Image: In November 2018, the Woolsey Fire destroyed parts of Los Angeles and Ventura counties, California, United States. Credited to Getty Images and Salameh Dibaei.

Since Jan. 7, wildfires have burned 40,000 acres in the Greater Los Angeles area and destroyed more than 12,000 structures. At least 25 people have lost their lives. Authorities in Los Angeles County declared a local health emergency. Recommendations for residents include using air conditioners that recirculate air and wearing an N95 or P100 filtering facepiece respirator when outside in smoky conditions for long periods of time.

This week, AIHA’s chief science officer, Michele Twilley, DrPH, CIH, spoke with Michelle Rosales, MPH, CIH, about her experiences during the wildfires. Rosales is a resident of Southern California and a director of environmental health services with Forensic Analytical Consulting Services. She has contributed articles and presentations on indoor environmental quality concerns from wildfire smoke, among other topics, and is a primary author of AIHA’s Technical Guide for Wildfire Impact Assessments for the OEHS Professional. She was also previously featured in an AIHA video about the potential exposures to workers and community members in the aftermath of wildfires.

The following transcript of Twilley’s conversation with Rosales has been edited for length and clarity.

Michele Twilley (MT): Michelle, thank you for taking the time to talk to me about the wildfires in Los Angeles and how AIHA can help either professionals responding to the fires or community members affected by them. Could you start by sharing where you are and how you're impacted?

Michelle Rosales (MR): I'm currently in Southern California, and I’ve got at least four or five fires within a 15–20-mile radius from my house. I've been living in Southern California for the last 25 years, so I've been impacted by a series of major wildfire events, in addition to performing industrial hygiene work with wildfires since 2008. I thought I had seen it all until now. This is unprecedented, just by the number of fires and the scale of impact to this area.

There are two different avenues that we think about as industrial hygienists with regard to wildfire impact: the occupational side, and the community aspect.

When we talk about occupational exposures, there are currently three states in the United States with wildfire regulations for workers: California, Oregon, and Washington. The regulations were established to protect outdoor workers from wildfire smoke as well as indoor workers with no mechanical ventilation system. Most people think California’s regulation is the most stringent, but it’s probably the least stringent of the three states. Washington is now the most stringent regarding worker protection during wildfire events. I'll give a brief overview of what the regulations generally entail.

EPA has what we call the Air Quality Index, which tells you how good the air quality is based on carbon monoxide, ozone, nitrogen dioxide, sulfur dioxide, PM2.5, and PM10. For all three states, the wildfire standards look to AQI values associated with PM2.5 because we know that's the small particulate that can be inhaled and get down to the respiratory system and eventually the alveoli area.

What the standards tell you is that once you hit a certain AQI value for PM2.5, and the employer should reasonably anticipate that employees may be exposed to wildfire smoke, this triggers the employer to begin implementation of a series of controls. One is to provide and recommend the use of respiratory protection such as N95s. Second, the employer needs to communicate wildfire smoke hazards to employees, including worsening air quality, and employees need to be trained on the health effects associated with wildfire smoke along with a series of other topics. There also needs to be the implementation of controls. Obviously, if you're outdoors, engineering controls usually aren't going to be something to look at. The options are stopping work or relocation.

Each standard has a certain AQI value when respiratory protection is no longer encouraged but becomes required. Once it becomes required, the employer is now held to their applicable respiratory protection program.

For California, the standard applies when the AQI value reaches 151, which is considered the “unhealthy” air quality range. At this level, some members of the public may experience health effects, with more serious effects for sensitive populations. Oregon’s employer requirements begin at an AQI of 101 (“unhealthy for sensitive groups”), and Washington’s at an AQI of 69 (“moderate”).

California also has a guideline that talks about indoor workers and things that the employer and building owners can do to try to improve air quality during a wildfire event—for example, adjusting the setting for the HVAC system’s outdoor air intake, decreasing the exterior entries into building, and enhanced cleaning efforts. In addition, employers can have people work remotely, but sometimes working from home is not a great idea, particularly if you're living in an area where there are active wildfires. Sometimes the commercial building you work in, which typically has a highly engineered HVAC system, might be a cleaner environment than your home.

With regards to the general community, the air quality management districts and public health departments are generally the entities who provide the recommendations, which tend to be similar to some of the ones mentioned for occupational workers—for example, staying indoors and enhanced cleaning efforts.

