And those that lived?

Little discussion has focused on the consequences the Carmel fire has had on the health of the brave rescue workers who rushed in to the blaze and stayed for four days.

By ERIC AMSTER
The CT scan of his lungs showed thick scars, which was not surprising. The pulmonary function test highlighting a severe decrease in lung capacity was something I had seen many times. And meeting with a patient struggling to breathe was also not a new experience.
What was shocking and frightening about my patient is that he was a 28-year-old police officer who had been in perfect health three years earlier, before the World Trade Center collapsed on September 11.
While I was training to become a doctor, I spent a few months at a clinic for rescue workers at the World Trade Center. The clinic at Mt. Sinai Medical Center is now following thousands of firefighters and police who were exposed to the toxic dust cloud and smoke of 9/11. The rescue workers are screened for diseases related to environmental exposures on that day. If an illness is found, as was the case with my 28- year-old whose lungs looked like someone who had smoked for 60 years, the clinic coordinates the patient’s health care.
How many lives will be forever changed by the disaster in northern Israel? The Carmel Forest fire raged for four days. During that time, more than 1,500 rescue workers rushed to help evacuate residents and extinguish the flames. Much of the subsequent discourse has focused on the political fallout of fire preparedness.
Little discussion has focused on the consequences the fire has had on the health of the brave rescue workers who rushed in to the fire without hesitation and stayed for four days. We know that 44 people died in the Carmel fires; what we don’t know is how many lives will change forever.
WHEN A forest burns, a toxic mixture of smoke and gases is released into the environment.
Those working in close proximity to the fire – police, medics and firefighters – have the most intense and damaging exposures. These can result in immediate and long-term lung, heart and digestive problems. Research from the World Trade Center disaster has shown that rescue workers are more likely to develop certain types of cancer, and have a much higher incidence of psychological disorders such as PTSD and depression.
While the fire in the Carmel was certainly different from the World Trade Center disaster, a similar opportunity has arrived.
We have the opportunity to provide a service to rescue workers who put themselves at risk, to understand to what extent they were protected from breathing toxic smoke and gases, what health effects may result, and to provide prompt treatment when they do.
It is crucial that the government take responsibility in protecting the health and safety of firefighters, organize a centralized and standardized occupational health system for them, and begin to research the health effects on such rescue workers. To protect them and ensure they are able to respond to fires in the future, we must first understand what happened during the Carmel blaze. How many of our rescue workers will become ill, and how we prepare for the next big fire are two questions that remain unanswered.
At the University of Haifa School of Public Health, we are undertaking an initiative to follow the rescue workers who responded to the Carmel Forest fire, to understand the health effects during and following the inferno. Hopefully what we find will not only provide valuable information regarding the health of the individuals there, but also help protect the health of rescue workers in the future.

The writer, from Harvard University’s School of Public Health, is a visiting Fulbright Post-Doctoral Research Fellow at the University of Haifa.