 Hey everybody, we're in for a special treat tonight, despite the devastation that's happened in my community. And I know many of you who are local are joining us or you'll be listening later from many different avenues, either on YouTube or Facebook or wherever this podcast shows. I am just, as I said before we went live, I am so honored and delighted today to have two amazing colleagues and friends from ICI that really have had experience and also some great information tonight for us on wildfires and how it affects air quality. Just a little background, if you haven't heard, I don't know who hasn't heard, but the Marshall fires that hit us on December 30th, in the community where I live of Superior in Louisville, Colorado, had a massive effect, actually the worst wildfire disaster in our state's history. Nearly 1,000 residential homes burned and many businesses besides. And I'm literally here in my office and I have right across the street is a burned statuesque. On this side of me, there's a whole neighborhood completely burned down. On this side of me, there's a whole neighborhood burned down in the back. I am like this oasis and there's a small section of offices here that are still standing. And every single side of me is massive, massive destruction and damage. And my story was I was actually on a writing retreat away thousands of miles away on the night that this happened. All I heard was my house was being evacuated and I started to watch like many people from all over the world were watching on the news and I looked at the maps of the fires and the evacuation and my office was smacked up in the center. So I that night went to bed knowing my office had burned down. Like I just assumed that and my house was surrounded on three sides by fires. So I literally that night had to really surrender and be like, you know what? I could come home to no possessions. And yet, you know, the people are loved ones. My pet was okay, my sweet dog Ravi. And so I knew I'd be okay. And yet, and yet devastation of losing everything is I don't know if there's a more traumatic experience. So even though I am sitting here in my office and it's fine, I know a lot of our community members are not in the same boat and I just have such great compassion and gratitude and that we can come together and provide more information. Because now a lot of you I'm hearing from businesses right around here and even my office. This is the first day in two weeks. We've been able to be back in the office and now the air quality is beautiful, but we did a lot, a lot of work. And we'll talk about some of those things that we did. I mean, I've been putting in hours and hours and lots of money to get the air quality back to normal. What's interesting, and we'll talk about this tonight as well, my air quality inside right now is better than outside because I've got air filters I've got. So it's kind of, I'm really proud of that. Like I'm here and I had no trouble at all with air quality, but it took a lot to get it back. And I know those people whose homes are still standing who maybe haven't lost everything, maybe either have no idea of the dangers or maybe they're starting to feel burning lungs or have bloody noses or have symptoms. And again, tonight I just wanna be a resource for all of you out there. And obviously our community is affected, but many, many, many other people in many other states have been affected far before this happened. So this is becoming more and more common because of our climate change. And I think it's a really important thing for not only me as a physician to really understand and be able to help patients, but for the community to know. So last a little bit here, if you want any information, you can find blogs all free on my website, just jillcarnahan.com. This episode and all the rest of the episodes, I think we're going on almost 90 now are on my YouTube channel and anywhere you listen to podcast. And you can find those after the fact if you miss this episode live. Okay, so now to my distinguished guest tonight, I'm so excited. I'm gonna introduce you both and then we'll jump right into conversation. Dr. Louise Tolesman to my side here is had undergraduate degree in biochemistry from Simon Frazier in Canada and a doctorate in naturopathic medicine from Bastier University in 97. She completed residency and began seeing patients with cancer and teaching on nutrition. She's been in private practice in Portland since 2005. She's also a co-member as well as Dr. Patrick Bellomi on the ICI group, the International Society for Environmentally Acquired Illness. I can't say enough good about this organization. I've been a board member since the onset and it's a nonprofit and just really pulls together some of the most amazing environmentally aware, conscious, mold literate physicians that I know. And I learned something from every one of them all the time. So like I said, I'm just delighted to have them. She particularly has lectured on air quality, smoke exposure, wildfire risk and toxic metals. And we're gonna talk about that tonight and produce video resources for fire departments to utilize in the training of first responders. So once again, maybe some of you are listening are some of the police or firefighters or people who've responded and you're wondering why your lungs hurt. And I remember after 9-11 really starting to see this with the burning of industrial buildings and housing fabricate all the materials and we're learning more about this. We'll talk about that tonight. Anyway, that's Dr. Tolesman. I could say more, but we'll keep going and you'll get to know her tonight. Dr. Lynn Patrick has been a friend. We have worked on her organization of environmental health symposium for several years and she's put together an amazing conference there. And so I really got to know her through that and through a lot of the lectures, the places where we teach together. She also graduated from Best Year University. And I often say my dearest friends are naturopaths and I feel kind of jealous because I have the heart of a naturopath and I just infiltrated regular medicine but I'm really more like you guys than my colleagues sometimes. So I hope that's okay to say but she has been in private practice as a state licensed naturopathic physician in Arizona and Colorado for 35 years. She's a published author on numerous articles in peer reviewed medical journals contributing at her from the former Medline Indexed Alternative Medical Review Journal and recently authored a chapter in the newly released textbook of clinical environmental medicine in 2019. She speaks all over the world. She's just well known for her breadth and depth of knowledge on environmental toxins and chemicals. And she's always one of my go-tos on referencing that not too long ago. I