Wildland firefighter exposure to smoke and COVID 19: A new risk on the fire line
Throughout the United States, wildland firefighters respond to wildfires, performing arduous work in remote locations. Wildfire incidents can be an ideal environment for the transmission of infectious diseases, particularly for wildland firefighters who congregate in work and living settings. In this review, we examine how exposure to wildfire smoke can contribute to an increased likelihood of SARS CoV 2 infection and severity of coronavirus disease (COVID 19) Human exposure to particulate matter (PM) a component of wildfire smoke, has been associated with oxidative stress and inflammatory responses; increasing the likelihood for adverse respiratory symptomology and pathology. In multiple epidemiological studies, wildfire smoke exposure has been associated with acute lower respiratory infections, such as bronchitis and pneumonia. Co occurrence of SARS CoV 2 infection and wildfire smoke inhalation may present an increased risk for COVID 19 illness in wildland firefighters due to PM based transport of SARS CoV 2 virus and up regulation of angiotensin converting enzyme II (ACE 2) (i.e. ACE 2 functions as a trans membrane receptor, allowing the SARS CoV 2 virus to gain entry into the epithelial cell) Wildfire smoke exposure may also increase risk for more severe COVID 19 illness such as cytokine release syndrome, hypotension, and acute respiratory distress syndrome (ARDS) Current infection control measures, including social distancing, wearing cloth masks, frequent cleaning and disinfecting of surfaces, frequent hand washing, and daily screening for COVID 19 symptoms are very important measures to reduce infections and severe health outcomes. Exposure to wildfire smoke may introduce additive or even multiplicative risk for SARS CoV 2 infection and severity of disease in wildland firefighters. Thus, additional mitigative measures may be needed to prevent the co occurrence of wildfire smoke exposure and SARS CoV 2 infection.
Science of The Total Environment