Related Articles Wildland firefighter exposure to smoke and COVID 19 A new risk on the fire line Sci Total Environ 2020 Dec 11 760 144296 Authors Navarro KM Clark KA Hardt DJ Reid CE Lahm PW Domitrovich JW Butler CR Balmes JR Abstract Throughout the United States wildland firefighters respond to wildfires performing arduous work in remote locations Wildfire incidents can be an ideal environment for the transmission of infectious diseases particularly for wildland firefighters who congregate in work and living settings In this review we examine how exposure to wildfire smoke can contribute to an increased likelihood of SARS CoV 2 infection and severity of coronavirus disease COVID 19 Human exposure to particulate matter PM a component of wildfire smoke has been associated with oxidative stress and inflammatory responses increasing the likelihood for adverse respiratory symptomology and pathology In multiple epidemiological studies wildfire smoke exposure has been associated with acute lower respiratory infections such as bronchitis and pneumonia Co occurrence of SARS CoV 2 infection and wildfire smoke inhalation may present an increased risk for COVID 19 illness in wildland firefighters due to PM based transport of SARS CoV 2 virus and up regulation of angiotensin converting enzyme II ACE 2 i e ACE 2 functions as a trans membrane receptor allowing the SARS CoV 2 virus to gain entry into the epithelial cell Wildfire smoke exposure may also increase risk for more severe COVID 19 illness such as cytokine release syndrome hypotension and acute respiratory distress syndrome ARDS Current infection control measures including social distancing wearing cloth masks frequent cleaning and disinfecting of surfaces frequent hand washing and daily screening for COVID 19 symptoms are very important measures to reduce infections and severe health outcomes Exposure to wildfire smoke may introduce additive or even multiplicative risk for SARS CoV 2 infection and severity of disease in wildland firefighters Thus additional mitigative measures may be needed to prevent the co occurrence of wildfire smoke exposure and SARS CoV 2 infection PMID 33341613 PubMed as supplied by publisher