Wildfires, air quality and our health

California’s current wildfires have been both record-breaking and deadly. While San Diego hasn’t felt the impact as significantly as Northern California, wildfire season is upon us, threatening the quality of our air.

Dr. Amy Zheng, an urgent care doctor at Sharp Rees-Stealy Downtown, has seen firsthand the health problems these fires have caused. “There’s definitely been an uptick in urgent care visits related to San Diego’s air quality,” she says. “People with sinus and respiratory problems seem to be paying a significant price.”

We asked Dr. Zheng to share important information about fires, air quality and health — from how to stay safe to how this affects our “new normal” due to COVID-19.

How do San Diego’s wildfires affect our health?
There are more particles in the air, such as ash and soot. While the hairs in our nose generally filter the larger particles, the smaller ones can get inside our lungs. These particles can also irritate our eyes, so you may find your eyes feel gritty with a burning sensation. Those with respiratory problems will be more likely to notice symptoms first, although poor air quality can affect anyone.

Who is at risk for escalated health problems?
For those with nasal problems — such as sinusitis, allergies or respiratory diseases like asthma or COPD — poor air quality can take its toll. People with heart disease may be affected because the heart and lungs are closely connected, and the smallest change in the oxygen level in the blood can affect how hard the heart has to work. Young children and seniors are also particularly vulnerable.

How can we protect ourselves from smoke-related health issues?
The best thing to do is proactively check the air quality index before leaving the house. The website for San Diego's Air Pollution Control District lets you search by ZIP code and will indicate where the air quality in your area falls on a scale from “good” to “hazardous.” If the scale is orange, people in the sensitive group should stay inside. If it is red, everyone should stay inside.

With an air quality index of “high,” keep your windows and doors closed, and use an indoor air purifier with a HEPA filter, if available. (Make sure you change the filter regularly as air purifiers can spread allergens if not cleaned properly.) And of course, be smart about fire prevention during these times, such as limiting indoor frying and steering clear of camping and campfires.

Is it safe to exercise outdoors when the air quality is bad?
Again, it depends on where you are on the index. If the index is red, stay indoors. If it’s orange, people in sensitive groups should not be exercising outdoors, but it’s probably OK for everyone else. However, there are so many exercises you can do online that it’s easy to get your workout in without compromising your health.

For someone feeling the effects of bad air quality, when should they seek medical attention?
For anyone experiencing fever, wheezing, difficulty breathing, heart palpitations or chest pain, seek help immediately. Also, seek help if you experience sinus symptoms that do not resolve after a week. The tricky thing about breathing polluted air is that it’s hard to know if your symptoms are related to air quality or to something else. A high air quality index will often cause a recurring pattern of nasal congestion, burning eyes or breathing difficulties.

Are there long-term effects associated with bad air quality?
Yes, long-term effects are well-documented in places such as China. Bad air quality can cause chronic issues such as bronchitis and asthma. There is also evidence that poor air quality is a contributing factor to lung cancer.

What are the health concerns associated with a drop in air quality during the COVID-19 pandemic?
The biggest concern is how we react to these things. With high indexes, more people are staying indoors, which, in theory, is ideal in a time when we are committed to stopping the spread of COVID-19. However, this could inspire people to move bigger gatherings from outside in, creating a potentially dangerous environment for passing on the virus.

The masks we wear to stop the spread of COVID-19 are also creating a false sense of security in terms of protection from poor air quality. Many of the particles caused by wildfires are so small that most masks are not designed to handle them. Masks may offer some protection if made of tightly woven fabric, preferably in multiple layers. A good test is to hold your mask up to the light. The less light you can see through it, the more effective it is.

How is the medical community addressing the growing frequency of wildfire-related health issues?
Climate change has caused California to have record-breaking heat waves and, as a result, increased fire dangers. Every year we see hotter days and more extreme fires. In response, the medical community has established a new branch of medicine called climate medicine, which focuses on how climate change affects our health and well-being. Unfortunately, this is not an issue that will be going away.