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