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Climate stressors and impacts
The growing impact of climate change is significantly intensifying the conditions that lead to wildfires, particularly in the western United States, a region already susceptible to these devastating events. Between 1970 and 2003, changes in climate, specifically warmer temperatures and less precipitation, resulted in a staggering 650 percent increase in the area burned in mid-elevation conifer forests. According to findings from the 2014 National Climate Assessment, climate factors have consistently outweighed other contributors in determining the extent of burned areas in this region.
Looking ahead, experts anticipate a notable rise in the frequency of “very large fire” weeks, which are periods characterized by conditions that significantly favor the ignition and spread of large fires. Projections indicate a dramatic increase by mid-century (2041-2070) based on the emissions scenario known as RCP 8.5, which assumes ongoing escalation of carbon dioxide emissions. Such forecasts suggest that parts of the southern Rockies could see a doubling of areas burned, while California might experience a surge of up to 74 percent in wildfire incidents. This situation presents severe challenges for healthcare facilities as they strive to meet community needs.
Hospitals under fire
As wildfires approach urban areas, hospitals may find themselves in a precarious position, sometimes necessitating evacuations even if the fire is not immediately threatening the facilities. Hospital ventilation systems rely on a consistent flow of fresh outdoor air to maintain proper indoor air quality. However, when the outdoor environment is filled with hazardous smoke, it poses significant risks to the health of patients and staff, creating potential barriers to safe operations.
Despite these challenges, emergency departments situated close to the fire are critical as they provide necessary care for both firefighters and residents affected by the blaze. To mitigate the dangers posed by smoke, hospitals situated in fire-prone regions have developed strategies such as isolating ventilation systems and utilizing recirculated air during emergencies. Further, implementing portable air scrubbers and HEPA (high-efficiency particulate air) filters can help manage airborne pollution when external ventilation is compromised.
A filter system saves the day
In 2008, Southern California faced two significant wildfires that demonstrated the challenges hospitals encounter. The Sesnon Fire in October lasted five days and introduced serious smoke threats to Providence Holy Cross Medical Center, while the subsequent Sayre Fire in November caused greater disruptions, blocking access for 40 percent of the hospital’s staff due to its intensity.
Recorded by NASA, an image from October 13, 2008, illustrates the extensive smoke generated by these fires around Los Angeles. As the only trauma center in Burbank, Providence treated over 200 patients from surrounding hospitals and made the difficult decision to cancel elective surgeries. Remarkably, the facility remained operational thanks to the preemptive installation of HEPA filters, initially acquired for pandemic preparedness. These filters not only assist in air purification but also ensure the hospital maintains critical air pressure in quarantine areas. Their use during the wildfires exemplifies how preparedness can enable healthcare facilities to continue functioning amidst crises.
The advantage of scrubbers
The Black Forest Fire in Colorado in June 2013 further illustrated the importance of rapid response in hospital settings during wildfire events. With around 300 employees of Memorial Hospital and Children’s Hospital Colorado forced to evacuate or prepare for such actions, the hospital’s administration quickly enacted safety protocols based on the lessons learned from the previous year’s Waldo Canyon fire.
Hospital safety teams began monitoring indoor air quality rigorously and implemented portable air scrubbers at Memorial Hospital North and Central to ensure patient safety amid rising smoke threats. This proactive approach, which included collaboration with off-site facilities to manage air quality, showcased the vital importance of preparedness in maintaining effective healthcare delivery during environmental crises.
This article was originally published as part of the U.S. Climate Resilience Toolkit’s “Case Studies” section. As part of the toolkit, users can see how climate change is impacting human health.
Sources:
Melillo, Jerry M., Terese (T.C.) Richmond, and Gary W. Yohe, Eds. (2014). Climate Change Impacts in the United States: The Third National Climate Assessment. U.S. Global Change Research Program, 841 pp. https://doi.org/10.7930/J0Z31WJ2.
Bell, J.E., et al. (2016). Ch. 4: Impacts of Extreme Events on Human Health. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. U.S. Global Change Research Program, Washington, DC, 99–128. https://doi.org/10.7930/J0BZ63ZV.
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www.climate.gov