Recovery & Resources: A GUIDE TO...

Visits to emergency rooms and doctors for respiratory illnesses and eye injuries doubled in the two days after the Oakland Hills fire two years ago. Now, health experts say Southern Californians exposed to heavy smoke and soot from this week’s fires should brace for similar health consequences.

Bronchial infections, laryngitis, eye infections and abrasions are the most common problems resulting from exposure to smoky, soot-filled air and can occur up to 48 hours later, said Dr. Paul Papanek, a Los Angeles County Department of Health Services official who studied the health effects of the Oakland Hills fire.

Even people not directly exposed to smoke can expect sneezing, wheezing and eye irritation, said officials for the South Coast Air Quality Management District.

The AQMD advised residents Thursday to follow guidelines for high-stage smog alerts, including staying indoors and limiting physical exertion. Air quality should improve by today.

“The precautions are the sensible ones but people should take them seriously,” Papanek said. “Kids should not be exercising. People who are asthmatic are the most at risk along with people with other kinds of lung diseases. They should take care of themselves and stay in air conditioning.”

Moreover, anyone who inhaled thick smoke or ash or spent Thursday sifting through rubble may be stricken with a sore throat, sinus infection, laryngitis, bronchitis, cough or eye irritations within a day or two, he said.

“The Oakland-Berkeley fires two years ago are similar to this, and what we learned from that is lots more people--up to 48 hours after smoke exposure--were going to emergency rooms and physicians for respiratory problems. There was a doubling of emergency room admissions for respiratory and eye problems. Even people that seemed to be OK initially came up with problems,” he said.

Breathing thick smoke can also prompt a first bout of asthma.

“It has to do with intensity of the smoke, but there are people who inhale smoke and can get a lung disease,” said Dr. Ralph Potkin, a Century City Hospital pulmonary specialist. “This could induce asthma in susceptible people who haven’t had a bout previously. They can even develop a form of respiratory failure or lung failure.”

Oakland officials also reported an increase in eye problems because of cinders and soot, which can scratch the eye and cause an extremely painful and serious condition, Papanek said.

Anyone who believes that they have a particle in the eye that will not dislodge should seek medical assistance, he said.

Officials also advised people working around the burned or smoky areas to use caution for another reason. The smoke or dust may contain potentially toxic chemicals that were released as homes and garages exploded in flames, said AQMD spokesman Bill Kelly.

“These houses are loaded with different toxic materials,” Kelly said. “The fine particles are likely to linger for the day. Fine particles evade the respiratory’s natural defense systems and get down into the lungs. That’s why people should minimize their exposure.”

Older houses that burned also may have released asbestos, a carcinogen once commonly used in insulation, Kelly warned.

“Asbestos might be in the ash. So people should not sift through rubble,” he said.

Although paper face masks can help block out larger particles, “they are not going to protect you against asbestos,” Kelly said.

Paper masks can help people with respiratory diseases if they go outdoors and the air remains smoky, Potkin said. Even with masks, asthmatics are likely to suffer aggravated symptoms from the poor air quality and should keep medications nearby, he said.

“If they are having trouble they should get in touch with their doctors,” he said. “The typical asthmatic could have trouble. There will be more attacks and an increase in severity as well. I’ll bet regional emergency rooms will have a significant increase in patients in the next day or two.”

People with sneezing and watery eyes will probably get relief from over-the-counter allergy products containing antihistamines, he said. Even had there not been fires, pollen, which triggers hay fever, is typically high this time of year, and pollen counts are boosted by Santa Ana winds.

Individuals with eye irritation should resist the temptation to rub eyes or use eyedrops, Papanek said.

Unless you have pain or the feeling of having a particle lodged in the eye, “Do nothing,” he said. “We see people get fancy with eyedrops and they make things worse.”

Smoke Inhalation

The effects of smoke inhalation can be subtle but fatal--in a room full of smoke, a person may become unconscious within minutes. Medical officials point out that smoke inhalation causes more fire-related deaths than burns.

* Symptoms: Shortness of breath, wheezing and coughing up soot. If victim does not get out of smoke, a symptom called stridor may occur, in which the windpipe closes.

* Recovery: Varies depending on severity, but the lungs will heal. Early treatment is essential, such as oxygen administered by paramedics.

* Effect on lungs: Swelling and inflammation. Smoke is very caustic and damage to the lungs may occur more than a day after a fire.

Sources: Burn Center at Sherman Oaks Hospital and Health Center.