The Chemistry of Fires at the Wildland-Urban Interface (2022) / Chapter Skim
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6 Human Exposures, Health Impacts, and Mitigation
6 Human Exposures, Health Impacts, and Mitigation
Pages 113-152
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This chapter begins by identifying chemicals and other pollutants of concern for human exposure and describing populations who may be more vulnerable to the impacts of WUI fires, and those who experience environmental injustice and health inequities. The next section describes what is known about routes of exposure, followed by a discussion of the acute and chronic health impacts for all near- and far-field populations, with a dedicated section on exposures and impacts for firefighters.
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: Inhalable particles with diameters equal to or less than 10 micrometers in diameter Environmental justice: A social movement developed in response to environmental racism; environmental justice research and practice involves identifying the disproportionate health burdens that populations experi ence from environmental exposures and social vulnerabilities, and focusing on solutions to alleviate those burdens in partnership with affected communities Fine particulate matter (PM2.5) : Airborne particles with diameters of 2.5 micrometers or less, small enough to enter the lungs and bloodstream, posing risks to human health Health equity: Identifying health disparities between populations that are driven largely by social, economic, and environmental factors, and focusing on solutions to eliminate those disparities Particulate matter (PM)
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30569-X. CHEMICALS OF CONCERN FOR HUMAN EXPOSURE Wildland fires are major sources of organic and inorganic gases and aerosols containing ultrafine particles (0.1 μm or less)
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Ozone (O3) Inhalation Acute and chronic respiratory symptoms NEPHT, 2020 including coughing and exacerbation of chronic diseases such as bronchitis and asthma; increased risk of pulmonary infections Particulate matter (PM)
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2,2-dichlorobiphenyl, Ingestion endocrine disruption; reproductive and 2,4,5-trichlorobiphenyl; Dermal developmental toxicity; respiratory toxicity PCBs typically occur as a mixture of PCB congeners (i.e., aroclors) Volatile organic Formaldehyde, acetaldehyde, Inhalation Cancer; reproductive and developmental EPA, 2021c compounds (VOCs)
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. Additionally, low-income housing units are less likely to have adequate cooling systems to allow them to keep windows closed during the summer heat when wildland fires and WUI fires are typically occurring (HHS, 2018)
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• Less access to resources (e.g., quality health care) • Barriers to receiving language- and culturally appropriate care Low-Income Communities • Fewer resources and means to evacuate Rudolph et al., 2018; Reid et al., • Less access to indoor spaces with air cleaners and air cooling 2016a; Brim et al., 2008 • Higher burden of asthma and cardiovascular disease • Existing health disparities • Lack of safety nets for missing work Rural Communities • Less municipal infrastructure, including access to drinking Rudolph et al., 2018 water and safe spaces • Lack of extensive evacuation routes • Fewer environmental monitoring units available • Less access to indoor spaces with air cleaners and cooling • Existing health disparities Unhoused/Homeless • Lack of access to multiple basic resources Rudolph et al., 2018 Communities • Existing health disparities People with One or More • Fewer resources and less means to evacuate Rudolph et al., 2018 Disabilities • Inadequate community infrastructure • Less mobility and ability to assess risks Occupation-Based Vulnerability Wildland Firefighters and • Lack of personal protective equipment during firefighting Rothman et al., 1991; Fent et al., Emergency Responders • Live and/or work in active fire zone 2017; Navarro et al., 2019 (e.g., Emergency Health • Some states use incarcerated populations for firefighting Care Personnel)
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2021g. "Which Populations Experience Greater Risks of Adverse Health Effects Resulting from Wildfire Smoke Exposure?
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However, data on the personal inhalation exposures of wildland firefighters and other emergency response workers in the immediate and near-field zones during WUI fires have yet to be reported. While such data could be extrapolated from that of wildland fires, burning structures could contribute to increased exposure concentrations and smoke components that are mostly absent in purely vegetative wildland fires (Fent et al., 2018; Jaffe et al., 2020)
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. Personal exposure of firefighters at the fireline to benzene, a blood carcinogen, may be even more elevated at WUI fires due to its enrichment in smoke emissions from the combustion of non-biomass WUI fuels (structural materials, vehicles, and furniture)
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Research need: There is a need to better understand the composition of gas and particulate exposures in WUI fires, and how they differ from wildland fires. Research need: Assessments of smoke exposure typically rely on outdoor concentrations.
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Likewise, the committee found no study of dermal exposure of recovery workers to contaminants in WUI fire ash; the committee expects that such exposure can be prevented by the use and cleaning of appropriate protective clothing and personal washing procedures. While dermal absorption of contaminants in settled indoor dust is a potential exposure pathway for residents returning after WUI fires (Meng, 2018; Shi, 2021)
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Consistent with wildland fires in general (Rust et al., 2018) , studies of WUI fires have observed an increased loading of sediments, carbon, nutrients, and metals into surface waters, because of exposed soil and ash, in storm flows following WUI fires (Burke et al., 2013; Burton et al., 2016; Emmerton et al., 2020; Hohner et al., 2016; Stein et al., 2012; USGS, 2012; Writer et al., 2014)
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HEALTH IMPACTS Wildland and WUI fires adversely impact public health as they represent a dramatic source of air, water, and soil pollution in neighboring and even more distant populations. Epidemiological studies estimate that the global mortality burden attributable to landscape fire smoke is approximately 339,000 deaths annually (Johnston et al., 2012)
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Most information about acute and chronic health conditions is based on wildland fire studies, because of the greater amount of data available. Research need: Studies that explicitly define the particular type of fire (i.e., wildland fires vs WUI fires)
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. By contrast, a study of the 2012 Washington state wildland fires found no association between acute bronchitis hospitalizations and wildland fire smoke using three different methods to estimate smoke.
