Last month, the Oregon Institute of Technology in Klamath Falls was awarded a $1 million grant by the Health Resources and Services Administration to expand research into the impact of poor air quality due to wildfire smoke on hospital admissions in Southern Oregon. The new federal dollars will allow scientists at OIT to buy equipment to monitor harmful particulate matter and other toxins in wildfire smoke both outdoors and indoors, and study how wildfire smoke impacts not only respiratory but also cardiovascular health, based on hospital admissions in the Rogue Valley and Klamath Falls. Kyle Chapman, is an associate professor of sociology and population health at the Oregon Institute of Technology. Adelaide Clark is an assistant professor of chemistry at Providence College in Providence, Rhode Island, and a former associate professor of chemistry at OIT. They join us to talk about the grant and how he hopes it may lead to better health outcomes for a region struggling with wildfires and worsening air quality.
The following transcript was created by a computer and edited by a volunteer:
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Bend had 18 days last year when wildfire smoke made the air unhealthy for sensitive groups. Medford had 27 days. Klamath Falls had 38. That’s all according to the latest report from Oregon’s Department of Environmental quality. But what are the effects of this smoky air on our health or on hospitalizations, and what can be done about it? These are just a few of the questions that a group of scientists at the Oregon Institute of Technology wanted to answer. They’ve been studying air quality in southern Oregon for the last three years.
They recently got a $1.5 million federal grant to expand their work. Kyle Chapman is an associate professor of sociology and population health at OIT. Adelaide Clark is a chemist who used to be at Oregon Tech. She just started a new position as a professor at Providence College in Rhode Island, but she will still be working on this air quality project. They both join me now. It’s good to have both of you on TOL.
Guests: Thanks. Thank you.
Miller: Kyle Chapman first. You have a background in medical sociology. So if I understand correctly the intersection of health and society broadly, why did you start to look into air quality?
Kyle Chapman: There’s a few different reasons, but from a sociological perspective there’s a lot of impacts in terms of what we do, how we live, when the air that you breathe is affected. It affects our relationships and our activities. And it’s an important – especially for our region – an important component to our overall health profile. As we’ve observed, there’s a lot of risk for folks in southern Oregon when it comes to air quality. And the region itself already experiences elevated levels of things like asthma and COPD. There’s higher rates of smoking, and that can be exacerbated by things like air quality.
Miller: So what exactly have you been studying over the last three years?
Chapman: What we’ve been trying to do is try to estimate the relationship between wildfire, poor air quality that’s related to wildfires and how that affects the number of people going into a hospital setting. And the reason we wanted to do this is because we wanted to see if wildfires seem to be increasing in their frequency, or at least the exposure to heavy levels of smoke seems to be going up over time. What’s that doing to our systems, particularly our healthcare systems? And so we wanted to be able to give hospitals a solid estimate of what they could expect if there’s a wildfire that causes a certain amount of smoke for a certain number of days. Can we help them estimate about how many more people are going to come into their hospital and more importantly, what’s the likelihood that they might receive more people than they can really handle?
Miller: Is there an immediate relationship between bad air quality and hospitalizations or does the damage take longer to show up?
Chapman: Actually, it’s both. What our research has found is that when we look at several different years of data, say we’ve looked at 2016 to 2019. What we find is that if it’s in what we call the purple, which is the bad, this is the really bad air quality, the likelihood that a hospital is going to exceed their capacity goes up to about 70%. So that’s significant. That’s an immediate sort of relationship. But if it’s a little bit less, say it’s in the red area for 3 to 5 days, we see about the same thing occur. So it’s both a sort of long-term issue: the longer you’re exposed to smoke, the more problems and complications we’re gonna have, the more burden the hospital’s gonna have. But when it’s really really bad, you’ll see that effect much quicker. And we don’t have a lot of days where it’s extremely bad for 5, 7, 9 days in a row. But we would expect that if we did observe those, it would continue to be a substantial impact on our health care systems.
Miller: Adelaide Clark, you’re a physical scientist, a chemist. What has your role been over the last three years?
Adelaide Clark: So I guess my role, I’ve been, quote-unquote, the air quality expert for the group. So my background is in air quality, particularly looking at the chemical composition of the particles that can make up wildfire smoke. Although my background is not necessarily in wildfires. And so my job has been to help the group understand the air quality data that we’ve been getting from the DEQ. And sort of managing it to make sure that we are using it correctly and in the best way possible, to help create these estimates for hospitals.
Miller: The acronym with some numbers that I see a lot here is PM 2.5. What does this mean? And why is it of such concern?