said, Benzing, can you tell me more or lead in certain, you know, so all these things I love to talk to Lynn about chemicals and toxicities and also on the member of the ICI group. So welcome to both of you tonight and thank you again for being on. Thank you, Jill. You know, as a fellow Colorado and having been in many, many fires myself in the last 20 years, my heart goes out to everybody here who's been affected. I just, I know personally how heartbreaking this can be. I've had to evacuate several ranches that got completely devastated when I lived in an extremely rural area and our town was evacuated in 2012 and came within a half a mile of being burned down the entire town of Mancus, Colorado. So I've had experiences that have allowed me to see up close and personal the incredible beauty and the horror of this experience. So beauty meaning, you know, just the strength of nature, like how strong nature is, but also how terrifying. And- Thank you, Lynn, because it's so true. And honestly, the beauty too is the community. What happens after like the people, just the outpouring of love and support has been absolutely amazing. So there is beauty even in the midst of devastation. Dr. Tolesman, I haven't heard your story but you definitely shared that you've had some personal experiences. Would you mind telling us a little bit about how you got into this work and some of your experience? Yeah, so I got into this work because of firefighters and it became part of my passion of working with firefighters, working with fire departments to try to kind of change some of the practices realizing how much exposure they're getting and how much cancer is happening and how many other just illnesses and risk factors they have by doing the job that they have and having the exposures. And part of it is there's this lag time, right? Between a cancer diagnosis and an actual exposure. And so we have all the language around what we know as a carcinogen and we know that's a carcinogen but buildings have changed significantly and they continue to change significantly. So even just looking in the last 20 years, the amount of plastics in our homes, the amount of different building materials makes those risk factors a lot higher. So I got into that. And then I started lecturing on smoke in general with the fires following in California. And then after having lectured and having done all this stuff, I was in Portland, which is where I live in the 2020, September, 2020, crazy fires and crazy air quality. We broke records. We had the worst air quality in the world and it all just kind of went up the entire West Coast. I mean, the images, the satellite images of it out on the ocean. And so, we only got to a level one of activation for our home in terms of fire, but the smoke just made it uninhabitable. And I'm in an old farmhouse, 1850s. And I knew all the things to do. So I knew all the things. I also knew all the dangers and the risks. And so the combination is really terrifying. And I think the other thing that we don't talk about a lot is how much the chemicals themselves affect our vagus nerve and affect our own nervous system. Because when you can't breathe or when you're exposed to a lot of these toxicants, it's like, I can't think, I can't do any. When you go into flight or flight, you become panicked. And that's a really hard way to function. So we ended up evacuating. Luckily, we had friends who had a home in Idaho and we got in the car with the entire family and the dog and the bird and like, literally, stifling with huge air particle masks on because that's something that I've learned. And so we all have respirator masks and we evacuated and the smoke ended up following us and we ended up coming back. But it's really, really hard to make your home safe in smoke events. And the reality is, is that every single year we have smoke events all over the country. That's the thing. And that's why I think this is so relevant for us to educate our co-physicians and our fellow members of ICI and all over the world, the docs that are dealing with this. Because the average doctor, like I wasn't trained in smoke damage, smoke inhalation, benzene, tooling, VOCs from the fires. And we'll talk about specific chemicals in just a few moments. My experience, of course, the fires happened. I'm my office is safe and I go back and the smell was, I walked in here within 10 minutes, massive headache, burning lungs and what happens. And again, both of you can maybe explain better but from my understanding, but whether it's little, basically these things grab onto dirt and dust particles. So anywhere there's dirt and dust, the VOCs and this very small, like 2.5 microns or smaller can attach onto them. So then you really need to in-depth clean. Now again, I'm shocked here, the two weeks later, I can breathe, there's no trouble. But what we've done is literally, we did hydroxyl machines, which I love your opinions on, but I think are a little safer than ozone. So we did a lot of hydroxyl machines to clear the air and air scrubbers. And we actually fogged with the same stuff the botanical products we use for mold because that would weight down those particles. And then after we fogged, we had a very in-depth clean wiping down walls, ceilings, floors, all the services, all of my bookshelves, all of that. And now we have five large capacity, VOC, small HEPA filters that will filter particularly down to 2.5 here growing, full blast, and it feels good, but it's been two weeks and it took a long time to get there. And let's just talk briefly about that. So after the fire, obviously there's a lot of buildings still standing and we think about those who've lost everything in our heart, it has so much compassion for them. But what I'm seeing is the people, the businesses and the people that have their homes in this area are really suffering too. So what's recommendations? I'd love to hear from both of you about what do you do with a home that's been in the fires and still standing and you can't breathe? So I'll let Louise take that because she's had personal experience. And I think also has learned a lot from that experience. And then I'll add, if there's anything I think that you need to say. Well, the thing that I know and you're absolutely right, Jill, it's in the dust, but the ash is so toxic. It is so toxic. They did a study in Southern California. It was like 2007, I think or 2008 after Southern California fires, analyzing the ash itself. And this was after kind of removing the toxic hazardous waste, they literally were just taking a regular old home ash. And it was full of metals and it was full of all these other chemicals. So every time that ash is getting disturbed, that's what's coming in. It's been concentrated, right? And it's everywhere. So it is inside the homes that are still standing. And it's in the areas where people are kind of sorting through, trying to find things around their destroyed homes. So first of all, wearing a respirator. So let's talk about that. So people really know what you're talking about. You're talking about the respirator that someone used for like auto body shops or where there's two charcoal filters on the side. And what are those called if someone's looking for that? Is it just a respirator mask or? It's a respirator mask. And I can actually pull, I meant to bring it. I'm so sorry, but it literally covers your face and they have 3M makes three different versions of it. There's more or less silicone versus the one with more silicone is up here. You have the two filters. So the filters that you want is a solvent filter and a particle 100 filter. So we've all gotten used to particles now, right? And 95 is a 95 particle. 