Like many in the West and other parts of the world increasingly affected by fire, I think often of the hard work and heroism of our wildland firefighters. “Los bomberos” have been regularly mentioned in our family prayers before meals and bedtimes, and my children have participated enthusiastically in making thank you cards. As a lung doctor, I worry frequently about the health of frontline workers. One person who is an expert in evaluating and protecting high risk occupations is my podcast guest today. Dr. Alya Khan is an occupational medicine physician at the University of California Irvine, and directs the Occupational Medicine Residency program there. In addition to a Master’s degree in Environmental Toxicology, she holds dual board certifications in internal Medicine and Preventive Medicine. She works at the Center for Occupational and Environmental Health which provides clinical and preventive services to local and regional employers, conducts worksite surveillance programs, as well as providing toxicology consultations. Earlier this year, she chaired a symposium on wildfires and health risks with a variety of professions, from public health researchers to wildland firefighters and forest management experts.
We talk about the health hazards facing wildland firefighters, including related to the variety of fuels that burn and the duration of the burns. Firefighters can absorb these toxins into their lungs and via their skin and other surfaces. Wildland firefighters are frequently working for prolonged periods without respirator precautions, which raises their risks for a variety of bad health outcomes and cancers.
We discussed steps that employers can take to protect their workers, and steps to ensure that outdoor workers are safer when air quality is hazardous. Many of my physician friends and patients have also asked when it is safe to go to in-person appointments, and we discuss this as well.
We also discussed the ultimate drivers of these wildland fires and the need for more active and extensive forest management in addition to addressing climate change. Dr. Khan works regularly with firefighters and encourages a multidisciplinary and collaborative approach with forest management and mitigating the effects of climate change and air pollution.
TLDR= Let's Keep Our Firefighters Safe and Decrease Fire
Ways to Take Action
- Thank your firefighters– and make sure you advocate for them to have lifelong high quality health coverage since they are risking their lives and health to keep us all safe. You can thank Steelhead Enterprises on their Facebook page!
- Donate to the National Fallen Firefighters Foundation– Charity Navigator Score of 93.91, and participate in the Tribute to Fallen Firefighters on October 4th
- Ensure protection for outdoor workers– ensure your state has workplace safety considerations in place for outdoor workers. These can be complex issues, but just because issues are complex, does not mean we should not work on them. One example is here.
- Check with your local fire department on how to make your home and community more resilient to wildfire
- Contact your legislators to support increased wildland fire prevention – for example with a pro-active forest management approach with year-round staffing. We need to let the science lead to help us understand which areas are at risk and spend the money to pay people to safely address it. This will also bring good, high quality jobs as well.
References:
California Air Resource Board Wildfire Resources– resources for wildfire risks
CAL OSHA– standard regarding air quality and outdoor workers
CDC/NIOSH Firefighter Safety– information on health risks and how to mitigate them
Future research– from CDC- we need ongoing studies on health effects so we can learn to prevent them if possible and screen when appropriate. Our firefighters deserve the best and most attentive health care!
Cardiovascular incidents– from CDC and NIOSH Cases of deaths in firefighters. I have written previously about the risk of sudden cardiac death with smoke from wildfires, and sadly, our firefighters are not immune. Robust pension and compensation programs and prevention and screening programs will be essential in our futures.
Joint Fire Science Program– 2017 evaluation by USDA Forest Service and Occupational Medicine researchers of particular wildland fire smoke risks and characterization of chemicals in smoke, health effects and risks to general population and firefighters, and suggestions for future research directions.
Forest Management– report on what is helpful (removing underbrush, thinning and fuel treatment) vs what makes fires worse (heavy clearcutting and large tree logging)
Insurance news coverage of National Prescribed Fire Act of 2020
Pamplin Media Group– coverage of Prineville Monument (source of image)
Western Occupational and Environmental Medical Association (WOEMA)– Dr. Khan hosts a podcast for them as well here.
