Study finds exposure to wildfire smoke can increase premature birth risk

Smoke from wildfires may have contributed to thousands of additional premature births in California between 2007 and 2012.

Satellite photo, smoke in Northern California
Satellite photo. Most of Northern California covered by a layer of smoke, at 9:11 a.m. PDT Aug. 7, 2021.

Exposure to wildfire smoke during pregnancy increases the risk that a baby will be born too early, a new Stanford University study suggests.

Exposure to wildfire smoke during pregnancy increases the risk that a baby will be born too early, a new Stanford University study suggests. (Image credit: Getty Images)

The study, published Aug. 14 in Environmental Research, finds there may have been as many as 7,000 extra preterm births in California attributable to wildfire smoke exposure between 2007 and 2012. These births occurred before 37 weeks of pregnancy when incomplete development heightens risk of various neurodevelopmental, gastrointestinal and respiratory complications, and even death.

Wildfire smoke contains high levels of the smallest and deadliest type of particle pollution, known as PM 2.5. These specks of toxic soot, or particulate matter, are so fine they can embed deep in the lungs and pass into the bloodstream, just like the oxygen molecules we need to survive.

The research comes as massive wildfires are again blazing through parched landscapes in the western U.S. – just a year after a historic wildfire season torched more than 4 million acres of California and produced some of the worst daily air pollution ever recorded in the state. During the 2020 fire season, more than half of the state’s population experienced a month of wildfire smoke levels in the range of unhealthy to hazardous.

This year could be worse, said Stanford environmental economist Marshall Burke, a co-author of the new study. And yet much remains unknown about the health impacts of these noxious plumes, which contribute a growing portion of fine particle pollution nationwide and have a different chemical makeup from other ambient sources of PM 2.5, such as agriculture, tailpipe emissions and industry.

One possible explanation for the link between wildfire smoke exposure and preterm birth, the authors say, is that the pollution may trigger an inflammatory response, which then sets delivery in motion. The increase in risk is relatively small in the context of all the factors that contribute to the birth of a healthy, full-term baby. “However, against a backdrop where we know so little about why some women deliver too soon, prematurely, and why others do not, finding clues like the one here helps us start piecing the bigger puzzle together,” said co-author Gary Shaw, DrPH, a professor of pediatrics and co-primary investigator of Stanford’s March of Dimes Prematurity Research Center.

Extreme wildfires

The new results show wildfire smoke may have contributed to more than 6 percent of preterm births in California in the worst smoke year of the study period, 2008, when a severe lightning storm, powerful winds, high temperatures and a parched landscape combined for a deadly and destructive fire season – one that has now been dwarfed by the record-setting infernos of 2020 and ongoing blazes like the Dixie fire in Northern California.

“In the future, we expect to see more frequent and intense exposure to wildfire smoke throughout the West due to a confluence of factors, including climate change, a century of fire suppression and construction of more homes along the fire-prone fringes of forests, scrublands and grasslands. As a result, the health burden from smoke exposure – including preterm births – is likely to increase,” said lead author Sam Heft-Neal, a research scholar at Stanford’s Center on Food Security and the Environment.

The research provides new evidence for the value of investing in prescribed burns, mechanical thinning, or other efforts to reduce the risk of extreme wildfires. Given that premature births cost the U.S. healthcare system an estimated $25 billion per year, even modest reductions in preterm birth risk could yield “enormous societal benefits,” said Burke, an associate professor of Earth system science at Stanford’s School of Earth, Energy & Environmental Sciences (Stanford Earth). “Our research highlights that reducing wildfire risk and the air pollution that accompanies it is one way of achieving these societal benefits.”

‘No safe level of exposure’

The researchers analyzed satellite data of smoke plumes from the National Oceanic and Atmospheric Administration (NOAA) to identify smoke days for each of 2,610 zip codes. They paired these data with estimates of ground-level PM 2.5 pollution, which were developed using a machine learning algorithm that incorporates data from air quality sensors, satellite observations and computer models of how chemicals move through Earth’s atmosphere. They pulled additional data from California birth records, excluding twins, triplets and higher multiples, which commonly arrive early.

After accounting for other factors known to influence preterm birth risk, such as temperature, baseline pollution exposure and the mother’s age, income, race or ethnic background, they looked at how patterns of preterm birth within each zip code changed when the number and intensity of smoke days rose above normal for that location.

They found every additional day of smoke exposure during pregnancy raised the risk of preterm birth, regardless of race, ethnicity or income. And a full week of exposure translated to a 3.4 percent greater risk relative to a mother exposed to no wildfire smoke. Exposure to intense smoke during the second trimester – between 14 and 26 weeks of pregnancy – had the strongest impact, especially when smoke contributed more than 5 additional micrograms per cubic meter to daily PM 2.5 concentrations. “If one can avoid smoke exposure by staying indoors or wearing an appropriate mask while outdoors, that would be good health practice for all,” Shaw said.