Clark: So PM 2.5 is the term that we use to refer to particulate matter. That’s what the PM stands for. That is less than 2.5 microns in what we refer to as aerodynamic diameter. And I realized I just said a lot of words that you may not be familiar with, but essentially it’s less than 2.5 microns if the particle was a sphere. But the particle is most likely not a sphere because they’re all irregularly shaped, based on how they’re formed. If you’ve ever looked at a smoke particle, you know that they’re not perfect little bead shapes. And the reason that PM 2.5 is of concern to us is that the smaller the particulate matter is, the deeper it can penetrate into the respiratory system, and into the lungs. So small particles equals bad for human health.
Miller: And then directly into our bloodstream?
Clarke: If it’s small enough. It has to be much smaller than 2.5 microns to go all the way into the bloodstream though.
Miller: Okay, so this particular size of particle that can be in the air. The biggest concern here are about easily getting into our lungs.
Miller: Can you give us a sense for what you have already learned over the last three years, before we turn to what you both will be able to learn based on the new grant?
Clarke: So as Kyle was mentioning, what we’ve learned so far is that there is a relationship between the PM 2.5 becoming elevated, and the number of patients that are seen by the hospitals. And as he mentioned, that number is sort of two-fold. It does go for how prolonged the bad air quality days are, that does cause it to go up. But also if we just have a really bad day that for one single day, that can also cause the numbers to go up. And so what we’ve learned so far is that sort of the thing that you would expect to be true, we have the data to back it up, that increases in bad air quality do lead to increases in people seeking medical attention.
Miller: Kyle Chapman, what are people going to the hospital increasingly for? On days when the air quality is bad and more people are going to the hospital, why are they doing so?
Chapman: So there’s a range of different issues that people are going to. The research that we’ve done so far has specifically looked at respiratory conditions. So things like, folks asthma being exacerbated, things like COPD, which is chronic obstructive respiratory disease, these are breathing problems. And then other things like emphysema we’ve also looked at. But there’s quite a bit of other research out there that suggests that any time things happen to the lungs and our breathing, our heart is affected. That’s why cardiovascular diseases and pulmonary diseases are very much related. And that’s what we haven’t quite got to. We don’t know the estimates for anything beyond those respiratory conditions yet, because that’s the only research we’ve done. And so respiratory is the big one. That’s the obvious one. Totally makes sense. But we have a feeling that some of these other conditions related to heart disease, which is much more widespread than chronic respiratory diseases, are also a big player here. So we don’t know. Right now, we know that it’s a lot of people going to the hospital for respiratory conditions, but it’s likely more that are not just solely respiratory.
Miller: If you’re just tuning in we’re talking right now about the increase in days with bad air quality in Oregon, especially because of wildfires. Researchers at Oregon Tech in Klamath Falls are studying this increase. They’re also hoping to come up with better ways for hospitals or local governments to respond. Adelaide Clark, what will you be able to do that’s new as a result of this big federal grant?
Clark: So I think one of the most exciting things that we’re going to be able to do as part of this grant is instead of only looking at the bulk measurement of how much smoke is in the air, how much PM 2.5 is in the air, we are actually going to collect samples and be able to analyze what the chemical composition of the smoke is as well, which will give us a lot more information. Not only about how much smoke was in the air, but what it’s made of gives us an indication of where it came from, what sort of things burned in the fire that created the smoke, and potentially how dangerous that smoke is to human health.
Miller: What are the examples of the kinds of things that could be burned that you’re going to be finding?
Clark: So the classic example when you think of a wildfire, of course, forest fires, trees, plants, that sort of thing and those, when vegetation like that burns, it does give off a certain chemical signature that has been well documented and well studied. However, as these fires have increased in size and scope and come up against sort of that urban boundary and structures have started to also burn in these wildfires, those are going to give off a different chemical signature, because the types of chemicals that you have in a house when you build it are not the same as the chemicals that are just in the vegetation.
Miller: My totally uneducated guess would be that all those chemicals burning the formaldehyde and lead paint and whatever else is inside someone’s couch, that that’s going to be worse than a Doug fir burning. Is there science to back that up?
Clark: Generally speaking, for what we know about those chemicals individually, yes.
Miller: It is worse?
Clark: It is worse.
Miller: But the hope is that with more of these sensors, and doing more sophisticated analysis of smoke on different days, you’ll actually be able to find data to see if that leads to an increase in hospitalizations?
Clark: What we’re hoping to be able to find is to contribute to the conversation of what is in this smoke that people are breathing, which is an area of study that no one has really looked into, because each fire is going to be unique based on what burned.
Miller: Kyle Chapman, my understanding is you’re also going to be able to look at both outdoor air quality and indoor air quality. Where are you going to be putting sensors?
