to provide respirators for workers to use on a voluntary basis when the Air Quality Index is 151 or greater.
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From page 42... ...
Forest Service, had been working on an interagency hot-shot crew focused on prescribed burns and wildfires.1 She described the kinds of exposures wildland firefighters face and the possible health effects of those exposures. In 2018, at the height of fire season, more than 27,000 firefighters were deployed in the western United States to suppress wildfires.
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From page 43... ...
At the time of the workshop, the National Institute for Occupational Safety and Health was conducting a 3-year study focused on cardiovascular and respiratory health, asking such questions as whether firefighters are able to recover lung function between seasons. 2 Firing is the process of intentionally setting fire to fuels between the main body of a fire and the fire control line.
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"We are talking about a vulnerable population that has probably little supervision about exposure to risk and little information." Navarro said that she could not comment on equity issues involving prisoners but noted that prison firefighters "are exposed out on the line, just like any firefighter, and they are exposed in camp." Navarro also noted, in response to a question, that firefighters get little if any training on how to avoid smoke exposure. In the trainings that she conducts for firefighters, her focus is making it simple and making it tangible and trying to get that message out that there are hazards in smoke and we need to start thinking about ways of reducing it.
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From page 45... ...
"If you do not have drinking water or a way to get water, it is going to be hard to have a sustainable community." In October 2017, the Tubbs Fire affected Sonoma and Napa Counties, where 5,656 structures burned; 2,500 parcels were affected in the city of Santa Rosa. Because of drinking-water system damage, Santa Rosa issued a boil water advisory.
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From page 46... ...
All contaminated hydrants, water mains, air release valves, blow offs, and service lines were replaced, and long-term VOC monitoring was required. The 2018 Camp Fire was on a different scale than the Tubbs Fire, with many more structures and water systems affected.
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From page 47... ...
water system had more than 2,200 parts per billion of benzene in its water in January 2019, and the Del Oro Water Company had found b enzene in two of its three systems. There are long-term exposure standards for benzene, Whelton noted, but acute exposures also can cause health problems.
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But the devices being installed were tested for typical drinking water use, not for the use of heavily contaminated water, said Whelton. Whelton and his colleagues identified six scientific challenges and opportunities associated with drinking water after wildfires: 1.
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"If you do not have drinking water or a way to get water, it is going to be hard to have a sustainable community." -- Andrew Whelton TIME-SENSITIVE STUDIES OF WILDFIRE EFFECTS In October 2017, fires broke out in the northern California counties of Napa, Lake, Sonoma, Mendocino, Solano, Nevada, Yuba, and Butte. More than 245,000 acres burned, close to 9,000 structures were destroyed, more than 100,000 people were evacuated, and 44 people died.
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From page 50... ...
Sample analyses were done of ash, air, and food. The combined projects had several goals: • Describe the population's experiences and needs • Learn about exposures -- smoke and contamination • Address both physical and mental health consequences • Establish cohorts to follow for long-term impacts on health • Understand the role of community socioeconomic factors in pre dicting long-term health and recovery • Collaborate and communicate with local organizations to enable improved future responses Hertz-Picciotto directed her remarks largely to the online survey, which gathered the following information: • Household -- basic information, location, members of household • When the fires broke out • Evacuation details -- respondent, other adults, and children in household • Recovery period, including needs and concerns • Handling debris from the fire • Employment status • Health status -- respondent, other adults, and children in the house hold, before fires and since the fires broke out • Demographic characteristics • Contact information for follow-up studies One issue Hertz-Picciotto and her colleagues wanted to pursue was the extent to which the underlying socioeconomic status of a community affects the long-term impacts.
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From page 51... ...
A majority of the households had to evacuate, and many of these evacuees had to relocate to three or more locations in the first 6 weeks. Respondents reported a wide variety of needs both immediately and 1 week after the fire, including transitional housing, clothing, safe drinking water, medicine, cell phone service, electricity, heat, hot water, sleep, breathing masks, and transportation.
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From page 52... ...
For example, Hertz-Picciotto described an effort to outfit an electric car with air monitors so that it could get data in places without air monitors, though firefighters sometimes refused to let the cars enter fire areas. From ash samples taken from homes that had been destroyed, analysis has revealed the presence of hundreds or even thousands of chemicals, many of which are unique to built environments.
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From page 53... ...
The California National Primate Research Center has about 4,500 rhesus macaque monkeys on site at any given time, with about half of them living outdoors on a 24/7 basis. With support from the California Air Resources Board, Miller and her colleagues studied the animals (who had been exposed to smoke shortly after they were born)
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From page 54... ...
They also had significantly reduced lung volume, which is consistent with what was observed in juveniles, and early-life wildfire smoke exposure was associated with increased airway radius and increased airway blood vessel density in adults. "Something that takes place very early in life can have long-lasting and profound effects on the respiratory system as well as the immune system," Miller concluded.
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From page 55... ...
Similarly, when Hurricane Katrina devastated New Orleans, people from the local community and from faith-based organizations came forward to help their neighbors and became a key part of the support for the community. Commenting on another analogous circumstance, Colleen Ryan, a surgeon who represents the American Burn Association, pointed to the many opportunities to apply lessons from the burn community to wildfire preparations.
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From page 56... ...
"That seems like a pretty bold assumption to me." She also pointed out that acquiring the resources to deal with wildfire requires knowing the true economic and societal impacts of those fires. "To get the health impacts right, we need to have this research, so that's why these research challenges are really important."
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