The findings build on an established link between particle pollution and adverse birth outcomes, including preterm birth, low birth weight and infant deaths. But the study is among the first to isolate the effect of wildfire smoke on early births and to tease out the importance of exposure timing.

“Our work, together with a number of other recent papers, clearly shows that there’s no safe level of exposure to particulate matter. Any exposure above zero can worsen health impacts,” said Burke, who is also deputy director of the Center on Food Security and the Environment and a senior fellow at Stanford’s Freeman Spogli Institute for International Studies. “While as a society it will be extremely difficult to fully eliminate all pollutants from the air, our research suggests that further reductions in key pollutants below current ‘acceptable’ levels could be massively beneficial for public health.”

Thanks and a tip of the hat go out to Mike.

Firefighter killed while working on Oregon fire identified

Frumencio Ruiz Carapia
Frumencio Ruiz Carapia

The firefighter who died Monday while working on a wildfire southeast of Eugene, Oregon has been identified as 56-year old Frumencio Ruiz Carapia of Medford.

Mr. Carapia was working on the Gales Fire when he was struck by a falling tree, according to a news release Tuesday from Lane County Sheriff’s Sgt. Tom Speldrich.

Despite immediate efforts by those around him, Ruiz Carapia died at the scene, the news release said. No other injuries were reported.

The 14,000-acre Gales Fire is part of the Middle Fork Complex of fires. Personnel across the complex shared a moment of silence Tuesday morning in his memory.

Mr. Carapia was a member of a contract Type 2 Initial Attack hand crew. Two other firefighters who were injured were treated at the scene.

“The wildland firefighting community and our partners mourn this loss,” said Incident Commander Brian Gales of Northwest 13 Incident Management Team. “Our thoughts and prayers are with his family.”

Gales Fire map

A preliminary investigation showed the accident wasn’t the result of any tree cutting but that the tree unexpectedly snapped and fell to the ground, according to the sheriff’s office.

After his death Monday first responders formed a procession in the firefighter’s honor as his body, wrapped in an American flag, was wheeled past them before being prepared for transport back home.

Friends of Ruiz Carapia have established a GoFundMe page to support his wife and children.

U.S. Senator Ron Wyden put out a statement regarding Ruiz Carapia’s death on Tuesday evening:

“A sad reminder about the dangers that firefighters face to protect all of us here in Oregon. My deepest condolences to the family, friends and loved ones of Mr. Carapia.”

We send out our sincere condolences to the family, friends, and co-workers of Mr. Carapia.

Thanks and a tip of the hat go out to Al and others.

Why are fires in the West growing larger this year?

Drought — fuel moisture — energy release component

Observed precipitation
Observed precipitation during the 30 days before August 23, 2021.

There are a number of ways to analyze the behavior of wildland fires using data that is easily available. The amount of moisture in the live and dead vegetation is a critical factor in determining how readily it will burn, because it has to be cooked off before the grass, brush, or woody vegetation will vigorously combust.

The amount of precipitation over days, weeks, months, and years affects how wildfires burn. The map above depicts precipitation during the 30-day period ending August 23, 2021.

The Drought Monitor is one way of using an index to express how the precipitation compares to normal for an area. As you can see below most of California is in either Exceptional Drought (the highest level of drought) or Extreme Drought. The only areas in California that are not, are a tiny sliver in the extreme northwest corner, and the five southernmost counties. Both drought categories can also be found in areas of Oregon and Idaho which I will get to later.

Drought Monitor, August 17, 2021

Extended drought lowers the moisture content of both live and dead vegetation. When that occurs, it takes less energy out of a fire to cook off the moisture, and that energy instead goes toward enhanced combustion of the material and then preheating and igniting nearby vegetation, resulting in faster spread of the fire.

The observed precipitation map at the top of the page shows that most of California received less than 1/10 inch in the 30-day period. This, and the multi-year drought has led to the 1,000-hour time-lag fuels, woody material 3 to six inches in diameter, being extremely dry. Fuel monitoring stations in the foothills of the Sacramento Valley and the Northern Sierras are finding moisture levels lower than kiln-dried lumber, which is usually 8 to 12 percent. Both stations recently have been recording levels around 6 percent, which is near and sometimes below the lowest levels ever recorded for the date (the red lines on the charts). The Incident Management Team on the Caldor Fire said the 1,000-hour fuels are at three percent moisture.

1,000 hour fuel moisture Sacramento Valley-Foothills fire

In these charts, “Min” is the historic minimum for the date. “Max” is the historic maximum for the date.

