As Los Angeles continues to grapple with devastating fires, it serves as a stark reminder of the dangers involved with both the flames, and medical needs of those who battle the blaze. The LA fires, which started on January 7 2025, has, at the time of this writing, led to the death of 27 people, with dozens more reported missing. The 7 different fires have destroyed more than 13,600 homes, businesses, and various other buildings.
These fires may also end up as the costliest in U.S history, destroying properties at an estimated value upwards of $250bn.
Unfortunately, as horrific as the fires have been, their dangers won’t necessarily end with the final flame extinguished.
Firefighters, emergency responders, cleanup crews, and other essential workers often face long-term health risks due to their prolonged exposure to harmful particulates, toxic gases, and other airborne hazards during wildfire containment and recovery efforts.
The aftermath of the LA fires highlights the critical need for robust respiratory protection and thorough medical evaluations for workers exposed to hazardous conditions.
Here, we’ll highlight the respiratory dangers these workers face, as well as outline the medical tests essential for diagnosing and managing potential health issues.
Related Article: Overcoming the Dangers of Firefighting.
Related Article: The Impact of Wildfire Smoke on Respiratory Health.
Respiratory Hazards During and After the LA Fires
Wildfires produce a complex mix of pollutants, including fine particulate matter (PM2.5), carbon monoxide, volatile organic compounds (VOCs), and other toxic substances released from burning vegetation, buildings, and industrial materials.
These pollutants can have both immediate and long-term effects on respiratory health, including:
- Acute Respiratory Risks
During fires, workers are routinely exposed to:
– Smoke Inhalation: Smoke inhalation can cause coughing, throat irritation, and shortness of breath. In severe cases, it can lead to acute respiratory distress syndrome (ARDS).
– Carbon Monoxide Exposure: High levels of carbon monoxide can reduce oxygen delivery to the body, leading to headaches, dizziness, and even loss of consciousness.
– Irritant Gases: Chemicals like formaldehyde and ammonia can cause inflammation of the respiratory tract.
- Chronic Respiratory Risks
In the aftermath of firefighting, prolonged exposure to wildfire debris and ash increases the risk of:
– Chronic Obstructive Pulmonary Disease (COPD): Persistent exposure to smoke and particulate matter can result in chronic bronchitis and emphysema.
– Asthma Development or Exacerbation: Workers with pre-existing conditions are particularly vulnerable to flare-ups.
– Lung Cancer: Inhalation of carcinogens like benzene and polycyclic aromatic hydrocarbons (PAHs) can increase cancer risk.
– Silicosis and Asbestosis: Ash and debris from destroyed structures may release silica dust and asbestos fibers, leading to progressive lung damage.
As you can see, the risks of battling blazes like these go well beyond the flames.
Respiratory Protection for First Responders
To mitigate the risks, respiratory protection is essential during and after fire containment operations. Personal protective equipment (PPE) and proper safety protocols can prevent many respiratory issues.
- Use of Respirators
Workers should wear NIOSH-approved respirators whenever possible. N95 respirators are effective for filtering fine particulates, while elastomeric half-mask or full-face respirators provide better protection against VOCs.
For extended use, powered air-purifying respirators may be necessary, as they reduce breathing resistance and improve comfort.
– See OSHA Standard on Personal Protective Equipment (1910.134).
– See (Mandatory) Information for Employees Using Respirators When not Required Under the Standard.
- Fit Testing and Training
Respirators must fit securely to ensure protection. Fit testing is necessary to confirm a proper seal, and workers must be trained in the correct use, storage, and maintenance of their equipment.
- Decontamination Procedures
Workers should remove and clean PPE properly to avoid secondary exposure to contaminants. Decontamination stations should be set up at work sites.
- Air Quality Monitoring
Regular monitoring of air quality, including levels of PM2.5 and toxic gases, can guide the use of appropriate respiratory protection.
– See the U.S Fire and Smoke Map.
