Due to the large number of wildfires in California the air quality in your vicinity may be significantly impacted. This health advisory is issued to augment the advice you may already have received from your county health officers and/or the air quality management boards.

Many county health officers have issued very sound health advice which should be followed. The joint health advisory letter from the El Dorado County Public Health Department and Air Quality Management District is a good example and is attached for your review.

In addition to these precautions, licensed health facilities are advised to take additional precautions designed to reduce the health risks to your residents/patients:

• Check the air ventilation system(s) to make sure they are set to recirculate air and that each has a clean air filter designed to reduce fine particulates from the air. Check the integrity of the ventilation systems and keep windows and doors closed.
• Keeping vulnerable individuals away from the unhealthy outside air can significantly reduce some harmful effects, but only if measures are taken to clean the inside air and keep it from being contaminated by open windows and doors or leaky ventilation systems.
• Check the diagnoses of your residents/patients to identify individuals at significant risk of harmful effects from unhealthy air quality.
• Elderly individuals, those with multiple health issues and those with respiratory or heart related diseases, are especially vulnerable. Residents/patients with asthma, COPD, emphysema, congestive heart failure, coronary artery disease and other related conditions need special observation.
• Once your facility has identified individuals that are especially vulnerable, those individuals should be observed more frequently for early signs or symptoms of compromise so they can be seen by their attending physician or the facility medical director.
• During this crisis, all residents or patients showing signs or symptoms attributable to the poor air quality should receive appropriate medical care as soon as possible.
• Consider placing individuals that are especially vulnerable into an environment that has an additional portable ultra-purification air filter.

Sincerely,

Original Signed by Scott Vivona for

Kathleen Billingsley, R.N.
Deputy Director

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