Ka Wai Ola - Office of Hawaiian Affairs, Volume 40, Number 10, 1 October 2023 — The Maui Fires: Where do our First Responders go From Here? [ARTICLE]

The Maui Fires: Where do our First Responders go From Here?

By Manijeh Berenji MD and Marc Wilkenfeld MD The Maui fires that occurred in Lahaina and surrounding areas on Aug. 8, 2023, have had a devastating impact on the island's environment. The fires burned over 100,000 acres of land, killed at least 97 people, and destroyed/damaged up to 3,000 structures. As of a September 18, 31 people were still missing. The environmental impacts of the Maui fires are still being assessed, but scientists believe that the fires will have a lasting impact on the island's ecosystem. The fires destroyed large swaths of forest, whieh will take decades to recover. The fires also killed or displaced many animals, including endangered species. The loss of vegetation and wildlife will disrupt the island's food ehain and could have a cascading impact on other species. The fires released harmful pollutants into the air, including smoke, ash, and carbon monoxide. These pollutants (including PM10 and PM2.5) could have long-term heahh consequences for residents and visitors. These pollutants ean potentially cause respiratory problems, heart disease, and cancer down the line. The fires had a significant impact on the first responders (including firefighters, poliee, and first aid workers among others). These first responders were on the front lines of the battle against the fires, working long hours and risking their lives to protect the island and its residents. Many first responders also lost their own homes in the fires. These first responders will face many challenges in the coming months and years. These challenges include post-traumatic stress disorder, finaneial hardship, grief and loss. Many first responders lost friends, family members, and/or neighbors in the fires and continue to suffer from these losses. Medical surveillance of first responders is important after such fires. Medical surveillance ean help to identify first responders who are at risk of developing heahh problems after

working in these hazardous conditions. Such surveillance ean ensure that they receive the appropriate medical care and monitoring. There are several ways to conduct medical surveillance of first responders after a catastrophic event such as what has occurred on Maui. One way is to conduct physical exams and spirometry tests. Spirometry tests measure the amount of air that ean be inhaled and exhaled. This ean help to identify firefighters who have respiratory problems. Another way to conduct medical surveillance is to collect blood samples and test them for biomarkers of exposure to smoke and other pollutants. Biomarkers are substances that ean be measured in the blood and that indicate exposure to a particular substance. Medical surveillance is typically eonducted by a physician or other heahhcare professional. It is important to start medical surveillance as soon as possible after such events, as this ean help to identify heahh problems early on. By taking these steps, we ean help to protect the heahh of these first responders and ensure they ean continue to lead healthy, productive lives and serve their communities to their fullest capacity. ■ Manijeh Berenji MD MPH ; mberenji@ hs.uci.edu is a double board certijied oecupational and environmental medicine and preventive medicine specialist with over 10 years ofclinical and puhlie heahh experience currently serving as elinieal assistant professor of occupational and environmental medicine at University of California Irvine Schools ofMedicine and Puhlie Health. Marc Wilkenfeld MD; marc.wilkenfeld@nyulangone.edu, associate professor of occupational and environmental medicine at New York University Langone School of Medicine, has heen practicing for over 20 years. He managed the World Trade Center Program for first responders and is a world-renowned expert on occupational and environmental medical surveillance programming.