Wildfire smoke carries microbes that can cause infectious diseases

Calwood Fire, Oct. 17, 2020
Calwood Fire, Oct. 17, 2020. Photo by Ben Nelson, Envision Studio, Boulder, Colorado.

Wildfire smoke contains microbes, a fact that’s often ignored, but one that may have important health repercussions.

In 2008, Captain Matthew P. Moore, a firefighter with the Murrieta, California Fire Department, died after being infected with a rare brain-eating amoeba that usually lives in soil. A biopsy showed his brain had been invaded by the parasite Balamuthia mandrillaris which enters the body through the lower respiratory tract or through open wounds. It is believed Captain Moore inhaled the parasite while fighting wildfires.

In an article published December 18 in Science, Leda Kobziar and George Thompson called the attention of the scientific community to the health impacts of wildfire smoke’s microbial content.

Smoky skies caused by wildland fires are becoming seasonal norms, especially in some parts of the United States and Australia. In 2020, wildfires in the Western U.S. set new records and led to extremely unhealthy or hazardous air quality levels for many weeks in a row.

It’s well-documented that exposure to wildfire smoke can damage the heart and lungs. Respiratory allergic and inflammatory diseases, including asthma and bronchitis, are also worsened by smoke exposure.

“The health impact of inhaling wildfire smoke increases dramatically during high-emissions wildfires and with long exposure,” said Kobziar, associate professor of Wildland Fire Science at the University of Idaho. “Yet, the risk of infection to the respiratory tract after this exposure is frequently overlooked.”

What role do microbes in wildfire smoke play in the spread of disease?

Wildland fire is a source for bioaerosol, airborne particles made of fungal and bacterial cells and their metabolic byproducts. Once suspended in the air, particles smaller than 5 μm can travel hundreds or even thousands of miles. Their movement depends on the fire behavior and the atmospheric conditions.

microbial cell transport wildland fire
A simulation of microbial cell transport potential using measured smoke cell concentration, particulate matter, and fuel consumption values shows a snapshot of the number of microbial cells under 2.5 mm in aerodynamic diameter per kilogram of air downwind of a fire in Utah’s Fishlake National Forest, USA. Leda N. Kobziar and George R. Thompson III.

Bacteria and fungi can be transported in these wildland fire smoke emissions. The consequences for more immediate populations, such as firefighters on the front line who often spend up to 14 consecutive days in smoky conditions, are likely greater given that microbial concentration in smoke is higher near the source of a fire. For example, the U.S. Centers for Disease Control and Prevention counts firefighting as an at-risk profession for coccidioidomycosis, an infection caused by a pathogenic fungus well known to be aerosolized when soils are disturbed.

“We don’t know how far and which microbes are carried in smoke,” said Thompson, associate professor of Clinical Medicine at UC Davis. “Some microbes in the soil appear to be tolerant of, and even thrive under, high temperatures following wildfires.”

As Kobziar explained, “At the scale of a microbe, fire behavior research has shown that heat flux is highly variable, so it may be that many microbes aren’t even subjected to the high temperatures for very long. They may also be protected in small clusters of particulate matter.”

The potential for wildland fire’s microbial content to affect humans who breathe in smoke, especially from high-emissions wildfires or for multiple weeks, is appreciable. How far and which microbes are transported in smoke under various conditions are critical unknowns, but the relevance of these questions is increasing with longer wildfire seasons and higher severity trends.

Study found hazardous air quality conditions at fire camps in Oregon and California

Smoke exposure levels at the Creek Fire ranged from hazardous to unhealthy for 30 days

(From Bill: Wildland firefighters and people who live in areas where long-term fires are common, such as Northern California and the Northwest, know that smoke can persist for days or weeks and can cause or aggravate respiratory and other medical issues. But knowing it exists and having peer reviewed quantifiable data proving it is hazardous to health, are two different things. Science like this could lead to changes that may benefit firefighters and the general public.)


