This year is turning out to be one of the worst on record when it comes to wildfires on the West Coast.

Hot, dry weather combined with high winds has led to the burning of more than 3.1 million acres in California, causing 20 reported deaths so far and destroying 3,900 structures, according to a report issued September 11 by the California Department of Forestry and Fire Protection.

Five of the 20 largest wildfires in the state’s history have occurred in 2020, according to a tweet from the agency.

In the course of three days, Oregon has seen more than 900,000 acres go up in smoke, the The Washington Post reported this week. And at least 480,000 acres have turned to ash in Washington state, according to a New York Times report.  Both states have lost hundreds of homes, and a few towns have been completely leveled.

The National Interagency Fire Center (NIFC) pins the blame on multiday lightning events, but human carelessness has also contributed.  A smoke-emitting pyrotechnic device used for a gender-reveal party sparked the blaze that has destroyed more than 7,000 acres in San Bernardino County, according to the Los Angeles Times.

Unfortunately, the NIFC is predicting the situation will get worse heading into October and November.

Here’s what you need to know about how wildfires and wildfire smoke can affect your health — even for those living hundreds of miles from the flames.

Wildfire smoke can cause irritation and inflammation from small-particle lung pollution, and Gold River CA health coaches says indications include watery eyes, a bit of a sore throat, coughing, or a burning sensation in the nose.  The worst possible news during a Pandemic.

“What this means is that allergens, pollutants, and irritants that normally cannot get deep into your lungs can aerosolize into smaller particles because of smoke and lodge deep into the lung tissue, causing inflammation, which then may cause cough, wheezing, shortness of breath, and trouble breathing,” says Purvi Parikh, MD, an allergist and immunologist with NYU Langone Health in New York City and a spokesperson for the Allergy and Asthma Network.  “Not to mention, carbon monoxide is often given off at dangerous levels around fires as well and can lead to carbon monoxide poisoning with poor ventilation.”

The Centers for Disease Control and Prevention warns that adults over 65, children (with developing lungs), and pregnant women are most susceptible to smoke.

“Also, those with underlying lung issues, such as COPD, asthma, and bronchitis are at higher risk, as this is adding insult to already injured lungs,” says Dr. Parikh.  Irritation in the airways of people with these respiratory problems can make symptoms of the conditions worse and increase risk of additional respiratory infections, like bacterial pneumonia, according to the Allergy and Asthma Network.

In addition, smoke can pose a threat to individuals with chronic cardiovascular issues.

“If you have heart disease, you have to watch for signs of having a heart attack and you must be aware if your heart is arrhythmic,” says Prunicki.

If individuals are feeling the effects of the smoke, they are advised to see a healthcare provider right away.

Otis Brawley, MD, a professor of oncology and epidemiology at Johns Hopkins University in Baltimore, warns: “Damage to heart, vasculature, and lungs can be permanent, and it can be fatal.”

Few studies have delved into the long-term health outcomes from wildfire smoke exposure, but IARC research has concluded that air pollution can cause cancer, according to Cancer Research UK.

While not an exact parallel, long-term health effects seen in people exposed to particulates after 9/11 may offer clues.  A study published in the February 2020 issue of NCI Cancer Spectrum, for example, shows that 9/11 responders have higher rates of leukemia than those not exposed to World Trade Center dust.  This corresponds with other research showing higher cancer rates in this population, according to the Leukemia and Lymphoma Society.

“It’s hard to know what long-term health effects from wildfires may be, but there’s certainly reason to be concerned,” says Prunicki.

Parikh adds that wildfires can wreak havoc on mental health as well.

“There is a sense of despair, depression, suicidality, and hopelessness, especially if you have lost your home or loved ones, or your health has become compromised by these fires,” she says.  “If you feel it is affecting your mental health or someone around you, please seek assistance from a mental health professional as soon as possible.”

When air quality alerts veer into the danger zone, people can take steps to protect themselves:

· Avoid going outside. One of the easiest actions to minimize smoky air intake is to stay indoors.  The CDC instructs people to keep windows and doors shut, and run an air-conditioner, but keep the fresh-air intake closed and the filter clean to prevent outdoor smoke from getting inside.  Those without air-conditioning may want to seek out an air-conditioned community center.

· Keep exercise indoors and to a minimum. Physical activity increases breathing and heart rates, so when air quality levels go into the red, exercise inside and at a moderate (rather than high-intensity) pace.  “Overexertion should be avoided,” says Dr. Brawley.

If you have an underlying health condition and have questions about how wildfire smoke might affect your health, contact your doctor.