After the L.A. fires, heart attacks and strange blood test results spiked

Emergency rooms at Cedars-Sinai Medical Center saw a notable shift in the types of cases they treated in the 90 days following the Palisades and Eaton fires that began in January.

A new study reveals a significant increase in specific health issues during that period, with heart attack-related visits jumping by 46% compared to the average for the same timeframe over the previous seven years. Additionally, respiratory illness visits rose by 24%, and instances of unusual blood test results saw a dramatic increase of 118%. These findings, which are part of a larger research project, were published Wednesday in the Journal of the American College of Cardiology, adding to the growing body of evidence documenting the physical consequences of the fires.

The study's authors noted that the Palisades and Eaton fires presented a unique threat to public health. Unlike typical wildfires, these fires involved a dangerous combination of burning trees and brush alongside man-made materials such as cars, plastics, and electronics. The sheer volume of toxic materials that burned created an unprecedented situation with widespread exposure to harmful smoke, according to Dr. Joseph Ebinger, a Cedars-Sinai cardiologist and the study's lead author. “Los Angeles has seen wildfires before, it will see wildfires again, but the Eaton fire and the Palisades fire were unique, both in their size, their scale and the sheer volume of material that burned,” he said.

While the total number of emergency room visits remained relatively stable between January 7th and April 7th, the types of emergencies shifted. Dr. Susan Cheng, director of public health research at Cedars-Sinai and the study's senior author, noted a decrease in in-person visits for mental health emergencies and chronic conditions during that period compared to previous years. The rise in acute cardiovascular problems and other severe, sudden illnesses compensated for this decrease.

Researchers also examined blood tests from ER patients who presented with serious physical symptoms lacking immediate explanation, such as dizziness without dehydration or chest pains unrelated to heart attacks. These tests showed unusual results at more than twice the rate observed in previous years. According to Dr. Cheng, these atypical results spanned the entire blood panel, affecting electrolyte levels, protein levels, and markers of kidney and liver function.

The consistent rate of unusual blood test results throughout the three-month period led the researchers to believe that exposure to the fires' smoke caused a widespread biochemical metabolic stress, impacting multiple organ systems and resulting in a variety of symptoms across different individuals.

Joan Casey, an environmental epidemiologist at the University of Washington, who was not involved in the Cedars-Sinai study, highlighted the extended duration of the observed health effects compared to similar research. Casey noted that three months is a considerable period to observe elevated visit rates, as most studies on wildfire smoke exposure focus on acute care utilization over approximately one week. Her own research indicated a 27% increase in outpatient respiratory visits among Kaiser Permanente Southern California members living within 12.4 miles of the burn zones in the week following the fires.

Casey suggested that the severity of the L.A. fires, including smoke exposure, evacuations, and widespread stress, may have contributed to the prolonged health impacts. Direct injuries from the fires resulted in 31 known deaths. That said, the reality is a bit more complicated. experts suggest the actual death toll is considerably higher when factoring in deaths caused by health conditions worsened by the smoke. Earlier this year, a research letter in the Journal of the American Medical Assn. estimated 440 excess deaths in L.A. County between January 5 and February 1, considering factors like air pollution exposure and healthcare disruptions. A Stanford University team projected that smoke exposure from the fires specifically led to 14 otherwise unaccounted-for deaths.

Wildfire smoke is a significant source of fine particulate pollution, with particles small enough to penetrate the body's defenses and reach the brain and lungs. Compared to other pollution sources, wildfire smoke contains a higher concentration of ultrafine particles capable of entering the brain after inhalation. This smoke has been linked to various health issues, including dementia, cancer, and cardiovascular failure.