In September and October the Centers for Disease Control and Prevention (CDC) deployed two staff members to serve as air resource advisors at wildfires in Oregon and California.

Air resource advisors were fully integrated into the wildfire incident management teams to provide insights into understanding and predicting smoke exposure levels. The individuals interacted with stakeholders, including air quality regulators, fire personnel, public health practitioners, and community residents. A primary aspect of this engagement was to forecast smoke levels for areas immediately affected by fires and generate a daily smoke outlook to keep stakeholders informed about prevailing smoke levels. 2020 is the first year during which the CDC worked with the Interagency Wildland Fire Air Quality Response Program and deployed staff members as air resource advisors for wildfire incidents.

From August 31 to September 14, 2020, one CDC staff member supported wildfires in central Oregon’s Cascade Range east of Sisters, which included the Beachie Creek, Holiday Farm, Lionshead, and Riverside fires. Strong east winds across the Cascade Mountains resulted in more than 560,000 acres of fire growth from September 7 through 10.

satellite photo fires smoke Washington, Oregon, and California
GOES-17 photo of smoke from wildfires in Washington, Oregon, and California at 5:56 p.m. PDT Sept. 8, 2020. The photo was taken during a very strong wind event.

Another CDC staff member was deployed to the Creek Fire from September 20 to October 5, 2020. This fire near North Fork, California started September 4 and grew to 193,000 acres during its first week; as of December 3, 2020, the fire had burned 379,895 acres.

Air quality study, fire camps, 2020
Abbreviation: PM2.5 = particles with aerodynamic diameters ≤2.5 μm.
       * Sensitive groups include persons aged ≤18 years; adults aged ≥65 years; pregnant women; persons with chronic health conditions such as heart or lung disease, including asthma and diabetes; outdoor workers; persons experiencing homelessness, and those with limited access to medical care. (https://www.cdc.gov/air/wildfire-smoke/default.htm).
       † Fire camps typically offer logistical support to the wildfire suppression operation by providing firefighters and incident personnel sleeping locations (camping), morning and evening meals, workspaces, and administrative services.
       § The monitoring instrument in North Fork, California, recorded errors and did not report data during September 12–15, 2020.
       ¶ Start date of Creek Fire in California was September 4. Start dates of fires in Oregon were as follows. Lionshead was August 16; Beachie Creek was August 16; Holiday Farm was September 7; Riverside was September 8.

During these two deployments, several public health concerns came to light. Of note, although smoke from wildfires drifted long distances and affected downwind communities, the brunt of poor air quality was observed in communities adjacent to wildfire incidents. For example, communities near the fires in California and Oregon experienced high concentrations of PM2.5, as measured by air quality monitors, resulting in “Unhealthy” to “Hazardous” conditions, as defined by the U.S. Environmental Protection Agency Air Quality Index.

Fire personnel who camped and rested between work shifts at nearby fire camps (North Fork, California and Sisters, Oregon) were also exposed to poor air quality levels. These fire camp exposures contribute to higher overall cumulative smoke exposure and, along with other occupational risk factors such as fatigue and stress, could limit recovery that is much needed for fire personnel while away from the active fire perimeter. In addition, environmental hazards such as extreme heat and higher concentrations of ambient carbon monoxide were prevalent during days with heavy smoke and after extreme fire growth days. These hazards added a layer of complexity to fire response efforts and might have limited fire personnel recovery between work shifts.


From: Navarro K, Vaidyanathan A.  — Notes from the Field: Understanding Smoke Exposure in Communities and Fire Camps Affected by Wildfires— California and Oregon, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1873–1875. DOI: http://dx.doi.org/10.15585/mmwr.mm6949a4

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

Smoke — and the health of firefighters

smoke pyrocumulus bushfires Australia
Photo of smoke from bushfires by Merrin Macleod on a flight from Canberra to Melbourne, Australia, posted January 4, 2020.

