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Smoke inhalation can cause short and long-term damage to workers

By Jon Waldman

One of the biggest stories of summer 2023 in Canada, if not the biggest, was the increase in wildfires that burned throughout the country.

Record numbers of fires and hectares of land burned have resulted in evacuations of cities and towns, while smoke warnings arose in areas far away from the directly affected regions. As reported by Environment Canada, Saskatchewan smoke hours (which is when visibility is reduced to 9.7 km) shattered previous records. From May 1 to Sept. 5, Saskatoon had 282 hours of smoke, with the previous high being 185 in 1981. La Ronge, meanwhile, had 802 hours, with a previous record of 165 from 2015.

Not only can this be a great concern for citizens who might otherwise enjoy a warm summer outdoors, it also increased caution for some in the heavy construction industry. Working outside in summer, where heat be overwhelming in normal conditions, is already a concern during lengthy stretches. Now, smoke and other particle inhalation is a greater risk.

“It’s more important than people realize. Wildfire smoke, especially, has several chemicals associated with it. There’s a significant respiratory risk. Even people who are otherwise healthy, on days where it’s really bad and you’re working outdoors in particularly strenuous activity, there’s potential to notice some of the effects,” said Dr. Niels Koehncke, a professor in the Department of Medicine and specialist in occupational medicine at the University of Saskatchewan. 

“People who are otherwise at risk, who have pre-existing lung conditions like bronchitis and emphysema, pregnant workers, are at higher risk for exacerbation. It’s a concern in those circumstances, but on particularly bad days, people who otherwise would generally consider themselves healthy will definitely notice some effect.”

CBS News reported an example of how bad the effects can be in late June. At the time, writer Li Cohen shared information from the Environmental Protection Agency in the United States.

“The particulate matter within the smoke irritates the respiratory system, impacting the body’s ability to function even among those who are healthy, and even short-term exposure of just a few days can have serious impacts,” Cohen wrote. “‘Sensitive groups,’ including children, the elderly, pregnant people and those with pre-existing respiratory and cardiovascular issues, are most vulnerable to these impacts.”

In Cohen’s comments, she focuses on those who come outside for recreation. For those whose livelihoods and income depend on being outdoors, there is no option to move indoors. As such, repeated exposure can be dire, especially for those with already weakened systems.

“For people with pre-existing medical conditions, they might find that wildfire smoke worsens them and that worsening can turn into a medium to long-term effect, particularly if this (the fire situation) is not going away,” Dr. Koehncke said.

Part of what makes wildfire so concerning is that its composition is not pure smoke. Instead, as Health Canada explains, it’s a complex mixture of gases, vapour and particles. Contents include ozone, sulphur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds and fine particle matter (also known as PM2.5). The latter is particularly concerning.

Working outside in summer, where heat can overwhelm the human body, is already a concern during lengthy stretches. Now, smoke and other particle inhalation is a greater risk.

“There is no evidence of a safe level of exposure for most of these pollutants. This means that smoke can impact your health even at very low levels,” the government agency stated on its website. “As smoke levels increase, your health risks increase. Air quality may be decreased even if you can’t see or smell smoke.”

Another wrinkle that comes into play for the construction industry is that exposure to hazardous materials in the air is already occurring, making the environment that much more troublesome to manage for construction jobs. “They (construction workers) are often exposed to a range of respiratory hazards. Sometimes it’s a crystalline silica layer,” said Jeannette Campbell, senior occupational hygienist with WorkSafeBC. “Layered on top, you have the exposure to substances that have long-term respiratory effects,” she said. “This is the stuff we’re still trying to wrap our brains around because it’s pretty unique.”

Campbell also points out that there is a gap in staff age, and those who have worked in these conditions for longer are more susceptible to illness and other effects from long-term exposure to contaminants and smoke.

“We have an aging workforce that, in some cases, has many years of exposure to respiratory hazards that are going to potentially make them more susceptible to the smoke,” she said.

Preparation

Arming oneself and one’s staff against wildfire smoke inhalation can be tricky. In many situations, the best defence is personal protective equipment (PPE).

PPE for breathing was a lesson learned during the height of the COVID-19 pandemic, where recommendations were made to wear masks when venturing outdoors. In particular, N95-graded masks can be a defence against the elements when worn properly.

“One of the things you can do is get the N95 masks that are well fitted,” Yellowknife’s Dr. Courtney Howard, an emergency room physician, said in a CBC article. “You can tell that it fits well (because) when you breathe in, the mask kind of sucks into your face. If you can feel the air coming around the sides, then it’s not a good fit or you may need to mould it more to your face.”

However, this is the last step in the safety process. “If there are other ways to avoid that exposure, such as administrative and procedural controls, they should be considered,” Dr. Koehncke said, adding that owners and project managers should ask questions such as, “are there changes to procedures and plans for a day or two days that can minimize workers or groups of workers that are exposed to smoke?”

“People who are otherwise at risk, who have pre-existing lung conditions like bronchitis and emphysema, pregnant workers, are at higher risk for exacerbation. It’s a concern in those circumstances, but on particularly bad days, people who otherwise would generally consider themselves healthy will definitely notice some effect.”

– Dr. Niels Koehncke, University of Saskatchewan

Combating the effects of wildfire can also be accomplished through pre-emptive moves, such as developing an Exposure Control Plan (ECP). The Manufacturing Safety Alliance of BC drafted a guide for its members on how to properly build an ECP, which includes: 

• A statement of purpose and responsibilities
• Risk identification, assessment and control
• Education and training
• Written work procedures (when required)
• Hygiene facilities and decontamination procedures (when required)
• Health monitoring (when required)
• Documentation and annual review (when required)

“Companies have a duty to protect their workers from exposure to wildfire smoke during construction activities that take place during wildfire smoke events,” The Manufacturing Safety Alliance of BC stated in the guide. “Effective controls are available to protect workers from exposure. A combination of control measures is required to achieve this objective.”

Forecasting can also help. Government organizations, in concert with meteorological groups, can aid in project planning by looking at weather patterns and results, as was the case in B.C.

“It was anticipated because last October was so dry and unseasonably warm that we were in a scenario where the soil didn’t have the moisture. So they were anticipating and we didn’t get the rains expected in June, and we have widespread drought conditions,” Campbell said. “It is anticipated that this is going to continue. The two fire weather forecasts I’ve listened to from committees I sit on were not looking at the seasonal shifts we get that bring in the rains in the fall. So, we’re in a wait-and-see scenario.”

While those conditions are still unfavourable, work has to start because of the damage incurred.

“As we move in these areas, as we move into the recovery phase, there’s still a lot burning and there will likely be additional fires,” Campbell said. “Those will now be in areas where we have construction workers going in and working.”

Another step in preparing for work in these new conditions is adapting heavy construction practices. Campbell sees preparation as being similar to dealing with higher temperatures.

“The piece is thinking of outdoor work in terms of how we manage it with heat – can we reduce the intensity with which that work is happening, can we take our breaks in cool places with clean air, using our vehicles as places of refuge,” she said. “Then we need to think of when we’re out there and in the environment of it, what those exposures are.”

In many situations, the best defence is personal protective equipment.

Recovery

The unfortunate reality is no matter how many preventative measures are taken, wildfire smoke inhalation is nearly impossible to avoid. 

Thankfully, treatment for smoke-related irritation has several options. In a blog for Hearthside Medicine Family Care’s website, Havilah Brodhead, FNP, listed several techniques, including using a saline-based nasal spray and eating ginger and other anti-inflammatories.

However, the simplest solution is to drink plenty of water.