Last year Vipul Jain, MD, a University of California San Francisco pulmonologist was proudly recounting the successes of his program to curb emergency visits and hospitalizations for patients with chronic obstructive pulmonary disease (COPD). His study was published Sept. 28, 2014 in Respiratory Medicine.

“ER visits were down by 75% and hospitalizations by 60%,” Jain said in an interview. Those numbers are now going up in smoke.

Record drought in the Western US that has contributed to an explosive wildfire season is sending droves of wheezing, coughing patients to physicians and asthma clinics. Jain’s patients’ ER visits and hospitalizations are rising again, up from 20% to 50%, he said.

The smoke from wildfires can contain particulate matter, polynuclear aromatic hydrocarbons, aldehydes, carbon monoxide and other irritants. It travels hundreds of miles. With no rain to clear it, the smoke has asthma patients gasping, and even those who do not have chronic breathing problems are suffering, physicians there report.