Taking Action to Address the Public Health Impact of Wildfire Smoke

By Alan Vette, Acting Director, Air and Energy National Research Program (ORD), United States Environmental Protection Agency (EPA) and Erika Sasser, Director, Health and Environmental Impacts Division (OAQPS), EPA

This story originally ran in NACCHO’s Essential Elements blog.

During Air Quality Awareness Week (April 30 – May 4), a focus on wildfire smoke is timely for public health because the 2018 wildfire season is about to begin for most of the U.S., and it has already started in some areas.

Exposure to wildfire smoke is a community health issue that has gained the attention of public health professionals and organizations, especially in states where fires are becoming more frequent and intense. Wildfire smoke has significant health implications for those near the fire as well as for those living farther downwind.

EPA offers a suite of wildland fire resources that can help with the development of health risk communications strategies aimed at improving public health outcomes in the event of smoke exposure. These resources can be found on the Agency’s online Smoke Ready Toolbox for Wildfires and on the AirNow website.

During a wildfire, emissions can exceed the nation’s air quality standards. Exposure to particle pollution (PM), a major component of smoke, is a concern for public health. Susceptible populations include older adults, younger children, pregnant women and fetuses, and those with pre-existing respiratory or cardiovascular diseases.

In addition to PM, ozone levels can also rise when air pollutants from wildfires interact with sunlight. Ozone contributes to a variety of respiratory problems and EPA is also studying potential cardiovascular impacts in older adults following short- and long-term ozone exposures.

Recent studies point to some of the health concerns:

  • scientific review article in 2016 by Yale University found that wildfire smoke was associated with increased risk of respiratory and cardiovascular disease. The authors noted that there was a need to better understand smoke’s contribution to adverse health outcomes.
  • A large wildfire in North Carolina that burned 40,000 acres of peat bogs resulted in extensive health impacts. An EPA study in 2011 documented an increase in emergency department visits for heart failure, asthma, chronic obstructive disease, pneumonia, and bronchitis associated with exposures to smoke from the peat fires.
  • A study in 2017 by EPA and others found a significant burden to public health nationwide from wildland fires. Between 2008-2012, particle pollution from smoke was estimated to account for between 5,200-8,500 hospital admissions for respiratory conditions per year and 1,500-2,500 for cardiovascular conditions. The estimated economic impact was $63 billion for short-term exposure and $450 billion for long-term exposure in 2016 dollars.
  • The number of people who are at risk from smoke exposure is expected to increase with more people living in at-risk areas for wildfires. A study by the University of Wisconsin-Madison and others in 2015indicates 10 percent of all land with housing is situated in the wildland-urban interface. At the same time, there will be a higher prevalence of chronic diseases in aging baby boomers that can put them at higher risk from smoke exposure.

To reduce public health impacts from wildfire smoke, EPA is focused on studying the toxicity of smoke from different biomass fuels, identifying the populations that are most at-risk, and developing intervention strategies that may be the most effective for communicating health risks and reducing smoke-related morbidity and mortality.

One EPA research project has led to the development of a community health vulnerability index that can be used to identify populations who are at greater risk from wildland fire smoke. A fact sheet describes the index and how public health officials are using it in North Carolina.

EPA scientists have also developed a Smoke Sense App for use on mobile devices for a citizen science study that assesses the effect of wildfire smoke on health and productivity. The results will assist with identifying health risk communications strategies to protect public health during smoky days. Individuals are encouraged to use the app, which is available for Android and iOS devices.

Exposure to wildfire smoke may be unavoidable in some instances, but public health consequences can be reduced by taking preventive measures and by informing people and communities about actions that can be taken to reduce smoke impacts.

Wildland Fire Resources to Protect Public Health:

  • Fires: Current Conditions web page on airnow.gov: Get current air quality conditions and health advisories, and NOAA Hazard Mapping System displays of smoke conditions for wildfires or prescribed fires on airnow.gov..
  • How Smoke from Fires Can Affect Your Health:  Learn who is more at risk from smoke, how to tell if it is affecting you, and steps you can take to protect your health. Learn what to do before, during and after a wildfire.  
  • Wildfire Smoke: A Guide for Public Health Officials: This guide outlines whose health is most affected by wildfire smoke, how to reduce exposure to smoke, what public health actions are recommended, and how to communicate air quality to the public.
  • Infographic Shows How to Wear a Mask: Learn what type of masks to use and how to properly wear one if you have to go outside when there is smoke. Only NIOSH N95 or P100 masks have been shown to be effective at reducing exposure to smoke.
  • Infographic Shows How to Reduce Health Risks in Areas with Wildfire Smoke: Learn about simple steps that can be taken in the home, car and when outdoors to reduce exposure to wildfire smoke and related health risks.
  • Particle Pollution and Your Patients’ Health Course: This accredited course provides health professionals with knowledge they can share with patients to help reduce overall risk of particle pollution related health effects, particularly in individuals with heart and lung disease. Continuing education credits available through CDC for physicians, nurses and health educators.
  • Online Healthy Heart Toolkit: Share this resource with cardiovascular patients and their caregivers to learn more about how fine particle pollution can trigger heart attacks, ischemic stroke, abnormal heart rhythms and worsen heart failure.
  • Smoke Sense App: The Smoke Sense mobile app, developed by EPA researchers, enables users to get information on air quality and learn how to protect their health from wildland fire smoke. The app is being used in a citizen science study to determine how smoke from fires impacts public health.

Upcoming NACCHO events related to wildfires:

  • NACCHO Webinar: Western Wildfires – Keeping Communities from Polluted Air: On May 21 from 1:00 – 2:00pm ET, join NACCHO and partners, including EPA, for a webinar on the role that local health departments play in preparing for and responding to wildfires and the health impacts of wildfire smoke. Register for the webinar here.
  • NACCHO Annual 2018: EPA will be presenting on wildfire smoke at NACCHO’s annual conference this July. Register for the conference here.

For more information, visit these websites: