IMMUNITION™ Report©

Volume II, No. 5

By Frank M. Jordan

Smoke and Smog Inhalation - What You Must Know for Health Protection

What Causes Death from Fires and What is "Burning"?

The number one cause of death related to fires is smoke inhalation (airway or pulmonary parenchymal injury).  Smoke inhalation occurs when you breathe in the products of combustion during a fire – the harmful gases, vapors and particulate matter (soot, etc.) contained in smoke.  Combustion produces these gases, vapors and particulate matter that results from burning, or the rapid breakdown of a substance by heat.  The exact composition of smoke produced by any individual fire cannot be predicted because of different temperatures, the products being burned in the fire and the amount of oxygen available to each individual fire.

Smoke inhalation typically occurs in residential or forest fires.  Note that cigarette smoking causes similar damage on a smaller scale over an extended period.  The primary source of injury in the upper respiratory tract is heat, but within the lung it is the deposition of particles, derived from the products burning, together with toxic gases given off by the fire.

How Smoke Inhalation Damages the Body

The harmful materials given off by combustion injure the airways and lungs by: (1) heat damage; (2) tissue irritation by irritant compounds and (3) oxygen starvation of the tissues defined as asphyxiation.  Remember that smoke inhalation victims may not show injury symptoms until 24-48 hours after the inhalation event.  Also, children under age 11 and adults over age 70 are most vulnerable. 

The degree of heat involved in the fire creating the smoke is directly related to the seriousness of potential damage from smoke inhalation.  According to W.R. Clark, Jr., “The mortality rate of smoke inhalation victims without a burn is <10%.  With a burn, the mortality rate is 30-50%, suggesting that thermal injury or its treatment is responsible for further lung damage.”

The primary source of injury in the upper respiratory tract is heat, but the thermal injury does not usually extend beyond the bifurcation or forking of the trachea (commonly known as the windpipe).  Within the lung the particulates, or particles of matter resulting from the combustion, combined with the toxic gases, cause the majority of damage in what appears to be a response to stimulation of the inflammatory response. 

Smog particulates can create a similar irritation, but are derived from other environmental particulates such as auto emissions and industry pollutants. Unless this particulate matter is removed, the continued presence may lead to damage and an impaired respiratory function.

The primary function of the leukocyte immune cells known as alveolar macrophages in the lungs, is to engulf and dispose of any matter entering the lungs not produced by the body (non-self) – a process described scientifically as phagocytosis.  The function of these large white immune cells is part of the innate immune response of the body.  For the body to be able to fight back successfully against the soot, carbon and other particulates from the smoke inhalation and smog, these macrophage cells, or immune soldiers, must be in peak condition and not be suppressed or damaged.

If suppressed or damaged, the immune response cannot naturally dispose of the invasive and damaging pathogens in an orderly manner and the signs and symptoms of smoke inhalation, including asthma and severe respiratory problems, can occur.

Chemical asphyxiants from a fire can produce compounds that damage the body by interfering with the oxygen use at the cellular level.  Carbon monoxide, hydrogen cyanide and hydrogen sulfide are all examples of such chemicals.  Why is this so important? If either the delivery of oxygen or use of oxygen is inhibited, cells will die.  Carbon monoxide is the leading cause of death in smoke inhalation for this reason.

What is known as simple asphyxiation refers to combustion using up all oxygen near a fire, which then leaves no oxygen to breathe.  When you have no oxygen to breathe for even a brief period, lung and respiratory damage can occur and, if for an extended period, you die.  Asphyxiation is recognized by shortness of breath, blue gray or bright-red skin coloration and in extreme cases by loss of consciousness or breathing.

Diagnosis of Smoke Inhalation Damage

In addition to inspecting for signs of heat damage, tissue irritation and asphyxiation, the attending medical personnel will assess the victim’s breathing by the number of breaths per minute (respiratory rate) and motion of the chest as the lungs inflate and deflate. The victim’s circulation is evaluated by the number of heartbeats per minute, or pulse rate. 

In most cases of smoke inhalation, when the victim has a shortness of breath or a persistent cough, a chest x-ray is ordered.  An initial chest x-ray often appears normal, even with significant signs such as the cough and shortness of breath, because damage many times does not appear for 24-48 hours.  A delayed second chest x-ray after 48 hours is recommended.

A Blood test after smoke inhalation should include if possible:

• Complete blood count to determine if there are enough red blood cells to carry oxygen, enough white blood cells (including alveolar macrophages) to fight infection and enough platelets to assure clotting can occur.

• A basic metabolic profile to reveal the change of pH in the blood that occurs because of interference with oxygen diffusion, transport or use.  Serum electrolytes in the form of sodium, potassium and choloride can be monitored, along with renal (kidney) function test involving creatinine and blood urea nitrogen.

•  An arterial blood gas test is indicated for victim’s with significant respiratory distress, acute mental status changes or shock.  This test helps in determining the degree of oxygen shortage.

• Carboxyhemoglobin and methemoglobin levels should be checked if there is respiratory distress, altered mental status, low blood pressure, seizures, fainting and/or blood pH changes.

