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Health risks from wildfire smoke

As the death toll rises and thousands of acres burn between California’s Camp Fire and Woolsey Fire, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

 

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon dioxide, a respiratory byproduct
  • Carbon monoxide, which competes with oxygen in the blood
  • Wood particles
  • Formaldehyde
  • Acrolein – used as a pesticide
  • Benzene
  • Plastics, and those byproducts after incineration
  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor, carbon monoxide, particulate matter, hydrocarbons and other organic chemicals, nitrogen oxides, trace minerals and several thousand other compounds. The actual composition of smoke depends on the fuel type, the temperature of the fire, and the wind conditions. Different types of wood and vegetation are composed of varying amounts of cellulose, lignin, tannins and other polyphenolics, oils, fats, resins, waxes and starches, which produce different compounds when burned.

What symptoms may individuals experience?

 

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Wheeze
  • Cough
  • Difficulty Breathing
  • Chest Pain
  • Mucous Production
  • Dizziness/lightheadedness
  • Fatigue
  • Racing Heart (palpitations)
  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
  • Increased susceptibility to new lung infections as well as flu

What are PM2.5s?

 

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the bloodstream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.

lungs_alveoli-57ffa7fe3df78cbc284e162b

LUNGS AND ALVEOLI (IMAGE FROM THOUGHTCO.)

 

Symptoms may begin at levels greater than 55 µg/m3 .

Which individuals are the most at risk?

 

  • Infants and Children
  • Elderly individuals
  • Those with chronic lung disease, including asthma and emphysema
  • Those at risk for heart disease and stroke
  • Those with diabetes
  • Smokers
  • Pregnant women
  • Those with chronic allergies
  • Pets

How can residents protect themselves?

 

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

 

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.
  • Take heed of wind and air quality advisories.
  • Recirculate the air in your home and car.
  • Keep windows closed.
  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

 

Editor's note: As a companion read you might also be interested in a story we published in Sept. last year: 5 apps to help you recover from hurricanes and wildfires.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in Health

This year, nine confirmed cases of rat lungworm disease have surfaced in Hawaii (Maui and the Big Island), and a couple in California who recently traveled to the Aloha State  came down with symptoms after they returned home from their honeymoon. Four additional cases have been suspected since the start of the year and fortunately no deaths have been reported. The Hawaii Department of Health confirmed 11 cases in 2016, and between 2007 and 2015, 42 cases were reported.  Here are your questions answered.

What is Rat Lungworm?

 

Rat lungworm is in the family of roundworms (nematodes), named Angiostrongylus.   Angiostrongylus cantonensis is a parasite that can cause neurological infections such as meningitis, and its sister species, Angiostrongylus costaricensis, can cause severe gastrointestinal illness.  The specific meningitis, or inflammation of the brain, caused by A. cantonensis is an eosinophilic meningitis, where the main blood cell involved is an eosinophil, prevalent in parasitic infections as opposed to a bacterial or viral meningitis.

 

It's found primarily in Southeast Asia and the Pacific Basin but up until recently it's been extremely rare in the United States.  In 2015 a study published in the Journal of Parasitology cited cases had been reported in Florida, Alabama, California, Louisiana, and Hawaii.

 

It primarily lives in rodents but the larvae can be passed to other species through rat feces.  Adult nematodes live in the pulmonary arteries of rats.  The females lay eggs and these, once they hatch and become first stage larvae, may migrate to the rat’s throat and then enter the GI system, eventually exiting through feces.

What are the symptoms of Rat Lungworm?

 

Symptoms include severe headache, fever, neck stiffness, visual disturbances, difficulty looking at light (photophobia), nausea, vomiting, numbness, temporary paralysis of the face and possibly coma and death.

The incubation period, on average, can be anywhere from a week to three weeks and symptoms could start within that time and possibly last for months.  Neurological sequelae of the survivors can last for extended periods of time.

How does one contract Rat Lungworm?

 

An individual could become exposed to A. cantonensis when one eats undercooked slugs, snails, frogs, shrimp, mollusks and contaminated fruits and vegetables.  Slime from slugs may also be a source of contamination of the deadly parasite.

 

 

How do we know Rat Lungworm is the cause of one’s symptoms?

 

If a person presents with symptoms of meningitis, the cerebrospinal fluid, or fluid surrounding the brain and spinal cord is able to be sampled during a lumbar puncture. The needle entering through the back could aspirate enough of a sample for laboratory technicians to determine if the meningitis is caused by bacteria, virus or parasites, the latter of which causing a higher concentration of eosinophils to be demonstrated in the CSF fluid as well as the blood.

 

What is the treatment for Rat Lungworm?

 

Currently there is no official treatment of the parasite.  The parasite will die on its own but can do so in a relatively short amount of time such as days, or become latent for months.  Dead worms could also cause severe neurological symptoms. Symptomatic measures of the patient are instituted to help with pain, although some have been treated with steroids and antiparasitic medications.

 

How do we avoid Rat Lungworm?

 

Make sure all raw vegetables are washed thoroughly,  Handle slugs and snails with gloves and wash hands diligently.  The University of Hawaii recommends boiling snails for at least 3-5 minutes prior to preparing for consumption.  And keep rodents, snails and slugs away from your food and kitchen counters.

 

For more on prevention of Rat Lungworm infections, read: Avoid Contracting Angiostrongyliasis (Rat Lungworm Infection): Wash Fresh Fruits and Vegetables Before Eating!

 

 

LearnHealthSpanish.com / Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

 

 

Published in News & Information