The Hellenic Pulmonology Society informs the residents and workers of the areas near the fronts of the fires, as well as all those exposed to smoke and suspended particles, regarding the possible consequences and ways of protection.

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 to recirculate the air in the room 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.

-Avoid sports and physical exertion.

-If the movement is deemed necessary, it should be done use of a high respiratory protection mask (FFP2 or 3) with a good fit. “Surgical” or cloth masks do NOT protect against smoke or ash inhalation. Movements should be made at times of lower thermal load, eg at night.

-As already mentioned, 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, diseases that are primarily aggravated by the environmental burden, strict adherence to medication is required, and upon any worsening of symptoms, immediate communication with the treating pulmonologist in order to adjust the treatment.

– It is recommended that citizens, especially on days with a particular burden on the atmosphere due to fires, follow the announcements of the official agencies on air quality and not 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 smoke exposure – When to seek medical help

The most frequent symptoms related to short-term exposure to smoke, regardless of the mechanism, concern 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 the 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 affect 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 the combustion of eg 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.