With wildfires raging across California, smoke, pollutants and allergens are filling our skies. Impacting not only those in the immediate vicinity of fires, but people throughout the state.
As many of our friends, colleagues, and readers are aware, the Experts.com corporate office is situated in Stockton, California. We are in the heart of the Central Valley and a safe distance from the roaring wildfires. However, we are surrounded by these fires and the airborne pollutants they are emitting.
The Mendocino Complex Fire (now determined to be the largest wildfire in California history) is occurring approximately 200 miles to the Northwest of our office. Those westerly winds, however, are blowing the smoke directly through the Central Valley.
The valley is known for terrible allergens, due in large part, to our amazing agricultural industry (responsible for producing somewhere in the neighborhood of 33-50% of the nation’s produce, depending on your data source). What we have been experiencing in the last couple of weeks is, for lack of a better phrase, a perfect storm of allergens and pollutants.
Stockton, and the Central Valley, are not alone. Smoke from the 19 (at the time of this writing) active wildfires in the state, are contributing to all kinds of allergy, respiratory distress and illness for Californians. As smoke does not recognize border lines, the smoke is impacting people across the West.
Here is what I know from personal experience. Children and older adults are most at risk from the airborne pollutants and allergies. Outdoor activities for these individuals should be minimal. The same goes for pets. Those afflicted with allergies or compromised respiratory systems should also minimize outdoor activity. You should also check your air quality daily. If you’re in California, here’s where to check: www.airnow.gov.
Beyond the above, I cannot tell you much more. I have been choosing to limit my outdoor activity and that of my dog because she has significant allergies and respiratory health problems. She’s also elderly. To better elaborate on fire related exposures, including allergies and respiratory impacts, I have reached out to one of our expert witnesses.
Allergy, Immunology and Dermatology Expert Witness – Dr. Ernest Charlesworth
Ernest N. Charlesworth, MD, is a Diplomate of the American Board of Dermatology, the American Board of Internal Medicine, American Board of Allergy & Immunology, and the American Board of Diagnostic Laboratory Immunology. He has over 40 years of experience in his field of expertise. He is one of only a few United States physicians who is board certified in both Allergy / Immunology and Dermatology.
Dr. Charlesworth specializes in respiratory diseases, Asthma, immunologic and allergic disorders, Allergic Pulmonary Disease, and more. He is located in Bronte, Texas. You can learn more about his expertise here. Below are my questions and Dr. Charlesworth’s answers.
Nick: What are the most common smoke-related allergic reactions?
Dr. Charlesworth: Smoke is a pulmonary irritant, even to healthy lungs, but for individuals with allergic asthma and chronic obstructive pulmonary disease, it has the potential to be life-threatening. Not only is the smoke an irritant, it may also contain allergic particles ranging from the oil in poison ivy (& poison sumac) to grass, weed, & tree pollen. The inflammation induced by smoke and pollutants release a cascade of inflammatory chemicals called cytokines. These cytokines augment and intensity of the allergic response.
Nick: Do allergy medications help at all when dealing with fire/smoke related exposure?
Dr. Charlesworth: Yes, individuals with inhalant allergies & asthma they will experience an increased need for using their “rescue” inhalers. The rescue inhaler contains a bronchodilator (usually albuterol) that helps to relax the smooth muscle that surround the bronchi, thus allowing an increase in the ease of air flow in the lungs. It is equally important that those with allergic asthma use their “control” medication which usually contain an anti-inflammatory steroid. One of the problems with smoke inhalation is that it increases the inflammation in an already inflamed & irritable airway. This additional inflammation has the potential to push even a well controlled asthmatic patient over the edge and require urgent intervention in the setting of a hospital emergency department.
Nick: Personally, I fight allergies all year, but with the smoke-filled air, they seem to be worse. Is that just a result of greater airborne pollutants?
Dr. Charlesworth: The simple answer is, yes. The irritants in environmental smoke “prime” the lungs & mucous membranes resulting in an exaggerated response to their allergies.
Nick: For those with respiratory illnesses, who are in smoky areas of California, what can they do to limit further damage to their compromised systems?
Dr. Charlesworth: The first step is to recognize that they are at much greater risk than the non-allergic population. This includes having an action plan that stresses regular use of their prescribed allergy medications. It’s also important to recognize the control inhalers should not be used for immediate relief. Finally, lungs require moisture & humidity to function in a healthy manner. Dry smoke-filled air will dehydrate the mucous membranes. Accordingly, the use of room humidifiers can be of immense help. In addition, they should have an evacuation plan, even in the absence of general evacuation orders. The use of filtration masks are recommended when outdoors and when indoors the air conditioning filters need to be changed.
Nick: Aside from staying indoors, what other items would you suggest for those currently exposed to California wildfire smoke?
Dr. Charlesworth: See above. A plan for early evacuation to outside the atmospheric area affected by the smoke & fire may be the most important. This might be a good time to take a vacation and visit family outside the affected area.
Nick: Please share any other information you think is appropriate for those exposed to smoke and other pollutants from wildfires…
Dr. Charlesworth: For those allergic to poison ivy, oak, & sumac there is a real danger that allergic oils aerosolized can cause not only respiratory but also an allergic contact dermatitis to exposed skin. For this reason, I would recommend long sleeves and staying indoors. If outside exposure is unavoidable, the use of a thin application of a petroleum cream (such as Vasoline) may be helpful. Lastly, one should remember that most antihistamines have a side effect of drying out the mucous membranes which will have a deleterious effect on those allergic individuals exposed to smoke. This particularly true for diphenhydramine (Benadryl) and less so with loratidine and cetirizine. There are also late complications that include an increased vulnerability to secondary infection of both the lungs and the sinuses. For protection of the sinuses, I recommend irrigation with dilute salt water a couple of times each day.
The last two blog posts have been entirely inspired by the events taking place in California. The goal is to provide some information beneficial to our sisters and brothers in the state.