A Coast Ablaze Part II: Health Effects of California Wildfires

Written by: Justin Perry '23
Edited by: Nina Mehta '22

Image: Wildfires and Public Health: A View from the Front Lines [Internet]. US Climate and Health Alliance. 2016 [cited 2020 Nov 1]. Available from: https://usclimateandhealthalliance.org/wildfires-public-health-view-front-lines/

Given that the federal government and the California state government do not have enough funds to prevent forest fires, are they perhaps failing to grasp the full scope of the impact of wildfires? Indeed, the one area that has been conspicuously absent in the debate about climate change and wildfires is the impact of wildfires on human health, which could perhaps be more costly, in both money and in lives, than addressing the fires themselves. According to a groundbreaking review of healthcare costs from 2005-2015, the inhalation of PM2.5, or extremely fine, smoke particles from fires in the Western United States costs, on average, $165 million annually. Temporarily, the various fires have led to the worst air quality in the world in Portland, Seattle, and San Francisco. This will likely contribute to serious health costs and health consequences for those suffering from respiratory distress. Given that the wildfire smoke reached the East Coast, these consequences could be much more widespread than in prior years.(1) Considering that the impact of wildfires in the Western U.S. has markedly increased as previously discussed, one can only expect such costs to increase.         ​

The effects of wildfires on human health are not only about money, as the inhalation of fine particles can lead to negative health outcomes among vulnerable populations, especially children, the elderly, and the socioeconomically disadvantaged. For instance, an observational study of emergency presentations among Medi-Cal patients found an increase in diagnoses of respiratory illnesses, especially asthma, during and after the 2007 San Diego wildfires in areas where people were exposed to fine particulate matter. The discovery of a 72% increase in outpatient visits for acute bronchitis and a 243% increase in asthma diagnoses among infants of ages 0-1years were particularly concerning. In addition, a study analyzing hospital admissions in Beijing, China from January 2010 to June 2012 revealed “significant exposure response association between PM2.5 and the number of hospitalizations for [congestive heart failure].” The onset of congestive heart failure is particularly concerning among elderly patients because they “have a high incidence of sudden cardiac death that is attributed to ventricular arrhythmias,” or abnormal heartbeats.(2) Unfortunately, the subpopulations of individuals over 65 years of age who appear to be more vulnerable to the health risks from wildfire smoke exposure include women, African Americans, individuals in poverty, and people without a bachelor’s degree.(3) It appears that like with many other societal ills, the health effects of wildfire smoke inhalation are impacting the most vulnerable among us.

The deleterious impact of wildfires may not just be limited to physical, biological health; wildfires might also directly and indirectly impact mental health. In a recent review of the literature on the subject, Massimiliano Buoli and his colleagues noted that several studies have demonstrated an association between fine particulate exposure and symptoms of depression.(4) While the notion that air pollution might alter the central nervous system in a way that leads to symptoms of mental illness is intriguing, the authors of the review paper conceded that much more research must be conducted in order to verify such claims. However, a more tangible impact of wildfires on mental health arises from the emotional strain of losing one’s possessions, perhaps even one’s livelihood or, even worse, one’s loved ones.

It is clear that California wildfires will not be disappearing anytime soon and that such fires are causing significant health impacts. What isn’t clear is how, or whether, the government will respond to this crisis. Unfortunately, it appears that there is a certain disconnect between politicians, scientists, and the populace that has resulted in a lack of understanding of different priorities and needs. Why would a coal miner in West Virginia, for instance, whose only means of providing for his family is digging coal from mines that will eventually produce carbon dioxide, care about how his work could, through a series of downstream effects, cause wildfires in California? Addressing California wildfires is not a question of science or of policy per se. It is a question of perception and of persuasion. 

For far too long, some might argue, climate scientists have had a monopoly on any discussion on climate change. This makes sense, as they are the experts in their field, and the fact that some politicians have given climate scientists the proverbial floor is a testament to the importance of climate science. However, it appears that climate scientists and politicians might be attempting to do the impossible—to convince many Americans who might lack a scientific background or do not believe that humankind could have such profound effects on climate to believe that the gas they put in their cars is, in a sense, lighting forests on fire. The arguably better approach, one could argue, is to make the issue of human-caused wildfires as approachable, relatable, and concrete as possible. Instead of utilizing complex climate projections about atmospheric warming, glacial melting, and sea level rise (which are all valid in their own right), focus on grandma and the baby. Focus on grandma and the baby who might wake up tomorrow, next month, next year, to a room filled with a smoky haze, coughing and gasping for air as they attempt to breathe. Focus on grandma and the baby who might end up in the emergency room, being treated for asthma, bronchitis, or congestive heart failure, hooked up to a ventilator and fighting for their lives.
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​Works Cited:

1.     Baker M. Some of the Planet’s Most Polluted Skies Are Now Over the West Coast. The New York Times [Internet]. 2020 Sep 18 [cited 2020 Oct 10]; Available from: https://www.nytimes.com/2020/09/15/us/fires-california-oregon-washington-west.html

2.     Bigger JT. Why patients with congestive heart failure die: arrhythmias and sudden cardiac death. Circulation. 1987 May;75(5 Pt 2):IV28-35.

3.     Liu JC, Wilson A, Mickley LJ, Ebisu K, Sulprizio MP, Wang Y, et al. Who Among the Elderly Is Most Vulnerable to Exposure to and Health Risks of Fine Particulate Matter From Wildfire Smoke? Am J Epidemiol. 2017 Sep 15;186(6):730–5.
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4.     Buoli M, Grassi S, Caldiroli A, Carnevali GS, Mucci F, Iodice S, et al. Is there a link between air pollution and mental disorders? Environ Int. 2018 Sep 1;118:154–68.