B.C. entered a provincial state of emergency on July 21, 2021, due to the worsening wildfire situation.

Wildfire smoke is a mixture of fine particulate matter and gases which can pose serious health threats to those exposed. Health risks vary by: i) fuel source, ii) weather (e.g., wind conditions), iii) proximity to the fire, iv) individual vulnerability and v) ability to shelter from the smoke.

Exposure can lead to respiratory tract irritation, systemic inflammation, increased risk of respiratory infections and exacerbations of underlying medical conditions.

Wildfire smoke conditions can change rapidly; therefore, everyone should be prepared for poor air quality events throughout the wildfire season. This guidance aims to help prepare your patients to protect their health during the wildfire season.

Who is most at risk?
Groups at highest risk are susceptible because of underlying medical conditions, higher respiratory rates, and because they may be exposed more. Some of these patient groups include:

  • Older adults and people with underlying respiratory (e.g., asthma, COPD) and/or cardiovascular disease
  • Infants, children and pregnant women
  • People experiencing poverty or housing insecurity
  • People who work or exercise outdoors

How can you support patients and families?

  • Create/update a chronic disease action plan (e.g. COPD/Asthma Action Plan) for exacerbations when air quality is poor
  • Ensure patients have a supply of rescue medications at home and have a contingency plan for filling their prescriptions in case of wildfire evacuations or other emergencies.
  • Counsel vulnerable patients to monitor air quality advisories and direct patients to advisory resources, including air quality alert subscriptions.
  • Advise vulnerable patients that they may benefit from portable air cleaners as an additional layer of protection. Advise those purchasing a unit to seek appliances certified by the Association of Home Appliance Manufacturers (AHAM) and with HEPA filtration, for those with respiratory comorbidities.

What are key counselling points for patients?

  • Reduce exposure: Keep windows and doors closed when possible (i.e. cool temperatures indoors can be maintained). Reduce sources of indoor air pollution (e.g., indoor burning, smoking). Reduce physical activity outdoors.
  • Keep cool and hydrated: Set air conditioning/ventilation systems to recirculation mode. Seek out public spaces with clean, cool air (e.g., libraries, community centres, shopping malls). Drink before you are thirsty.
  • Monitor your health: Carry rescue medications/inhalers at all times. Advise patients to self-monitor:
    • Relatively mild symptoms (e.g., mild cough, rhinorrhea, eye irritation, sore throat, and headache) should prompt reduction of exposure/outdoor activity
    • More severe symptoms (e.g., dyspnea, severe cough, dizziness, chest pain and palpitations) should prompt seeking of medical attention
  • Check in on loved ones and other vulnerable community members regularly

Note that air pollution has a cumulative health effect; advise patients to choose walking/exercising routes away from high traffic areas when possible.

What else can you do?

  • Consider opportunities to be a clean air practice by supporting your staff/patients to access services via active transportation.
  • Be an advocate for policies to address the climate crisis and promote active transportation that both reduces air pollution and has health benefits.

Additional resources

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