Smoke Carries Risks to Health

The smoky air from the region’s weeklong wildfires is exacerbating asthma and other respiratory diseases and even irritating healthy throats, lungs and nasal passages, setting up many for pneumonia and sinusitis, some doctors say.

The fires are spewing abnormally high levels of particles, gases and poisonous compounds, which have been hovering in a stagnant mass. Because shifting of winds, much of what might have dissipated is circling back, delivering another toxic punch.

But even with the worst air quality in years, health and emergency medical officials are reporting fewer emergency room visits than they had expected, an indication that “people may be heeding the warnings, taking precautions and staying indoors,” said Dr. Paul Simon, chief of health assessment and epidemiology for the L.A. County health department.

At the same time, doctors are bracing for an increase in visits as lungs and sinuses become infected. And with diminished defenses, people could be more vulnerable, just as cold and flu season gets underway.

“Folks that have asthma attacks or lots of irritation in their airway would be expected to be at increased risk for infection,” Simon said. Those who may not be feeling “all that sick right now,” but are suffering sore throats, headaches, nausea and mild discomforts should remain vigilant, he said.

Dr. C. Philip Amoils, a Santa Clarita ear, nose and throat specialist who has treated patients sickened by smoke from the Simi Valley fires, predicted that the constant exposure to wildfire pollution would -- in the next couple of weeks -- send “a tremendous amount of patients” to specialists and primary care doctors.

The gray haze is likely to have widespread health effects because it is spread over hundreds of square miles of Southern California. The wildfires are “far-reaching and all-encumbering” and are producing dangerously high levels of air pollutants, said Joe Cassmassi, the senior meteorologist for the South Coast Air Quality Management District. “Even in the riots, when we had fires all over metropolitan Los Angeles, we didn’t see levels that were in this range.”

Along with a variety of noxious gases, including carbon monoxide and oxides of nitrogen -- components of smog -- smoke from the wildfires contains very fine particles that lodge deep in the lungs, where they irritate and narrow the airways. Long-term exposure can reduce lung function and damage cells. In recent days, levels of these particles have been “four to five times greater than on a normal day,” Cassmassi said. “If you’re directly downwind in the smoke plume, you’re talking hundreds of times” greater.

In the eastern parts of the L.A. Basin, levels of larger, easier-to-measure particles have reached readings twice the federal standard and five to seven times the state standard, Cassmassi said.

The byproducts of burning buildings, such as asbestos and plastics, are making smoke even more toxic. In addition, smoke particles that have settled on the ground are shot back into the air in firestorms, “like a second helping of an air pollutant,” Cassmassi said.

In addition to pollution generated by the flames, the air still has everyday smog.

And, although cooler temperatures and some moisture may feel welcome, the moisture can turn some of the polluting gases into acids, intensifying the assault on the lungs.

Even people living in areas unscathed by the flames are vulnerable. Winds have brought some of the smoke and particles billowing back toward the coast, so that residents miles from the fires, in West Los Angeles and Santa Monica, for instance, are being exposed.

Despite the extra doses of pollution, only a few hospitals, such as Providence Holy Cross in Mission Hills, near the Simi Valley fires, and Community Hospital of San Bernardino, posted increases in emergency room patients with respiratory complaints resulting from underlying lung diseases.

At Providence Holy Cross, Dr. Michael R. Blum, an emergency room physician, said these patients are coming in for treatment “because the medication at home is not handling it.” But at Henry Mayo Newhall Memorial Hospital in Valencia, Mark Wallerstein, the nurse who directs the emergency room, said his department wasn’t being overrun because of the fires. But, he predicted, if the pollution-enhancing Santa Ana winds continue, people will “start coming out of the woodwork who just can’t take it anymore.”