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WhereThere’sWildfire,There’sSmoke
JohnR.Balmes,MDUniversityofCalifornia,
SanFranciscoandBerkeley
Outline
• Wildfire• ClimateChange• What’sinwildfiresmoke• Healtheffects• Publichealthmessaging• Post-fireissues• Prevention
Wildfire
Sonoma-NapaWildfires–Oct.2017
SouthernCAWildfires–Dec.2017
Carr,MendocinoComplex,andCampFires-2018
7Source: National Interagency Fire Center
2017and2018wereBadWildfireYears-Why?
• 5yearsofdrought2011-2016;manydeadtrees
• ElNinowinterof2017broughtlotsofrain,endingthedrought
• Increasedgrowthofvegetationinspring
• Normallydryandveryhotsummerweathergeneratinglotsoffuel
• Lackofraininfall
2017and2018wereBadWildfireYears-Why?
• 5yearsofdrought2011-2016;manydeadtrees• ElNinowinterof2017broughtlotsofrain,endingthedrought
• Increasedgrowthofvegetationinspring• Normallydryandveryhotsummerweathergeneratinglotsoffuel
• Lackofraininfall
ClimateChangeandIncreaseinWildfires
10
Wildfireemissionsandrelatedhealthimpacts
Youssoufetal.AtmosphericEnvironment2014;97:239-251
Emissions from Wildfires Primary air pollutants
– Particulate Matter (PM) – CO – NO2 – Polycyclic aromatic hydrocarbons
(PAHs) – Volatile organic compounds
(VOCs)
Secondary air pollutants – Particulate Matter (PM) – Ozone
12
CoffeyParkneighborhoodburning
WhenBuildingsandVehiclesBurn
• Structuralfiresmokecontainsothertoxicaircontaminants,including– HCN,HCl,phosgene,metals– toluene,styrene,dioxins
• TheSonoma-Napa,Thomas,andCampfirescausedmanybuildingsandmotorvehiclestoburn– Localresidentsexposedtomorethanwoodsmoke
AustralianBushFires• 16millionacreshaveburned(8timeswhatburnedinCaliforniain2018
• Firesareinpopulatedareaswithmorethan2500homesdestroyed
• PoorairqualityinSydney,Melbourne,Canberra,andNewZealand
• Climate-forcingemissions=8monthsfromman-madesources
Acutehealthimpactsofshort-termcommunitywildfiresmokeexposures
16EnvironHealthPerspect2016;124:1334–1343
Clearevidenceofanassociationbetweenwildfiresmokeand
respiratoryhealth• Asthmaexacerbationssignificantly
associatedwithhigherwildfiresmokeinnearlyeverystudy
• Exacerbationsofchronicobstructivepulmonarydisease(COPD)significantlyassociatedwithhigherwildfiresmokeinmoststudies
• Growingevidenceofalinkbetweenwildfiresmokeandrespiratoryinfections(pneumonia,bronchitis)
17
Haikerwaletal.2015JAmHeartAssoc
• Wildfire-PM2.5associatedwithheartattacksandstrokesforalladults,particularlyforthoseover65yearsold
• Increaseinriskthedayafterexposure:- Allcardiovascular,12%- Heartattack,42%- Heartfailure,16%- Stroke,22%- Allrespiratorycauses,18%- Abnormalheartrhythm,24%(onthesamedayasexposure)
Wildfire-PM2.5 Increases Heart Attack & Stroke
19
AllCardiovascularCauses
1.2
1.1
1.0
0.9Re
lativ
eRisk
AllAdults
Adults18-44Adults45-64Adults65+
Light Medium Heavy
WettsteinZ,HoshikoS,CascioWE,RappoldAGetal.JAHAApril11,2018Slidecredit:WayneCascio
24
WettsteinZ,HoshikoS,CascioWE,RappoldAGetal.JAHAApril11,2018
OtherHealthOutcomes• Adversebirthoutcomes
– Healthofpregnantmothers• Mentalhealth• ?ChroniceffectsfromrecurrentexposuresbasedonthePM2.5literature– Metabolicoutcomes– Cognitivedecline– Childneurodevelopment– Healthofpregnantmothers
WildlandFirefighterHealthEffects
• Cross-shiftchangesinlungfunction,urinarybiomarkersofexposure,andbloodbiomarkersofinflammation
• Pre-postseasonchangesinlungfunction,airwayresponsiveness,andairwayinflammation
• Dothefireseason-associatedchangespersist?
