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The Informed Parent

Smoke and Flames Across The Ridge

by John H. Samson, M.D., F.A.A.P.
Published on Nov. 19, 2007

The TV coverage screams of disaster. Constant coverage shows our children burning homes, stables and trees. Mothers and fathers are interviewed, relating the terrible misfortune that the wild fires have bestowed upon them. As you can imagine, this fills our children with fear and anxiety.

The impact of these infernos in our pediatric population does more than scare our little ones. It has pulmonary consequences. That is, it may make some cough and wheeze. Children that have reactive airway disease or asthma may be significantly effected.

First off, let me explain that asthma and reactive airway disease, RAD, are essentially the same. The expression RAD came about because it explained what was happening in the lungs; that is, a reaction with increased mucus and tightening of the breathing tubes. Asthma, on the other hand, was not a descriptive word. In addition, the term RAD seemed less threatening to parents than asthma. It was a new word and did not have the history of problems that asthma brought to relatives in the past.

These wild fires pose two problems for children:

  1. The real or apparent threat of losing possessions, pets or parents and even causing pain or injury to themselves.
  2. Causing activation of their RAD due to particulate matter inhaled from the smoke.

How do we control these issues? Let’s look at problem #1. Suppose the fire is in plain view of your home or in the proximity necessitating evacuation. Reassurance and calm directive action on the part of the parents is critical. At times such as this parental action sets the tone more than words to highly influence the children.

Fortunately, only a small percentage of families in Southern California were made to evacuate. The fires created an emotional impact on our offspring with the TV coverage. Sensational video imaging most often generates high ratings for the stations. But, in turn, it causes significant anxiety in children with fear of impending disaster which is unfounded.

It is important to minimize TV watching of such programming. Be sure to be there with your children when they view it so that you can keep everything in perspective. Small children cannot do this alone when they see ashes in the yard and smell the scent of the fire. To them it seems to be a greater threat than it is. We live in an era where TV news fills their young minds with apparent threats that are unreal. Therefore, use this caution not only with wild fire telecasts but with daily news.

Problem # 2: there is no question that particulate matter in the inhaled air can trigger a vasomotor RAD. Cigarette smoke, paint fumes, perfume, etc. for patients with this type of RAD may cough and wheeze. Severe air contamination with smoke will make us all cough. The main problem is seen in RAD patients since it takes a small amount of air foreign particles to start their symptoms. 

I advise my patients who have RAD triggered by air contamination to:

  1. stay indoors
  2. avoid strenuous activity that provokes fast or deep breathing
  3. be sure to use their inhalers to prevent an acute attack.

Obviously if an acute exacerbation occurs they must be treated as an RAD attack has been managed in the past.

The child will not sustain lung damage from inhaling distant fire smoke unless it would be sustained for a very prolonged time (i.e., longer than they were subjected to in this current fire season.) 

I thought I would end this discussion with a little story that points out how sometimes we humans act not only inconsistently but down right stupidly.

An Orange County area office worker presented to work wearing a filter mask to protect him from the ravages of inhaled distant fire smoke. Keep in mind he worked in an air conditioned, filtered, closed windowed building. Admittedly he was a very cautious man. At his coffee break he took his usual trip to the parking lot so he could remove his mask and enjoy a cigarette! After his smoke he replaced the mask and returned to work.

We wonder why our children sometimes find it hard to follow our directions; maybe they view our actions! Our children are faced with enough things to provoke fear and anxiety. Let’s not unnecessarily add to their burden.

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