Staying healthy during 'smoke season'

In recent years, the second half of summer in the Inland Northwest has become a fifth season - Smoke Season. When wildfires occur across the region, the smoke can result in dangerous air quality issues. Live Well asked Dr. Todd Hoopman, MD, who specializes in pulmonary and critical care with North Idaho Lung, Asthma and Critical Care, to talk wildfire season health issues.

LIVE WELL: What are some of the conditions you treat/see more of during forest fire and smoke season?

DR. TODD HOOPMAN: We see increased numbers of patients with chronic lung diseases, including COPD and asthma presenting with exacerbations of their condition. Typically these exacerbations consist of increased breathlessness, chest tightness, wheezing and reduced oxygen saturations.

LIVE WELL: Who is most at risk for complications when the air quality becomes an issue locally?

HOOPMAN: Any patient with a chronic lung disease is at risk for worsening control of their illness during the smoke/fire season, but the elderly are particularly more vulnerable. This can be especially true if they have other medical conditions that predispose them to illness, including concurrent heart disease, diabetes or obesity.

LIVE WELL: What are some of the symptoms specific to this kind of smoke inhalation that people should watch out for? What are things that can be treated at home, and what are some symptoms that require more medical attention?

HOOPMAN: The most common symptoms include breathlessness, chest tightness, wheezing and coughing. These symptoms often indicate a severe reaction to the smoke inhalation and require medical evaluation. Less severe reactions can include eye irritation, runny nose, and coughing when outside. Any patients with these early symptoms need to try their best to avoid the dangerous air conditions so that their underlying lung disease does not progress into an exacerbation.

LIVE WELL: What do you recommend people do if they must spend some time outdoors?

HOOPMAN: It is best to try and limit the amount of time outdoors, if possible. It is better to spend any necessary time outdoors early in the day before the air gets warmer and the sun is higher in the sky. Often the worse time for exposure is the end of the day.

LIVE WELL: When should people be concerned about inside exposure -- for example, they may smell the smoke in their home, but does that mean they are being directly exposed?

HOOPMAN: Small amounts of smoke and particulate matter will penetrate a home merely through doors opening and use of an air conditioner. Making sure proper sealing around doors and windows (i.e. consider smoke similar to the cold air entering a home in the winter… it serves as a reminder that the house is not protected from outside dangers).

See the sidebar on page (INSERT page number here) on more ways protect the inside of your home.

LIVE WELL: What are the medications/treatments that can ease the situation besides the typical medications people might have for their existing breathing issues?

HOOPMAN: Patients with chronic lung illnesses typically have a dedicated regimen of inhalers and medications they utilize to prevent their symptoms from worsening or their general condition from declining. There are not a lot of non-prescribed medications that can be used to combat the irritation experienced by people during smoke/fire season. Avoidance is the number one recommended treatment. Use of a dust mask is also recommended if prolonged periods of time must be spent outdoors.

LIVE WELL: Is there concern for people who have typically handled the smoke season okay but are suddenly experiencing new symptoms?

HOOPMAN: A sudden change for someone who has not struggled in the past is always a concern and typically warrants an evaluation by their doctor or a medical clinic. These new symptoms could reflect the development of lung issues related to the smoke or they could signal a different problem that needs to be separated from the smoke exposure. Regardless, evaluation is the safest way to make sure a change in symptoms does not become a life-threatening event.

LIVE WELL: Are there long-term risks to this kind of frequent, annual exposure to smoke, and what can be done to reduce those long term issues?

HOOPMAN: Long-term exposure does not necessarily cause the development of asthma or COPD, but it can create a situation in which patients at risk for these illnesses may develop symptoms at an earlier age or their symptoms may be more severe as a result of chronic and repeated exposure.

Again, avoidance is the key. If you smoke, quit. If you have a history of asthma be certain to utilize the proper controller medications to prevent lung inflammation and irritation. If the air quality is particularly poor create strategies to minimize your exposure.