Originally published by the Centers for Disease Control and Prevention

While research has not yet been conducted on all the hazards and risks associated with the wildland firefighting job, the National Institute for Occupational Safety and Health (NIOSH) is asked numerous questions about the hazards of fighting wildland fires. This blog is designed to answer some of those questions.

What Is in Wildland Fire Smoke?

Wildland fire smoke is a mixture of gases and particles such as carbon monoxide (CO) and respirable particulate matter (PM) that may cause short- and long-term health effects. Wildland firefighters can be exposed to smoke at wildfires and “prescribed” fires (planned and intentionally ignited low-intensity fires). The contents of and exposure to wildfire smoke can vary greatly throughout the day depending on the vegetation type, fire behavior, and meteorological conditions. Research has shown that wildland firefighters have been exposed to gases and particles such as CO and PM above the occupational exposure limits during both wildland and prescribed fires. While burning vegetation is the primary exposure of concern for wildland and prescribed fires, when fires burn in the wildland urban interface (WUI, where wildland vegetation and urban areas meet) the smoke may contain compounds that are more similar to what structural firefighters encounter. Wildland firefighters will often suppress these fires and may be exposed to some of the hazardous compounds of WUI smoke such as volatile organic compounds (VOCs), flame retardants, and polycyclic aromatic hydrocarbons (PAHs). However, wildland firefighters do not have the benefit of wearing some of the personal protective equipment (PPE) typically used in a structural response (e.g., self-contained breathing apparatus [SCBA], turnout gear) that could provide protection from these compounds. Additionally, wildland firefighters may be exposed to smoke at firefighting base camps (incident command posts) where they eat and rest while off-duty.

What Do We Know About the Health of Wildland Firefighters?

Cardiovascular and Lung Health

In the past decade, several studies have linked exposure to wildfire smoke to short-term health effects, such as increases in inflammation and respiratory effects, for example, lung function decline.[i] However, these studies have only examined the health effects across a few shifts or a single fire season. It is not clear if these adverse health effects continue after fire season and whether they worsen after several seasons of fighting fires. Researchers suspect that exposure to particulate matter and other contaminants from wildfire smoke, heavy physical exertion, existing health and behavior risk factors, and cardiovascular strain could contribute to sudden cardiac events for wildland firefighters. Recent research indicated that wildland firefighters may be at an increased risk of mortality from cardiovascular disease and lung cancer than the general public from career exposure to wildfire smoke.[ii]

COVID-19

The strenuous work, long work shifts, close living and working conditions, limited access to hygiene supplies, and a workforce that responds to incidents all over the country on short notice to wildland fire incidents may be conducive for the transmission of infectious diseases, including SARS-CoV-2. Exposure to air pollutants in wildfire smoke can irritate the lungs, cause inflammation, alter immune function, and increase susceptibility to respiratory infections, possibly including COVID-19.[iii] In addition to potentially making firefighters more vulnerable to getting COVID-19, inflammation in the respiratory tract due to wildfire smoke might also increase the risk of developing more severe outcomes for those with COVID-19.[iv] Wildland firefighters should implement the recommendations described in the CDC’s FAQ for Wildland Firefighters to prevent infection and spread of COVID-19.

Heat-Related Illness and Rhabdomyolysis

Due to the nature of their work, firefighters are at risk of developing severe heat-related illness (such as heat stroke) and rhabdomyolysis (muscle breakdown).[v],[vi] Delays in diagnosis and initiating treatment of these illnesses increase the risk of permanent muscle damage. Since 2010, 62 cases of severe rhabdomyolysis among wildland firefighters have been reported to a passive surveillance system designed to capture fatalities and certain types of injuries and illnesses including rhabdomyolysis. The actual number of cases is likely higher due to underreporting and inconsistencies in reporting requirements and systems. Prior to 2010, no cases were reported.

