With the Bootleg Fire decreasing and 98% of its perimeter contained as of Aug. 9, Gabriela Goldfarb, Environmental Public Health Section manager at the Oregon Health Authority (OHA), reflected on the health impacts of wildfires on Oregonians, the disparities found in treatment of smoke inhalation, and OHA action to address respiratory health concerns.
The Bootleg Fire is the third largest wildfire and second largest forest in Oregon since 1900, according to Oregon Public Broadcasting. The fire displaced over 2,000 people and was the nation’s biggest wildfire in late July with over 400,000 acres burned. As of August 9, the estimated containment date is Oct. 1, 2021.
Goldfarb says eastern Oregon residents, Idaho, and Montana were mainly affected by the fire’s smoke. Now, many fires from Northern California, especially the Dixie Fire, are affecting communities in southern Oregon.
Goldfarb is concerned about the adverse health impacts of populations that are especially vulnerable including those with chronic diseases, respiratory diseases, pregnant women, young children, the elderly, and outdoor workers.
Oregon is seeing approximately a 20% increase in emergency department (ED) visits related to respiratory issues and requests for respiratory medications, according to Goldfarb.
“We are seeing things like an uptick in respiratory medications in counties all across the state. There’s lots of different places where we are seeing increasing trends [of health issues], especially starting last week, with asthma-like illnesses.”
EDs are also seeing increased mental and behavioral health visits in areas affected by fires. However, Goldfarb says last year’s “Labor Day” fires saw more ED patients and worse health outcomes.
Goldfarb says smoke inhalation can increase the risk of respiratory infections and can worsen existing respiratory infections, which can exacerbate COVID.
“The two [COVID and smoke] can really be intermingled. For example, maybe people come in [to the hospital] for COVID complaints who were pushed over the edge by smoke inhalation or might not have suffered as severe of an infection if they weren’t exposed to smoke.”
The rise in smoke in Oregon has exposed many disparities around health outcomes and access to preventative measures. Goldfarb says lower income communities and historically marginalized communities are more likely to experience smoke inhalation due to lower quality housing susceptible to wildfire smoke permeation, less flexible employment to stay out of the smoke, more underlying health conditions, and less access to primary health care.
In Oregon, for example, Latinx individuals are seen around 30% more in hospital EDs for smoke-related issues than normal. That’s 10% more than the statewide average of increased hospitalizations.
Another barrier to underserved communities is access to necessary information like health alerts, messages, and resources. Goldfarb says these obstacles result from language and disability barriers. Unreceived messages can be from simple knowledge of precautionary steps to evacuation notices.
In response to this, Goldfarb says OHA is “ramping up” their investments in translation efforts and is working with localized public health and emergency response partners who act as trusted community-based organizations.
OHA also holds frequent statewide calls with local government and health officials on the recent developments of fire and smoke dangers and how it might affect their area. Many localized representatives participate including tribal leaders and community-based health care professionals from historically marginalized communities.
Goldfarb expects to see these problems every year. She says these health impacts of smoke coupled with another heat wave in the Pacific Northwest and other parts of the country will make operations and care more challenging. These are all effects of climate change, which were addressed in the recent report released by the Intergovernmental Panel on Climate Change earlier this week.
“This is the new normal going forward. Everything that the climate scientists said was going to happen is happening … This is something where we will need to continue to up our game on these intermingled health impacting climate events … For us, it’s not just a global pandemic but a global crisis of climate change. We are having to battle two global health crises at the same time.”
OHA’s Environmental Public Health section is continuing to work with the state government to improve worker protection standards and access to public health information.