Disaster Guidance: 10 Tips for Staying Healthy During Wildfires

Within the past week, fierce winds in Southern and Northern California have exacerbated the current wildfires in California. As of this writing, 3 major fires (Woolsey, Hill and Northern California’s Camp) are burning in Ventura County, in northwest Coastal Los Angeles County and Butte County in Northern California respectively. The Camp fire is now the most deadly in CA history. The South Coast and Bay Area Air Quality Management Districts list the following areas of direct smoke impacts:

http://www.aqmd.gov/docs/default-source/air-quality/advisories/advisory1.pdf

http://www.baaqmd.gov/about-air-quality/interactive-data-maps

The California Thoracic Society (CTS), a chapter of the American Thoracic Society, has prepared an educational document to be shared with the general public, healthcare professionals and patients affected by the catastrophe of wildfires.

Wildfire smoke can irritate the eyes, nose, throat, and lungs. It can cause coughing wheezing or difficulty in breathing. Inhaling smoke can be especially dangerous to those with lung disease (such as asthma, COPD/emphysema, pulmonary fibrosis, etc.), heart disease, pregnant women, the elderly and children. These high-risk populations need to take special care and consider consulting with their doctors regarding specific precautions.

Here are 10 basic steps to consider for patients and healthcare providers:

1. Stay indoors with windows and doors closed.
2. Reduce physical activity.
3. Reduce other sources of indoor air pollution such as smoking cigarettes, using a wood-burning stove or frying meat. Do not vacuum anywhere in the house.
4. Use central air conditioner or filters: A home’s heater set to the fan mode may be able to filter out some of the particles by “re-circulating” the indoor air through the filter.
5. Use air purifiers with HEPA filters.  Note: do not use filters that produce ozone such as “super oxygenators”.
6. When traveling in a vehicle, keep windows closed, run the air conditioner and set air to re-circulate to reduce smoke.
7. A N95 or greater mask can help reduce inhalation of particulates if properly fitted. A surgical or simple dust mask will not protect against particulate exposure. None of these masks protect against hazardous gas inhalation. The following video demonstrates how to properly put on an N95 mask.  https://m.youtube.com/watch?v=0d_RaKdqeck

8. Consider evacuationto areas with lower air quality index for individuals with lung disease (especially those with asthma, COPD / emphysema, pulmonary fibrosis).
9. Create a clean room at home. Use an interior room with fewer doors and windows and run an air conditioner and room air cleaner if available.
10.Patients with asthma or COPD should ensure that they continue to take their maintenance (“controller”) medications or discuss an appropriate regimen with their physician.

Adapted from Fire Dangers, Air Quality and Safety for Pulmonary Clinicians and Their Patients from the California Thoracic Society by

ATS/California Thoracic Society (CTS) Members:

  • Lorriana Leard, MD (lorriana.leard@ucsf.edu), University of California, San Francisco, CTS Education Committee
  • Angela Wang, MD (a1wang@icloud.com), Scripps Clinic, Chair, ATS Council of Chapter Representatives and Past President of CTS
  • Lekshmi Santhosh, MD (lekshmi.santhosh@ucsf.edu), University of California, San Francisco, CTS Education Committee
  • John Balmes, MD (john.balmes@ucsf.edu), University of California, San Francisco, Past President of CTS

ATS Members:
Shazia Jamil, MD (sjamil@ucsd.edu), Scripps Clinic and University of California, San Diego School of Medicine, ATS Education Committee, CTS Education Committee

W. Graham Carlos, MD (wcarlos@iu.edu), Indiana University, ATS Education Committee

Nitin Seam, MD (nseam@cc.nih.gov), National Institutes of Health, ATS Web Editorial Committee Chair

Charles S. Dela Cruz, MD, PhD (charles.delacruz@yale.edu), Yale School of Medicine, ATS Education committee

References/Resources