Fires Are Over, but Some Aren’t Breathing Easy : Health: Experts say the smoke spread irritants. Some hospitals report more emergencies.

Something is in the air. What it is, Orange County physicians aren’t entirely sure, but many suspect a lingering effect of the recent fires that swept through Orange County.

The smoke from burning brush and homes, medical experts said Monday, spread a wide variety of irritating materials into autumn air already laden with allergy-triggering pollens.

The warm Santa Ana winds have also dried respiratory tracts, increasing the chance of infection in people with bronchial problems.

“All the worst that could happen occurred all at one time,” said Lakshmi Duriseti, an allergist in Lake Forest.

“Smoke combined with the dry air,” she said, “can irritate and inflame the lining of the respiratory tract--including the nose, throat and sinuses as well as the windpipe and bronchial tubes.”

The result, she said, is that many people who are usually susceptible to milder forms of allergy or asthma this time of the year have seen their symptoms go “out of control.”

Physicians said patients’ complaints have ranged from sinus headaches to coughing and shortness of breath.

Dr. Greg Super, director of emergency services at Hoag Hospital in Newport Beach, said 15 to 20 people a day with chronic breathing problems have sought emergency respiratory therapy at the hospital since the fires began. He said usually no more than four people a day need such assistance.

Dr. Paul Selecky, medical director of the pulmonary department at Hoag, said members of the Better Breathers Club, sufferers of chronic lung disease who meet weekly at the hospital, reported that the fire added to their discomfort.

“Many elected to stay indoors and turn on their air conditioners,” he said.

Children, because they have smaller air passageways than adults, are even more susceptible to airborne irritants that cause swelling, said Dr. Paul Lubinsky, director of the pediatric intensive care unit operated by Children’s Hospital of Orange County in Mission Viejo.

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Lubinsky said the number of asthmatic children admitted to intensive care at CHOC facilities in Mission Viejo and Orange has increased three- to fourfold since the fires. “We see really sick kids not responding to regular medications,” he said.

Not all hospitals have seen a like number of such emergencies, however. South Coast Medical Center in Laguna Beach, for example, reported nine fire-related cases of asthma or bronchitis, but neither Mission Hospital Regional Medical Center in Mission Viejo nor Saddleback Memorial Medical Center in Laguna Hills reported any similar cases.

“We anticipated a lot of airway problems and didn’t see a bump,” said Dr. Wes Fields, medical director of emergency services at Saddleback. “Probably it was because the prevailing wind was blowing toward the water.”

Dr. Leo Cummins, a pulmonary specialist in Orange, said his patients with chronic lung ailments reported only a “modest” increase in discomfort, which he attributed in part to their knowledge of how to control their symptoms with medication.

Medical problems can linger and even worsen after the smoke clears, though, some doctors say.

“Whatever the irritant is, it can get into your lungs and set up a reaction that feeds on itself and can continue for a few days to a week unless adequately treated,” Lubinsky said.

Dr. William Sokol, a Newport Beach allergist, said smoke seems to have a delayed effect. He said that immediately after the fires, he was surprised not to see any increase in patients. Then about five days after the fires, the tide of asthmatic patients began to rise.

“I still see patients reporting more and more asthmatic symptoms even now,” Sokol said, “either because of the amount of pollutants still in the air or the effects which can be long-term.

“Bronchial tubes can be hypersensitive for weeks to months after heavy pollen and an irritant exposure” such as that from the fires, he said.

Sokol said he believes that in places where the odor of smoke persists, pollution still threatens the health of those who already have respiratory problems.

“Even if you cannot see it, if you can smell it, it would be better to get out of the area or wear a mask,” he said.

Dr. William Berger, an allergist practicing in Mission Viejo, said he has seen a 50% increase in patients reporting respiratory problems over the past weekend.

“I had a lot of calls from people saying for the first time in months their asthma has flared up,” he said.