Smoke Busters

A breath of clean air

Situation Overview

For the past several years Southern Oregon has experienced extended periods of wildfire-created smoky conditions that have ranged from “unhealthy” to “hazardous,” particularly for those with chronic lung conditions such as asthma, bronchitis or COPD.  During smoky days people are encouraged to wear face masks or stay indoors.  However, in homes with less than adequate air filtration remaining indoors may represent a health threat as well.

Health Impacts from Wildfire Smoke

Wildfire smoke is a mixture of gases and fine particles from burning trees and other plant material.  The gases and fine particles can be dangerous to inhale.  The particulate matter (also called PM) in wildfire smoke poses the biggest risk to public health.  The potential health effects vary based on the type of plants burning, atmospheric conditions and, most importantly, the size of the particles.  Particles larger than 10 micrometers usually irritate only the eyes, nose and throat.  Fine particles 2.5 micrometers or smaller (PM2.5) can be inhaled into the deepest part of the lungs and may cause greater health concerns.[1]

The Oregon Health Authority FAQ (footnote 1) reported that those most likely to have health effects from wildfire smoke exposure included persons with asthma or other chronic respiratory disease; persons with cardiovascular disease; persons over age 65, infants and children, pregnant women and smokers.

A California research study[2] found that wildfire smoke exposure was associated with increased rates of emergency department visits for numerous cardiovascular disease outcomes, including ischemic heart disease, dysrhythmia, heart failure, pulmonary embolism and stroke.  The observed risk was greatest among adults age 65 years and older.  The clinical implications were:

  • Individuals with underlying cardiovascular disease risk factors may be at risk for an acute cardiovascular or cerebrovascular event during a period of wildfire exposure.
  • Further studies should explore individual-level behavioral interventions that may help reduce exposure to smoke during wildfires.
  • Hospital administrations and public health planners may want to use these results to inform surge planning of emergency departments, particularly among stroke centers and hospitals with cardiac catheterization facilities.

The initial pilot program would involve 50-100 home interventions and carrying out the following activities:

  1. Baseline measurement of in-home air quality using a Temptop hand-held air quality detector (PM2.5, PM10, CO2).
  2. Evaluation of in-home furnace and replacing old filters with high performance units having an MPR (microparticle performance rating) higher than 1,500 or a MERV (minimum efficiency reporting value) of 13 or higher (on a 1 to 20 scale). Setting the furnace thermostat from “auto” to “on” can reduce particle concentrations by as much as 24 percent (source:  EPA)
  3. Evaluation of air conditioning units for filter replacement or cleaning.
  4. Examination of clothes dryers to insure proper venting and reduce fire risk.
  5. Evaluation of the need for a portable air cleaner. Portable air cleaners fitted with high efficiency filters can reduce indoor particle concentrations by as much as 85 percent.  The cost of a portable air cleaner is dependent of the unit efficiency and square foot coverage.  A HEPA filter unit that could “clean” a 350-450 square foot room costs approximately $250.  Units with higher efficiency and coverage cost proportionally more but bulk purchase could well reduce the unit costs.
  6. Assure individual is registered to receive emergency notifications.

Participant Screening (tentative)

Referrals to this pilot Smoke Busters program would come from Southern Oregon respiratory and pulmonary specialists.  Candidates would need to meet the following criteria:

  1. At risk senior (over age 60)
  2. Nonsmoker
  3. Low income
  4. At high risk from wildfire smoke

The program would need to satisfy HIPPA confidentiality requirements that might necessitate doctors providing their patient with the Smoke Busters contact information, so they can request assistance from RBT-RV directly.  There will be no cost to the participants.

[1] Http://Public.Health.Oregon.gov  Frequently asked questions about wildfire smoke and health. OHA 8826

[2] Cardiovascular and Cerebrovascular Emergency Department Visits Associated with Wildfire Smoke Exposure in California in 2015.  Journal of the American Heart Association (J Am Heart Assoc. 2018;7;e007492.)