5 Questions: Lisa Patel on California wildfires and school ventilation | News Center

The wildfires that burn hundreds of thousands of acres in California every year aren’t just scorching the land; they also pump toxic smoke into the air. Pediatrician Lisa Patel, MD, an expert on the health effects of climate change, is concerned about the smoke harming children, especially since the peak of wildfire season coincides with the start of the school year.

But Patel, a clinical assistant professor of pediatrics at Stanford University School of Medicine, sees an opportunity in the confluence of two public health crises. The global COVID-19 pandemic has prompted state and federal governments to fund upgrades to schools’ ventilation systems. Thanks to the new Action Lab for Human and Planetary Health Program hosted through the Stanford Center for Innovation and Global Health, Patel works in collaboration with Mary Prunicki, MD, senior research scientist at Stanford’s Sean N. Parker Center for Allergy and Asthma Research, and Michael Wara, JD, a senior research scientist with the Stanford Woods Institute for the Environment, to help school districts benefit from the funds.

“We should have better indoor air quality for our children; it’s helpful for so many reasons,” said Patel, who spoke to science writer Erin Digitale about the situation. “COVID-19 has given us a moment where we can think synergistically about different issues.”

1. During last year’s fire season, California students learned online because of the global pandemic. This year they are returning to the classroom just as the fire season intensifies. What concerns does that raise?

patella: I started thinking about preparing for wildfires and schools before the pandemic. Kids in places like Marin County [north of San Francisco], which was hit by smoke from devastating fires, missed more than three weeks during the 2018-2019 school year due to wildfire smoke, evacuation orders, or power outages. I had seen the pre-pandemic data on what all those days of missed school mean for kids’ academic and social-emotional outcomes.

Then the pandemic hit, schools across the state were closed, and school district officials have since spent an enormous amount of time and resources reopening our schools with pandemic safety in mind. That’s very important, but I’m afraid we’ve forgotten this other risk factor, wildfire season, which is also hugely disruptive.

2. Why is wildfire smoke dangerous for children’s health?

patella: A study that just came in Pediatrics shows that smoke from wildfires is 10 times more toxic than other pollution we’re used to, which isn’t surprising since what’s burning includes houses and cars. The smoke contains ultra-fine particles, all smaller than 2.5 microns. It is a mixture of solids and liquids released in the smoke. Because they are so small, the particles can get into the lungs, into the vascular system and into our bodies, potentially triggering a cascade of inflammation. This leads, for example, to more visits to the emergency room because of asthma.

We’re also starting to see evidence of other health effects. I am a children’s hospital and work in the neonatal intensive care unit; last September and October we saw an increasing number of pregnant women with preterm labor coming to the hospital.

3. The COVID-19 pandemic drew attention to indoor air quality and to buildings’ heating, ventilation and air conditioning or HVAC systems. Why should we upgrade these systems in our schools?

From the point of view of COVID, we think of the exchange of fresh air because it is an airborne disease. HVAC systems can bring in more air from the outside and allow for more air exchange so that respiratory droplets don’t linger.

HVAC systems can also purify the air from a variety of pollutants that affect children’s learning performance. When equipped with high-quality filters, the systems purify the air of particulate matter pollution caused by diesel trucks or gas-powered cars, or the pollutants in wildfire smoke. A lot of research has been done on schools’ Indoor air quality. We see improvement in children’s test scores and fewer absenteeism days as we improve indoor air quality.

4. How are schools in California doing in improving their ventilation?

I was hopeful, given new ventilation concerns during the pandemic, that HVAC systems would be upgraded while schools were closed. But what we’ve learned is that many districts are juggling a lot of other demands around school reopening, and some don’t have the capacity to apply for funding to improve ventilation, even if there is money.

Last October, California’s state legislature passed a bill allocating up to $600 million for upgrades, maintenance and repairs to schools’ HVAC systems. Federal funds have also been allocated through the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020, and the Environmental Protection Agency is raising funds to create clean air shelters, some of which may be located in schools, to provide places for people to have access to clean, filtered air. Every week we learn about new funding sources. We maintain an active list of various cash pots and collaborate with several other organizations such as the American Academy of Pediatrics and the nonprofit Mothers Out Front, to teach doctors and parents how to help school districts access the funds.

Even with this funding, we see challenges ahead. Many schools do not have HVAC systems, and schools that do often fail to maintain them. For example, it may be that the filters are not of the right quality or are not replaced regularly. That has to do with bigger problems related to the way school infrastructure is financed and maintained.

5. What else can help schools adapt to longer, more intense wildfire seasons?

patella: After more than a year in a global pandemic, the Centers for Disease Control and Prevention have finally come out and said: personal learning should be our priority for children’s health. We should have said this a long time ago. This generation of children will have to overcome a lot from a year of missed school due to the pandemic, and I am concerned about what the continued disruptions from wildfires mean in terms of children’s progress.

The state is making a remarkable effort to help schools with air quality from wildfires, and has good guidance and resources. We need to tighten up a few things; For example, right now we leave it up to school districts to decide whether to close at certain air quality index levels. I think our goal is to ensure that schools can continue to operate despite days of poor air quality outside. There may be days when the air quality is so bad that even transportation to school is too risky and children have to stay at home, but there will also be many days when schools can continue to operate despite the poor air quality. We can equip schools to monitor their levels of air pollution on the ground, and we can provide more education for parents and teachers so that school communities understand why certain decisions are made and how they help children stay safe.

Ultimately, it’s about climate change. There are things we can do now to reduce the effects of wildfire smoke, but until we think about the root causes of climate change and address them at a policy level, wildfires will occur annually and possibly year-round.

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