Symptoms of Smoke Inhalation Damage

 To know if you have Smoke inhalation damage, determine if you are a potential victim experiencing:

• A hacking and persistent cough is a common symptom of smoke inhalation damage and smog also.  Mucus is secreted when the mucous membranes of the respiratory tract become irritated from smoke inhalation composed of toxic gases and dangerous particulates.  Bronchospasms, or contractions of the smooth muscle in the walls of the bronchi in the lungs, and the increased mucus result in reflex coughing.  This mucus may be either clear or black, depending on the number of burned particles in the lungs.
• Shortness of breath is generally caused by injury to the respiratory tract, which in turn decreases oxygen delivery to the blood, decreases oxygen-carrying capacity of the blood itself because of chemical damage to the blood, or the inability to use oxygen at the cellular level. 
• Rapid breathing often occurs in an attempt to compensate for the injuries to the respiratory system and lungs.
• Hoarseness or wheezing is a sign fluids are collecting in the upper airway and causing a blockage. 
• Irritant chemicals can also cause vocal cord spasm, swelling and constriction of the upper airways.
• Redness and irritation in the eyes from smoke can include cornea burns that should be checked as soon as possible.
• Skin color ranges from pale to bluish to bright cherry-red.
• Soot or carbon and particulate deposits are present in the nose and throat, often causing nasal passages and nostrils to swell.
• Headaches are frequent due to inhaled quantities of carbon monoxide. Carbon monoxide poisoning to some degree can be present even if no respiratory problems are evident.  Headache, nausea and vomiting are symptoms of carbon monoxide poisoning demanding immediate professional medical attention.
• Confusion, fainting, seizures, coma and other changes in mental status can occur due usually to chemical asphyxiants in the smoke and low levels of oxygen in the victim.

Smoke Inhalation Treatment

The primary objective of treatment is to provide an adequate level of oxygen while reestablishing and maintaining an open airway.  If the airway is open and stable, high-flow humidified oxygen may be applied with a mask, nose tube or tube down the throat.  If signs and symptoms of upper airway problems such as hoarseness are observed, a doctor will intubate a tube down your throat to keep the airway from closing due to swelling. 

In the case of respiratory distress or mental status changes, intubation will often be done to ease breathing, suction off mucus and keep the victim from breathing the content of the stomach. Patients with a wheezing cough (bronchospasm) indicating bronchial airways are constricted or blocked, often are given a bronchodilator to relax muscles and increase ventilation. 

In the cases of severe carbon monoxide or cyanide poisoning, HBO (hyperbaric oxygenation) is the process of receiving oxygen in a compression chamber at three times the normal atmospheric pressure. 

Natural Supplements and Vitamins 

Natural supplements and vitamins are also beneficial, especially U.S. Patented MG Beta Glucan (40 mg divided into 4 doses) in NSC-24, NSC-100 and NSC-24 Respiratory Formula IMMUNITION™ to nutritionally potentiate the alveolar macrophages in the lungs to promote ingestion of the particulates from the smoke and soot and toxins from gases. 

These white immune cells are prime parts of the body’s natural defense against invasion of foreign substances, including environmental toxins such as smoke, smog and soot.  CoEnzyme Q10 (200 mg) is beneficial to cell metabolism and oxygenation, essential to cell health at this critical time.

Quercetin toughens mast cell linings and prevents unwanted histamine production, thus reducing mucus secretions that narrow air passages and contribute to coughing. Vitamin C (up to 10,000 mg divided into 5 doses) , Vitamin E (300 IU) and B Complex act as antioxidants to neutralize free radicals.  Beta Carotene (30,000 IU) and Grape Seed Extract are additional antioxidants particularly effective in aiding the lung function. 

Bromelain, an enzyme found in pineapple, alleviates inflamed bronchi.  Magnesium (1,000 mg adults) can open the bronchioles, relaxing the muscles inside the air tubes. Chlorophyll purifies the blood and enhances the blood’s oxygen-carrying capabilities while chelating toxic metals out of the system.  L-cysteine, N-acetyl-cysteine and glutathione peroxidase help repair damaged tissue in the lungs by counteracting the effects of smoke and other environmental toxins.  The NSC-24 Eye Care Immunition Formula aids removal of toxins and nutritionally promotes eye wellness during particle assaults.

Mullein tea is beneficial for inflammatory conditions of the lungs while in the homeopathic area, belladonna often alleviates breathing difficulties.

An essential aid in particulate protection is an air cleansing system, with the Pionair Technologies product line recommended (866-746-6247 * www.pionair.net ) due to duplicating natures natural process of UV light, safe levels of ozone and a proven negative ion process.

To be prepared for smoke inhalation, smog or environmental toxins from forest fires, pollution and residential fires, keep the immune system in peak condition by proper diet, moderate exercise, adequate sleep, reduced stress and supplementation with MG Beta Glucan and the other supplements and vitamins previously enumerated. 

The best defenses against smoke inhalation injury and damage are to be prepared for smoke inhalation and be aware of risk and remedies while keeping the immune system in peak condition.  For prevention of indoor smoke and smog inhalation, install air conditioning, smoke detectors, carbon monoxide monitors, special air filters and air purifiers (Pionair at www.Pionair.net recommended) . Plan escape routes and keep numbers for emergency services easily  available.