What happens when whole communities are affected by days of smoke from wildfires? This is happening with increasing frequency in the West. I recall asking myself these questions frequently while the air outside was listed as beyond the hazard index and thinking of my three young kids and my senior citizen parents. I have written previously about the acute risks of severe fire events, but what happens over the seasons and years that follow? On the podcast today, I am joined today by Professor Christopher Migliaccio, who is a researcher and professor at the University of Montana Center for Environmental Health Sciences. He earned his PhD in Immunology at the University of California, Davis and his doctorate of Pharmacy at the University of Montana. He is a certified asthma educator as well, and studies the way the immune system of the lung interacts with environmental exposures. He has also studied the impact of wildfire smoke on our health and published a study that helps answer this question.
In 2017 significant wildfires affected communities in the Northern Rockies. The Seeley Lake Region in Montana suffered exposure to hazardous PM2.5 levels for 35 of 49 days in a row due to location near to fires as well as an inversion. The levels reached over 600ug/m3, and averaged over 200 for the period. As a reference, the American Thoracic Society advises that chronic levels should be below 11ug/m3 and transient exposures no higher than 25ug/m3. At the request of the Missoula Health Department and Division of Environmental Quality, the University of Montana assembled a multi-disciplinary team to survey members of the population and do lung function testing.
They recruited volunteers in the community and performed lung function testing (spirometry) in 2017, 2018 and 2019. They found that in the years following the fire, lungs were more “obstructed” than expected for age and sex matched cohorts. As a lung doctor, I pay careful attention to the FEV1/FVC ratio (the test they evaluated) because if it falls too far, it can mean a patient has asthma or another form of obstructive lung disease where the breathing tubes are damaged or hyperactive and people struggle to breathe in and out. Twitchy Airways Club members will be familiar.
Other researchers found that the Montana areas with higher PM2.5 exposures also experienced more cases of influenza in the following flu season than anticipated. They saw that for each 1ug/m3 increase in PM2.5 during the wildfire season, the following influenza rate increased 16-22%. This is particularly concerning with the current circulating COVI19 pandemic and as we enter the current flu season.
In summary, heavy episodic exposure to wildfire smoke can affect our lungs for years and may make our lungs more susceptible to infection in the year following smoke exposure. We should all be getting our flu shots this year and be extra cautious about the raging COVID19 pandemic. I also worry that there may be an increased risk for long term obstructive lung disease, which can be seen from long-term effects of other particulate matter inhalation (eg tobacco, traffic, etc). Wildfires are with us for the near future- the climate is warming and years of fire suppression have led to high fuel burden and conditions ripe for burning. It is important for us to learn about these health effects and to work for community resilience while we work to address climate change. Listen to the episode today to learn more, and think about what you might be able to do for your family and community.
Twitchy Airways Club Members–
1- Make sure you have a plan for indoor air quality- remember fire and smoke season will come again; make sure you have a place in your home at least where you can breathe healthy air. See earlier post on indoor air quality prior and listen to the episode with Professor Gall for more information.
2- Get your flu shot- this is always a good idea, but increased flu burden was seen in the year following the severe smoke exposure in Seeley Lake.
What can you do?
1- Follow Twitchy Airways Club advice above, since smoke affects all airways.
2- See what your community can do to collaborate to promote resiliency during smoke season with clean air shelters, in particular supporting vulnerable and elderly populations to have clean air access.
3- Do your part to mitigate climate change
4- Stop smoking- decrease general smoke burden for yourself and your family
5- Help your community “stop smoking” transportation and construction fuels, this may help us be more resilient to severe fire episodes.
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