95% of the PM 2.5s are kept out. A 100 keeps 100% of the PM 2.5s out. And do you have to get fitted at all or can you buy them? Do you have to get fitted at all or can you buy them and just... You can buy them. There are three sizes and you can buy them at your local hardware store. You can buy them online. The masks themselves run anywhere from 20 to $30 and then the filter is the same thing. And I mean, I literally have one. I bought them and fitted my entire family and we just have a bin of them. And when we go anywhere, when we travel, it comes with us. I mean, we have basically our smoke pack. And so, when we drove across the country this summer and there I was walking the dog while wearing this full-on particle mask in the middle of Nebraska and it was insane, but... But honestly, that's where we're going. I mean, with the rates, with things are happening. If we don't are protecting, these are our precious resources of our body. So what happens when we... So first of all, the ash you talked about, this is really important because people are sifting through. And I noticed, so we had this massive hurricane like winds that made the fire blow. Of course, it was like 60 or 50, very warm for December 30th. And then the next day, thank goodness it snowed. We had a snowstorm. So then of course the ash got covered with moisture. That was perfect. It couldn't have happened better to kind of tamp it down. But what I'm assuming now is as it gets warm and cold and thaws that the ash will start to like, probably six months, 12 months. What happens then with the temperature, with the environmental changes, with this ash now that's all over? Well, in some places, I mean, they do remediation by literally scraping up the top levels and dumping it. One of the things that Lynn and I have talked about are mushrooms, right? And that's like, what mushrooms are bio-remediators and they've been used after fires and there are several companies now that have lots of kind of videos on them. One of them is, let me find it here, the Butte Remediation, B-U-T-T-E remediation. They've just got a website with lots of videos on how to do it and what they did. But there's lots of different mushroom companies and what I did was buy, it's basically oyster mushrooms. So you can buy oyster mushrooms and sprinkle it over your garden beds and they basically bio-remediate and kind of, it's slower than the kind of scraping off of all of the ash. So obviously, but when you scrape off all the ash, you're losing all the top soil and you're losing all of it. And then what I've heard is, of course, you have erosion and then the dryness because there's no shrubbery or anything, it causes more dust and debris, which again, just spreads it, so that makes sense. Right, and the thing to think about with soil, with our plants, our plants are really good remediators, right? But that's not necessarily something you wanna eat. So lots of the leafy greens really suck up lead and suck up other metals and there are metals in this ash, right? So it's like, if you're just planting a garden after you've had a bunch of ash fall on it, chances are those plants are gonna be pretty toxic. Yeah, so you don't wanna necessarily wanna eat them. I've heard that with thallium and some of the gourds and squashes and things, zucchinis that actually pull that out of the soil, but then of course you don't want it, which is why some of these leafy greens or green juices, if you're not careful, you're getting massive thallium doses in this, right? Lynn, any comments on that with air quality and fashion? What is occurring to me as we're talking is that we need to, because nobody else is gonna do this, create a, we have a wildfire smoke action plan that we've shared with you and you can maybe put that up where people can access it. It is available, I think, through the NAEM organization. It's also, I think, on the Environmental Health Symposium website, but we need a step-by-step action plan. So for example, with 1,000 homes that have been incinerated, you've got a 9-11 size problem here. Yeah. And there are a variety of different things that have to be addressed. The for sure the air quality is number one, absolutely. Everyone needs to understand how to look at airnow.gov and look at, because the air quality is gonna change based on the wind temperature and the humidity and the air temperature. And so people need to know at what point should they start wearing protection? And how- How quickly about that resource? Cause that's a big one. You said airnow.gov, what is on that page? Yeah, it's just a way to put in your city or your subcode and make it the air quality index. And that would relate to weather and moisture and all those things. Yes, yes. The EPA maintains many monitoring stations all over the United States that actually in real time post the air quality online. Dr. Talsman actually took matters into her own hands and got a purple air indoor air monitor and out, or excuse me, maybe it was just an outdoor air monitor, Louise, I can't remember, to actually do her own home monitoring which is also very helpful. Maybe you can say something about that, Louise. So I, they were completely sold out. So, but that reminds me that I'm gonna get one. Yeah, I wanna get one too. I love this. So purpleair.org is a great resource. So airnow.gov is the government site, but it just gives you one number. It gives you kind of the, you know, the AQI for your area one number. If you look at purple air, it's all the monitors around. They've, and so you can kind of get a sense. You can unclick the indoor air monitors and just see the outdoor air monitors. The air in Portland right now is actually really terrible. And so I pulled it up today looking at it. And it's like, it's just a great image because you can see all over the different neighborhoods and you can just get a sense of like, it's sucky, right? But you can also just, rather than just having one