Wildfire/Brushfire Smoke Health Problems What You Can Do About Smoke Inhalation, Cough, Sinus & Related Problems

Respiratory Health

Eye Health

Respiratory (Ear, Nose, and Throat) Health

Smoke is very dangerous. Most people die in fires from smoke, not burns, but even much more moderate smoke exposure has many health effects. As the wildfires/brushfires sweep through Southern California, consuming hundreds of thousands of acres, a huge amount of smoke in being inhaled. This will have unfortunate effects on the health of thousands, as was observed after the Indonesian fires of 1997, which were similarly widespread. For the many asthmatics, allergy patients, and people with sinus problems, these fires are especially serious and will worsen their condition. For example, after the Indonesian fires, a large increase in the incidence in asthma was seen in 10-14 year olds. What can one do if you live in or near a fire zone to avoid becoming a health statistic?

The by-products of forest fires/wildfires/brushfires include chemicals such as carbon monoxide and various aldehydes that act to impair cilia function. In the respiratory tract — the nose, sinuses, trachea (windpipe) and the smaller airways of the lungs, there are millions of tiny "oars" called cilia. These beat to remove foreign material out of the sinuses. In the nose they beat backwards and move the foreign materials, such as smoke particles, out of the nose to the stomach. In the chest they beat upwards to move the unwanted material out of the lungs to the throat, where the end up harmless in the stomach. If you can keep the cilia active, you can avoid the problems that come from smoke inhalation.

One bad sign: when the cilia of the chest can’t do their job, coughing takes over. Either there is too much material in the lungs for the cilia to handle or the cilia aren’t moving enough to do their job.

Besides avoiding the smoke, what can you do?

1. Breathe through a wet mask.
2. Drink large amounts of tea or other warm liquids. Tea stimulates the cilia. Decaffeinated tea is good, because you can drink lots without disturbing your sleep. Chicken soup also speeds cilia.
3. Guarding against dehydration also helps you and your cilia: drink enough so that the urine turns light.
4. Use a nasal moisturizer spray. Be sure there is no benzalkonium or other preservative that might impair the nasal function. If possible, find an enhanced nasal moisturizing formula free of additives and preservatives. By cleaning the nose this way you can preserve the normal nasal function.
5. Use Pulsatile Nasal Irrigation — this is a machine to cleanse your sinuses; you can do this at home, by yourself. It is quick, easy, and pleasant. The pulsation is the best means of restoring the cilia function. The pulsating stream is effective in removing foreign material and the rhythm of pulsation helps in restoration of cilia movement.
6. Most of the over the counter cough preparations such as Robitussin are fine for loosening thick phlegm in the chest. Try to avoid codeine preparations as these may slow cilia.
7. After exposure to smoke, use pulsatile irrigation, or if that’s not available, make a solution with 1/2 teaspoon of salt — pickling salt is best — to 8 ounces of clean warm water. Place it in the cupped hand and sniff the solution through the nose and out the mouth. This is difficult for some persons to do and is the reason why a pulsatile irrigation machine works better.
8. Caution: although antihistamines work well for seasonal allergy, they may cause additional drying of the mucus secondary to smoke exposure. Fine to use Entex LA, Zephrex LA, Sudafed and similar products for congestion after smoke inhalation, but caution in using the regular antihistamines. The congestion following smoke exposure is not necessarily an allergic response as it is an inflammatory one.

After the fires stop, many persons continue to have thick phlegm and mucus as a result of the smoke products affecting the cilia. Do daily pulsatile irrigation. If thick phlegm continues, proteolytic enzyme tablets are helpful. Look for proteolytic enzyme tablets with both papain and bromelain in them, calibrated in enzyme activity units. This is a combination of Bromelain from pineapple and Papain from papaya. These enzymes thin the mucus and can clear the problem. Fortunately they taste good. You take one three times a day, let them melt in your mouth in the buccal pouch, that is, between the cheek and gum. They are *much* more effective this way.

Are you suffering from smoke from wildfires/brushfires in the Simi Valley Fire? The San Diego Fires? Let us know (ENTconsult@aol.com). We'd like to help, and we'd really like to hear from any large institutions, including medical facilities. For institutions, I would like to offer some special treatment plans and even some free supplies for appropriate facilities.

©2003 Dr. Murray Grossan

Wildfire/Brushfire Smoke, Eye Protection & Health

With the Southern California wildfires filling the air with smoke and debris, some helpful hints for eye protection could be very important to preserving the health of your eyes.

1. Protective glasses or sunglasses are essential. There can be excessive glare from the sun filtering through the smoke, and anti-glare coatings can be very helpful.
2. In active fire areas, goggles can help prevent ashes or debris from blowing into the eyes, burning either the cornea or conjuntiva. If something should blow into the eye, immediately irrigate the eyes with cool water (or any water available) for at least ten minutes before seeking medical attention.
3. Dryness, burning and stinging can be helped by frequent use of over-the -counter Artificial Tears, available at any pharmacy or supermarket. These can be used as often as every hour, if necessary.
4. People with contact lenses are at greater risk for drying and irritation. It would be safer to wear glasses during the times of poor air quality. If contact lenses must be worn, non-preserved Artificial Tears should be instilled frequently.
5. If the eyes actually become painful, consult an ophthalmologist, as there is a greater risk for corneal abrasions or infections.
6. As with all risky situations, common sense is the number one protection against serious eye injuries.

Lawrence J. Schwartz, M.D.

Dr. Schwartz is an ophthalmologist practicing at Cedars Sinai Medical in Los Angeles.

©2003 Dr. Murray Grossan

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