By Ana B. Ibarra
September
4, 2018
EAST
BAKERSFIELD, Calif. — Viviana Aguirre, 14, knows the air is bad when she has to
reach for her inhaler once, maybe twice a week.
But
this summer, the high school freshman has relied on her inhaler almost every
day to keep her asthma under control.
The air
in her low-income neighborhood has been thick with smoke for weeks, she said,
forcing her to remain indoors most of the time. It’s hard for Viviana to tell
whether the smoke is coming from the usual controlled burns in the farmers’
fields surrounding her home — or from the record-breaking wildfires
blazing to the north and south of her, she said.
“I do
see smoke,” Viviana said, “but I see smoke most of the time.”
People
like Viviana and her family are hit disproportionately when wildfires ignite —
because smoke adds another layer of toxic substances
to the already dirty air, experts say.
“Without
a doubt, these communities are at higher risk” when fires break out, said
Emanuel Alcala, a postgraduate fellow with the Central Valley Health Policy Institute at
California State University-Fresno. “Especially because you already have other
environmental hazards: toxic waste sites, poor quality of water, and sometimes
no air conditioning.”
More
than a dozen major blazes still rage across California, including the two
Mendocino Complex fires in the northern part of the state that together have
charred nearly 460,000 acres. One of those fires, the Ranch Fire, is the largest in state history.
Fires
are also burning in Colorado, Oregon, Washington and Idaho. Smoke from
these blazes has drifted as far as Ohio. Portions
of northern Nevada recorded
some of their worst ozone pollution ever last month because of the fires, and
officials across the West have
issued health warnings to alert sensitive groups — such as young children,
older adults and people with respiratory diseases — of the potential risks.
In
neighborhoods like Viviana’s, which lies within a few miles of dairy farms,
packing sheds and oil fields, particulate and ozone pollution already poses a
health threat. The air is sullied by a constant, diesel-spewing stream of big rigs as
well as pesticides and dust from agricultural operations.
The
smell of petroleum and cows saturates the neighborhood, said Gustavo Aguirre,
Viviana’s dad, and creates a toxic brew with the wildfire smoke.
“When I
go outside just to hang out with my friends, I start coughing and I have to
come back in,” Viviana said.
About
26 percent of school-aged children in the San Joaquin Valley have asthma — the
highest rate in the state, according to California Health Interview Survey.
Cities
in the San Joaquin Valley, the state’s agricultural heartland, top the list of
those with the worst air pollution in the country. The valley is also home to
some of the state’s poorest communities: Seven of the 10 California counties
with the highest child poverty rates are there, according to a 2017 report by
the San Joaquin Valley Health Fund.
“The
geography and climate of the valley can trap unhealthy air for days, if not weeks,”
said Will Barrett, clean-air advocacy director for the American Lung
Association in California.
The
combination of industrial ozone and fine particulate matter from wildfire smoke
becomes trapped between the mountains surrounding the valley and pushes air
quality to dangerous levels. “You’re combining two of the most widespread and
pervasive pollutants,” Barrett said. “It really is a double whammy.”
Adding
smoke to existing pollution can not only exacerbate someone’s asthma symptoms,
but also trigger new cases of the respiratory disease, said Dr. Kari Nadeau, director of
the Sean N. Parker Center for Allergy & Asthma Research at Stanford
University.
In some
cases, all it takes is about five days of exposure to wildfire smoke for people
without asthma, especially children, to develop wheezing, coughing and other
symptoms, she said.
In
already polluted places like the San Joaquin Valley, “the wildfires worsen your
rates of asthma by fourfold and increase the rate of heart attack by 42 percent,” she
said. “This is just going to make it exponentially worse.”
In
southwest Fresno, a community dense with public housing, Maria Garcia, 62,
lives within 2 miles of a poultry processing plant, warehouses and Highway 99.
Garcia
considers herself healthy, but a persistent cough this summer left her gasping
for air.
She
compares some of her recent symptoms — such as chest pressure and headaches —
to those experienced by her adult son, who has asthma.
“My
guess is it’s probably the smoke,” Garcia said.
Other
regions in the state also are suffering. Smoke from the Mendocino Complex fires
has drifted into the San Francisco Bay Area, about a three-hour drive south of
the blazes.
A
mobile asthma clinic called the Breathmobile provides free appointments and pulmonary
function tests for children at East Bay schools with a high number of students
enrolled in Medi-Cal, California’s Medicaid program for low-income residents,
said Mary Frazier, a registered nurse and project director of the Northern
California Breathmobile program.
“Kids
on Medi-Cal have more asthma,” she said. “It can be because they are exposed to
more triggers. They live in low-income housing, which has some poor indoor-air
quality and the houses are near freeways or industry.”
When
she starts visiting kids again in September after classes resume, Frazier knows
she will encounter many children who have been coughing and wheezing because of
the smoke.
Back in
southwest Fresno, Gary Hunt, 54, has remained mostly housebound this summer,
leaving only for important errands and medical appointments. Even then, he
wears a mask.
Pollution
from fires are “definitely making a drastic difference,” worsening Hunt’s
asthma, causing more fatigue, chest pain and headaches, he said.
But
extinguishing wildfires doesn’t guarantee relief. There is a meat-rendering plantnear
his home, and busy state Route 41 is about a quarter-mile away.
“Because
of where we are, we don’t really get a break,” he said.
Three
years ago, Hunt had a severe asthma attack that sent him to the hospital. He
had to leave his job as a school maintenance worker and lost his job-based
insurance. He enrolled in Medi-Cal, and soon learned that not all doctors
accept public insurance — which means that getting quick access to care during
fire season can be a problem.
For
instance, he said, he needs to see a pulmonologist — but has to wait three
months for an appointment.
People
with Medi-Cal or those without insurance can in some cases wait up to a year
for treatment, said Kevin Hamilton, a respiratory therapist and CEO of the
Central California Asthma Collaborative.
Hunt
said he is frequently asked, even by doctors, why he and his family don’t move
to a healthier community. The answer is that he simply can’t afford it.
“If I
could, I wouldn’t be here,” he said.
Ana B.
Ibarra: aibarra@kff.org,
@ab_ibarra
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