UCLA Pulmonologist: Wildfire Smoke, Including from Burning Batteries, Causes Immediate and Long-term Health Risks

UCLA pulmonary specialist John Belperio told the California State Assembly Health Committee on Jan. 7 that wildfire smoke is causing immediate respiratory illness and can trigger longer-term systemic problems.

Belperio, chief of the division of pulmonary, critical care, allergy, immunology and sleep at the David Geffen School of Medicine at UCLA, said the fine particles produced by fires are especially hazardous. "The purple dot is particulate matter, 2.5 microns or less," Belperio said, adding that those particles "make people with asthma, COPD, interstitial lung disease, and lung transplant patients decompensate."

Why it matters: Particulate matter 2.5 (PM2.5) penetrates deep into the lung and can produce both localized pulmonary inflammation and systemic effects that increase risk for infections, heart attacks and stroke. Belperio described how inhaled particles can trigger inflammation in the lungs that then affects arteries and the brain and can contribute to complications in pregnancy.

Key details and clinical guidance Belperio summarized research and clinical experience from the Palisades, Eaton and other fires that have stricken the region. He said wildfire-related smoke commonly places people in the hazardous "maroon" air quality index range and noted that "you see particulate matter getting deep down into the lung" where it is difficult to remove. He described clinical outcomes ranging from asthma exacerbations and COPD flare-ups to rejection in lung-transplant patients.

On lithium-ion batteries: In a committee question-and-answer session, Belperio said fires that involve electric vehicles and battery storage can release additional heavy metals and metals-containing particulates — "lead, magnings, tungsten carbide... beryllium" — and that such exposures can make respiratory illness worse and, in some cases, lead to granulomatous disease that resembles sarcoidosis. He said it can be difficult to distinguish clinically between "typical wildfire smoke" and smoke containing metals and that physicians should monitor symptomatic patients with chest X-rays and pulmonary function testing.

Advice for residents and clinicians Belperio recommended that people who develop increased cough, shortness of breath or dizziness after exposure see a clinician promptly: "If you have symptoms such as shortness of breath, cough, or dizzy on exertion ... they should see ... their doctor." He emphasized staying indoors and sealing homes when smoke is present, avoiding outdoor exercise during poor air quality, and using medical evaluation to rule out treatable infections that can present during wildfire exposures.

Evidence and research needs Belperio and committee members noted gaps in long-term data: some lung diseases caused by environmental exposures may not manifest for years or decades. He called for monitoring and follow-up of people exposed to heavy smoke, and for outreach so that residents understand when to seek medical care.

Ending: The witness urged clinicians and local health systems to be alert for both immediate exacerbations of lung disease and for potential longer-term, less visible harms from repeated or intense wildfire smoke exposure.