1,000 hour fuel moisture, Northern Sierras

Knowing the moisture content of the fuel is an ingredient in determining another index, the Energy Release Component (ERC) which can help predict the intensity and rate of spread of a fire. It is defined as a number related to the available energy (BTU) per unit area (square foot) within the flaming front at the head of a fire. The ERC is considered a composite fuel moisture index as it reflects the contribution of all live and dead fuels to potential fire intensity. As live fuels cure and dead fuels dry, the ERC will increase and can be described as a build-up index. The ERC has memory. Each daily calculation considers the past 7 days in calculating the new number. Daily variations of the ERC are relatively small as wind is not part of the calculation.

Since mid-May the ERCs at two locations in Northern California have been flirting with the historic daily highs, either slightly above or slightly below. This is consistent with the observed fire activity this year on several large fires in the northern part of the state. The Dixie Fire is closing in on three-quarters of a million acres, and the Caldor Fire in nine days has blackened 117,000 acres. Fire Behavior Analysts at the fires are describing historically low fuel moistures.

Here is an excerpt from the recent Fuel Model Summary for the Caldor Fire:

There is a heavy dead and down component with drought-stressed fuels. Live fuels are cured to levels normally seen in late September, and fuels are extremely receptive to spotting. Fuel moistures are historically low. Northern California remains under a Fuels and Fire Behavior Advisory. ERC’s are above the 97th percentile. 100 hr and 1000hr fuels are below the 3rd percentile.

These fires are primarily fuel-driven. They are burning very well with gentle breezes. When the wind increases above 10 mph, they are hauling ass.

ERC Sac Valley-Foothills fire
Energy Release Component, Northern Sierras fire
Continue reading “Why are fires in the West growing larger this year?”

Will unvaccinated firefighters be restricted from traveling to fires?

Colorado engine 4321 Dixie Fire
Colorado DFPC SLV Engine 4321 on the Dixie Fire, California, 2021. DFPC photo.

A letter from the US Forest Service’s new Chief, Randy Moore, dated August 17, 2021 could lead a person to believe that Federal firefighters might be restricted from traveling to wildfire assignments. The initiative apparently stemmed from a July 29, 2021 White House statement:

Anyone who does not attest to being fully vaccinated will be required to wear a mask on the job no matter their geographic location, physically distance from all other employees and visitors, comply with a weekly or twice weekly screening testing requirement, and be subject to restrictions on official travel.

The Chief Moore document says all federal agencies are working to establish specific safety protocols for fully vaccinated individuals and those who are not fully vaccinated. These protocols will be consistent with the Centers for Disease Control and Prevention (CDC) July 27, 2021 guidance and align with the revised model safety principles from the Safer Federal Workforce Task Force.

The last link above is from, Safer Federal Workforce Task Force COVID-19 Workplace Safety: Agency Model Safety Principles, Issued July 29, 2021. Here is the section on travel:

Federal employees should adhere strictly to CDC guidelines before, during, and after travel.

For Federal employees who are fully vaccinated, there are no Government-wide restrictions on travel (although agency travel policies still apply).

For Federal employees who are not fully vaccinated or who decline to provide information about their vaccination status, official domestic travel should be limited to only necessary mission-critical trips. International travel should also be avoided, if at all possible, unless it is mission critical (e.g., military deployments, COVID-19 response deployments or activities, diplomats traveling, high-level international negotiations that cannot occur remotely). Heads of agencies should issue specific guidance to account for the particulars of their agency’s mission.

So after wading through all those documents, including a post from Chief Moore that triggered this journey of discovery, it at first appears that only “mission critical” travel will be allowed unless you are an international diplomat or a member of the military.

But all this is left up in the air, for now, since the letter says, instead of using clear text, the USFS is “moving forward … to establish specific safety protocols.”

Of course if the five federal agencies that fight wildland fire simply decree that firefighting is “mission critical”, end of discussion.

Meanwhile firefighting goes on, but with reduced numbers of available firefighters.

Examples of COVID outbreaks among wildland firefighters

From firefighters to an Area Command Team

firefighter Dixie Fire California
A firefighter and another person at Diamond Mtn. Rod on the Dixie Fire. Photo by Luanne Baumann. Posted August 11, 2021.

Over the last few days we ran across a number of examples of COVID outbreaks among wildland firefighters.

Dixie Fire

In an August 20 article, the Redding Record Searchlight, a Northern California newspaper, reported that CAL FIRE said there have been 14 positive cases at the Dixie Fire’s West Zone fire camp.

The positive cases include five from one crew, two from the same dozer, two from the same water tender and five “random cases,” the agency said. “These personnel were immediately released from the incident.”

Two of the cases led to hospitalizations, with one individual now in San Diego, who Cal Fire said is “doing well.” A second person, now in Redding, is “showing improvements,” the agency said.

The information below came from the Wildland Fire Lessons Learned Center.

