This blog post was written by Katie Keating, RN, MS, patient advocate

Firepits, Fireplaces and Chimineas-Tips for Respiratory Patients

Do you enjoy sitting around a crackling fireplace indoors or cozy firepit outdoors on a fall night? I have always loved doing so; it brings back fond childhood memories of toasting marshmallows or singing around the fire. Outdoor fires make you feel alive. The crackling sounds of indoor fireplaces, the hearth of a home are comforting, inviting.

I have been in denial about the possibility of fire smoke irritating my lungs or causing lung damage for years since I enjoyed using fireplaces and firepits so much. Over the past few years though, I have decided that it just is not worth taking a chance of injuring my lungs.  Hence, I no longer sit by a campfire, a firepit, chiminea or an indoor wood-burning fireplace. I value my health too much and will take any preventive measure to lessen the chance of aggravating the health of my lungs.

The best way to manage chronic lung disorders is to avoid the things that make them worse. It is so important to identify irritants that can trigger respiratory symptoms.

Burning wood releases pollutants into the air we breathe; wood smoke contains millions of tiny particles. Breathing in wood smoke can irritate sensitive airways, cause airway tightening, increase respiratory symptoms, increase hospital admissions, exacerbate COPD, and decrease your ability to breathe normally. Simply put, if you have a lung disease, breathing in wood smoke can make your disease worse and cause a flare-up.

Smoke isn’t the only health hazard you should avoid. Y The heat itself can be harmful. Inhaling air that is consistently at a higher temperature than the surrounding air can cause more damage to the lining of your lower respiratory tract than smoke inhalation. ⁽¹⁾

Environment Canada and Health Canada has identified many hazardous chemical substances in wood smoke, including: ⁽²⁾

• PM2.5 consists of a mixture of microscopic particles of varied size and composition and  has been declared a toxic substance under the Environmental Protection Act. These particles can be inhaled deep into the lungs, leading to serious respiratory problems, including mortality, especially among those with pre-existing cardiopulmonary illnesses.
• Carbon monoxide (CO) can reduce the blood's ability to supply necessary oxygen to body's tissues, which can cause stress to the heart. When inhaled at higher levels, CO may cause fatigue, headaches, dizziness, nausea, confusion, and disorientation.
• Oxides of Nitrogen (NOx) can lower the resistance to lung infections. In particular, nitrogen dioxide can cause shortness of breath and irritate the upper airways.
• Hydrocarbons (HC) — can damage the lungs.
• Volatile organic compounds (VOCs) can cause respiratory irritation and illness. Some VOCs emitted by wood-burning appliances, such as benzene, are known to be carcinogenic.
• Formaldehyde can cause coughing, headaches and eye irritation and act as a trigger for people with asthma.
• Polycyclic aromatic hydrocarbons (PAHs) prolonged exposure to PAH's is believed to pose a cancer risk.
• Dioxins and furans some dioxins and furans are carcinogenic.
• Acrolein can cause eye and respiratory tract irritation.

Outdoor fire pit burning creates smoke that contains many pollutants and irritants, which can cause or aggravate lung health problems as well as negatively impact air quality. Environment Canada and Health Canada have identified many hazardous chemical substances in wood smoke specifically for firepits, including:

• PM10 inhalable particulate matter less than 10 microns in diameter) consists of a mixture of microscopic particles of varied size and composition, and has been declared a toxic substance under the Environmental Protection Act
• Also, carbon monoxide (CO), oxides of nitrogen (NOx), volatile organic compounds (VOCs), formaldehyde, dioxins and furans, polycyclic aromatic hydrocarbons, (PAHs) and acrolein as previously listed and discussed above.

Chimineas are ceramic wood burning appliances that people use outdoors, often on patios. The same concerns apply here as to other open burning. The open design of these devices leads to inefficient burning of the wood. Wood smoke from chimineas may stay closer to the ground since they have low chimney stacks, and can pose a problem for neighbors. Many communities have laws regarding burning outdoor fires.

Hence, all wood burning devices may result in respiratory issues. If you must join in on activities that may put you at risk, try to sit as far from the fire as possible and pay attention to the direction the wind is blowing.  Absorb the atmosphere — but not the smoke.  Remember the old cliche: An ounce of prevention is better than a pound of cure. I wish you the very best. Other comforts will eventually replace the loss of the firepits, chimneas and/or fireplaces.

References:

1) Lungs, Breathing and Allergy Team, Pulmonary Function Lab Director Bohdan Pichurko, MD.

https://health.clevelandclinic.org/2017/04/fire-pits-bonfires-and-your-lungs-7-safety-tips/">https://health.clevelandclinic.org/2017/04/fire-pits-bonfires-and-your-lungs-7-safety-tips/

2) Canadian Lung Association, 2017, www.ab.lung.ca

The COPD Foundation advises that before you make any changes to your medication or therapies that you first consult with your doctor.