number, you kind of get the sense of where it is and where it's clean again. Where it's, the depressions. I use that all summer with our wildfires. I remember August 6th, I'll never forget the day I was out hiking. I had not checked air quality. And it was like you in Oregon the year before the worst in the whole entire world. And I could not breathe on the typical hike I was doing. And later I found out I should have looked because it was like I had smoked a pack of cigarettes that day. So, and I looked at purple air. I'm putting these resources if you're watching now live, these links are in the feed. If you're watching on YouTube, I will put them in the feed below the video as well. So you'll find these, I'll make sure they're all there for you. And so purple air does have a link to be able to buy a monitor that you can have for indoor or outdoor to help contribute to kind of monitoring air. And is that the one you said is sold out at the moment but available? Okay. It was the last time I looked, but it might've just been during that wildfire craziness. Okay, very good. So Lynn, what would you say? I would advocate for everyone to get an indoor air monitor if you don't have an air filter that has an air monitor built into it. Because I think that that is a really much more personal and useful than AQI, even though AQI is the air quality index is also really available and it's free. You don't have to buy anything. So that's number one. And then number two, what we're talking about right now is protection. So protection has a bunch of different levels. One is if you have an old leaky house, how can you make that house less leaky? Dr. Tolesman had an old leaky house, right? That she tried really hard to make less leaky. And sometimes you can, there's really good information that we put up in a bunch of blogs that I wrote for free. It's not behind a paywall at the Environmental Health Symposium website. EnvironmentalHealthSymposium.com. Under resources, you can go to the blog page and we have about four blogs on wildfire smoke, exposure and things you can do to remediate that. And one of them, the California Air Resources Board has wonderful resources that actually help people figure out how to seal up their homes. And I think this is gonna be an issue for you guys, right? Because newer homes are made to airtight. They don't breathe well enough. Older homes aren't made airtight enough and they're too leaky. And so being able to actually figure out how to seal up your home and making it tighter so that when you do filter the air inside the home, you're not constantly having to fight air that's coming in from the outside. That will be really important. So this is so helpful. And again, even with my office, we sealed all the outlets with the little simple dollar, either silicone or foam pads that you can put in there. That's just from the wall cavity air. That'd be like a mold remediation technique. But you're talking like... So tell us, Dr. Tolesman, what did you do like around windows or tell us a few of the things that you found out with your older home? Because this is very relevant. Well, we taped windows. We attempted to tape windows and tape doors and do things to try and seal up areas. In retrospect, I realized we missed the fan above the toilet, it didn't occur to me, right? That that was kind of coming in. It was like, but in my bin, we have over a dozen rolls of painters tape. And you literally just go around all the windows and tape them, all the doors and tape them. You kind of go in and out through a certain door. So we kind of have this whole strategy about which door we would go in and out of. So it wouldn't pollute too much of our house. And this summer we had someone come and kind of do an assessment of the house of where it was leaky and what was leaky. And it's one of those things where you have to kind of work in steps. Our house is really leaky. So it's like, and it's a huge old three-story home. So it's a matter of also, can we make certain areas safe, right? Can we prioritize being able to have these two rooms, have all the air filters in there, seal it completely, come in and out through one door and then let the other parts of the house be less, be more leaky and be more smoky. But we weren't able to do that successfully, which is why we ended up leaving. And it was harder to problem solve in the moment. Right now it's like we've got much more of a plan in place of exactly what to do. So you talk about this kid, it sounds like your mask are there. What would be in a kit? Cause it sounds like everybody should have a kit. And what would that look like? What's in your kit? Well, in my kit is all the masks and all filters and extra filters on the face and all the painters take. I'm talking about the cartridges that. Yes, respirators and extra respirator. Partridges. Yeah. And replace them. Yeah. A quick question on that. How often would you replace? Say you were using them regularly, like right after the fires, is this like a week or a month or is there a timeframe for replacement? No, okay. I mean, I guess it depends on how much exposure it's had. Totally, okay. Makes sense. Keep going then, I'm sorry. I've also then ordered extra filters for all the air purifiers. So I've got a backup thing for that and extra filters for the furnace filter. You know, people do all those makeshift box, the box fans with the filters on top. I mean, those are great in a pinch. I mean, they will grab stuff. I mean, in terms of just decreasing dust levels and things like that. But I have, that's what I have in terms of that. I have a whole different thing when we start talking about supplements or nutraceuticals or things like that. But in terms of this, it's like I traveled with a bin that had all face masks for the whole family and cartridges and we were like ready to go in case we needed it. Brilliant. So super helpful. So let's switch just briefly to air filters and we can talk anything here if you have any opinions. I always say, yeah, good help with filtration down to 2.5 microns with a VOC filter which is typically charcoal or some sort of absorbable zeolite. I have always used Austin air. IQ air is another great brand and I'm just starting to use some air doctor. And again, feel free to talk if you want, but what's your favorite air filters? So the way that I talk about air filters is specific to the individual who needs the clean air. And there are different kinds of humans that need clean air. There are humans that have lung injury perhaps. They have COPD or very severe asthma. They actually need cleaner air than someone who's healthy and doesn't have a history of respiratory infection or respiratory disease. And so the filter on the air filter is very, very thick or very, very thin. And the way that that's decided is by what's called