Area Command, October 2020

In October of last year while working on the August Complex of fires, 9 of the 14 members of an Area Command Team that were working out of the Shasta-Trinity National Forest Supervisor’s Office in Redding tested positive. The first case was discovered after the team had been released and they were all in travel status followed by days off. That made it difficult to contact everyone. Some family members of individuals who tested positive also became infected. Given these unintended outcomes, a Facilitated Learning Analysis was initiated to develop lessons learned that could be shared with the wildland fire community.

The next four all occurred in California this year:

Hotshot crew, May

Four days after the crew began their season, one person tested positive. The crew Superintendent and Forest took immediate action to identify close contacts; 19 employees were identified. Of the 19, 7 were fully vaccinated (and returned to work immediately) and 12 were placed into quarantine (some at home and some in hotels).

Fuels module, May

On May 14th a fuels module member developed COVID-like symptoms; the person received a positive COVID test on May 16th. Contact tracing identified 10 close contacts (7 other fuels crew members and 3 additional employees who worked in the building). All of the close contacts were encouraged to get tested for COVID-19 and advised to quarantine (although 4 had been vaccinated, it was not used in the decision). One unvaccinated individual lived in barracks and moved to a hotel on the 16th. A second individual (the supervisor of the module) tested positive on May 17th.

Two additional cases were confirmed later that week (4 total in the cluster); none of the vaccinated employees tested positive or showed any symptoms. At the time of the review (June 2), one of the sick employees had returned to the office and others were teleworking. One of the four individuals was contacted by county public health, two were contacted by state public health, the fourth individual was never contacted by any public health department.

The four vaccinated employees did not get sick while four of the seven unvaccinated employees ultimately tested positive

Hotshot crew, July

An Interagency Hotshot Crew (IHC) finished a 14-day assignment with 18 crewmembers and arrived home June 22, 2021 (the IHC had 2 additional crewmembers who returned early and were not exposed); no employees were aware of exposure or had symptoms. The IHC was off duty on June 23-24, 2021 for mandatory rest.

On June 24th a crewmember developed a fever and took the initiative to get a COVID test immediately; the test returned a positive result the same day. Contact tracing found that the 17 other crewmembers were close contacts within 48-hours prior to the onset of symptoms. All of the close contacts were other IHC crewmembers (during travel home) and no other personnel were identified.

Of the 18 crewmembers who returned from assignment on June 22nd, 3 were fully vaccinated and returned to work on June 25th. The remaining employees (15) have not returned to work; the sick employee was put into isolation and the remaining close contacts on the crew were told to self-quarantine for 14-days by unit leaders. The 2 crewmembers who returned early (1 vaccinated) were not impacted.

None of the vaccinated employees got sick while 6 of the unvaccinated employees have tested positive.

Engine crew plus others, July

On July 6, 2021, the local county public health contacted the Forest Service regarding an employee who had been exposed to a confirmed case of COVID-19. The employee had no symptoms and received negative test results (rapid test and PCR test). Public health advised the employee to quarantine for 10 days.

No other FS employees were involved in this exposure since they were considered a secondary contact because the employee was exposed outside of work.

The employee in quarantine impacted the availability of a fire engine during high fire danger, therefore an employee from a different station began working on the engine on July 6, 2021.

On July 7, 2021, the employee covering for the engine (from the other station) developed COVID-like symptoms and tested positive for COVID-19 on the same day.

This cluster involves 12 employees, with only 1 vaccinated and one who was in quarantine and not exposed. By July 12, 6 of the unvaccinated employees tested positive for COVID -19. All unvaccinated employees (10) were placed into quarantine. One employee chose to stay in a hotel and all others remained at their residences.

The vaccinated employee did not get sick while 6 of 11 unvaccinated employees have tested positive for COVID-19.


Lessons to be learned?

While the Delta variant, which began spreading widely in the United States in July, changed how easily it is to become infected even among those who are vaccinated, it is still true that a vaccination greatly reduces a person’s chance of severe infection, hospitalization, and death.

Here are the final paragraphs from an excellent, detailed article published August 18, 2021 at Healthline:

Vaccines are highly effective even if they’re not perfect

The COVID-19 vaccines were developed to stop developing severe forms of the disease that can lead to hospitalization and death. In that aspect, they have been extremely successful even if the vaccines are not 100 percent effective.

While it is true that some partially and fully vaccinated people have developed COVID-19, breakthrough infections should not be a concern for most of the population. Doctors, however, do still recommend people exercise caution in areas with low vaccination rates and high transmission.

Vaccines also greatly reduce the likelihood of mild and symptomatic infections as well as prevent death and hospitalization.

Kullar noted that the Delta variant is both more contagious and transmissible, and those who are harboring the Delta variant can carry as much as a 1,200 times higher viral load than the original strain.

“Given all of this information, it is important for everyone not only to get fully vaccinated but also follow infection prevention measures, such as wearing a face mask in the public, physically distancing from others, and avoiding large crowds until we round the turn of this surge.”