Health Concerns from Smoke Released by Fires

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Health Concerns from Smoke Released by Fires Key Points The materials released by a fire vary from one fire to another, depending on the items burning, the availability of oxygen and fresh air, and the temperature of the fire itself. Even within a fire covering a large area, the materials released may vary from location to location. Inhaling the smoke from a fire can cause injury from the heat of the smoke, the chemicals within the smoke, and the particles of soot. " The heat can cause burns to the nasal passages, airways and lungs. " The chemicals can poison the body, depending on the amount of carbon monoxide, cyanide, and other chemicals produced by the burning. " Soot particles and other substances can irritate the airways. Inhaling smoke can cause asthma and other lung conditions to worsen for hours to days after breathing the smoky air. The best course of action is to leave the smoky air as soon as possible. Staying indoors with closed windows is better than being outdoors when smoke is widespread. If symptoms occur after smoke inhalation, seek medical care for further evaluation and treatment as needed. Fire Chemistry and Toxicology The products of combustion from a fire are a complex mixture. Carbon monoxide is produced in every fire. In general, more carbon monoxide is produced from fires occurring indoors. Carbon monoxide is important to health because it interferes with a person’s ability to use oxygen to maintain body functions. As carbon monoxide levels rise, the amount of impairment also rises. Carbon monoxide levels above 10% typically cause symptoms. Therapy with oxygen is generally recommended until the levels fall. In severe cases, hyperbaric oxygen therapy may be utilized. Cyanide may be produced in some fires. Cyanide is produced after burning of many plastics, wool, silk, and synthetic fabrics. If significant amounts of cyanide are inhaled, the ability to use oxygen is also interrupted. Cyanide antidotes can be provided emergently if cyanide poisoning is suspected. Many other chemicals are produced in a fire. Some of these have been recognized to be carcinogens, so minimizing exposure is prudent. Sensitive populations Some people are more sensitive to the effects of smoke inhalation. Pregnant women, infants, and young children are more sensitive because of their higher metabolic rates, which create a greater need for oxygen. People with pre-existing lung or blood conditions are likely to be more sensitive. The irritating effects of the smoke on airways may worsen asthma and COPD. Severe anemia and conditions which already reduce the body’s ability to absorb and utilize oxygen may be particularly susceptible to the effects of smoke inhalation. If you have specific questions, suggestions for contact include: The Pediatric Environmental Health Specialty Unit serving your area. The poison control center serving your area. The public health department serving your area. Your primary health care provider. Selected References Alarie Y. (2002). Toxicity of fire smoke. Crit Rev Toxicol 32, 259-289. Geller R.J., Barthold C., Saiers J.A., Hall A.H. (2006). Pediatric cyanide poisoning: Causes, manifestations, management, and unmet needs. Pediatrics 118, 2146-2158 Produced by: Robert J. Geller, MD Emory Southeast Pediatric Environmental Health Specialty Unit March, 2017.

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