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While the preponderance of evidence suggests an association between cardiovascular disease and wildland fire–generated PM, a conclusive link between wildland fire smoke exposure and adverse cardiovascular effects still remains somewhat elusive. However, a recent review by Chen et al.
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Researchers observed strong associations between wildland fire smoke and COPD ED visits, but saw null results for hospitalizations during the 2008 Northern California wildland fires (Reid et al., 2016b)
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Adolescent monkeys demonstrated reduced lung function and long-term immune alterations dependent on sex. The authors concluded that modulation of peripheral blood cytokine synthesis and altered later-in-life lung function was significantly associated with early-life wildland fire smoke exposure (Black et al., 2017)
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Firefighter Acute Exposures and Effects Although ongoing research exists on WUI firefighter acute exposures and health effects, the committee found no published studies specific to WUI fires. A limited amount of information is available on acute exposures and health effects for wildland firefighters, with additional data available on structural firefighters from municipal fire departments.
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. Firefighter Chronic Effects As with acute exposures and health effects, although there is ongoing research on WUI firefighter chronic health effects, the committee found no published studies specific to WUI fires.
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These limitations are underscored by the lack of comprehensive information about fire emissions specific to WUI fires, such as the chemical composition of PM and pollutants that may not be monitored in targeted analyses. Evacuation While no data sets systematically track the occurrence of emergency evacuations or other exposure reduction actions for wildland fires (CCST, 2020)
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. Research need: Research is needed to better identify at-risk and vulnerable residents and workers affected by near-field WUI fires, and to identify culturally appropriate opportunities for interventions to reduce adverse health impacts.
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. Research need: A need exists for research on the effectiveness of interventions to mitigate WUI firefighter smoke exposures and the associated adverse health effects.
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Standard dust or surgical masks do not keep out fire smoke. Make sure the mask fits as recommended by the manufacturer.
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EPA (2018) reviewed residential measurement studies that used portable air cleaners and central HVAC system filters to reduce indoor PM2.5 exposures overall, not PM2.5 specific to wildfire smoke.
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. Reducing Other Routes of Exposure While interventions to mitigate dermal exposure to firefighters working at wildland fires have been studied, the committee found no published studies related to mitigation to reduce dermal exposure to contaminants in other outdoor workers, fire recovery (cleanup)
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. These reviews and studies are limited by not clearly differentiating WUI and non-WUI fires, and by having limited information on the accessibility of exposure reduction actions (e.g., portable air cleaners)
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2017b. "Impact of Work Task Related Acute Occupational Smoke Exposures on Select Proinflammatory Immune Parameters in Wildland Firefighters." Journal of Occupational and Environmental Medicine 59 (7)
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2017. "Early Life Wildfire Smoke Exposure Is Associated with Immune Dysregulation and Lung Function Decrements in Adolescence." American Journal of Respiratory Cell and Molecular Biology 56 (5)
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2021. "Cardiovascular Health Impacts of Wildfire Smoke Exposure." Particle and Fibre Toxicology 18: 2.
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2016. "Observations and Impacts of Transported Canadian Wildfire Smoke on Ozone and Aerosol Air Quality in the Maryland Region on June 9–12, 2015." Journal of the Air & Waste Management Association 66 (9)
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2020. "The association between wildfire smoke exposure and asthma-specific medical care utilization in Oregon during the 2013 wildfire season." Journal of Exposure Science & Environmental Epidemiology 30: 618–628.
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2021. "Health Effects of Wildfire Smoke in Children and Public Health Tools: A Narrative Review." Journal of Exposure Science and Environmental Epidemiology 31 (1)
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2012. "Followup in Southern California: Decreased Birth Weight Following Prenatal Wildfire Smoke Exposure." Environmental Health Perspectives 120 (9)
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2017. "Who Among the Elderly Is Most Vulnerable to Exposure to and Health Risks of Fine Particulate Matter from Wildfire Smoke?
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2016a. "Critical Review of Health Impacts of Wildfire Smoke Exposure." Environmental Health Perspectives 124 (9)
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2021. "Composition of Particulate Matter during a Wildfire Smoke Episode in an Urban Area." Aerosol Science and Technology 55 (6)
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2018. "Cardiovascular and Cerebro vascular Emergency Department Visits Associated with Wildfire Smoke Exposure in California in 2015." Journal of the American Heart Association 7 (8)
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2018. "Intra-continental Wildfire Smoke Transport and Impact on Local Air Quality Observed by Ground-Based and Satellite Remote Sensing in New York City.
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