Hearing

Wildland firefighters work around power tools and heavy equipment that produce noise levels that are hazardous to hearing. In addition to hearing loss, noise exposure may also cause tinnitus (ringing/buzzing in ears), increased heart rate, fatigue, and interfere with verbal communication. Researchers from NIOSH and the United States Forest Service (USFS) evaluated personal noise measurements on 156 wildland firefighters conducting various training and fire suppression tasks, and reported that 85 of the 174 measurements were above the NIOSH maximum allowable daily dose[vii]. A follow-up study showed use of hearing protection was mixed; while almost all the wildland firefighters were aware of the noise in their environment and potential risk, very few were enrolled in hearing conservation programs.

What Are NIOSH Researchers Doing to Better Understand Exposures and Health Effects?

NIOSH is currently conducting research to understand the exposures and health effects of firefighters suppressing wildland and WUI fires. NIOSH researchers and collaborators at the US Forest Service and Department of the Interior have finished the second year of a multi-year study investigating exposures and health effects among six federal 20-person firefighting crews. The primary goal of this study is to measure exposures in the wildland fire environment and examine associations between those exposures and changes in lung, cardiac, kidney, and hearing function during each fire season and the off season over multiple fire seasons. This study has been paused in 2020 due to COVID-19 but is expected to resume.

To understand exposures and health effects faced by WUI firefighters, NIOSH is working with researchers from the University of Arizona and University of Miami to expand an existing collaborative research study (the Fire Fighter Cancer Cohort Study) to collect data regarding exposures from WUI fire incidents during the 2019 and 2020 fire seasons. Characterizing the types of chemicals, as well as the routes and levels of exposures, will help us understand health risks for wildland firefighters.

NIOSH is also in the process of developing a study assessing self-reported exposures to wildfire smoke and COVID-19 health outcomes among wildland firefighters. Additional information about this research will be available soon on the NIOSH Fighting Wildfires Page.

 

Authors of this article:

LCDR Corey Butler,MS REHS, is a Lieutenant Commander with the United States Public Health Service and an Occupational Safety and Health Specialist in the NIOSH Western States Division.

CAPT Christa Hale,DVM, MPH, DACVPM (Epi), is a Captain with the United States Public Health Service and Senior Epidemiologist and Veterinarian in the NIOSH Western States Division.

Kathleen Navarro, PhD, MPH is an Associate Service Fellow with the Division of Field Studies and Engineering.

Elizabeth Dalsey, M.A., is a Health Communication Specialist in the Western States Division.

CAPT Chucri (Chuck) A. Kardous, MS, PE, is a Captain with the United States Public Health Service and a research engineer with the NIOSH Division of Field Studies and Engineering.

Pamela S. Graydon, MS, COHC, is an Electronics Engineer working in hearing loss prevention in the NIOSH Division of Field Studies and Engineering. 

CAPT David C. Byrne, Ph.D., CCC-A, is a Captain with the United States Public Health Service and a research audiologist with the NIOSH Division of Field Studies and Engineering.

References

[i] Adetona O, Reinhard T, Domitrovich J, Boryles G, Adetona A, Kleinman M, Ottma R, Naher L [2016]. Review of the health effects of wildland fire smoke on wildland firefighters and the public. lnhal Toxicol 28(3): 95-139. Available from: https://pubmed.ncbi.nlm.nih.gov/26915822/

[ii] Navarro K, Kleinman M, Mackay C, Reinhardt T, Balmes J, Broyles G, Ottmar R, Naher L, Domitrovich J [2019]. Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality. Environ Res 173:462-468. Available from:https://www.sciencedirect.com/science/article/pii/S001393511930194X

[iii] Reid CE, Maestas MM. Wildfire smoke exposure under climate change: impact on respiratory health of affected communities. Curr Opin Pulm Med 2019;25:179–187.

[iv] Moore JB, June CH. Cytokine release syndrome in severe COVID-19Science 2020;368:473.