Medical Tests for Workers Affected by LA Fires
For workers exposed to the respiratory hazards of fires, including wildfires, comprehensive medical evaluations are essential to identify potential health issues early and provide timely intervention. These tests and screenings typically involve:
- Pulmonary Function Tests (PFTs)
These tests measure lung capacity and airflow to assess conditions like asthma, COPD, or restrictive lung disease. Common PFTs include spirometry and diffusion capacity testing.
- Chest X-Rays and CT Scans
Imaging studies can detect structural changes in the lungs caused by inhalation of harmful particles, such as inflammation, scarring, or nodules. CT scans are particularly useful for identifying early-stage lung diseases.
- Blood Tests
– Carboxyhemoglobin Levels: To assess carbon monoxide exposure, especially in the early stages after a fire.
– Complete Blood Count (CBC): To detect inflammation or other systemic effects of exposure.
– Liver and Kidney Function Tests: Some toxic substances can cause systemic damage, which may affect these organs.
- Bronchoscopy
For workers with severe or unexplained symptoms, a bronchoscopy may be performed to examine the airways and collect samples for analysis.
- Methacholine Challenge Test
This test helps diagnose asthma or airway hyper-responsiveness, particularly in workers with persistent wheezing or coughing.
- Biomonitoring for Toxic Substances
Testing for exposure to specific toxins like benzene, arsenic, or heavy metals can guide targeted treatment and monitoring.
- Long-Term Health Surveillance
Regular follow-up evaluations are essential to monitor for delayed health effects, including the development of chronic respiratory diseases or cancer.
NFPA 1582
First established in 1992, the National Fire Protection Association’s 1582 safety standard, known as NFPA 1582, laid the groundwork to protect firefighters from medical risks associated with the job.
Surprisingly, the biggest threat to firefighter health comes not from the flames, but from cancers, overexertion, and stress. In fact, according to the NFPA, NFPA, 54 percent of firefighter deaths are caused by overexertion and stress.
NFPA 1582 aims to ensure that firefighters are able to handle the physical demands of the job via a serious of physical tests designed to test aerobic capacity, muscle strength, flexibility, and endurance.
Additionally, the standard involves conducting a series of medical tests, including blood work, cancer screenings, chest x-rays, and more.
Although not enforced nationwide, some state departments, such as the Ohio Department of Public Safety, require firefighters to meet the NFPA 1582 medical requirements.
It’s worth noting, however, that even in locations where no requirements exist, adhering to the standard significantly improves the health and safety of firefighters everywhere.
For a more in-depth look at NFPA 1582, check out a breakdown of the standard, right here:
Breaking Down the NFPA 1582 Standard
Key Takeaways
As devastating as the LA fires have been to thousands of residents, it nonetheless underscores the importance of proactive respiratory protection and thorough medical evaluations for affected workers.
By equipping workers with proper PPE, conducting regular health screenings such as those laid out in NFPA 1582, and providing long-term support, you can help safeguard their health and well-being in the face of future disasters.
The lessons learned from these fires should guide policies and practices to ensure that those who protect our communities are themselves protected.
How Do I Schedule?
To keep your team protected, you’ll need to find a medical provider in your area that specializes in occupational health.
In the case of Worksite Medical, we make that easier with mobile medical testing.
With Worksite Medical, you can get all the resources of a lab brought directly to your worksite. We’ll tailor a comprehensive medical surveillance program to your specific needs. Our services include those related to NFPA 1582 mentioned above, silica exams, physical testing, heavy metal labs, PPE fit testing, x-rays, audiometric exams, and much more. We safely maintain all of your team’s medical records, and provide you with quick access.
You’ll keep your employees at work, and stay ahead of OSHA inspections.
Protect your team and your workplace now with Worksite Medical. Not sure what you need? Try our medical testing wizard here.
Give us a call at 1-844-622-8633, or complete the form below to schedule an on-site visit or to get your free quote.
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