Dr. John Balmes, a California air pollution researcher for more than three decades, is worried about this year’s wildfire season. Four of the five largest wildfires in California history occurred in 2020, and this year is even drier than last year. “We are all bracing for a very bad season,” he said.

As one of the nation’s foremost researchers on health impacts of wildfires and air pollution, Dr. Balmes has given dozens of talks on the subject to health groups, public health departments, local, state and federal agencies and medical and health associations across the country.

“I consider wildfire smoke kind of like tobacco smoke without the nicotine,” he said. In a presentation to nurses in May co-hosted by the American Lung Association and the Alliance of Nurses for Healthy Environments, Dr. Balmes cited a recent study in Pediatrics suggesting that wildfire smoke is 10 times more potent than other air pollutants, like car exhaust, factories or power plants, in causing ER visits for respiratory problems, especially in children.

A recent study by Stanford researchers concluded that the fires in California alone last fall caused 1,200 excess deaths and 4,800 extra emergency room visits, mostly among people 65 and older with pre-existing conditions like respiratory issues, diabetes and heart disease. Many additional studies are supporting these alarming statistics.

We have also learned that those in the immediate vicinity of a wildfire are not the only ones at risk. Smoke plumes can travel thousands of miles, impacting residents in states far away. No one is immune from wildfire smoke.

Wildfires and Climate Change

The ongoing wildfire threats are a dramatic reminder that climate change not only impacts the environment but has also become a pressing health issue. “We need the public to understand that these mega fires are being driven by climate change and we need to be working to mitigate climate change,” said Dr. Balmes.

As the climate continues to warm and wildfires increase, Balmes believes that government agencies must more directly address the health risks of smoke, particularly to the elderly and low-income people. "Clean room" cooling centers, rebates for home air purifiers and broader public education campaigns are key. Prescribed burning to reduce the risk of catastrophic wildfires is also playing an increasing role in wildfire prevention efforts, so agencies must respond with coordinated efforts to reduce smoke exposure. One example is the newly launched “Smoke Spotter” app created by the California Air Resources Board to help inform the public of potential smoke from prescribed fire activities being used to reduce wildfire fuel.

Tips to Stay Safe

Dr. Balmes has three main pieces of advice to protect yourself from wildfire smoke.

1. Stay indoors

Balmes says when people can smell smoke outdoors that should go inside and close doors and windows. On very smoky days, towels, masking tape or painter’s tape can block leaks. In addition, checking the Air Quality Index (AQI) system can keep you informed about any air pollution dangers in the area. The AQI tracks ozone (smog) and particle pollution (tiny particles from ash, power plants and factories, vehicle exhaust, soil dust, pollen, and other pollution). An AQI above 150 is considered unhealthy, and is when Dr. Balmes suggests remaining indoors. If it gets too hot indoors, you can check for the nearest cooling center set up by the city to provide clean, filtered air during dangerous AQI times.

2. Use air purifiers or HEPA filters.

Studies have shown that air conditioners or air cleaners can filter out harmful smoke particles. When smoke is present, keep doors, windows and fireplace dampers shut. Place damp towels under the doors and other places where the outside air may leak in. Use air conditioners on the recirculation setting to keep from pulling outside air into the room with a MERV 13 filter or better. Portable air purifiers with HEPA filters can provide added protection from the soot and smoke.

3. If you must go outside, wear proper protection.

“Cloth masks don’t work for protection from wildfire smoke.” Dr. Balmes explained. Masks are designed for beardless, adult faces, and adjustments should be made to make sure that they fit properly “You can’t properly fit-test someone with a beard,” said Balmes. “And they’re not made for kids’ faces, so they’re not officially recommended for children.”

It is also important to understand that wearing a mask does not mean you are safe to do all activities. “People get a false sense of protection,” Dr. Balmes elaborated. “You see people jogging with N95 masks and that’s the wrong idea.”

Getting Prepared

In advance of a wildfire season projected to be among the worst, the American Thoracic Society has released a report that calls for a unified federal response to wildfires that includes investment in research on smoke exposure and forecasting, health impacts of smoke, evaluation of interventions, and a clear and coordinated communication strategy to protect public health.

The American Lung Association has many resources that can help you devise a plan to deal with a current wildfire as well as the aftermath. Recommendations include:

  • Having a disaster preparedness plan and emergency kit
  • Signing up to receive local emergency alerts
  • Creating a clean room in your home
  • Making sure you have enough medications on hand
  • Checking in with your doctor and keeping an eye out for any respiratory symptoms that may signal a bigger problem

Visit Lung.org/wildfires for additional tips, fact sheets, videos and other resources.

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