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Smoke is not good for the lungs or heart, causing health officials to issue warnings

PMG PHOTO: JAIME VALDEZ - A thick layer of smoke hovered recently over the encampment of evacuees located at the Clackamas Town Center mall. People should stay inside if they can to avoid hazards of wildfire smoke. But not everyone can, triggering health concerns.

The wildfires raging across Oregon and Washington state have given Portland the distinction of having the worst air quality among cities in the world And much of the rest of the state also has hazardous air, according to an ar quality warning issued by the National Weather Service.

The impacts on people will vary in part based on their living and working situation, according to interviews with health officials.

The smoke probably won't cause much in the way of long-term effects, said said Dr. Gopal Allada, a pulmonologist who serves as associate professor of medicine in the OHSU School of Medicine.

But in the short term it can cause headaches, shortness of breath and heart issues, and is expecially risky for those who already struggle with chronic heart or lung disease.

"In terms of how people can be affected, it's from the upper airway to the lower airway," he said. "Your eyes can get irritated, your nose, your throat, your sinuses can all get inflamed and congested and have symptoms. It does get down into your lungs (causing) shortness of breath, wheezling coughing, ssputum production. Some people get headaches, some people get chest pain "

As wildfires grew across the region, Hazel Wheeler, health and safety program manager at Virginia Garcia Memorial Health Center, started monitoring air quality projections.

He says he quickly informed the health center's leadership that air quality Friday would likely be at unhealthy levels, and it could impact staff and patients.PMG FILE PHOTO: - The Virginia Garcia Memorial Hospital's mobile health clinic travels to farm labor camps across the state every year to provide healthcare to Oregon's seasonal farmworkers.

Virginia Garcia is a Washington County-based nonprofit health care provider that primarily serves low income and Latino patients, many of whom are seasonal or migrant farmworkers. The health center runs a mobile health clinic that travels to farmworker labor camps across the state every year to offer care to the more than 160,000 farmworkers working primarily outside during harvest season.

Physicians at Virginia Garcia proactively reached out to patients with respiratory, cardiovascular and other health conditions to tell them they should take steps to mitigate exposure and monitor symptoms that could be triggered by smoke because unhealthy air would persist.

"The concern that we have for the farmworkers is they're going to be out in this," Wheeler said. "I know some farms and nurseries are making sure that they've distributed the KN95 (masks) that were pushed out by the state."

He said respirators create a catch-22 for people who have to work outdoors in smoke. They filter out harmful particulates well but they also reduce the people's airflow during physical exertion.

Wheeler said farmworkers continuing to work in smoky air should drink a lot of water because hydration can mitigate some of the short term negative impacts of smoke exposure. He said employers and employees should also try to create spaces isolated from the smoke so people can periodically breathe clean air throughout the day during breaks.

Over at Oregon Health & Science University, Allada, the pulmonologist, has seen an uptick in calls from worried patients seeking advice.

Most people have been using surgical or loose-fitting home-made masks to reduce the risk of transmitting coronavirus, but it's important for people to realize that those masks to do nothing to stop the fine airborne particles that are the main hazard contained in smoke.

Those are called PM2.5, referring to particles of 2.5 microns or less. COURTESY OHSU - Dr. Gopal Allada, a pulmonologist who serves as associate professor of medicine in the OHSU School of Medicine, says the masks people typically use to reduce coronavirus risk won't keep smoke from your lungs. Stay inside if you can,  he says.

"A micron is essentially really smaller than the size of a red blood cell in your body, and smaller than the width of hair shaft," Allada said. "Those size particles actually are well situated to not only breathe in but but also bypass your throat and your tongue and get directly into the deep areas of your lung."

He also suggests drinking plenty of water.

Most masks don't help, other than the sort of industrial-strength respirators issued to some workers, including in health care.

"We just want to make sure that folks don't have what I call a false sense of security," Allada said. "Now's the time to probably stay indoors as much as possible."

Indoors, people with the funds to do so can use furnace or air conditioner filters with a high MERV rating to filter out some small particles. For an older dwelling that's prone to air flow from outside, people also can use painters tape or masking tape to try to block drafty cracks around windows or doors if the smoke bothers them.

" I think if people are otherwise healthy, and they're not feeling any symptoms within their home, it's probably a sign that things are pretty good," Allada said.

Of course, many people don't have homes to protect them from the oppressive anxiety of inhaling smoke. And many don't have special respirator masks, either.

"For patients or people who do have chronic lung and heart problems, the best way to stay healthy other than all the things that I've mentioned is to continue taking their medications as prescribed by their medical providers so that it'll keep their lungs and their heart in the best shape ... to hopefully keep them out of the hospital," Allada said.

There are no specific state laws requiring that farms and other employers keep their employees from working in smoky conditions, Wheeler from Virginia Garcia said.

However, in a statement Friday afternoon, workplace regulators and health officials urged employers "to stop or delay outdoor work activity where they can and take other reasonable steps to protect workers when air quality reaches the 'unhealthy' zone, or worse."

Officials said such steps are especially important because Latino workers make up a substantial portion of the workforce and they have been disproportionately affected by COVID-19.

Employers are responsible for providing safe and healthy workplaces, and recognizing and addressing hazards to workers, officials at the Oregon Occupational Safety and Health Administration and Oregon Health Authority said.

Those responsibilities included: closing outdoor work activity when air quality in an area becomes "unhealthy," or reaches an air quality index of at least 151; allowing workers with underlying health conditions to stay home; re-arranging work schedules and tasks in a way that enables workers to get relief from smoky outdoor air; and providing N95 masks, where and when appropriate, and informing workers of their proper use and care.

"During this incredibly challenging and evolving emergency, we are encouraging employers — particularly those with outdoor operations — to take all reasonable and necessary precautions and steps to ensure the safety of their employees," said Michael Wood, administrator for OSHA.

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