Ask the Doctors by Eve Glazier, M.D. & Elizabeth Ko, M.D.
Wildfire smoke dangerous to those with lung conditions
DEAR DOCTORS: I got sick with COVID-19 this summer — racing heart, heavy lungs, the whole bit. I was just getting back to normal when our part of Washington got hit hard with smoke from wildfires. It seems like it’s making my COV- ID-19 symptoms come back. How can I stay safe while this is going on?
DEAR READER: Drought condi- tions throughout much of the West have led to wildfire seasons that are longer than in previous years. Fires are growing larger and hotter, which causes the smoke to rise high into the atmosphere. As we have seen in recent years, this smoke travels far from its source, sometimes thousands of miles, causing air pollution that can be quite severe.
In addition to gaseous pollutants, such as carbon monoxide nitrogen oxide and volatile organic compounds that act as irritants, wildfire smoke contains microscopic particles. These particles can irritate the eyes and respi- ratory tract, cause reduced lung function and tax the heart. People living with chronic lung conditions that make it difficult to breathe — such as asthma, bronchitis, emphysema and COPD — are par- ticularly vulnerable to the adverse health effects of wildfire smoke. Air that has been polluted with wildfire smoke also poses a health risk to infants, children, older adults and pregnant women. People who are sick with COVID-19, or who, like you, are in the process of recover- ing from coronavirus infection, are also at increased risk.
On the milder side, exposure to wildfire smoke can cause red, watery or stinging eyes; a dry, sore or scratchy throat; runny nose; coughing; fatigue; and headache. More serious symptoms include wheezing, shortness of breath, a rapid or irregular heartbeat and chest pain. It’s important that these symptoms not be ignored. Even a mild reaction is a warning that the smoke is beginning to damage the tissues of the body. That means taking steps to protect yourself from its effects.
When wildfire smoke moves into the area, it is recommended that people avoid exertion. When pos- sible, they should remain indoors with doors and windows closed. Central air conditioning, which involves an air filter, can help reduce particulates in the home. But window air conditioners, which pump outdoor air directly into the home, should be used only as needed to keep the room cool.
If you have an ordinary box fan, you can make a homemade air filtration system. Simply secure an HVAC filter, available at most hardware and home improvement
stores, to the rear of the fan. How many of these devices are needed depends on the size of the room. A somewhat more robust system is known as a Corsi-Rosenthal box. It’s a “cube” made up of five air fil- ters taped together, with a box fan lying on top, facing upward, toward the ceiling. When you do need to be outdoors, N-95 or KN-95 masks have been shown to be effective at filtering particulates from wild- fire smoke. And please remember — anyone who experiences severe symptoms should seek medical care.
Eve Glazier, M.D., MBA, is an in- ternist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assis- tant professor of medicine at UCLA Health.
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