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Health

The Air Out There: A Pulmonary Expert Talks Risk As Smoke Returns To The Front Range

Williams Fork Fire
Kari Greer
The sun sets through smoky air above the southern leading edge of the fire in the Williams Fork drainage on Aug. 27.

The air along the Front Range may be much clearer at the moment than it was at this point last week, but fires continue to burn across our area, including the Cameron Peak Fire in Larimer County. State officials are now warning that air quality could get worse again in time for Labor Day, as shifting weather patterns bring in smoke from California wildfires.

Dr. Fernando Holguin, professor of medicine specializing in pulmonary sciences at University of Colorado Anschutz, joined Colorado Edition to discuss the impact that wildfire smoke can have on our lungs.

Interview Highlights:
These interview highlights have been lightly edited for length and clarity.

Erin O’Toole: It seems pretty obvious the smoke that we have been seeing in the air is bad for the lungs. But can you talk us through what the threat is?

Dr. Fernando Holguin: What you're seeing in the air — that haze that happens when the fires are burning, or when there's a lot of pollution — that’s usually a combination of gases and pollutants like small particulates. Those particles are actually very dangerous because they have capacity to get deep inside your lungs and cause a lot of inflammation and damage.

These particulates and this ozone — what do they do when they enter our lungs? Or even get into our blood streams.

The particles that we're talking about are fine particles, that means that these particles are typically under 2.5 microns of diameter — much, much, much smaller than even a hair. When the particulate matter reaches deep inside your lungs, it generates inflammation and activates immune cells. These immune cells will try to get rid of them. And in doing so they can generate other substances that could have side effects for you.

The efficiency of the particles is they can get through the lungs into the capillaries in the bloodstream. And, not surprisingly, they can cause cardiovascular disease. This is why when forest fires and air pollution levels are very high, we tend to see a spike in the number of cases of people having strokes or myocardial infarction. Some of those may be related to particulate matter from fires as well.

How can we gauge our personal risk? I’m thinking specifically of people going outside to exercise — especially right now, because people still are not going to the gym because of the pandemic. Are there best practices you can recommend for people to be able to exercise outside without damaging their lungs?

I recommend people look at the times of the day in which the concentrations tend to be a little bit lower. And that's probably the best time to exercise if you can, particularly if you don't have any lung disease. Now, if you're someone who has asthma, heart failure or any chronic cardiovascular disease, my recommendations during these times when pollution is bad is to really exercise indoors, if at all possible.

"If you're someone who has asthma, heart failure or any chronic cardiovascular disease, my recommendations during these times when pollution is bad is to really exercise indoors, if at all possible."
Dr. Fernando Holguin

Have hospitals been seeing an uptick in people coming in with respiratory illness that's exacerbated by the wildfires?

I run a severe asthma program and I can tell you from our own cohort of patients that we follow here at the University of Colorado, we are seeing patients come into the clinic and the urgent care centers a lot more frequently. It's something you may not be aware of at the time that it's happening. But when you look at your data, your rate of admissions over time, you always see the spikes during the forest fires.

Is there anything we can do to protect ourselves? I assume the masks we’re already wearing to prevent the spread of COVID-19 are not really doing much to keep out these tiny particles that you've been talking about.

So these particles are very, very small and most masks are not very efficient in taking care of the particles very much. The only well-known way to protect yourself is to be indoors, in a place that's well sealed. Typically that's air conditioned. Those places tend to have the lowest levels of particulates. If your house windows are open or your house is not very well sealed — an old house for example — particles may still get in and reach high levels inside.

I'm wondering if doctors such as yourself and hospitals are concerned about increased respiratory risk with COVID-19 overlapping with the wildfire, smoke and pollutant risk?

The two of them may be connected. There are some studies that are looking into higher rates of disease from COVID-19 in areas where pollution is higher. Inflammation due to pollutants may even increase the number of receptors the virus uses to get into our system. So, there could be some intricate relationship between both conditions.

Breathing in high concentrations of pollutants as in from smoke could make people more susceptible to COVID-19?

More susceptible and more likely to develop severe disease. Now again, this is mostly theoretical, but it certainly is a possibility.

But, the forest fires will end, the air quality will get better. Most of the health effects that are being experienced now from people breathing this air will end. Your body has a tremendous ability to overcome and fight it and get you back into a good place. So, we will get over this and we'll get over the pandemic, as well.

This conversation is part of KUNC’s Colorado Edition for Sept. 2. You can find the full episode here.

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