Coughing, Wheezing, Inflammation Could Be Signs of Wildfire Smoke Inhalation

Irina Dralyuk, MD, pediatric pulmonologist at Cedars-Sinai Los Angeles, spoke with The American Journal of Managed Care^® about how inhaling wildfire smoke could have both short- and long-term effects on children and adults if preventive measures are not taken, making safe practices important for those living in the Los Angeles area.

This transcript has been lightly edited for clarity.

Transcript

What symptoms should parents look for in their children to identify respiratory distress?

Cough is going to be the most common symptom that we encounter. Other things you're going to see right off the bat [are] going to be an itchy sore throat, some chest tightness, chest pain, maybe slightly increased work of breathing or panting, things like that. You start hearing wheezing or significant loud noises, sort of gasping for air. Those are kind of more later signs. Retractions, belly breathing, just gasping for air, is something that we're trying to avoid. But for babies, just having a difficult time getting air in and out is something that we might notice. But in the early stages, or what I'm seeing a lot of right now, is just a lot more cough and wheezing.

What are the long-term implications on children today if proper precautions aren’t followed?

Potentially, long-term effects can include inflammation, irritation to the lining of the airway, and this can lead to prolonged cough and difficulty with breathing, especially in the younger airway; we're still developing. This can lead to more infections, more days missed at school, more trouble with breathing, trouble with exercise, so more like an almost induced asthma process. So, a lot of long-term effects that potentially are quite harmful to pulmonary health.

What should residents do until air quality meets its target and it is safe to breathe again?

As far as targets, ideally under 50 [air quality index (AQI)] would be great. But even if we're under 75 [AQI], I think we're within a more or less reasonable range. Until then, staying indoors is going to really be the best choice that people can make, and getting to an area where the air quality is sufficiently safe. So unfortunately, sometimes just moving out of the area where the air quality is very poor is going to be the best step. But if that's not an option, or the air quality is not sufficiently poor to warrant moving, then staying indoors with an air purifier, wearing masks with a filter that goes down to 2.5 particulate matter is going to be the most helpful way of preventing some of these long-term effects and short term effects on the lungs.

So if somebody is having symptoms, one important thing that folks can do is seek medical attention and see a doctor. There are a lot of interventions that we can offer for patients who are having symptoms. And so it might be something as simple as an inhaler. It might be steroids if things are progressing. But if there's an infection on board that sort of came on because of the the smoke irritating the lungs, then certainly treating the infection is important. But basically, I would advise anybody who's having significant or mild symptoms to seek medical care and advice from a doctor.