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Overview: A&WMA Conference on Impacts of
Wildfires on Air Quality and Health
Michael T. Kleinman
University of California, Irvine
A&WMA West Coast Section Seminar
Overall Goals
Provide a glimpse of the future
Provide an overview on risks to health of the general
public
Examine risks to Wildland firefighters
Discuss our abilities for monitoring and forecasting
exposures
Look at some things we can do to mitigate future crises
Acres of Wildland Burned – 1985 to 2013
19
85
19
90
19
95
20
00
20
05
20
10
10,000,000
5,000,000
1,000,000
Source: National lnteragency Fire Center
Catastrophic Wildfires
CA Climate Action Team, 2009 Report:
“An increase in the number, size andduration of fires will add to the air pollutionthat already burdens California."
• Risk of large w i ldfires:
- u p to 55% increase by 2050
- u p to 128% increase by 2099
• estimated burned area increase
of 57 percent to 169 percent
Focus of this Presentation
• Inhaled Particles and Cardiovascular Disease• Heart disease is associated with exposures to
particulate matter• Inhaled particles and gases associated with wildfires
are composed of chemicals associated with heart disease and cancer.
• Firefighters and exposed bystanders can suffer increased health risks.
Wildfire Smoke and Cardiovascular
Disease Outcomes
• There is wide agreement that exposure to the mixture of components that we characterize as urban air pollution is associated with illnesses and deaths.
• Exposures worsen the frequency and severity of lung disease episodes (including respiratory tract infections, chronic diseases such as bronchitis or emphysema and inflammatory diseases such as asthma) and can directly or indirectly affect people’s hearts.
• Epidemiological studies have been major contributors to our understanding of the relationship between ambient particulate matter (PM) and cardiac morbidity and mortality with both short- and long-term exposure (1-8).
• Wildfire fighters are exposed, in addition to conventional ambient PM, to PM from biomass combustion.
• The composition of wildfire smoke includes several chemicals that initiate lung inflammatory responses, are known carcinogens and exacerbate atherosclerosis and cardiovascular diseases.
• Exposure may represent a significant risk factor for adverse cardiovascular health effects.
Emissions from Wildfires
Primary air pollutants- Partic ulate M atter (PM)- CO- N 02- Polycyc lic aroma tic hydroc arbons
(PAHs)- Vola tile organ ic c ompounds
(VOCs)
Sec ondary air polluta nts- Partic ulate M atter (PM)- Ozone
Coffey Par k Fire
When Buildings and Vehicles
Burn• Smoke from structura l fires contains
toxic air contaminants in addition to Particles:
- HCN, HCI, phosgene, meta ls
- toluene, styrene, dioxins
• The Sonoma-Napa, Thomas,and Camp fires caused manybuildings and motor vehicles toburn
- Local residents exposed to more
tha n wood smoke
• The plumes that travelled to the SFBay Area and Greater Los Angeleswere almost entirely wood/biomasssmoke
Sonoma-Napa 10/17
Southern California 12/17
Chemical Composition of Wood Smoke
PM and Cardiovascular Effects
• The composition of wood fire smoke emissions vary depending on multiple parameters such as the physical features of the vegetation of the ecosystem, and environmental parameters such as humidity, temperature, wind speed, and the type of ignition.
• During wood combustion, polymers break apart, which produce a variety of smaller toxic molecules such as polycyclic aromatic hydrocarbons, aldehydes, free radicals and others that are carcinogenic.
• The mode of toxicity of inorganic gases was through an irritant response and that of free radicals and particulate matter was through a stress reaction.
• However, several other mechanisms have been suggested.• inflammatory response in the airways,• Alteration of cardiovascular risk by increasing acute-phase proteins .
• A population-based study of emergency department visits and daily concentrations of fine particulate matter during a wildfire in North Carolina determined an excess relative risk of 42% for congestive heart failure.
