Posted in fires, Health, news

Health Risks From Wildfire Smoke

As thousands of acres burn in Southern California, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon monoxide, which competes with oxygen in the blood
  • Carbon dioxide, a respiratory byproduct
  • Wood particles
  • Formaldehyde
  • Acrolein – used as a pesticide
  • Benzene
  • Plastics, and those byproducts after incineration
  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor,
carbon monoxide, particulate matter, hydrocarbons and other
organic chemicals, nitrogen oxides, trace minerals and several
thousand other compounds. The actual composition of smoke
depends on the fuel type, the temperature of the fire, and the
wind conditions. Different types of wood and vegetation are
composed of varying amounts of cellulose, lignin, tannins and
other polyphenolics, oils, fats, resins, waxes and starches, which
produce different compounds when burned.

What symptoms may individuals experience?

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Cough
  • Wheeze
  • Difficulty Breathing
  • Chest Pain
  • Mucous Production
  • Dizziness/lightheadedness
  • Fatigue
  • Racing Heart (palpitations)
  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
  • Increased susceptibility to new lung infections as well as flu


What are PM2.5s?

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the blood stream. Although the direct health impacts of the fine particulate matter are not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.



Symptoms may begin at levels greater than 55 µg/m.

Which individuals are the most at risk?

  • Infants and Children
  • Elderly individuals
  • Those with chronic lung disease, including asthma and emphysema
  • Those at risk for heart disease and stroke
  • Those with diabetes
  • Smokers
  • Pregnant women
  • Those with chronic allergies
  • Pets


How can residents protect themselves?

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.
  • Take heed of wind and air quality advisories.
  • Recirculate the air in your home and car.
  • Keep windows closed.
  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

    Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.


Posted in 4th of July, fires, fireworks, Health, news

Avoiding Firework Injuries this Independence Day

The most sparkly and spectacular holiday of the year is unfortunately one of the most dangerous when it comes to fireworks.  As more Americans shoot off fireworks themselves, injuries are rising exponentially.  Let’s break this down.


When were fireworks first invented?

Many historians believe fireworks have their origins dating back to 200 BC in China.

According to, They would roast bamboo, which explodes with a bang when heated due to its hollow air pockets, in order to ward off evil spirits. At some point between 600 and 900 A.D., Chinese alchemists—perhaps hoping to discover an elixir for immortality—mixed together saltpeter (potassium nitrate, then a common kitchen seasoning), charcoal, sulfur and other ingredients, unwittingly yielding an early form of gunpowder. The Chinese began stuffing the volatile substance into bamboo shoots that were then thrown into the fire to produce a loud blast. The first fireworks were born.


When were fireworks first used to celebrate Independence Day?

On July 3, 1776, John Adams penned a letter to his wife suggesting fireworks, “illuminations” be used to celebrate the upcoming Independence Day (the next day the Continental Congress adopted the Declaration of Independence).  The following year, fireworks were used in Philadelphia’s celebration of Independence Day along with a parade.


What types of fireworks are legal/illegal?

Currently, Massachusetts is the only state that bans any individual from owning or setting off fireworks.  As for the other states, laws vary.  For most states, party poppers, smokers, hand-held sparklers, wheel and ground spinners and those approved by the CPSC (Consumer Products Safety Commission) are approved.  Illegal fireworks most commonly include rockets, Roman Candles, wire and wooden sparklers, projectile fireworks, those using  arsenic, phosphorus, thiocyanates, and gunpowder.

Each state’s laws can be viewed here.


How many people get injured each year during Fourth of July?

Statistics vary but according to the National Fire Protection Association (NFPA) :

  • Fireworks start an average of 18,500 fires per year, including 1,300 structure fires, 300 vehicle fires, and 16,900 outside and other fires. These fires caused an average of three deaths, 40 civilian injuries, and an average of $43 million in direct property damage.
  • In 2017, U.S. hospital emergency rooms treated an estimated 12,900 people for fireworks related injuries; 54% of those injuries were to the extremities and 36% were to the head. Children younger than 15 years of age accounted for more than one-third (36%) of the estimated 2017 injuries.


Which fireworks appear to be the most dangerous?

Many fireworks range in potential for injury, and fire hazards appear to be the most worrisome. However, sparklers appear to be the culprit in the majority of cases sending kids and adults to the emergency room.


What types of injuries can be incurred from fireworks?

Keep in mind some sparklers can reach up to 2000 degrees.  Not only is direct contact with fireworks dangerous but secondary injuries may occur trying to avoid the firework.  These include:

  • Burns
  • Eye injuries
  • Facial injuries
  • Hearing Loss
  • Lacerations
  • Broken Bones
  • Sprains
  • Car accidents

Burns comprise the majority of injuries, however many other tragic ones can occur.  One of my in-laws was a bystander when he lost his cornea (outer layer of the eye) from a popper that jumped towards his face, blinding him.



How can we protect ourselves from firework injuries?

  • Avoid purchasing and using illegal fireworks.
  • Do not allow young children to handle the fireworks.
  • Use neighborhood areas that are not in the flow of traffic.
  • Have buckets of water and fire extinguishers nearby.
  • Have bystanders back up and remember that they can be in the line of danger as those handling the fireworks.
  • Never relight a firework.
  • Dispose of fireworks only after thoroughly doused with water by a bucket or hose.
  • Don’t carry fireworks in pockets.
  • Don’t shoot fireworks out of metal or glass casings.
  • Opt for watching professional fireworks shows.  They are true fireworks, created by pros, and much more spectacular and beautiful than what we can do on our own.

Happy 4th of July!!





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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.