[v] West MR, Costello S, Sol JA, Domitrovich JW [2020]. Risk for heat-related illness among wildland firefighters: job tasks and core body temperature change. Occup Environ Med77(7):433-438. Available from: https://pubmed.ncbi.nlm.nih.gov/31996475/

[vi] NIOSH [2012]. Report of a NIOSH health hazard evaluation, HHE 2011–0035. By Eisenberg J and McFadden J. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Unpublished.

[vii] Broyles G, Butler C, Kardous C [2017]. Noise exposure among federal wildland fire fighters. J Acoust Soc Am 141(2) EL177. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975217/

Smoke cloud from Australia’s wildfires was three times larger than anything previously recorded

Smoke from the summer of 2019-2020 blocked sunlight from reaching Earth to an extent never before recorded from wildfires

SAOD perturbationResearchers with the University of Saskatchewan’s Institute of Space and Atmospheric Studies are part of a global team that has found that the smoke cloud pushed into the stratosphere by last winter’s Australian wildfires was three times larger than anything previously recorded.

The cloud, which measured 1,000 kilometers across, remained intact for three months, travelled 66,000 kilometers, and soared to a height of 35 kilometers above Earth. The findings were published in Communications Earth & Environment, part of the prestigious Nature family of research journals.

“When I saw the satellite measurement of the smoke plume at 35 kilometers, it was jaw dropping. I never would have expected that,” said Adam Bourassa, professor of physics and engineering physics, who led the USask group which played a key role in analyzing NASA satellite data.

Prior to Australia’s “Black Summer,” which burned 5.8 million hectares of forest in the southeast part of that continent, the smoke cloud caused by the 2017 forest fires in Western Canada was the largest on record.

The international team was led by Sergey Khaykin from LATMOS (Laboratoire Atmosphères, Milieux, Observations Spatiales) in France. Bourassa said the team’s findings provide critical information for understanding how wildfires are impacting the Earth’s atmosphere.

“We’re seeing records broken in terms of the impact on the atmosphere from these fires,” said Bourassa. “Knowing that they’re likely to strike more frequently and with more intensity due to climate change, we could end up with a pretty dramatically changed atmosphere.” Bourassa, his post-doctoral student Landon Rieger, and research engineer Daniel Zawada were the only Canadians involved in the project. Bourassa’s group has expertise in a specific type of satellite measurement that is very sensitive to smoke in the upper atmosphere. Their contributions were funded in part by the Canadian Space Agency. According to Bourassa, wildfires such as those in Australia and Western Canada get big enough and hot enough that they generate their own thunderstorms, called Pyrocumulonimbus. These, in turn, create powerful updrafts that push smoke and the surrounding air up past the altitudes where jets fly, into the upper part of the atmosphere called the stratosphere.

“What was also really amazing was that as the smoke sits in the atmosphere, it starts to absorb sunlight and so it starts to heat up,” said Bourassa. “And then, because it’s getting hotter, it starts to rise in a swirling vortex ‘bubble’, and it just rose and rose higher and higher through the atmosphere.”

Information collected by satellite, using an instrument called a spectrometer, showed smoke from the Australian wildfires blocked sunlight from reaching Earth to an extent never before recorded from wildfires.

The measurement technique, proven by Canadian scientists including Bourassa over a decade ago, measures the sunlight scattered from the atmosphere back to the satellite, generating a detailed, image of layers in the atmosphere.

The stratosphere is typically a “pretty pristine, naturally clean, stable part of atmosphere,” Bourassa said. However, when aerosols–such as smoke from wildfires or sulphuric acid from a volcanic eruption–are forced up into the stratosphere, they can remain aloft for many months, blocking sunlight from passing through, which in turns changes the balance of the climate system.

While researchers have a general understanding of how these smoke clouds form and why they rise high into the stratosphere, Bourassa said more work needs to be done to understand the underlying mechanisms.

Researchers will also be comparing their findings from Australian wildfires with satellite data captured from California wildfires this past summer and fall.

(From the University of Saskatchewan)