For the better part of a week, Oregon has been inundated with thick heavy smoke from wildfires. The air quality index has gone from unhealthy to hazardous to off the charts and back again, with experts advising everyone to stay indoors and wear N95 masks when they must go outside.
Even indoors, the air has felt heavy and unhealthy. Air purifiers are completely sold out in many places, and people are rigging up box fans with filters while simmering herbs on their stoves in an effort to clean the air inside their homes.
The questions on many minds: How unsafe is this smoke I am breathing inside my house? And can I expect long-term health problems from breathing in this polluted air for so long.
Unfortunately, there aren’t an easy answers, according to Dr. Gopal Allada, an associate professor of medicine specializing in pulmonary and critical care in the OHSU School of Medicine.
“The challenging issue with long term effects is that it has to be studied for years or even decades to understand those effects,” Allada said.
That data doesn’t currently exist, he said, and it isn’t as easy as comparing it to something that has been studied, like cigarette smoking.
“The problem is it’s different,” he said. “It’s not a cigarette.”
The make-up of what we are inhaling is different, Allada said, and it varies from place to place and hour to hour. It is aerosolized organic and inorganic material that changes depending on what is burning.
“There’s a whole bunch of gasses and really small particles, less than 2.5 microns,” he said. “These are the sizes of a single blood cell.”
That’s so small that they go through bandanas and cloth masks.
It’s those particles that cause problems, he said, getting deep into the lungs and triggering an inflammatory response.
What Allada can say is that wildfire smoke does cause flares or exacerbation for people with chronic lung conditions like cystic fibrosis or asthma.
“We do know that the greater the number of flares that happen cumulatively over time,” Allada said, “there is good evidence that your lungs will have greater damage over time.”
For children, this question of flares in patients with lung conditions is especially concerning, said Dr. Kelvin MacDonald, an associate professor of pediatrics who works in pulmonology in the OHSU School of Medicine.
“We do know that the strongest association with wildfires is increased respiratory visits,” MacDonald said, in children under 12.
There is also no data on what prolonged exposure to the kind of smoke Oregonians are breathing in does to the developing lungs of children, MacDonald said, but there are places to look for clues.
“There is evidence that children that live close to freeways or anywhere that there are diesel particulates have more risk for lower lung function and asthma,” MacDonald said.
It’s not a direct link, but it is an indication that breathing in polluted air can have long-term impacts on children.
And then there is a study on monkeys that may make parents think twice about letting their kids play out in the smoke, no matter how cooped up they feel indoors.
In 2008, a group of monkeys were inadvertently exposed to high levels of wildfire smoke, MacDonald said.
These rhesus macaque monkeys were living in an outdoor facility over an extended period of time in Northern California as infants and exposed to smoke from a series of fires over one summer.
“It would be unethical to study this deliberately,” MacDonald said. “It was an accidental exposure.”
What researchers found was a decrease in lung function as well as immune dysregulation in adolescence in the monkeys exposed to wildfire smoke as infants.
“It’s not a people study and it’s not perfect,” MacDonald said.
But, he said, “It does point out that it’s something to certainly think about.”
“So what can you do about it?” he said, asking the question most parents are asking themselves.
The only way to get rid of particulate matter that small is to wear an N95 mask, MacDonald said, but those masks are not made for children and certainly not babies.
He said he would discourage parents “from thinking they could use any kind of mask that they could make it safe for kids to go outside.”
In his house, he said, he is using both a HEPA filter in the air handling system and a portable HEPA filter. Of course, those are currently in short supply, but you can make your own filter that should help somewhat.
“I don’t know what the right answer is,” MacDonald said, but he suspects there will be epidemiological studies when this fire season ends, which should lead to some real data down the road for next time fires fill the West Coast with smoke.
— Lizzy Acker
503-221-8052, email@example.com, @lizzzyacker