• EstimatedthedailydoseofwildfiresmokePM2.5• Thedailydoseforfirefightersworking98daysperyearofPM2.5rangedfrom0.30mgto1.49mg
• Forcareerdurations(5–25years),wildlandfirefightershadanestimatedincreasedriskoflungCA(8percentto43percent)andCVD(16percentto30percent)mortality
EnvironRes2019;173:462-468
PublicHealthResponse
Improved planning and readiness on the part of the public health infrastructure and health care providers are necessary to reduce morbidity and mortality due to wildland fire smoke exposure
24
25
PublicHealthAdvisories Based on the U.S. EPA’s Air Quality Index:
“Good” 0-50 “Moderate” 51-100 “Unhealthy for sensitive groups” 101-150 “Unhealthy” 151-200 “Very Unhealthy” 201-300 “Hazardous” >300
• Largefireburnedfor2monthswithpoorairquality(highPM10)
• CDCinvestigatorsdocumentedincreasedhealthcareutilizationforlowerrespiratoryillness
• Recollectionofpublicserviceannouncementswasassociatedwithareducedoddsofreportingadverserespiratoryhealtheffects
WestJMed2002;176:157-162
JoshuaAMott,PamelaMeyer,DavidMannino,StephenCRedd
• IncreaseddurationoftheuseofHEPAaircleanerswasassociatedwithareducedoddsofreportingadverserespiratoryhealtheffects
• Noprotectiveeffectswereobservedforuseofmasksordurationofevacuation
WestJMed2002;176:157-162
JoshuaAMott,PamelaMeyer,DavidMannino,StephenCRedd
CaseStudy–UCBerkeley• Oct.13,2017–theAQIgoesover200duringtheday– UCBerkeleyissuesahealth
advisorytostudents,staff,andfaculty(stayindoors,considerwearingN95masksifyouhavetobeoutside);classesnotcancelled
– BAAQMDasksUCBerkeleytocancelthetelevisedfootballgamewithWashingtonState
– GamenotcancelledbecauseAQI<200bykickoff
24-hourPM2.5levelsexceeded200μg/m3inNapaand70μg/m3inOaklandonOctober13
CampFire–Nov.9,2018
PoorAirQualityinBayArea
• Nov.14,2018–PM2.5goesover200µg/m3thatThurs.eveningandisprojectedtostayhighfordays– UCBerkeleycancelsclasses,butdoesnotclosecampus
– UCBerkeleypostponesthe“BigGame”withStanfordscheduledforSat.Nov.16
EvenPoorerAirQualityClosertoFire
Nov.15,2018–PM2.5goesupto250µg/m3inSacramentoandover300µg/m3inYubaCity
Post-WildfireProblems
• Post-traumaticstress• Housingshortage,especiallyforlow-income,immigrantrenters
• Post-firestructuralbuildingclean-up– Muchoftheworkdonebydayworkers
• Mudslides
34
Fire suppression has increased fuel availability
Prevention
• MostoftheU.S.ForestServicewildfirebudgetgoestosuppressionactivities,leavingpreciouslittlefornecessaryforest-maintenanceactivities.– The2013RimFirestartedinYosemitebutmostlyburnedintheStanislausNationalForest–why?
• Deadtreesandexcessiveundergrowthneedtoberemovedfromourforests
• CommunitiesnearNationalForestsresistprescribedburns
36
IncreasedDevelopment-UrbanWildlandInterface
CommunityProtection• At-riskcommunitiescando
moretoprepareforwildfires– Bulldozefuelbreaksaroundneighborhoods
– Installnewsmoke-detectioncamerasandsensors
– Removevegetationaroundhomes
– Improveescaperoutesinsubdivisions
– Trainresidentsininitialfiresuppressionmethods(i.e.,wateringdownroofs)
Summary• Thedurationofthewildfireseasonislongerandcatastrophicwildfiresareincreasinginfrequencyduetoclimatechange
• Acuterespiratoryeffectsarewelldocumented,butnewstudiessuggestacutecardiovasculareffectsaswell
• Post-firehealtheffectsareimpactful• Long-termeffectsofhighand/orrecurrentexposuresneedfurtherstudy
• Needtoinvestheavilyinforestmanagementandcommunityresilience
Thankyou