the micron filtration capacity. So micron is just a little teeny tiny, I don't know, 1,000th of a millimeter. I can't remember, but it's how we measure holes in things. And the air filtration that I use for my patients has a micron filtration capacity of 0.001 micron. So you're talking about 2.5 microns, which is a very big hole compared to a very small hole, 0.001 micron. The reason that I recommend air doctor is just to name a brand. I think those down to 0.003 micron and IQ air, which is a high-end brand and it's expensive. So not everybody can run out and spend $700, $900 on an IQ air filter, but for people who are really sensitive to mold and mildew and have asthma, it is a lifesaver. So that filtration capacity is 0.001 micron. So I think, when we were talking before about ash, ash is 10 microns and bigger, right? So that's really easy to filter out. You can filter that out with a MIRV 12 filter. You can get it at Home Depot or Lowe's. And people do that. They build their own filters with the fan and in a box with the MIRV filters they get from Lowe's. And that will do great for the ash. I think the difficult conversation we have to have is that when you burn down a home, you not only burn down the wood in the home, but you burn down the plastic in the home. Homes that are just have a lot of plastic in them, right? The appliances, the bookshelves, and you create a lot of solvent gas and a lot of particulate matter that's really fine. Because it took a lot of heat to burn down those homes, right? There was an incredible high temperature to have homes melt, literally that's what happened. So into the environment went these things called ultrafine particles, which are tinier than 2.5. So they are down to 0.01 micron in size. Kind of like a virus, you know, really tiny. So that's what we have to think about is how can we help people have clean air and not have them go broke, right? And so for me, that's a conversation about, how's your health? Do you have a respiratory disease? Are you challenged in terms of your need for clean air? If so, then if you can afford it, it's better to get one of those high-end air filters. Austin Air, by the way, is a great company. You know, Consumer Lab just did a wonderful, very extensive, they did a whole project on air filtration and Austin Air came out on top. Wow. The best. I've never been my personal experience with the mold. I didn't know anything about air filters, but I knew that filter one right beside me here really saved my life. Like I could tell a difference every time I was around it. So I became a believer and then I found out there's all kinds of other good brands as well, but I am a fan. I will say, if you're listening and you're in our community, this is just for people affected by the fires, but we have secured a really large discount if you're needing air filter, you can email clean air at flat air and functional medicine dot com and we'll get you the direct information about that. Again, I can't even say it on here how much it is, but for someone who's affected by the fire, we have a very large discount on these good air filters for you. If you need one. And I would highly recommend getting an air filter because the bottom line is those of us who live in the West, like Louis said, we are going to be challenged with this from now on. That is just what we're going to have to problem solve. Yeah. And it's interesting here. I thought I was, I was, I'm not on the foothills, right? Like it's, I can see the foothills. I'm close, but my thought was always, oh, those people in the foothills, they always have to deal with the wildfires. No, we're in the residential section way away from the foothills. It had nothing to do with the foothills. And again, you realize we're all at risk out here. What were you going to say, Louise? Well, I was going to say two things. One, we all need air filters because our homes are so toxic air wise. Very often indoor air is worse than outdoor air when outdoor air is good. So I mean, in terms of that, but the other thing that I tend to do, I totally wholeheartedly agree with you, Lynn. It's all about the patient. And I think if, if I have to choose, it's always about the bedroom. Yes. Right. Just make your bedroom super safe. Get your bedroom super clean, get all the stuff out of your bedroom, have as little stuff in there and run an air filter. You're in there seven to nine to 10 hours and breathing clean air at least at night and being able to like, if you can just do one thing, that's the thing, get it in your bedroom. Oh, I love that. I'm going to shift. I have an article here that lists some of the chemicals and you guys, maybe you can have more, but let's talk just a little bit about what is in the fire. And then let's shift to what we can do about it. What can we do? Not only about air quality, we've talked about that pretty extensively, but there's some good supplements and things out there that we all use as tools to help the body detox from these chemicals. And again, this is not exhaustive. Please feel free to add, but aldehydes, acid gases, sulfur dioxide, nitrogen oxides, polycyclic aromatic hydrocarbons, benzene, tooling, styrene, heavy metals. I want to talk specifically about that in dioxins. Anything else that comes to mind? And let's talk, you can both have a turn on talking a little bit about the chemicals and the metals especially, because that surprises people. Metals are being released. Lynn, do you want to start just briefly about some of the chemicals and then? Sure. So we knew about metals from forest fires because trees that have needles actually will pull mercury out of the air and sequester it in their needles, which is kind of an amazing thing that the trees do for us. When those trees burn, the mercury actually becomes a gas and it will travel for a long way on clouds of smoke. So when 9-11 happened, one of the things that New York City did is they started their own study looking at the blood of New York City residents to see what was in there. And what they found in the period after 9-11 was that the average blood level of mercury in New York City residents went up significantly. Now this wasn't because they all started eating more stinky all of a sudden, right? And they had a lot of data, the health department actually had a lot of data because there's some problems with mercury in New York City. But what they found was that it had been going along fairly steadily and then it just shot up after 9-11. And this was because the mercury from the building that came down the Twin Towers actually became airborne and was breathed in. And we are very good at picking up mercury in our lungs and transporting it into our bloodstream by mercury. So unfortunately, mercury is one of the metals as is lead, as is cadmium, as is arsenic. And