Fumes and smoke

Question

Hello,
We would like to know if there are precautions, arrangements to be made in relation to fumes and smoke emitted during concerts, shows… for people with cystic fibrosis?
Is it better to avoid them? Do they carry risks?
You can also find this kind of machine to make smoke in certain stores or to diffuse vapors of essential oils, what precautions are to be taken?
Thank you beforehand,
Cordially.

Answer

Hello,

You ask a question that is difficult to answer in a simple and clear way. It is true that fumigants used for recreational purposes as well as in concerts do not present the same risks as smokes used for military or law enforcement purposes or for domestic purposes for the extermination of insects.

Public safety presupposes that the manufacturers of recreational fumigants used for concerts comply with production rules and that the organizers of these events, especially if they take place in closed enclosures, abide by rules of use. Since public demonstrations must be declared and authorized by the town hall of the municipality where they take place, it is important to verify that this authorization has been granted. At the very least, it would be unwise to use hand-made fumigants.

Smoke generated during shows are manufactured by vaporizing machines. The thick vapor is made up of water and glycol or glycerine. To create a homogeneous cloud, a fan disperses the cloud at the output of the machine. In order to obtain a thicker and heavy smoke sliding on the ground, dry ice is used also causing an air cooling. Inhalation of these components at high concentrations may cause side effects on the respiratory level by irritation of the bronchial mucosa. People with respiratory mucosa already sick, such as in asthma or cystic fibrosis, are more exposed. The cold air also increases the hyperactivity of the bronchi. Cough and asthma attack have been observed. In this festive context, there may be additional exposure to tobacco smoke from passive smoking, ie an additional bronchial irritant known to have deleterious effects in cystic fibrosis and which must also be avoided (Ortega-Garcia JA and Mc Ewan FA, JCystFibros 2012). The harmfulness is related to the level of exposure, which differs depending on the place. The risks are greater indoors in an unventilated room than outdoors with wind!

For diffusers of essential oils, the problem is different. It is a vapor made up of water and an oily solution with sometimes an addition of alcohol. The volume of vapor diffused is less important because it is the pleasant odor that is sought and not the "smoke or fog effect". But regular and repeated inhalation of oily products is toxic because the pulmonary alveoli are unable to evacuate and eliminate it. The oily product accumulates over time to cause lipid pneumonitis with the risk of repeated infection and eventual respiratory disability.

Concerning the particular risk for patients with cystic fibrosis (or other respiratory pathology), a general recommendation is to avoid atmospheres polluted by toxic or potentially irritating substances because the chronic inflammatory state of their bronchi makes them much more sensitive to their potentially harmful effects. However, it is also a matter of moderation: what can be tolerated by a patient who has good respiratory status, has no bronchospasm reaction to known substances can be very poorly tolerated by a patient known to have bronchial hyper-reactivity especially if he already has respiratory insufficiency. On the other hand, putting patients in extreme caution may involve the risk of escaping recommendations for a secret moment of freedom and pleasure. But in this case, a wise precaution is that patients are in the vicinity of an outlet enabling them to leave a place quickly

Hope this answer can help.
Best wishes
Gilles RAULT, MD, Roscoff CF Centre
Nadine Desmazes-Dufeu, MD, Marseille Ad CF Centre

24.02.2017