Fire smoke protection guidelines

Protection instructions of the residents and workers of the areas that are close to the fronts of the fire but also of those exposed to smoke and suspended particles, given by the Hellenic Pulmonology Society (HPE).

Basic instructions in conditions where the atmosphere is burdened by fire smoke

• Immediate removal from the source of the fire.
• Complete avoidance of travel for people with serious underlying diseases, the elderly, children and pregnant women.
• Stay indoors as much as possible with closed windows and doors. The use of air conditioning recirculates room air and is encouraged in high ambient temperature conditions, provided the room is and can remain protected from outside air. Otherwise, it is recommended to create a protected and air-conditioned room inside the house.

It is recommended to avoid activities that further deteriorate indoor air quality, and especially smoking. By extension, the use of candles for lighting, cooking on an open stove, the use of aerosol products and the use of a vacuum cleaner are discouraged.

• Avoiding sports and physical exertion.
• If the movement is deemed necessary, it should be use a mask of high respiratory protection (FFP2 or 3) with good fit. “Surgical” or fabric masks do not protect against smoke or ash inhalation. Movements should be made at times of lower thermal load, eg at night.
• Patients with chronic respiratory or cardiovascular diseases should not be moved, especially if the use of a high respiratory protection mask is not possible.
• For patients with asthma and COPD, conditions that are primarily aggravated by environmental exposure, strict adherence to medication is required, and upon any worsening of symptoms, immediate communication with the attending Pulmonologist in order to adjust the treatment.
• Citizens are advised, especially on days with a particular burden of the atmosphere due to fires, to follow the announcements of the official agencies on air quality and not to trust only their smell and sight. Also on the internet there are dynamic maps with air pollution data (mainly PM2.5) that are updated in real time. Examples include the website of the Ministry of Environment and Energy and the website of the European air quality measurement platform, PurpleAir.

Possible symptoms and consequences of short-term exposure to smoke

The most common symptoms associated with short-term exposure to smokeregardless of the mechanism, they involve the upper respiratory tract and are manifested by rhinitis (nasal congestion, runny nose) and a feeling of dryness in the pharynx. A cough that is dry and irritating may also occur, while regardless of the existence of an underlying disease, shortness of breath may also occur.

Systemic symptoms such as dizziness, nausea, vomiting and headache indicate possible carbon monoxide toxicity that should be investigated immediately and the treating physician informed.

These symptoms can also appear in generally healthy people, but it is clear that the frequency and intensity are greater in people with underlying diseases, mainly of the respiratory and cardiovascular systems.

It is known that toxicity from inhalation of combustion products can cause thermal or chemical damage to the respiratory system. Direct thermal damage is caused by the inhalation of hot steam near the source of the fire and involves the upper airways.

Chemical damage is caused by the inhalation of organic microparticles of different composition and size or chemical irritants and can involve both the airways and the lung parenchyma.

The main, immediate cause of death in the event of a fire is suffocation due to the consumption of oxygen near the source of the fire combined with the inhalation of a large amount of smoke. Often some degree of chemical suffocation coexists with systemic symptoms, from the inability to use oxygen at the cellular level. Chemical suffocation is due to inhalation of products of incomplete combustion such as carbon monoxide or hydrogen cyanide from combustion e.g. plastics or other materials containing nitrogen.

At a greater distance from the focus of the fire, the inhalation of microparticles and chemical irritants can cause damage to a significant number of people involving both the respiratory and cardiovascular systems.

The severity and extent of damage from inhalation of particles and/or toxic gases depends on several factors such as the size and diameter of the particles, the duration of exposure, the solubility of the toxic gases, and the presence of an underlying disease. Respiratory toxicity, as mentioned, may involve the upper airway, tracheobronchial tree, and lung parenchyma.

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