People with compromised immune systems struggle with smoke, heat

Marlene Ferguson is tired of beingstuck inside.

"It's a beautiful summer day, and I'm sitting and looking out the window," she told CBC News over Zoom from Kelownaon Tuesday.

On that day, smoke blanketedthe mountains across Okanagan Lake from her home,and she didn't dare venture outside to tend to her vegetable garden.

After dealing with rheumatoid arthritis, lung disease and asthma for more than 28 years, she's figured out when she can and can't go outside.So far this summer, she estimates she's been stuck inside for about two weeks. And when she does venture outside, she has a variety of face masks to help her manage.

British Columbians, like Ferguson, with autoimmune diseases experience a variety of symptoms specifically duringwildfire season.However, there hasn't been much research into how the smoke affectstheir conditions and medications, according to a couple of medical experts.

As thefrequency and intensity of wildfires continues to increase, so do concerns about how they'll manage during summer months.

Sometimes the smoke affects her so much she can'teven get out of bed andher husband has to lift her into a wheelchair.

And she's not the only one.

Angel Seto, from North Vancouver,hasrheumatoid arthritis and she said the heat and smoke affect her long after they occur.

"For people like myself, the heat and wildfire smoke ... has a cascading effect," she said. "To actually recover from that takes days to weeks."

Seto has been trying differentmedications for months in an attempt to manage her rheumatoid arthritis symptoms.

"The weather makes it more difficult to tell if the drugs are working," she said. "It's been two years now since I was diagnosed, and now I'm on drug number 14."

Brenda Bergen in New Westminster also has difficulties with the intense heat and smoke that B.C. summers bring.

She has had lupus, a disease that affects organs, breathing and energy levels,for 36 years.

For Bergen, sunscreen and ahat are a must even for short periods outside, and even in the winter.

While stress can be a trigger, the record-breaking heat is also making it more difficult. A flare up can bring onextreme fatigue making her so tiredshe can't leave home. In addition, it can triggerbreathing issues, skin rashes and inflammation of the eyes.

WATCH | What to watch for in wildfire smoke:

Health signs to watch for as wildfire smoke blankets Sask.

1 month ago

Duration 1:18

Jill Hubick, a registered nurse with Lung Saskatchewan, says everyone should take precautions during extreme wildfire conditions when the air quality is poor.

Not enough research

Dr. Michael Brauer, a professor with the University of British Columbia's School of Population and Public Health, said more research into how wildfire smoke affects people with autoimmune diseases needs to be done due tothe changing climate.

"Even though we've been having extreme heat or air pollution in parts of the world for a long time, the extreme levels that we're seeing now with climate change [are] relatively new," he said."But because we're going to be living in this kind of a future, we need to do those kinds of studies."

He shared that medication can make it difficult to regulate body temperature, but said he isn't aware of any specific studies about wildfire smoke.

"We don't want to stigmatize people and say you can't do this, you can't do that, you can't go exercise, you can't be outside,without having the direct evidence for it," he said. "We want to be careful."

He recommends consulting resources such as Environment and Climate Change Canada's Air Quality Health Index, which offers insights into how much particulate matter is in the air on any given day.

Medication

Bergen requires 17 medications to manage her lupus symptoms, and finds that heat and smoke lower their effectiveness.

She acknowledges that it isn't the case for everyone, but it's something she plans to bring up in the bi-weekly support groups she runs, as part of her work for the B.C. Lupus Society.

Vancouver General Hospital'sHead of RheumatologyDr. Kam Shojania said some medications make it more difficult to manage the heat because they reduce the ability to sweat, while othersmake it more difficult for the kidneys to manage dehydration.

And while there are no studies that look at wildfire smoke and medication directly, Shojania pointed out that there are studies that show cigarette smoke reduces the effect of medication.

"That's well documented, and you could extrapolate that other fine particulate matter can do the same thing reduce the effectiveness of medications used to treat rheumatoid arthritis and lupus," he said.