And fires like the ones raging
in Indonesia can cross mountains and oceans, spreading lung-clogging
particles and toxic chemicals.

Dr. Praveen Buddiga knew he would find a
packed waiting room when he arrived at his office that warm September
day in California’s Central Valley. White flakes drifted from the sky,
as if he were inside a snow globe.
The Rough Fire,
a 152,000-acre blaze sparked by lightning in the Sequoia National
Forest, was lofting thick smoke, soot, and ash into the air—and into the
lungs of Buddiga’s patients 35 miles away, in Fresno.
As an allergist, Buddiga knows that wildfires pose a serious,
sometimes lethal, threat to people’s health, particularly for those with
asthma or heart disease.
“Older [patients] made the universal choking sign—you know, hands
around the throat,” Buddiga says. “Younger ones just pointed to their
chests. The Rough Fire was devastating for us.”
The emissions from wildfire smoke have tremendous public health implications.
Around the world, billions of people are finding that the air carries
a dangerous dose of smoke as wildfires become bigger and more intense.
“We see these trends, and the emissions from wildfire smoke have
tremendous public health implications,” says Dr. Wayne Cascio, head of
environmental public health at the Environmental Protection Agency’s
National Health and Environmental Effects Research Laboratory in North
Carolina.

Satellite images confirm that smoke can cross mountain ranges,
continents, and oceans. Fires 250 miles away have triggered 911 calls in
Albuquerque. Quebec blazes have sent plumes 800 miles to make New
Yorkers wheeze.
The eyes of Texans have been reddened by Honduran farmers’ burning
1,500 miles to the south. And North American smoke has traveled 5,000
miles to twitch nostrils in Eastern Europe. Some, such as Indonesia’s
fires, have plumes of smoke so huge they obliterate entire countries in
photographs shot from outer space.
Smoke’s Hidden Dangers
Fires can smolder for months, and layers of stagnant air known as
inversions, common in the western U.S., can hold smoke down where people
breathe. On some days, the health threat can far exceed the air
pollutant levels that federal standards allow.

New evidence is emerging that the heart is vulnerable to damage inflicted by smoke.
EPA researchers found
that emergency-room visits for heart failure jumped 37 percent
following the smokiest days of a big 2008 peat fire in eastern North
Carolina. ER trips for breathing problems rose by 66 percent. Poor
people faced the most risk, even with access to medical care, EPA
statistician Ana Rappold says.
The challenge is in front of us. We know that these ecosystems will burn.
And in 2015, Dr. Anjali Haikerwal of Australia’s Monash University reported
a 7 percent increase in out-of-hospital cases of cardiac arrest when
bushfire smoke blanketed greater Melbourne in 2006-07. “Now we have
very, very strong evidence,” she says.
Babies in the womb also are at risk. During Southern California’s
2003 fires, babies weighed on average 0.2 ounces less at birth than
those born just before the fires, a 2012 study
found. Those exposed in the second trimester had the biggest deficit,
just over one-third ounce. The differences might not matter much in the
long run, but they add to evidence that smoke affects health.

Reasons for the trend toward bigger and more damaging fires vary, but
the shifting relationship between people and the planet is a primary
culprit. People are moving into cities’ wilder, fire-prone edges,
particularly in California, Texas, and Florida. Especially in the West,
decades-long suppression of blazes has set the conditions for today’s
raging fires. Globally, while fire is an age-old farming tool, burning
to clear cropland has reached an industrial scale; in East Asia, forests
are being burned down to transform them into palm-oil plantations.
Climate change also is worsening exposure to wildfire smoke. In 2011, the National Research Council estimated
that for each 1.8 degree F. (1 degree C) rise in global temperature,
the number of acres burned in the western U.S. could increase by 200 to
400 percent.
One-fourth of the Earth’s vegetated surface is seeing much longer fire seasons, according to
U.S. Forest Service scientists. “If these fire weather changes are
coupled with ignition sources and available fuel,” the researchers
wrote, “they could markedly impact global ecosystems, societies,
economies and climate.”
So what can people and society do? Unfortunately, choices are limited
-- “you cannot block smoke with some enormous filter in the sky,” says
Klaus Moeltner, a Virginia Tech economist who has studied wildfire
costs. Nevertheless, limiting smoke exposure could become a goal of
firefighting strategies. “Upwind of a big populated area might be a good
place to start,” Moeltner says.
Also, setting small, controlled blazes would eliminate the vegetation that fuels huge fires.
“The challenge is in front of us,” says Pete Lahm, smoke manager at
the U.S. Forest Service. “We know that these ecosystems will burn.”
But that approach presents problems. Many state and local air-quality
rules limit when prescribed fires are allowed, and fire guidelines
generally forbid burning when smoke might reach neighborhoods.
For those in the smoke, experts advise people to stay inside with
windows shut and air conditioners and air filters on. And don’t work out
when the world seems like a giant campfire.
“You might not want to ride your bike or go running,” says Samet, “when you can smell the air.”
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