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What Are The Long-Term Health Effects Of Breathing In All This Wildfire Smoke?

Christopher Michel
Creative Commons, used under CC-BY-SA 4.0
Smoke from wildfires across the west coast caused the longest stretch of bad air quality in the Bay Area this August. (Image of the Bay Bridge under orange skies caused by smoke.)

Wildfires have caused record-breaking stretches of bad air quality in the Bay Area these last few years. In this interview, Dr. Gina Solomon from UCSF and the Public Health Institute speaks about the long term health effects of breathing in all this smoke.

Some people who are breathing wildfire smoke today are paying a price right away ... Other people are going to be paying the price years and years from now decades from now, as their lung function declines in a subtle way as they get older.

This interview has been condensed and lightly edited for clarity. 

Click the play button above to listen.


MARISSA ORTEGA-WELCH, SCIENCE REPORTER: What do you worry about for people in terms of the long term health effects of all of this smoke? 

DR. GINA SOLOMON: I was interviewed a few years ago about wildfire smoke and health effects. And I was saying, “This is a short term thing. It’s just happening for a few weeks this year. And so we need to worry about the acute effects.” And year after year, as these fires come back and they stretch over more weeks and more months, it gets harder and harder to just talk about the acute effects. We really have to think about long-term health effects. 

Some people who are breathing wildfire smoke today are paying a price right away. You see a big spike in emergency room visits and hospitalizations from cardiovascular and lung conditions immediately, when air pollution levels go up. Other people are going to be paying the price years and years from now decades from now, as their lung function declines in a subtle way as they get older.

Our lung function actually improves year after year until we hit our early twenties. And then it starts to decline year after year very slightly as we get older, but the slope of that improvement and the slope of that decline is affected by things like the air that we breathe. For example, there have been studies of children in Los Angeles and the children who are breathing more polluted air, their lungs don't develop as well as a child who grew up breathing clean air. Similarly, if you're in a polluted community, your lung function gets worse year after year in your adulthood. The same kind of thing is probably happening from the wildfire smoke. 

These kinds of things are going to be very hard to measure. And on an individual basis, you won't necessarily know. You just won't feel as good; you won't be able to run as far or walk as fast as you age. And that’s not good news for any of us. 

ORTEGA-WELCH: A lot of us are getting used to checking the air quality reports when we wake up in the morning. For example, yellow means moderate air quality; red is bad air quality. How should we be interpreting the different colors in terms of their long term health effects?

SOLOMON: How worried you should be depends a bit on your underlying risks. If you have asthma or any underlying condition, you want to be much more cautious. But once the air quality turns red, all of us are at risk. And so we all need to be really careful, you may be doing yourself more harm than good going out for a run and breathing in all that bad air. I am a doctor; I never tell people to cut back on exercising! And here I am telling people to cut back on exercising when the air quality's bad because it's not worth it.

One of the slightly positive things in the Bay Area at least is that the air quality has been variable. So I am watching the air quality like a hawk to try to get out during those windows of time when it's safe to do so. That's really not an option for some of our family and friends up in Sonoma County, for example, where they're just dealing with incessantly bad air; but here in the Bay Area: get out when you can. It is important for mental health and physical health.

ORTEGA-WELCH: How has your behavior changed? Do you go out for a walk when the air quality level is in the red or do you stay indoors?

SOLOMON: I'm a dog owner, so I go out for walks no matter what. But I make them shorter or longer walks depending on what the air quality looks like. I also happen to have just a couple of N-95 masks from previous fire years. I've pulled those out. It's not a hundred percent [effective], but it definitely reduces the exposure.Even a regular surgical mask will slightly cut back the amount of air pollution by an estimated twenty or or thirty percent The masks that we're wearing to protect ourselves and to reduce the risk of COVID do have a slight benefit for air pollution.

With bad air quality, you just have to try to limit your exposure to the air, but you can't just climb into a bubble. You don't want to be reckless, though, because you are at a certain point, you're really gambling with your health.

ORTEGA-WELCH: How does the smoke and bad air quality affect people that might have COVID-19?

SOLOMON: There were a few studies that have come out that suggest that death rates may be higher from COVID in areas with worse air quality. That's not that surprising, to be honest. Wwe already know that our pollution worsens both respiratory and cardiovascular conditions. And COVID is linked to both of those. We're going to have more science on this soon, but it certainly is a concern. 

ORTEGA-WELCH: How good is the air quality in the Bay Area when it's not fire season? 

SOLOMON: The air quality in the Bay Area depends quite a bit on where you live. There are communities in the Bay Area that have real challenges with air quality and other communities where the air quality is just great. And so we need to think about that. And we need to think about it not only at a broad general county level, but down to a block-by-block level. Because what we've found is in places like West Oakland, for example, you can see hotspots that are just a few blocks with big disparities because of local pollution sources. 

It's not happy news to think that being a Californian is potentially going to impact me later in my life. How do you feel about the fact that we could be right back here next October, talking about bad air quality again from the fires?

Unfortunately, climate change is not just hitting California. So we may be dealing with the fires right now. And there are a lot of people who I hear about who are trying to leave California, but there's nowhere to run to. Climate change is global. Climate change is going to affect people wherever they live. It's going to hit in one form or another. Right now, you know, in the southern US they're staring down a hurricane that is coming right at them. We are dealing with the situation where we have to pull through this together and get our act together to address climate change, and also do what we can to make wherever it is that we live, more resilient and more habitable. And some of that happens just right in our own homes. 

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