How toxic compounds and nanoparticles form during the combustion process
Inhaled Nanoparticles from Combustion Will
Deposit in the Respiratory Tract
Atmos. Chem. Phys., 5, 2989–3002, 2005
www.atmos-chem-phys.org/acp/5/2989/
SRef-ID: 1680-7324/acp/2005-5-2989
European Geosciences Union
Ideal size for deep lung penetration
Wildfire Smoke Size Distribution
Efficiency of Particle Deposition as a Function of Particle Size
Wildfires Increase Concentrations of Nano-
sized PAHs and Nitrates in Ambient Air
Inhaled Pollutants can Induced Effects Through
Multiple Pathways
Adapted from: Pope, 2006, Ischemic heart disease events triggered by short-term exposure to fine particulate air pollution,. Circulation :114, 2443 -8
Indirect EffectsDriven by Mediators Induced in The Lung
Direct EffectsDriven by Particles that Translocate from the Respiratory System and Impact the Vascular Endothelium and Myocardium
Physiological Changes
10/20 10/21 10/22
10/23 10/24 10/25
Rats or Mice Can Be Exposed to Purified Air or CAPs in Sealed Chambers
The Sealed Chambers Can Be Placed Onto Racks to Facilitate Transport
Blood Pressure
Blood Pressure Stable in Air-Exposed Rats
Significant Drop in Blood Pressure in UFP-exposed Rats During Fire
Results… (cont.) Ambient PM2.5 concentrations during exposures
BP decreases with increase in number/mass ratio,
suggesting a larger impact of UFP during fires
(mm Hg)
Decrease in BP Peak n/mass
Wildland Firefighters (WLFFs) are
exposed to high concentrations of PM for
several hours per day
Shift
Duration
(hrs)
Time on
Fireline
(hrs)
Mean
Fireline
Exposure
(mg/m3)
Mean Shift
Exposure
(mg/m3)
Initial
Attack 12.4 6.1 0.97 0.26
Fire Crews 13.6 10.1 0.64 0.50
Fires Mgmt 14.5 9.2 0.38 0.21
Rx Burns 10.5 6.1 0.86 0.56
Rx Natural 13.6 10.2 0.33 0.26
Fire Fighting Involves Various Tasks Requiring
Several Activities with Different Levels of Exertion
Task Code Task Code Labels Activity Codes Activity Code Labels Obs WLFFs
1 Handline (direct) 1,3,6,7,13,31,55,56,57
handline direct scratch, handline direct swamper, handline direct squad, handline
direct firefighter, improving direct line, initial attack, working with aviation, scouting
hazard trees, grid the black
7064 75
2 Handline sawyer (direct) 2,53,54 handline direct sawyer, felling sawyer, felling swamper 2317 34
3 Pump Op 5,20,21 handline direct pump operator, engine pump operator, holding pump 495 13
4 Mop Up 8,12 mop up, cold trailing 10823 67
5 Handline (Indirect)14,22,24,26,27,28,30,58,59,6
0
improving indirect line, handline indirect scratch, handline indirect swamper,
handline indirect pump, handline indirect squad, handline indirect firefighter, Line
prep, grid the green, structure protection, medical event
8384 59
6 Holding 15,16,17,18,19,37,40holding direct line, holding indirect line, holding firefighter, holding squad, holding
engine, rx holder, suppression holder11028 59
7 Handline sawyer (Indirect) 23 handline sawyer indirect 1186 13
8* Dozer Boss 29 handline indirect dozer boss 20 1
9 Lighting 36,39 rx lighter, suppression lighter 2466 18
10 Project 44,45,61,62,64 project saw, project stacking, staging, compound work, station/compound work 20328 109
11 Briefing 46 briefing 4770 176
12 Training 99 training (medical scenario) 213 2
13 ICP 32,35 ICP stationary, ICP other 3490 58
14 PT 43 PT 2652 36
15 Hiking 48 hiking 8711 158
16 Standby 49,50,51,52,63 lunch break, rest break, operational break, refurb tools, tool up/tool down 38212 208
17 Driving 47 driving 21859 199
Total 144,018 208
* Moved Task Code = 8 to Task Code = 5 since there was only one firefighter and 20 observations for "Dozer Boss".
The Exertion Levels of the Various Tasks are
Associated With Increased Heart Rates and Increased
Ventilation Rates
Task Estimate SE lower 95% CI upper 95% CI Estimate SE lower 95% CI upper 95% CI
1 107.27 1.85 103.65 110.90 30.22 0.73 28.79 31.64
2 120.73 2.69 115.45 126.00 34.20 0.84 32.55 35.85
3 92.38 3.06 86.38 98.39 24.46 1.15 22.22 26.71
4 103.30 1.72 99.93 106.66 29.23 0.59 28.08 30.39
5 109.71 2.88 104.06 115.37 31.75 0.72 30.35 33.16
6 90.07 2.04 86.07 94.06 23.13 0.67 21.82 24.44
7 126.25 2.44 121.46 131.03 35.35 0.87 33.64 37.06
9 113.79 4.06 105.83 121.75 31.77 1.37 29.09 34.44
10 91.30 1.71 87.95 94.65 25.07 0.62 23.85 26.29
11 88.00 1.01 86.03 89.97 23.40 0.39 22.64 24.16
12 111.90 6.99 98.20 125.59 31.47 3.64 24.34 38.59
13 85.52 2.18 81.24 89.79 24.07 0.76 22.58 25.57
14 127.10 3.21 120.82 133.39 37.29 1.20 34.93 39.65
15 123.51 1.47 120.63 126.39 35.59 0.59 34.44 36.74
16 89.86 0.95 88.00 91.72 23.81 0.30 23.22 24.40
17 83.00 0.97 81.10 84.91 23.35 0.44 22.48 24.21
Heart Rate (beats / minute) Respiratory Rate (breaths / minute)
Exposure Data Can Be Used For Calculating Health
Risks
1. PM3.5 from most fires after correction for coarse mode
contribution using the measured concentrations of
quartz is assumed to be PM2.5 from tobacco smoke, so
that the RR estimates from Pope et al. (2004) can be
used.
