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California Fire: What is the Impact on Health in the Long Run?

— "There is simply no precedent for this," expert says at ACAAI annual meeting

MedpageToday

SEATTLE -- The short- and long-term health impact of environmental events, such as the Camp Fire in California, on large populations are not well understood, according to experts at the American College of Allergy, Asthma, and Immunology (ACAAI) annual scientific meeting.

The Camp Fire, which was still burning across more than 200 miles of Northern California on Sunday, ranked among one of the worst natural disasters in the U.S. this century, with the death toll continuing the climb and close to 1,300 people still counted among the missing.

After burning for more than a week, the fire elevated air pollution levels in San Francisco and surrounding areas to the point where the region reportedly has the poorest air quality on the planet.

Most outdoor events in San Francisco (about 180 miles from the fire zone) on Saturday were cancelled or postponed, including the game between football rivals Stanford University and the University of California Berkeley. San Francisco officials also took the city's iconic open-air cable cars out of commission due to the poor air quality.

David Peden, MD, of the University of North Carolina Gillings School of Global Public Health in Chapel Hill, spoke about the Camp Fire at an on the impact of the environment on allergic disease.

"At these levels, any outdoor activity is dangerous for people with chronic diseases like COPD [chronic obstructive pulmonary disease] or heart disease," Peden said. "Everyone understands the allergy risk, and the risk for other airway diseases. But there is a clear signal of inflammation in cardiac disease and breathing pollution triggers inflammation."

Peden, who studies the roll of air pollution in airway and cardiovascular disease, noted that while California has seen wildfires of increasing frequency and intensity, other regions of the country are also increasingly vulnerable as drought conditions intensify. These areas include eastern Montana, western portions of the Dakotas, and large parts of the Mexican border.

Peden, along with ACAAI attendee Katherine Gundling, MD, of the University of California San Francisco, told 鶹ý that current air quality in San Francisco -- reported to be in the very unhealthy PM2.5 range of 201-300 on Saturday -- compared unfavorably to some of the most polluted areas of China and India, which have average air quality PM2.5 in the range of 100-150.

Peden stated that during the 2013 California Rim Fire, daily air pollution exposure levels among people in urban areas affected by the fire were up to 35 times greater than the 24-hour PM2.5 standard (35μg/m3) considered safe by the Environmental Protection Agency (EPA).

Gundling agreed that it will take time to understand the short- and long-term health impact of events like the Camp Fire.

"There is simply no precedent for this," she told 鶹ý. "We are used to wildfires, but not fires that kill large numbers of people who have no chance of escape. That is the new and horrible reality we are living."

She added that the increasing frequency and intensity of the California fires should serve as a wake-up call for the country.

"These fires are different," she said. "It's not just that there are more of them and that they are more severe. It's a number of factors. It's climate change. It's forest management. All of this has to be addressed."

Forecasts were for air quality to remain in the unhealthy 100-200 range through Tuesday in San Francisco, the East Bay, and other parts of the Bay area. Rain bringing wind is expected in the area on Tuesday.

Public health officials whenever possible and wear N95 masks when outdoors. Some city governments and independent organizations are distributing face masks.

Primary Source

ACAAI 2018 Annual Scientific Meeting

International Symposium: "The impact of the environment on allergic disease" ACAAI 2018.