it's not only coming from the trees, it's also coming from buildings. Unfortunately, we still have mercury in gauges of old antique clocks. We have mercury from people who spilled mercury on the carpet from breaking a thermometer, from old fluorescent light bulbs, from light bulbs that are basically compact fluorescent light bulbs, those contain mercury. So there are a lot of places that mercury can come from in homes. Not everybody's gotten rid of their compact fluorescence. You know, we went through this phase where we thought that's how we were gonna save the environment. And we realized that was a bad idea. So mercury is one of the metals that becomes airborne and becomes part of that. And remember, you were just talking about PM2.5, those little particles floating around in the air. They're sticky, they're like velcro. And so what sticks on to them are metals and pesticides and solvents, gases will say, just benzene and toluene polycyclic aromatic hydrocarbons. So these little molecules floating around in the air have a lot of stuff stuck to them that are toxic. And so, you know, that's why we're making such a big deal about not breathing them in because you do not, well, you don't want them on your skin and you don't want them in your lungs. You don't want to breathe them in. And two things that I just thought, so first of all, that's why after the fires, the cleaning is actually a huge part of safety because first of all, if those are aerosolized, you need to bring them down with whatever way that you're kind of getting the hydroxyl machines, I believe will do that. And then also for us, fogging worked, even though that might not be the standard, it worked. And then just physiology, the lungs, if you're listening like, well, how does this happen? Our body's meant to take in air and oxygen and things into these alveoli and they're just right up against the blood vessels. So literally our lungs are a direct route to our bloodstream. This is why mold is so toxic. We used to years ago think it was ingested. It's not ingested most of the time, it's actually inhaled. And again, the smaller the particle size, it goes right through without even needing transportation to the bloodstream. So we're after the fires, literally loading our blood with toxic chemicals. Louise, any thoughts on the chemicals and your experience and anything we do to protect ourselves? Well, the chemicals, I mean, when you start to actually look around a home and think about a home, I mean, if we just talk about plastics, new home construction has plastic water pipes through the whole house. Sometimes there's plastic siding, plastic windows, fencing, outdoor garden irrigation is often plastic. Arsenic and some of the other metals, right? Lynn, the dex, yeah. The dex. Decking is plastic. Right. And other decking is often pressure treated lumber that can be arsenic, right? That were then also burning, right? And so you're getting the arsenic. And homes often have things that are contained, like there's asbestos that is still contained. It doesn't need to be remediated because it's just around the pipes maybe or someone feels like, oh, you know, it's fine. But when that burns, that gets aerosolized. You're inhaling asbestos, right? And batteries contain cadmium and car batteries, cars that burned, homes with batteries, all the chemicals. So just think about a garage or think about a basement with paint and all the different chemicals people use, pesticides, herbicides, all of that got released. Unbelievable, unbelievable. Let's talk just a little bit about what, so supplements, nutrition, IVs, sauna, where do we start? Well, I think the place to start, can I share my screen with that? Can I think, please, and I think I have it ready to go. So please go ahead. Okay. There we go. This is... Oh, beautiful. Action. Let me call the Firesmoke Exposure Action Plan. Amazing. This is something that Dr. Walter Krunian, Luis and myself worked on back, I think, in 2018 or 2019. So all of these supplements have been used in human trials. Now we're not talking about animal trials. And some of these trials are actually, they have a procedure where they'll actually put a human in what's called a pollution box, a pollution chamber. So they actually put a human in there and then they will fog the pollution chamber with a very specific particle. Size and a very specific density of the particle. So they can replicate Firesmoke Exposure. Wow. So some of these studies have actually used this actual exposures in humans. So this is really good evidence. First thing, B vitamins, very cheap, very accessible, very important in these specific doses. Now, of course, we know that B complex is a family, right? And you really should use them all together, not just folic acid. And by the way, that is my typo, it was folinic acid. I just looked up the original research and it was really folinic acid. So methylfolate, however you wanna dose that. And again, we know that people are very specifically sensitive to folates, right? But if they're healthcare providers in the audience, you know what, how to figure this out. But in a pinch, just good old folic acid will probably be helpful. So this specific dosage of these specific B vitamins, they don't automatically come like this in a B complex vitamin. So you may have to buy them separately. Fish oil, EPA and DHA, used in the elderly who were exposed to specific, I think this was an outdoor air pollution exposure study. They looked at how the fish oil affected these elders and the ability of, this is really important because air pollution causes heart disease and it can actually cause strokes that can actually cause acute heart attacks. And heart rate variability is a way to measure how the heart is affected by toxicants, right? And so very dramatic protective effect of fish oil on heart rate variability in these elders that were exposed to air pollution. So a good quality fish oil, high quality fish oil, not the fish oil you get from Costco because the fish oil you buy from Costco does not have some of the other pollutants that are found in fish oil removed from it. So there are pollutants in fish oil that have to be removed by a process. And a high quality fish oil will have those removed. So one and a half grams of a combination of EPA and DHA. Then good old vitamin C. This is literally just good old regular powdered vitamin C that you can buy anywhere. It kind of doesn't matter what it is. And vitamin E have been shown to protect from a whole variety of different air pollutants. You can see here nitrous oxide been used in kids with asthma. Ozone, by the way, is one of the pollutants that everybody will be exposed to from these fighters, for sure. There'll be combination of sunlight and some of the solvents will make ozone ground level. So very important