Chapman: For the indoor air quality monitors, we’re gonna be putting those inside people’s homes, residences and a variety of different areas. And we want to do this because really the only tool we have to shield people from wildfire smokes and that sort of negative effects of those smokes on their health, is to stay indoors. And so one place we need to go is to understand, ‘okay, well, what does the air look like inside homes?’ And so what we’re gonna do is we’re gonna try to get a variety of different samples, old homes, new homes, homes with air conditioning, homes without air conditioning. Homes in different parts of town, homes near water or away. So what we’re gonna be able to do there is try to get a variety, put together a composition of what people’s experiences might look like with this indoor air quality. And also, like Dr Clark said, we’re going to try to get some measures on what are the chemical makeups of the indoor air quality, because the things that are in our homes are not quite the same as the things that are outside. And so even though maybe there are fewer smoke-related pollutants inside your home, there could be other things. And so we want to be able to get a better idea of the potential outcomes, or potential interference, that some of our recommendations for protecting the health of the public, what those might be.
Miller: Adelaide Clark, I’m interested in in one of the things that we just heard from Kyle Chapman, which is that there are other aspects of air quality that that some of these sensors could pick up, because wildfire smoke, which is the focus of your work and this conversation, it’s probably the most visible version of poor air quality, a kind of emergency moment that we all pay attention to and pay attention to increasingly. But how does wildfire smoke air quality, the negative effects that come from that, how does that compare in terms of human health on things that many of us breathe all the time day in day out, even in the middle of the winter that we’re not thinking about? I’m thinking about diesel and particulate emissions from trucks and cars for so many of us that live pretty close to big roads.
Clark: Unfortunately, air is the one part of the environment that you can’t get away from. You don’t have to drink the water that comes out of your tap. You don’t have to eat the fish that comes out of the contaminated lake, but you really don’t have a choice when it comes to the air you breathe. And that’s part of what we hope this study will allow us to sort of get a bigger picture of, is the things that people are being exposed to outside of their homes during a wildfire event. Or even just during a normal day, as you mentioned, if you live close to a big road, you are going to have diesel exhaust outside in certain areas during the winter, you might have wood stove smoke that is, is outside and and just how that signature compares to what you’re exposed to inside of your house, what’s the same and what’s different, just to have a better understanding of the exposures that people are getting.
Miller: Kyle Chapman, let’s fast forward a couple of years. Let’s assume that all this data comes through and you’re able to say with even more specificity, this is what happens when a fire of this magnitude creates this much smoke in our community. This is what it means for people in various settings. What should we do with that information?
Chapman: First we need to make some adjustments to some of our emergency preparedness plans. So we’ve done a really good job everywhere in the Pacific Northwest of making good solid plans for what we do. If a town experiences a burn and you know, the town burns, what do we do? Can we find homes for those folks? Do we have those types of protocols, but we don’t have a lot in terms of being exposed in a large scale to this amount of smoke. And so, one, making adjustments to our emergency preparedness plans, and then working together with hospitals and public health organizations to figure out what communities, what then specific needs of particular communities are. Because every community is different, right? Klamath Falls has a different infrastructure than say Bend or Medford, and it’s certainly different than the Portland Metro area. And so one of the things that we want to do down the road is to evaluate our current practices and see if we need to try to expand those practices. Like right now we have all through the state, with the heat wave, we have a much heavier use of our cooling centers, just like in the winter, sometimes we have warming centers. Well, it might be a good idea to make sure that those cooling centers are also clean breathing centers. If some of these things are gonna go together, the temperatures go up, the smoke goes up, those types of things. And so what I would like to see is a sort of widespread or multifactorial set of interventions with our healthcare system, but also with our policies and our public health organizations that try to address the needs of specific communities that very well may be different from city to city.
Miller: Adelaide Clark, just on a personal level, I’m curious because as I noted at the beginning, you had been in Klamath Falls for a while, but you just moved to Providence, Rhode Island to take this job at Providence College. Moving away from a place that is really prone to bad air from wildfires to a place that doesn’t really have that issue. How do you feel about getting away from wildfire smoke?
Clark: Lucky, I guess maybe. I’m not from the West Coast. My first wildfire experience was back in 2017, and knowing what I know about particulate matter, it did scare me a little bit as to what I was being exposed to. But that’s why I think it’s very important to continue seeking the answer to the question, ‘what is in there?’, so that I can continue to help people who aren’t able to move away from the area. And as things continue to change throughout the climate and throughout the planet, more and more people will be affected by this and it’s possible I won’t be away from wildfire smoke.
Miller: Adelaide Clark and Kyle Chapman, thanks very much.
Guests: Thank you.
Miller: Adelaide Clark is now an assistant professor of Chemistry at Providence College in Rhode island. Kyle Chapman is an associate professor of Sociology and Population Health at the Oregon Institute of Technology.
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