2. Pope et al. (2004) suggested that because relevant
biological pathways for CVD may be activated at low
levels of exposure and that increasing exposure further
increases risk, but at a decreasing marginal rate, even
short term exposures can have a long term, adverse
outcome.
3. Using the Pope et al. (2004) RR for Ischemic Heart
Disease (IHD), Cardiovascular Disease (CVD) and Lung
Cancer (LC) mortality factors and Exposure Estimates
for WLFFs we estimated RISKS of death from those
diseases.
Relative Risk for Lung Cancer, Ischemic Heart
Disease and Cardiovascular Disease Mortality
Relative Risk
Activity
Codes
Included
from Table
2 Activity
Duration
(hrs)
Shift
Exposure
(mg/m3)
Activity
Minute
Ventilati
on (LPM)
Total Shift
Exposure
mg/day Lung Cancer
Ischemic
Heart
Disease
Cardioascular
Disease
Shift Mean
95%
UCL Mean
95%
UCL Mean
95%
UCL Mean
95%
UCL Mean
95%
UCL
9
Prescrib
ed Burn 10.5 ± 2.2 0.48 0.72 27.00 8.20 12.10 2.80 3.40 1.50 1.55 1.46 1.51
1,2,3
Prescrib
ed
Natural
Fire 13.6 ± 2.2 0.20 0.30 32.00 5.20 7.80 2.35 2.77 1.40 1.49 1.41 1.45
4,5,6,7,10
Fire
Project
Manager 14.5 ± 2.2 0.16 0.21 21.00 2.90 3.80 1.91 2.09 1.39 1.41 1.35 1.38
8,11,12,13
Fire
Project
Crew 13.6 ± 1.5 0.51 0.64 23.00 9.50 12.00 3.02 3.36 1.52 1.55 1.48 1.51
7,14,15
Initial
Attack 12.4 ± 3.6 0.15 0.20 24.00 2.70 3.60 1.90 1.93 1.38 1.41 1.34 1.37
Note: Exposure (mg/shift) = Hr/shift x Shift Exposure Concentration (mg/m3) x Minute Ventilation
(Ve, L/min) x 60 min/hr x m3/(1000 L)
Public Health
Response
Improved planning andreadiness on the partof the public healthinfrastruc ture andhealth c are providersare necessary toreduce morbid ity andmortality due towildland fire smokeexposure
Wildfire Sm,okeA Guide for Publ ic Health 10ff ic ials
Re,41mdJul1l008
(\\"ith2012 AQI Value )
Prevention
• Most of the U.S. Forest Service wildfire budget
goes to suppression activities, leaving precious
lit t le for necessary forest-ma intena nce activities.
- The 2013 Rim Fire started in Yosemite but mostly
burned in the Stanislaus Nationa l Forest - why?
• Dead trees and excessive undergrowth need to
be removed f rom our forests
• Communities near Nationa l Forests resist
prescribed burns
Community Protect ion
• At-r isk communities can do moreto prepare for wildfires
- Bulldoze f uel breaks aroundneighbor hoods
- Install new smoke-detectioncameras and sensors
- Remove vegetation around homes
- Improve escape routes insubdivisions
- Train residents in initia l firesuppression methods (i.e., wateringdown roofs)
Pre-fire season recommendations
for people with pre-existing heart
and lung disease:
• Have an adequate supply of medic ation.• Have a writ ten asthma plan.• If you install a portable air cleaner, buy a correctly-
sized one before a smoke emergency.• Contac t a health care provider if your condition
worsens when you are exposed to smoke.• Use of HEPA air cleaners was associated wit h a reduced
odds of reporting respiratory health effects.
• Consider appropriate respiratory protec tion.• However, in one study masks were not protective
(Mott, et al., Western J. Med 176:157-162, 2002)
Source – Balmes (2019)
Contents lists available at ScienceDirect
jou rnal of Environmen tal Management
ELSEVIER j ou r na l h o m epa g e: w w w. e ls ev ier .co m / l o c at e/ j e nv m an
Review
Effectiveness of public health tnessaging and con1n1unication channels
during smoke events: A rapid systematic review (Fish et al., JEM 193:247-
256, 2017)
• Smoke-related public health messages are communicated via avariety of channels.
• Limited evidence is available regarding their effectiveness forthe genera l public or at-risk groups.
• Messages that use simple language are better recalled,understood, and complied with.
• At-risk groups may be advised to stay indoors before the genera lpopulation.
Conclusions
PM exposures can exacerbate lung disease, heart disease and cancer
Nanoparticles emitted during combustion processes contain toxic
components and carcinogens
Individuals with pre-existing lung and heart conditions are at elevated risk
Firefighters may be at elevated risk of heart disease and possibly cancer
compared to the general population.
We can take precautions to reduce potential risks
As climate change accelerates warming and drought conditions, wildfire
frequency and intensity will increase.
We dwell in this very wonderful place - but a place that 's
getting hotter.“ - Gov. Jer ry Brown, 12/9/17
Questions and Discussion
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