to have vitamin C. So- Lynn, if I can just say really quick and I'd love to comment because it's relevant is some of the air filters that have specific mechanisms to treat the air can create ozone in the air when they react to the particulate. I'm not a fan of these at all. Would you agree? Yeah, ozone causes can create asthma and people are prone to asthma. It can also cause COPD, a chronic obstructive pulmonary disease. If you have a air filtration device that's generating ozone, you don't wanna be in the home when it's running. That's the bottom line. You don't wanna be exposed to ozone. So yeah, absolutely not. So fluorophane. This is the wonderful and powerful compound that's found in broccoli. Broccoli sprouts are exceedingly high in fluorophane but there was a great study that was done in China in a highly industrialized city where they gave a group of adults that lived in this highly polluted city, broccoli sprout powder in a beverage. A powder you just stirred up in water and drink and they showed a significant improvement in their ability to detoxify and eliminate benzene specifically, which benzene is an ingredient that is gonna be one of the things people are exposed to from the fire and acrylene, which is also a combustion product. So it's also an air pollutant. Lynn, just a really quick note on benzene. I just interviewed my grandmother for the book I'm writing about six months ago and I just found out she's 90 years old. She's the only one in her family still surviving. They, when she was 15, moved into an auto dealership where her father bought and they lived above an auto body shop with lead and benzene. Her sister died early of metastatic cancer liver. Her father died of liver cancer. Her mother died of liver failure with no alcohol, cirrhosis, no known cause and her brother died of metastatic liver cancer. So I mean, to me, I was like shocked because they had this massive and all the siblings that other than her were younger. So they all got a lot more exposure to the benzene and the lead than she did. But it was a really like here, the story in my own family of benzene toxicity and they all had liver issues. Yeah, benzene is a carcinogen, class A carcinogen, right? I wanna skip, well, and let's quickly go through anacetyl cysteine that is an amino acid that is very specifically, it's got an NA in front of it. It's not just regular cysteine, it's acetylated. Absolutely crucial for protection of the lungs. The very good evidence in human studies that NAC protects the lungs from air pollution exposure because it is a precursor to glutathione. You know, our lung lining, we have a fluid that lines our lungs and we've evolved to be able to handle, we think about volcanoes, right? Humans actually lived at a time when there was a tremendous amount of air pollution from volcanoes, but fast forward several million years and here we have a lot of things we're exposed to all the time that lung lining fluid is very rich in glutathione and vitamin C and vitamin E and several other antioxidants to protect us from the exposures we have, not just to air pollutants, but to some of the bugs that get into our lungs, viruses, for example. So NAC is part of that whole system, so it's very important. Typical adult dose is 1800 milligrams. The only people who should not take anacetyl cysteine are people with active peptic ulcers. If you're battling an ulcer and you've got a heartburn, you should not take NAC because it thins the mucous lining of the stomach. Resveratrol is an excellent antioxidant, has also been shown to protect the lung lining, that really crucial and beautiful, vulnerable lining of the lungs that can become inflamed. And then I want Dr. Tolzman to talk about green tea because she did a lot of research in the last webinar in this. Green tea is pretty amazing. Well, they did a nice green tea study. It was a cross, no, it wasn't a crossover study, but it had four different groups and they were using gasoline workers, people who were pumping gasoline. So a big exposure of benzene when you're pumping gasoline. So two of the groups were pumping gasoline. One of those groups was taking green tea and the other one wasn't. And then in the other group, there was the not pumping gasoline, taking green tea and not taking green tea. And what they found, they were then kind of measuring inflammation and also measuring DNA damage, literally. And what they found in the people, it was beneficial in the people who were not pumping gasoline at all, just doing green tea was actually really protective and helpful. But in the people that were pumping benzene, they were actually protected down to the levels almost of people who weren't pumping benzene. So really an easy thing to do if you like drinking it, right? You can just be drinking green tea. We know it has lots of other beneficial effects as well. Absolutely. And it is available in little capsules if for some reason you're adverse to drinking it, you just will not drink it. It is available green tea extract is available in capsules but it is a wonderful beverage. It has a tremendous amount of benefit in many other ways as well. And then curcumin, everybody has probably heard about turmeric, contains curcumin as well as many other beneficial substances. And you will wanna, you know all about this, Jill, because it's an anti-endotoxin basically. Oh yes, I saw that and I've talked about that before. So that's just for any of you listening, LPS is the bacterial coatings in the gut that sneak over the blood and create massive inflammation, really underlying obesity, heart disease, lots of mood disorders, sleep disorders, et cetera. So curcumin also assists in some of the metabolism and excretion of these toxicants. Curcumin has been shown to increase urine elimination of lead, urine elimination of mercury and several other metals. So curcumin by itself, although it's not a key later per se, it does assist in getting some of these metals out of the body. So I think curcumin is, you can buy turmeric root now and make a tea out of it or you can get curcumin in capsules. We don't have a dosage there and I'm not sure why, but a standard dosage is 450 milligrams a day, something like that. And then alphalipoic acid, which is an antioxidant, the body makes it. So it's not a drug, it's actually made in the body. There are different forms of alphalipoic acid. The R form is a more stable form. So R-ALA is how you would see it. And the R form alphalipoic acid has actually, again, been shown to really minimize the damage from toxicant exposure from air pollution. So that's our little action plan. And I think, you know, we don't have actual studies with house fire smoke. The studies have been done with wildfire forest fire smoke and air pollution, but that's what we're dealing with is the combination