By: Zoe Williams 

Fire smoke inhalation can affect more than just the lungs; it may also impact other health conditions, healing processes, and wound care. The recent fires in L.A. highlight how exposure to smoke can influence overall well-being, including respiratory health and recovery. Even residents who have evacuated safely may experience the effects of the smoke, which has spread far beyond the fire’s immediate area.

With fire smoke inhalation, harmful particles and gases in the air can weaken the immune system, delay recovery, and increase the risk of infections in open wounds. Understanding this connection is essential for those managing injuries in areas affected by wildfires to provide better care and achieve better outcomes. Renowned wound care surgeon and founder of Skilled Wound Care and Skilled Physician Group, Bardia Anvar, lends his professional perspective to unpacking the hidden threats of fire smoke inhalation.

What is Fire Smoke Inhalation?

Fire smoke inhalation occurs when harmful substances from burning materials are breathed into the lungs. This exposure can lead to serious respiratory and systemic issues, even for those who may believe their exposure to be insignificant. 

“While we generally understand the basic and immediate dangers of smoke inhalation, it’s easy to discount how it can indirectly affect wound healing by weakening the body’s natural defenses,” says Dr. Bardia Anvar. “Understanding the specific components of fire smoke and its health effects is essential for protecting vulnerable individuals, particularly those managing wounds unrelated to the fire event who may not immediately understand the added threat to their health.”

Fire smoke is a dangerous mixture of particles and gases released during combustion. Its harmful effects stem from several toxic elements. Carbon monoxide is a colorless, odorless gas that blocks oxygen from binding to hemoglobin in the blood. When CO levels rise, oxygen delivery to tissues significantly decreases, causing hypoxia, a condition that starves cells of oxygen. 

Tiny particles of soot, ash, and debris can enter deep into the lungs. This particulate matter contains irritants that damage lung tissue, impair respiration, and trigger inflammatory responses throughout the body. Fire also releases harmful chemicals depending on what materials are burning. This may include hydrogen cyanide, a byproduct of plastics and synthetic materials, as well as formaldehyde and ammonia. 

Such compounds are particularly corrosive and can cause chemical burns within the airways. The composition of fire smoke is highly variable, but even short-term exposure can be life-threatening when multiple toxins combine to overwhelm the respiratory system.

Health Effects of Fire Smoke Inhalation

Inhaling fire smoke can lead to immediate and widespread health effects. The respiratory system is often the first to be impacted, with smoke quickly irritating the nose, throat, and lungs. This irritation can result in coughing, wheezing, and difficulty breathing. In some cases, inflammation and swelling may contribute to airway obstruction and respiratory discomfort.

Prolonged smoke exposure can lead to carbon monoxide accumulation and toxin absorption. This significantly strains the heart, brain, and other vital organs, potentially causing long-term damage.

Notes Dr. Anvar, “There is an urgency to address smoke inhalation once exposed. Safety is key, and the long-term threats to your health can go undetected at first if you are not properly examined after fire smoke inhalation.”

Protecting respiratory health should be a priority in wildfire-prone areas or when a wildfire event occurs, particularly for individuals with injuries or chronic conditions. Understanding the immediate dangers helps guide medical decisions and improve outcomes for at-risk patients.

Fire smoke inhalation has significant repercussions for wound healing. The poisonous compounds in smoke hinder the body’s ability to repair itself. To understand how smoke interferes with healing, it’s essential to examine its effects on oxygenation, inflammation, and systemic toxicity.

Oxygen is essential in wound healing, as tissue repair cells depend on a consistent oxygen supply. Smoke inhalation can interfere with this process, potentially slowing tissue repair. Reduced oxygen levels may affect collagen production and the activity of wound-healing cells like fibroblasts and macrophages. In such cases, wounds may take longer to close, increasing the likelihood of complications.

Smoke inhalation fuels excessive inflammation in the body long after immediate exposure. When harmful components like particulate matter and toxic chemicals from smoke enter the lungs, they release inflammatory compounds. While some inflammation is necessary for healing, an overactive response becomes counterproductive.

Overproduction of pro-inflammatory molecules slows wound healing by damaging healthy tissue around the wound. The body’s energy and resources are shifted toward fighting systemic inflammation rather than supporting localized tissue repair. 

Beyond its localized effects, fire smoke inhalation introduces harmful toxins into the bloodstream. Substances like hydrogen cyanide and formaldehyde, released during the burning synthetic materials commonly found in homes, can spread throughout the body. This systemic toxicity creates additional barriers to effective wound healing.

Toxins from smoke hinder circulation, decreasing the body’s ability to deliver essential nutrients, oxygen, and immune cells to the injury site. Additionally, some toxins impair the immune system, reducing its ability to fend off infections and causing delayed wound closure. For individuals exposed to prolonged wildfire conditions, this toxic burden overwhelms the body’s resources, making recovery from injuries much more difficult.

Clinical Signs of Fire Smoke Inhalation in Patients with Wounds

When managing patients who have both wounds and smoke inhalation injuries, it is critical to identify clinical signs promptly. Exposure to fire smoke can exacerbate existing injuries and lead to additional complications that delay recovery. Wound patients are particularly vulnerable because their immune systems are already working hard to repair damaged tissue. 

Patients exposed to fire smoke often display respiratory symptoms that signal damage to their airways. These symptoms include persistent coughing, wheezing, and difficulty breathing. In more severe cases, individuals can experience airway swelling, marked by hoarseness or stridor—a high-pitched sound during breathing.

Beyond the more obvious respiratory symptoms, the systemic effects may be more subtle but equally dangerous. Common signs include headaches, dizziness, nausea, and confusion. For patients with wounds, systemic effects compound the challenge. 

“Low oxygen levels not only interfere with physical recovery but also burden the brain and cardiovascular system. Over time, this can lead to fatigue and reduced energy—two factors that delay healing. When dizziness or confusion occurs, it signals that the body struggles to maintain balance, making it even more susceptible to infection and other complications,” says Dr. Anvar.

Wound care patients exposed to fire smoke inhalation may experience delayed healing, with wounds appearing to stagnate in their recovery or signs of infection, such as increased redness, swelling, or warmth around the wound site. Providers can offer timely, focused interventions by being aware of respiratory, systemic, and wound-specific symptoms. 

The dangers surrounding fire smoke inhalation are far-reaching but often not top of mind for those fleeing from the destructive power of wildfires. As fleeing residents are mourning lost homes or making plans for the next steps, it’s essential to prioritize medical care. Preparedness and awareness are key to improving outcomes for those navigating the unexpected challenges compromised health brings when wildfires rage. 

Disclaimer: The information provided in this article is for educational and informational purposes only. It is not intended as medical advice, diagnosis, or treatment. Please consult a qualified healthcare professional for any concerns regarding smoke inhalation, wound care, or other health-related issues. The perspectives shared are based on general insights and do not substitute for personalized medical consultation.

Published by Stephanie M.