Scenes of the ash and smog from wildfires in the West Coast not only trigger sympathy for those with friends and family living in a paradise under siege, but also are a cause for concern for doctors who specialize in the lungs.

While doctors don’t know how far and wide the effects of these fires might be for those who are already struggling with their breathing, such as people with asthma, chronic obstructive pulmonary disease or chronic bronchitis, physicians said the effect could spread well beyond the areas battling these blazes.

The danger is “not just at the site of the fire,” said Dr. Norman Edelman, a professor of medicine at Stony Brook University and a core member of the program in public health at Stony Brook. “I’m sure [the effect of the fire] is pretty wide.”

Indeed, at some point down the road, the small and large particles that are aerosolized during the fire could reach as far away as Long Island.

“We know quite firmly that air pollution from coal burning generator plants [in the Midwest] emits pollution that makes its way all the way to the East Coast,” Edelman said.

The current use of masks may offer some protection for residents on the West Coast.

Particulates, which are aerosolized particles that can get in people’s lungs and affect their breathing, come in various sizes. The larger ones tend to get lodged in people’s noses, throat and eyes and can cause coughing, hacking, and watery eyes. An ordinary mask can filter some of those out, although masks are not completely effective for these bigger particles.

The smaller ones are more dangerous, Edelman said. They can get further into the lungs and can exacerbate asthma, chronic bronchitis and emphysema. They can even contribute to increased incidence of heart attacks.

“Nobody really knows” why these smaller particles contribute to heart attacks, Edelman said. Anecdotal evidence suggests that a reduction in pollution improves the health of a population.

When New York banned smoking in all public places, the level of heart attacks dropped by 15 to 20 percent.

“This level of pollution is nothing like what we’re seeing in the area of the wildfires,” Edelman said.

Additionally, lower pollution can improve the health of people with lung problems.

At the Summer Olympics in Atlanta in 1996, officials put in alternate day driving restrictions, which allowed people to drive every other day. By cutting down the pollution from traffic, doctors noticed a 25% reduction in admission to the emergency room for asthma.

If he were a doctor on the West Coast, Edelman said he would make sure his patients had all their medications renewed and available. He would also check in with his patients to make sure they had emergency instructions in case they need to boost the amount of any pharmacological agents.

The effect of the pollutants on people with asthma or other lung issues can be more severe if they are already dealing with an inflamed airway.

“The effects of various irritants are probably synergistic,” Edelman said. “If this is your allergy season, you become much more susceptible to the inflammatory effects of air pollution.”

COVID and the Lungs

As for the pandemic, Edelman said he didn’t come to the emergency room to work at the Intensive Care Unit during the pandemic.

His colleagues did, however, ask him to take care of patients who didn’t have to come in by telehealth. He’s continued to see many patients over the last three or four months.

One surprise from the data he’s seen related to the pandemic is that asthma does not seem to exacerbate the effects of COVID-19.

People with asthma “are not dying with COVID at any greater rate than the general population,” Edelman said.

He hasn’t yet seen the data for people with chronic bronchitis or COPD.