of the two, right? We're dealing with wildfire smoke and air pollution. That's what the house fire smoke really is, is air pollution. I just wanted to go back to some of these things like the fish oil. I think it's exactly what Lynn said. You need to look at the EPA and the DHA on the label. So it'll say, you know, often they'll advertise on the front total, you know, total fats or total omega-3s or something like that. And it'll see this really big number. But when you turn it to the back, you'll actually realize it has hardly any EPA and DHA in it. So you really need to add those up. That's what you need is the 1.6 grams. So when you do that, it suddenly kind of really makes clear which ones are good and which ones aren't. Because I think with fish oil, I really am concerned about people getting exposed to toxicants. Because if it isn't a company that's well known or taking really good care to make sure they're pulling things out, then you are potentially getting stuff that is more toxic. But the vitamin C and the B vitamins and the NAC are really fairly inexpensive, very accessible, easy to get. It's a little trickier now with NAC, but you know, and green tea, and those are some amazing things to be doing to just be able to start immediately. And the data and the research was really compelling. It's really compelling when you put people in a pollution chamber with a simple B vitamin versus no B vitamin. So, Jill, I will, I think this is, I'm not sure this is the exact exposure action plan that I gave you, but it's very similar. We have action plans that actually have information about how to make your house secure and what filters to use as well. Oh, great. I will be sure and distribute and give you all credit because it's definitely needed. And that's what I've been trying to do is how to get the information out to the community. No credit is needed. Just share this and get it out there. I think the more we can come together as providers, and you know, this is gonna be an ongoing discussion because it's like Louis said, what they did in the Paradise Fire and many other fires is the EPA came in with thumb trucks and they literally just dug all of the ash out of the home site and took it, I don't know where they took it, so somebody could hole in the ground. And that process is gonna need to take place times 1,000. Right, exactly. Like that's the thing, I literally, I'm sitting right now surrounded on four sides by sites that are acres and acres and acres and acres of nothing but rubble. So again, here I am thinking as I have many, many air filters around me, I'm doing great, and we have this building sealed. So just like you said, like I'm in a good spot here, but this is going to affect many. And my instinct is number one, like you said, this is not gonna stop here. I'm very committed. It's my life as I'm a guinea pig. You guys have said this to me, I mean, like that's how we live, right? We experienced up and then like Louis, your experience motivated you to really learn more. And I'm now gonna be one of the biggest advocates for this stuff and hopefully out there, just like you teaching because in this year, any conference I'm like, let's talk about wildfire smoke because it's a really big deal. And I'm a practitioner, I've been doing functional medicine 20 years and I did not really know a lot about the wildfires until they happened here. So thank you both for being on the cutting edge and for being such great researchers and researchers and just all around amazing, amazing colleagues and practitioners to bring this information. And for taking the time on short notice, I am so grateful. Sure, absolutely. Let us know how we can continue to be helpful. Yeah, absolutely. Thank you. Any last comments or bits of wisdom that we didn't cover? I guess one quick thing I wanna say is that there was a study that was done in Lake, Sealy Lake, Montana. Sealy Lake is outside of Missoula. And I believe in 2017, they had six weeks of air quality around 220. So, you know, the air quality index was 220. They went in and measured the lung function of a group of older adults and then they went back and measured it three months, six months, nine months, 12 months and two years later. And what they found from just that six weeks of exposure is that they continue to lose lung function and their loss of lung function was accelerated in about a third of those folks, three times faster than everyone else in terms of their FEV, you know, their forced expiratory volume, right? And so this is serious. Like we really need to take this seriously because that one exposure of six weeks, there were a bunch of wildfires in the West, right? In Montana and in Canada. Maybe it was 2018. Anyway, that exposure did damage. And none of those folks that I know of in the study had any kind of intervention. They didn't take vitamins. You know, they didn't take supplements. And so I think we need to obviously do more research with intervention and see if we can actually prevent that from happening. Oh, so, so important. And, you know, one of my first, well, five years ago with my mold exposure, my lung function, first of all, I have this GSTP-1 mutation on my lungs which causes mucosal lining in my lungs to not be able to process chemicals as well and to produce less glutathione. One thought, and I'd love to know if you use this, but I've been prescribing nebulized NAC and glutathione to some of those who actually have the topical symptoms. So you can, from a doctor who knows how to prescribe it, get, you can buy a nebulizer anywhere online. You can get a prescription or buy it yourself. You don't need a prescription. And then you can actually use anesthetical cysteine and or glutathione inhaled. And I found it to be really, really helpful. Would you recommend that during the fires? Is there any contraindication or issue with that? Not that I know of, no. Okay, awesome. Yeah, any comments, Louise, last bit, Dr. Tosman? No, I would just say for you, every time you're leaving your amazing sanctuary, that you're actually in a respirator because you are being exposed, walking outside your house and walking your dog and walking to your car or to your home or things like that, ways of kind of protecting. Excellent, I'm gonna get one. It's so funny, because here I know about this and I'm not wearing, I'm wearing a mask, but not a respirator, so I'm gonna go get one. Thank you both from the bottom of my heart and on behalf of my community that's been affected for being here for taking the time. This is priceless information. I will be sure and spread the word and share your resources. And I'm just grateful for two of you for being the leaders in this discussion. Thank you so much. You're welcome so much. Let us know honestly, Jill, how we can continue to be helpful. Yeah. Thank you.