Smoke from Boyle Heights fire drove hospital throat visits

emergency visits – During the eight-day Lineage cold storage warehouse fire in Boyle Heights that began June 17, Los Angeles County data show a sharp rise in emergency department visits mentioning smoke inhalation and throat pain—far exceeding typical daily levels—while official

For days. acrid smoke blanketed much of Los Angeles after a warehouse fire in Boyle Heights tore through industrial materials inside a massive cold storage facility. By the time the blaze ended. June 17 marked the start of an eight-day emergency that did more than discolor the sky—it pushed more people through hospital doors with symptoms that sounded like smoke itself.

Los Angeles County Department of Public Health data obtained through a public records request show that during the fire. the number of Angelenos who went to emergency departments within 10 miles of the Lineage warehouse with throat pain and concerns about smoke inhalation spiked sharply. More than three times as many people made those visits during the fire compared with the two weeks before it began.

The pattern was especially visible within days. The county also noted a near doubling of patients mentioning throat pain within five miles of the fire on June 21—1.9 times the baseline levels.

The department described how unusual the numbers were. Typically, fewer than 50 people go to an emergency room each day for throat pain, and fewer than 20 people for smoke inhalation.

The data were tracked through the department’s syndromic surveillance project. which monitors trends in what people report when they come to emergency departments in Los Angeles County and also reviews diagnosis codes noted by providers. The department warned that the system is not as comprehensive as full patient health records. Clinicians may not always include key words about “fire. ” “smoke. ” or other circumstantial information in their diagnoses. and the county said the project cannot capture the true number of emergency department visits related to symptoms from the fire and likely underestimates the true burden of fire related symptoms.

Even so, the findings offer a jolt of clarity—and a note of uncertainty at the same time. The county did not note a substantial increase in asthma, acute respiratory symptoms, or chronic obstructive pulmonary disease-related emergency department visits during the fire.

Experts said that doesn’t mean the danger was absent. The fire is believed to have started on the solar array on the roof of a 500. 000-square-foot building housing 85 million pounds of frozen food. It then reached an ammonia line, prompting two brief shelter-in-place orders for nearby residents. Over the next week. the blaze continued to burn through dense insulation foam within the building’s walls and other unknown industrial materials. sending fumes across Los Angeles.

Residents across downtown Los Angeles. northeast Los Angeles. Burbank. the San Gabriel Valley. and many other parts of the city and county reported seeing and smelling the smoke. The South Coast Air Quality Management District issued multiple warnings about unhealthy levels of PM 2.5, or fine particulate matter. City and county officials opened two smoke respite shelters in the immediate area so people could breathe cleaner air.

What exactly was in the smoke remains unclear. Industrial fires can release far more materials than the burned wood smoke emitted during wildfires. “The makeup of the smoke can include toxic chemicals. fine particles and other serious risks to lung health depending on fire conditions and what is burned. ” Will Barrett. assistant vice president for nationwide clean air policy at the American Lung Assn. said as the fire was burning. Children and elderly people are particularly at risk.

David Eisenman. director of the UCLA Center for Public Health and Disasters. said urban industrial fires can create hazards that standard PM 2.5 warnings don’t always capture. Those advisories are “blunt instruments” that don’t adequately capture emissions from burning man-made goods—or convey that the source of pollution may include burning batteries or toxic refrigerants. he said.

Eisenman described the lack of a sharp rise in asthma attacks as “somewhat reassuring,” but he warned that emergency department data do not tell the full story. “People may have gone to their primary care doctors, which this would not capture. This data deserves follow up.”

The air district and the U.S. Environmental Protection Agency deployed air monitors during the early days of the blaze to assess particulate matter. airborne toxic metals. and other harmful compounds. The air district said it didn’t find significant levels of air toxics during the first two days of the fire. but it did record significantly elevated concentrations of particulate matter within the plume downwind. Some measurements from mobile monitors—five-minute snapshots—also showed increased bromine and chlorine, which are often found when buildings burn. The air district said those were at levels “below short-term health-based exposure thresholds.”.

Monitoring expanded as the fire progressed. The South Coast Air Quality Management District began continuous PM 2.5 monitoring at two nearby elementary schools on the third day.

The Los Angeles Fire Department said it detected low-level toxic hydrogen fluoride on the second day of the fire, which can be a byproduct of burning lithium-ion batteries.

Lineage, the tenant-operator of the warehouse, said no concentrations of ammonia were detected in the air at any time.

In a statement last week. company officials said they understood the scale of the disruption and that they would continue to engage with the community. “There’s no doubt this fire has had a huge impact on the local community. and we are committed to showing up in every way we can. ” the company wrote. The statement said Lineage worked closely with the Fire Department during the blaze and delivered masks. air purifiers. and other supplies to the community. and would work to ensure the fastest cleanup possible.

Researchers may need weeks—or longer—to understand what the smoke did to lungs over time. Eisenman said the long-term health effects probably won’t be known unless researchers conduct a follow-up study. He pointed to the possibility of delayed pulmonary effects from hydrogen fluoride and burning insulation foam that. when combined with elevated PM 2.5 levels in a dense urban environment. could produce health outcomes that do not appear immediately in emergency room data.

“They will show up in increased primary care office visits and exacerbations of chronic disease over the next few weeks,” Eisenman said. “So from a public health standpoint, this fire is not over.”

Boyle Heights fire Lineage warehouse smoke inhalation throat pain emergency department visits PM 2.5 hydrogen fluoride ammonia line Los Angeles County Department of Public Health syndromic surveillance South Coast Air Quality Management District UCLA American Lung Association