Wildfire Smoke at Work Is an Avoidable Health Inequity

APHA | Climate, Health and Equity WILDFIRE SMOKE AT WORK IS AN AVOIDABLE HEALTH INEQUITY 52,480- 55,710 Estimated premature deaths attributed to California wildfire PM2.5,2008-2018 Protecting California agricultural and other outdoor workers from PM2.5 (Connolly et al., 2024) 1 PUBLIC HEALTH IMPACT PM2.5 Fine particles can travel deep into the lungs and enter the bloodstream. Community Impact Key Risk Factors Outdoor workers may inhale smoke for hours during long labor, increasing respiratory and cardiovascular symptoms, work disruption and long-term disease risk. • Long or strenuous outdoor shifts • AQI at or above 151 and simultaneous heat • Asthma, heart disease, pregnancy, or older age • Limited monitoring or respirator access • Low wages, language barriers, limited care access, or fear of retailation 6 --> 8 million worker days Projected smoke-exposure days under future climate conditions +35% (Marlier et al., 2022) 2 EPIDEMIOLOGY AND PREVENTION EPIDEMIOLOGIC MODEL PREVENTION AT EVERY LEVEL AGENT: PM2.5 & toxic smoke gasses PRIMARY HOST: Health status, pregnancy, age, - Monitor AQI, relocate or reschedule work, provide filtered rest areas, paid breaks, N95s, fit testing and bilingual training SECONDARY exertion & exposure duration - Conduct symptom checks, peak-flow screening for workers with asthma, and rapid clinical referral ENVIROMENT: Wildfire intensity, wind, drought, jobsite, housing, & access to care TERTIARY - Provide disease management, workers compensation assistance , & safe return-to-work planning 3 CURRENT POLICY, OUTCOMES, AND EQUITY CALIFORNIA TITLE 8, SECTION 5141.1 The rule applies when wildfire-smoke AQI for PM2.5 is at least 151. Employers must monitor AQI, communicate hazards, train workers, and use feasible engineering. N95s must be supplied at AQI 151-500, but use is voluntary. POPULATION OUTCOMES Monitoring, training, exposure controls, and N95s availability can reduce smoke exposure and prevent respiratory and cardiovascular complications. 4 RECOMMENDED POLICY CHANGE Implementation View MAKE EMPLOYER-PAID PROTECTION MANDATORY AT AQI .=151 Employers may face costs for respirators. Phased Amend section 5141.1 to require fit-tested N95 use, paid smoke breaks or relocation, worksite implementation, grants, and PM2.5 monitoring, enforceable bilingual notices. NIOSH's hierarchy of controls guidance technical assistance can reduce and recent mortality and exposure support stronger protection ( NIOSH, 2024; Connolly et burden without shifting health al,,2024; Marlier et al., 2022). risks to workers. 5 INITIATING POLICY CHANGE 1 Build Coalition 2 Draft Cost 3 Petition 4 Hearing& Comment 5 Adopt, Fund, Enforce & Evaluate STAKEHOLDER INFLUENCE HIGH: Cal/OSHA Standards Board, California Legislature MODORATE: CAL/OSHA and CDPH administrators, employers References : American Public Health Association. (n.d.). Climate, health and equity https://www.apha.org/topics-andissues/climate-health-and-equity California Department of Industrial Relations. (n.d.). § 5141.1: Protection from wildfire smoke.https://www.dir.ca.gov/title8/5141_1.html Connolly, R., Marlier, M. E., Garcia-Gonzales, D. A., Wilkins, J., Su, J., Bekker, C., Jung, J., Bonilla, E., Burnett, R. T., Zhu, Y., & Jerrett, M. (2024). Mortality attributable to PM 2.5 from wildland fires in California from 2008 to 2018. Science advances, 10(23), eadl1252. https://doi-org.lopes.idm.oclc.org/10.1126/sciadv.adl1252 Marlier, M. E., Brenner, K. I., Liu, J. C., Mickley, L. J., Raby, S., James, E., Ahmadov, R., & Riden, H. (2022). Exposure of agricultural workers in California to wildfire smoke under past and future climate conditions. Environmental Research Letters, 17(9), Article 094045 DOI10.1088/1748-9326/ac8c58 National Institute for Occupational Safety and Health. (2024). Draft hazard review: Wildland fire smoke exposure among farmworkers and other outdoor workers (NIOSH Docket No. 352-A; CDC-2024-0065). Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/docket/review/docket352a/default.html