What In the Blazes?

Introduction

The stubborn blaze at International Terminals Co. (ITC) in Deer Park has been raging for the past 4 days, as health concerns emerge from anxious Houston-area residents in the vicinity. Plumes of dark smoke have been sighted emerging from the chemical tanks which have been engulfed by the blaze. While the skies have visibly darkened from the outpouring of chemicals into ambient air, representatives from the Harris County Public Health have reassured residents that the quality of air is being continuously monitored. At the time of writing (2 AM, 20 Mar 2019), the Air Quality Index (AQI) has a reading of “MODERATE” – implying that unusually sensitive persons should consider reducing prolonged or heavy exertion. At risk individuals such as pregnant women, children and the elderly are not at significant risk at the time of writing. The AQI is updated real-time and can be accessed by readers at https://www.readyharris.org/Deer-Park-Fire.

The Toxicity of Fire Smoke

Fire smoke has 4 main components which each lend an element of risk and danger to persons exposed to it. These are carbon monoxide, a myriad of organic chemicals within the smoke, oxygen depletion and heat. Additionally, due to the rapid introduction of large quantities of synthetic polymers into building infrastructure in the last few decades alone, the release of hydrogen cyanide and inorganic acids represent additional toxic threats. Regardless, studies have suggested that carbon monoxide production as a result of incomplete combustion, is still the major toxicant in modern fires.

The toxicity of fire smoke is largely dependent on the proximity of the affected individual to the origin of the fire. Persons who are in the immediate vicinity of the fire will experience the following:

  • Sensory irritation of the eyes and subsequent tearing leading to impaired vision. This is due to the large number of organic and inorganic toxicants within the fire smoke.
  • Respiratory inhalation of these toxicants results in upper respiratory symptoms such as coughing, choking and gagging. This is because the bronchial walls are irritated by the toxicants.
  • Heat-stress due to close proximity to the fire. Thermoregulatory mechanisms are activated to maintain core body temperature. This leads to perspiration as well as cool and clammy skin.
  • Limited visibility due to high smoke density from the fire.

In regard to chemical fires, if the burning materials contain chlorine, bromine or fluorine, hydrogen chloride, hydrogen fluoride and hydrogen bromide are released. These chemicals significantly exacerbate the irritant and choking effects of the toxic smoke. Furthermore, they may have delayed and long-lasting effects on the respiratory system in view of their corrosive effect on the respiratory lining.

While there are understandable fears surrounding the carcinogenic (cancer-causing) effects of some of the toxins present in chemical fire smoke [e.g. polycyclic aromatic hydrocarbons, acrylonitrile, vinyl chloride, asbestos, formaldehyde and polychlorinated biphenyls (PCBs)], these can be assuaged in view of the chronicity of the smoke-exposure. Short-lived exposures to toxic chemical smoke are unlikely to culminate in cancer, as opposed to a sustained chronic exposure over a longer period of time (e.g. months to years).

Vulnerable Populations

In view of the fact that most residents will not be in the immediate vicinity of the origin of the Deer Park fire, who then should be concerned? While the current AQI reading is “MODERATE”, and the risks for the general and at-risk population are deemed to be low, vulnerable populations are still advised to take precautions.

Patients who have known respiratory disease, such as Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Cystic Fibrosis should stay indoors for the duration of the fire. This is because while the toxic irritants within the smoke are not directly responsible for their primary disease, they may very well exacerbate them. Asthmatics and COPD patients in particular should always have their rescue-therapy inhalers on hand at all times.

Patients who have known allergies to air-borne particles (e.g. pollen or animal dander) or have chemical hypersensitivities should also endeavour to stay indoors. If they have suffered a severe allergic reaction or anaphylaxis before, and have been prescribed an Epipen for precautionary measures, they should also keep this on hand at all times.

Patients who have known cardiovascular disease should not exert themselves during this period. This is because any compromise in oxygenation would tax the heart’s workload and may precipitate acute coronary events (e.g. heart attack).

Pregnant women and children, whether healthy or not, should also follow the precautions set out above as a general safety measure.

Additional Precautions & General Advice

At Community Health 1st ER, the community’s well-being is our first and foremost priority. This includes your psychological well-being as well. We want to re-assure you that our staff are ready and available to attend to you and your family’s needs during this troubling time. As such, we have prepared a General Advisory as follows:

  • Continue to stay updated on the AQI – surveillance and monitoring is necessary to ensure readiness
  • Limit outdoor exposure until the AQI has dipped down to a “LOW” reading for a few days continuously
  • Consider purchasing Personal Protective Equipment (e.g. face-masks)
  • Be mindful of vulnerable persons in your household and neighbourhood and follow the guidelines set out above

In the event that you or your family member experiences the following symptoms:

  • Chest Tightness
  • Shortness of Breath
  • Chest Pain
  • Severe Coughing
  • New-onset Allergic Reaction

Please seek urgent medical attention – at CH1ER we are ready to serve you.