Q&A: Industrial fires present unique respiratory health risks

Key takeaways:

• People with asthma and COPD are vulnerable to smoke.
• Fine particulate pollution can penetrate deep into the lungs.
• Health care providers should have surveillance guidelines in place for fire events.

The fire that started at the Marck Industries Recycling Center in Rogers, Arkansas, on Oct. 16 prompted local officials to issue a hazardous smoke warning and advise residents with respiratory problems to shelter indoors.

Paper, cardboard and plastic all burned during the fire. As firefighting continued for several days, residents reported ash and debris falling from the sky.

Healio spoke with Kevin Stewart, BSE, director, environmental health, of the American Lung Association while the fire was ongoing to find out more about the impact of industrial fires on vulnerable patients.

Healio: What kind of dangers do industrial fires like this present for people with asthma and other respiratory illnesses?

Stewart: Industrial fires can vary considerably in the variety of materials being burned in an uncontrolled manner and in the toxicity of the emissions. But all smoke from burning materials is potentially harmful to anyone who is exposed to it.

The Marck Industries fire is no exception. While starting from burning cardboard, we have not yet seen a full report as to what all is being burned, so caution is warranted, particularly among the brave emergency responders working the blaze and in areas that may be downwind of the conflagration.

It is clear that the smoke plume itself has shown a significant amount of air pollution being generated. The groups of people potentially at risk from this pollution are large and certainly include those with lung diseases such as asthma and COPD, but also those with cardiovascular disease, infants and children, pregnant people and seniors, those living in poverty and people of color. Problems that can result from breathing such air pollution range from asthma attacks and the need for medication use to heart attacks, strokes, emergency department visits and even premature death.

Healio: Are there any illnesses that present particularly dangerous risks because of fires like this?

Stewart: This kind of uncontrolled burning event creates huge amounts of fine particle pollution, the kind of pollution that can penetrate to the deepest parts of the lungs, and even cross into the bloodstream. People with cardiovascular disease are known to be at higher risk. However, it also is expected that such fires also produce high levels of toxic gases that can also find their way into people’s homes and bodies and can pose a variety of adverse health risks. As always, the question is how much exposure people are being subject to. However, this combination of pollutants, if inhaled, does act together to increase the risk for adverse health impacts of the kind mentioned above.

Healio: Residents with respiratory illnesses have been advised to stay indoors. Do you have any other advice for people who live near similar fires?

Stewart: Residents should pay close attention to and follow guidance and directions provided by the appropriate authorities and the emergency personnel on the ground. Since an incident such as this one has the potential to acutely impact their health, individuals should watch for symptoms and reach out to their health care provider if needed.

People should contact emergency services if symptoms warrant or if they are directed to do so. Otherwise, people are invited to call the American Lung Association HelpLine at 1-800-LUNG-USA if they have questions. Also, they can learn more ways to protect their lung health at the American Lung Association page.

Individuals should use common sense as well, e.g., not visiting the site of the fire, not getting in the way of responders doing their work. People should be sure to take special precautions if they or their family members have a history of being sensitive to air pollution or if they are members of the risk groups listed.

Note that while running air conditioning on recirculating mode may help reduce exposures to people sheltering in place, there are limits to the amount of protection it can afford. Likewise, masks such as N95 masks, properly used, may reduce exposure to fine particles, but will not be able to reduce exposure to toxic vapors that may be components of the smoke from uncontrolled combustion.

While sheltering in place is generally the first best advice in most such events, if conditions deteriorate, it may be necessary to travel safely away from the area affected and to access shelter and services needed, being sure to bring along all necessary medications and medical equipment.

Healio: What impact could this fire have on populations beyond the immediate area?

Stewart: The pollution created by this event, if not necessarily having large local impacts, will find its way downwind over subsequent days. Since, simply, “what goes up must come down,” though much of this air pollution will be deposited onto the ground or become part of precipitation, some will make its way into people’s lungs, perhaps even hundreds of miles distant. While the average impacts for any single individual may not be large, collectively, this air pollution will contribute to the poor health outcomes people experience from air pollution.

Healio: What should doctors do now and in the immediate future to manage patients who may come in with complications because of fires like this?

Stewart: Health care providers, clinics and hospitals should have good surveillance guidelines in place to be alert for the possibility that patients may present with symptoms from this event. They should also be aware that people may sometimes experience symptoms delayed by several days after the exposure event, even after the initial cause of the exposure episode has been abated. Otherwise, physicians and other providers should take seriously symptom reports or health problems that may arise that might not be commonly experienced in clinic, such as health problems among emergency responders who may have been exposed to toxic gases, etc. Keeping track of these kinds of things over the next few months may help reveal patterns of impacts that might not be apparent on a day-to-day basis.

Healio: On a policy level, what can be done to mitigate or prevent industrial fires like this?

Stewart: Prevention involves the careful review of material storage, processing and management at industry facilities. For example, large quantities of material should not be stored in such a way that a small fire can quickly grow out of control. Likewise, potentially hazardous materials also need to be properly isolated and protected from triggering events that may result in their catastrophic release or combustion.

Emergency planning, surveillance, emergency abatement infrastructure and trained staffing at facilities need to be demonstrated to be up to the task of identifying and promptly addressing any loss-of-control event in its very earliest stages.

References:

• Emergency crews respond to four-alarm fire at Marck Industries in Rogers. https://www.kark.com/news/state-news/emergency-crews-respond-to-three-alarm-fire-at-marck-industries/. Updated Oct. 17, 2024. Accessed Nov. 6, 2024.
• Marck Industries fire continues as officials warn of air conditions in Rogers. https://www.5newsonline.com/article/news/local/residents-advised-avoid-rogers-fire-area/527-ad17ec8b-2eb7-4418-b320-d378d6a37c5a. Published Oct. 17, 2024. Accessed Nov. 6, 2024.