Smoke clears, but health threats likely to return

REGIONAL- After wildfire smoke pushed air quality readings beyond the top of the standard federal scale last week, residents across northern St. Louis County awakened Wednesday to air that was nearly pristine.
The Air Quality Index in Ely stood at 19 Wednesday morning, comfortably within the “good” range of zero to 50 and a dramatic change from the hazardous conditions experienced only days earlier.
But with multiple wildfires continuing to burn across the region, public health officials caution that clean air today offers no guarantee about tomorrow.
“It’s important for people to recognize that we could be dealing with air quality impacts for a long time to come,” said Amy Westbrook, St. Louis County Public Health Division director.
Smoke conditions can change by the day or hour and vary considerably by location, Westbrook said. County officials encouraged residents to use periods of cleaner air to prepare for the possibility that smoke will return.
So far, the extreme readings have not produced a noticeable increase in patients seeking care at Ely-Bloomenson Community Hospital.
“At this time, we have not experienced any uptick in inpatient or Emergency activities, and nothing expressly related to respiratory concerns,” EBCH communications leader Jodi Martin said Tuesday afternoon. “However, we know this is a dynamic emergency that can change quickly, and EBCH remains vigilant in our preparation to care for the communities we serve.”
Health effects
Of greatest concern in wildfire smoke is PM2.5, particulate matter measuring 2.5 micrometers or less in diameter. Those particles can travel deep into the lungs and enter the bloodstream.
Exposure can irritate the eyes, nose, and throat and cause coughing, wheezing, chest tightness, shortness of breath, dizziness, headaches, heart palpitations, and fatigue. It also can aggravate asthma, chronic obstructive pulmonary disease, heart disease, and other existing conditions. More serious exposure can contribute to asthma attacks, heart attacks, and strokes.
Smoke can affect anyone, but those at greater risk include children, adults age 65 and older, pregnant people, and people with heart or lung disease, high blood pressure, or diabetes.
Outdoor workers, athletes, and others performing strenuous activity outside also face greater exposure because they breathe more deeply. Those without air conditioning, people living in homes that do not keep smoke out effectively, and people without permanent shelter also face increased risk.
Watch the AQI
Health officials recommend checking current conditions and forecasts through AirNow.gov, the AirNow app, or Minnesota Pollution Control Agency air-quality alerts.
AQI readings from zero to 50 are considered good, while 51 to 100 are moderate. Readings from 101 to 150 are unhealthy for sensitive groups, who should reduce prolonged or strenuous outdoor activity, take more breaks, and watch for symptoms.
From 151 to 200, air is considered unhealthy for everyone. All residents should reduce prolonged or strenuous outdoor activity, while sensitive individuals should consider moving activities indoors.
Air quality is considered very unhealthy from 201 to 300 and hazardous above 300. People should avoid outdoor exertion and remain in cleaner indoor air as much as possible.
Anyone who begins coughing, wheezing, feeling unusually tired, or experiencing shortness of breath should reduce exposure and move to cleaner air, regardless of the AQI reading.
Keeping indoor air clean
During heavy smoke, residents should close windows and doors and set heating or air-conditioning systems to recirculate indoor air rather than bring in outside air.
The U.S. Environmental Protection Agency recommends using a MERV 13 furnace or HVAC filter, or the highest-efficiency filter the system can safely accommodate. Running the system fan continuously can help remove particles. Filters should fit snugly, be checked frequently, and be replaced when dirty.
Portable HEPA air cleaners can provide additional protection, particularly in the room where household members spend the most time. Consumers should check the recommended room size and clean-air delivery rate rather than relying on the HEPA label alone.
A temporary air cleaner can be made with a 20-inch box fan and a same-sized MERV 13 furnace filter. The filter should be secured to the intake side of the fan, with its airflow arrow pointing toward the fan. Tape should seal gaps around the edges so air passes through the filter rather than around it. A cardboard shroud covering the corners on the front of the fan can improve performance.
The EPA recommends using only newer box fans with UL or ETL safety certification and never leaving a do-it-yourself unit unattended. Instructions and illustrations are available at epa.gov/emergencies-iaq/diy-air-cleaners.
During smoke events, residents also should avoid creating more particles indoors by smoking or vaping, burning candles, using wood-burning appliances, and frying or broiling food. Vacuuming should be avoided unless the vacuum has a HEPA filter.
Keeping windows closed can create a separate danger during extreme heat. Anyone unable to remain safely cool should seek an air-conditioned public location. When outside air improves, opening windows temporarily can help air out the home.
Masks can help
People who must be outdoors during heavy smoke can reduce their exposure with a properly fitted NIOSH-approved N95 or P100 respirator.
The respirator must seal closely around the nose, mouth, and chin. Facial hair and gaps can reduce its effectiveness. Cloth masks and loose-fitting surgical masks do not reliably filter wildfire smoke particles.
Respirators filter particles but do not remove all gases in smoke, and wearing one does not make strenuous outdoor activity risk-free. People with heart or lung conditions should consult their health care provider if they have concerns about wearing one.
Residents should contact a health care provider for persistent coughing, wheezing, shortness of breath, heart palpitations, or worsening symptoms. Severe difficulty breathing, chest pain, or possible signs of a heart attack or stroke require an immediate call to 911.
Local resources
St. Louis County Public Health has begun compiling a list of indoor public locations with good air quality. The partial list currently includes locations in Tower, Virginia, and Cook, with more to be added. Addresses, hours, and other resources are available at www.stlouiscountymn.gov/residents/emergencies.
During an Ely community meeting last Friday, Ely Community Response encouraged residents needing a cooler indoor space to consider The HUB, the Ely Public Library, Carbonation, the Ely Historic State Theatre, and several local churches.
County public health workers and local volunteer organizations have been distributing protective masks, with area businesses contributing masks and support. County officials are working to obtain more for future distribution.
The clean air Wednesday offered a welcome break, but also an opportunity. Filters, respirators, medications, and a plan for reaching a cleaner indoor location are easier to arrange before the smoke returns than after the sky has again disappeared behind it.