The death toll from the catastrophic wildfires in Los Angeles has risen to 24, and is expected to increase further. The Eaton Fire alone killed 16 people directly, making it the fifth deadliest wildfire in California, while the Palisades Fire killed eight people and was the 14th deadliest fire in the state.
However, the disaster's final death toll is likely to be higher once the health effects of the fire's toxic smoke are fully understood. Many more deaths are expected in the coming years, as a disaster of this magnitude causes massive disruption to people's lives, similar to what happens after a major hurricane, resulting in thousands of indirect deaths.
read: The silent disaster: The health effects of wildfire smoke
Wildfire smoke deadly
“Our research suggests that during large fire events, more people may die from smoke exposure than directly from the fire,” Marshall Burke, associate professor of earth system science at Stanford University, wrote in a 2020 policy brief. number of people, and more people may die from the fire.” ”
Wildfire smoke contains high concentrations of PM2.5, with particles no larger than 2.5 microns in diameter. These particles have long been linked to an increased risk of illness and death because they are small enough to enter the lungs and bloodstream, damaging the cardiovascular and respiratory systems.
A 2024 study “Mortality due to PM2.5 “California's Wildland Fires from 2008 to 2018,” found that wildfire smoke may have contributed to the premature deaths of as many as 12,000 Californians in 2018, the year Paradise and several other communities burned.
The study found that wildfire smoke may have caused more than 52,000 premature deaths in California over the 11 years from 2008 to 2018 — nearly 5,000 deaths per year — with the economic impact of the deaths exceeding $430 billion.
This is an issue outside of California. A 2024 paper, “Long-term exposure to wildland fire smoke PM2.5 The study found that long-term exposure to wildfire smoke may have killed more than 11,000 people each year between 2007 and 2020. Research, about 13% of deaths are attributed to climate change, “Attributing human deaths to fire PM2.5 climate change.
In a warming world, the future health impacts of wildfire smoke are of great concern. A 2024 paper, “Mortality Burden from Wildfire Smoke Under Future Climate Change,” found that by 2050, increases in wildfire smoke in the United States due to climate change are expected to result in 27,800 excess deaths per year and $244 billion in damage. Warming scenario. That's a 76% increase compared to the estimated average from 2011 to 2020, the authors wrote.
“Our study shows that the health costs of climate-driven wildfire smoke may be one of the most important and costly consequences of a warming climate in the United States,” the authors added.
Buildings release toxic smoke when burning
According to reports, millions of people in the Los Angeles area experienced two days of heavy smoke, causing air quality to be in the red “unhealthy” range when the fires were at their worst, while air quality was higher in the “hazardous” range near the fires. These air quality ratings only take into account the small particles tracked by the EPA: PM2.5 (particles 2.5 mm in diameter or smaller). Last week's air quality was rated “unhealthy” No Given the urban nature of these fires, the smoke produced has a significant toxic component.
A similar pattern occurred during the 2018 Camp Fire in Paradise, California, which burned more than 18,000 structures: Lead and zinc levels in the air increased significantly. The presence of lead is particularly concerning because lead exposure has been linked to high blood pressure, reproductive effects, and cancer. Infants and young children are particularly sensitive to low levels of lead, which is known to cause behavioral changes and learning deficits. Wildfire smoke also contains toxic carcinogens similar to those found in cigarette smoke.
Hundreds of Californians could die prematurely from toxic smoke inhalation in the coming years as large numbers of people were exposed to dangerous levels of toxic smoke in last week's fires. Of particular concern are the many elderly or sick people who were evacuated and forced to breathe high concentrations of toxic fumes from burning buildings and vehicles. News images of dozens of nursing home residents being pushed in wheelchairs through smoky streets are particularly heartbreaking because I know these vulnerable populations will inevitably suffer high rates of health complications and deaths in the coming weeks.
“Short-term exposure (days or weeks) to wildfire smoke is strongly associated with increased severity of asthma, chronic obstructive pulmonary disease (COPD), and COVID-19; inflammation or infection, including bronchitis and pneumonia; emergency department visits; and hospitalization,” According to the California Air Resources Board.
A 2024 paper reported that “long-term exposure to wildfire smoke is associated with higher mortality from a variety of diseases, including cardiovascular disease, ischemic disease (related to blood flow), digestive disease, endocrine disease, and chronic Kidney disease.
The spread of infectious diseases after disasters
The spread of infectious diseases among evacuees will also take a toll. January is the peak of flu season, and California is experiencing “very high” flu levels, according to the Centers for Disease Control and Prevention. Influenza and COVID-19 can spread rapidly among tens of thousands of people who are forced to evacuate to shelters or live temporarily with friends or family.
Read: The hidden health toll of hurricanes
Comparison to post-hurricane excess mortality: Thousands more expected to die
In a stunning 2024 paper, “Deaths from Tropical Cyclones in the United States,” Rachel Young and Solomon Tsiang found that hurricanes that made landfall in the United States between 1930 and 2015 caused an average of 24 direct deaths. However, they observed an increase in excess deaths (more deaths than expected for the period) that continued for 15 years, resulting in a total of 7,000-11,000 excess deaths per storm. This burden is 300-480 times higher than government estimates of direct deaths and equals 3.2-5.1% of all deaths in the continental United States.
The largest single category of deaths was cardiovascular disease (36%), while 12% of deaths were caused by cancer, “consistent with some evidence that extreme weather stress affects long-term health,” the authors wrote.
Young and Tsiang hypothesized five ways in which hurricanes may cause excess mortality. Four of these factors may apply to catastrophic wildfire events like the one California just experienced:
(1) economic chaos May alter household economic decisions, ultimately leading to worse health outcomes. For example, people who lose their jobs may also lose their health insurance. Or retirement savings can be withdrawn to repair property damage, both of which can reduce future medical expenses.
(2) Social network changes May affect future health. For example, people of working age may leave, changing social support for older people who remain behind.
(3) fiscal adjustment How state or local governments respond to disasters may affect future health outcomes. For example, restructuring budgets to support recovery may reduce spending on health infrastructure.
(4) Increased physical and mental stress May change health in the long run..
The fifth factor hypothesized by scientists is changes in natural environment Health damage may occur—for example, ecological changes may redistribute disease vectors, or flooding may expose people to harmful chemicals. Flooding affects the natural environment very differently than wildfires, so this factor is less relevant to wildfires than the other four factors.
read: How to protect yourself from wildfire smoke
How to help
In addition to sending my prayers and positive thoughts to the victims of the Los Angeles fires, I have been supporting multiple charities. I encourage everyone to help in any way they can. Below is a Bluesky post where I donated to two charities.
Bob Henson contributed to this article.
Only 28% of U.S. residents regularly hear about climate change in the media, but 77% want to know more. By 2025, you can show Americans more climate news.
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