Wildfire Smoke Could Affect Vulnerable Parties, Requires Preventive Measures

Irina Dralyuk, MD, pediatric pulmonologist at Cedars-Sinai Los Angeles, spoke with The American Journal of Managed Care® about what residents of Los Angeles and the surrounding areas should know about protecting themselves from inhaling toxic wildfire smoke as the Los Angeles Fire Department continues to fight the blazes.

This transcript has been lightly edited for clarity.

Transcript

What should residents of Los Angeles know about wildfire smoke as the city continues fighting the fires?

So a few things to think about. One, if we can smell smoke, that means there's already pollution and small particles in the air that are going to be harmful to our lungs. And so taking precautions early, even if we can't necessarily see fire close to us or large billows of smoke, just the fact that we could smell it is enough of an indication to take some sort of steps toward protecting our lungs and our bodies from this. That can involve putting on a mask when we go outside, trying to stay indoors as much as possible, running our air purifiers, and potentially considering relocation from areas. I've already made recommendations to a number of my patients or their families who have kids with significant respiratory diseases to go ahead and consider evacuating early, even if they're not in the evacuation zone, simply because there's a lot of smoke in the air. That would be where I would start.

Who is the most at risk of adverse health effects from the wildfires?

We have a number of groups. I'll talk about as many of them as I can. One most obvious group is folks with asthma, both children and adults who have been diagnosed, or [who] parents or families think might have reactive airway disease. Anybody who's had a history of needing inhalers or having recurrent respiratory symptoms, anybody who's been diagnosed, or we have a suspicion might have asthma, is certainly at risk of complications right now. Patients with COPD [chronic obstructive pulmonary disease], other lung diseases like cystic fibrosis, primary ciliary dyskinesia, lung cancer, all of these patients are at risk. Some of the other groups include patients with tracheostomies or any kind of oxygen support, so anybody who has intrinsic lung disease or chronic lung disease is certainly at risk. Folks with a compromised immune system, people who are going through chemotherapy, all of these patients are going to be at risk for complications from the poor air quality at this time.

One important group of patients I should probably have started with, is our NICU [neonatal intensive care unit] babies—so babies who are born early or have significant issues early at birth, especially if they're related to the cardiopulmonary status. Those are kids that we're going to keep a close eye on [as well as] just kids that are very, very young and very small because of the size of their airway and the maturity of the airway. We do worry about those kids as well. So babies, even if they're born on time, still warrant special attention.