It’s also important to talk about returning home. Even if your home didn’t get burned down, it doesn't mean it wasn't impacted by wildfires.

These wildfires are not just burned vegetation. Thousands of structures have burned. There's a lot of nasty stuff in the smoke and fire debris, which can eventually infiltrate people's communities and properties—things such as heavy metals, polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), carcinogens such as formaldehyde, and more.

We don't recommend anybody cleaning up large accumulations of debris themselves. The work should be done by a qualified contractor, cleaning company, or remediation contractor that knows how to properly clean.

MT: I'm sure the incident command structure is not allowing people back in right now, but what advice would you give someone who is returning to their home after the fire?

MR: I have seen news broadcasters in the field near burned structures touching surfaces and burned debris with their bare hands. We need to let the community know that this is not safe. Despite homeowners wanting to go back to their home to see if anything is salvageable, it's really important to know that it's not safe. There's potentially a lot of nasty stuff in that burned material. Potential exposures can occur through inhaling the debris, touching it, and then potentially ingesting it. Only those qualified to be out there should be out there. That qualified individual needs to be wearing the proper personal protective equipment to reduce their exposure.

In addition, there are other health and safety issues that should be anticipated, such as electrical issues, structural integrity, flammable gases, etc.

MT: What about latent health effects from the fires?

MR: I haven't seen research on potential exposures after the fire is over. Burned material just sitting there has the potential to off-gas, and wind can cause airborne particulate to move to other locations. There's not a lot of research on that side. In terms of during the fire, there is research about increases in asthma for children in areas prone to wildfires, sensitive populations, and cardiovascular issues.

MT: Is there anything else you would like to share?

MR: There's an emotional aspect even for those who did not necessarily have a home or property that burned down. There's an emotional, mental aspect of just being in the area. I am in the middle of this madness and could not sleep last night because I was worried about a potential evacuation. I woke up five times from five different alerts from my phone. They weren’t necessarily specific to my area, but you have to keep your phones on and ready. There is a constant awareness of the situation and anxiety about what's happening and potential issues. For example, do we have enough bottled water if the water becomes contaminated? I know there's contaminated water in the Pasadena area and in Pacific Palisades. They're not allowed to drink water at this time, brush their teeth or even shower with it.

MT: I keep thinking of the children in this. How do you explain it to a four- or five-year-old?

MR: I have a 16-year-old and a 14-year-old, and they are scared and worried. It's the uncertainty of what is going to happen. Last night they both woke up and came to my room because they too were getting alerts on their phones for evacuations. When we looked further into it, it was not for our area, but it freaks everybody out.

It's just really hard to explain to children of any age. My children wanted us to evacuate, but I told them everyone in the county cannot evacuate because that would clog up all of the freeways. Our roadways are not equipped to handle the whole county leaving at the same time.

So it's difficult for any age group, even adults. Making sure you have a gameplan for any emergency is very important. Do you have water? Do you have important documents? Do you know what you would take with you if you had to? Do you know where you would go if you had to, what route you would take? Emergency preparedness is important.

MT: This has definitely given me food for thought, even though I'm on the East Coast and we've had a foot and a half of snow. I started thinking, What would I do?

MR: You never think it’ll happen to you, even though, like I said, I'm in the center of the San Fernando Valley, and the closest fire is probably two to two-and-a-half miles away. It'd have to go through 100 houses before it got to me. But at the same time, you never know.

It's just been crazy, and it's now getting us to think that anything can happen, and the odd thing is that we're finding out this year, especially in California, that a lot of the insurance companies are refusing to insure people. For wildfire coverage, my sister-in-law just bought a $2 million home that's next to a mountain, and she told us today that she does not have wildfire insurance because nobody would insure her. And a lot of people are going through that right now.

MT: I do appreciate your time, and I really hope you and your family stay safe, and that this thing comes to an end soon.

MR: I appreciate that.

To donate to L.A. wildfire relief efforts, visit the website of the American Red Cross, select “Disaster Relief,” and then select “California Wildfires.”

Resources:

AIHA: Technical Guide for Wildfire Impact Assessments for the OEHS Professional (2018).

AIHA: Wildfire Safey Resources.

AirNow: Air Quality Index (AQI) Basics.