August 2023, A series of wildfires broke out on the island of Maui, killing more than 100 people, destroying thousands of homes and causing billions of dollars in damage. Kanaka Maoli and Maui Medic Healers Hui co-founder Noelani Ahia helped mobilize nearly 600 volunteers in Lahaina, including doctors, nurses and therapists.
Three years later, the housing and health crises remain dire. Maui Medic Healers Hui operates free clinics, but Ahia hopes to open 10 more clinics to meet the needs of the community. “The fire may have been put out, but the disaster is not over yet,” she said.
The devastation went far beyond casualties and destroyed buildings. Research published last year by researchers at the University of Hawaii at Manoa’s Maui Wildfire Exposure Study (MauiWES) found that more than one in five residents had reduced lung function.
Now, new research from the same project has found that islanders had elevated levels of toxic metals in their bodies months after the fires, and that higher exposure levels were associated with impaired lung function. The findings add to evidence that the health impacts of catastrophic wildfires can persist long after the flames are extinguished and the smoke clears.
“What we sometimes think of as a one-time event is no longer really a one-time event,” Alika Maunakea, Kanaka Maoli and co-director of MauiWES, told Grist.
Researchers don’t yet know how much of the pollution came from the fires and how much was already in the environment. The difference matters because wildfires are increasingly sweeping through towns like Lahaina and cities like Los Angeles, burning homes, cars and infrastructure that can leave behind pollutants that people still encounter months or years later.
“Traditionally, we have thought of wildfire exposure primarily through smoke,” Mauna Kea said in a press release. “But when an entire community is on fire, we face a much more complex exposure environment.” He said researchers must also understand what pollutants are already present, what pollutants the fire may have released, and what pollutants are entering residents’ bodies.
The study looked at 1,400 adults on Maui between six and 18 months after a fire, measuring 24 metals in urine samples. The study found that participants in a national health survey conducted before the fires had higher concentrations of several metals than people in their bodies. The arsenic content is 2.2 times the original, the barium content is 2.3 times the original, and the manganese content is 3.8 times the original. Antimony, used in flame-retardant materials, had previously been linked to lung irritation, stomach pain and other symptoms, but levels have now been found to be nearly 40 times higher.
Because the researchers lacked comparable data from before the fire, they couldn’t determine how much metal exposure was caused by the disaster. Maunakea told Grist that answering that question is the next step for the project, which has received $3.6 million in funding from the National Institute of Environmental Health Sciences. The work will include investigating whether and to what extent past agricultural and industrial activities contributed to the pollution.
“It’s important to realize that these are all part of settler colonialism,” Ashia said. “So what we’re looking at are confounding factors that are detrimental to the health of local people.”
Decades of plantation agriculture altered water systems, introduced herbicides, and replaced native plants, leaving a legacy on the islands that is still felt today. Disasters such as fires and storms can exacerbate these ongoing environmental problems.
“If we start telling stories when fires happen, we miss the decisions that shape landscapes and communities’ ability to respond,” said Katie Kamelamela, an assistant professor at Arizona State University in Hawaii. “Microclimate change acts on places that are already shaped by histories of inequality in land ownership, water diversion, development and access to resources.”
Cameramela said true recovery must go beyond the fires. “I hope to measure recovery by whether people are able to stay in their communities, care for āina, and pass on their knowledge and practices,” she says, using the Hawaiian word for land, which has deeper meanings and relationships than property or simply place. “Regeneration should not recreate the same conditions that put people at risk. Care for āina and care for people need to be co-funded and planned.”
Mauna Kea said the numerous cross-pressures were one of the reasons he wanted to conduct the study. As climate change continues to accelerate, long-term issues facing Native Hawaiians, such as housing, harm from tourism and the legacy of plantations, may exacerbate the problem. “We are concerned that disasters like the one we experienced on Maui, as well as the flooding and other storms we are experiencing now, will only continue to widen the health disparities that already exist among these populations,” he said.
Going forward, the program will not only identify health risks but also help residents manage those risks. Study participants receive their results, discuss them, and meet with health professionals. “People now know that these types of potential dangers exist, and how to deal with them is a big question,” Mauna Kea said. “We still don’t have all the answers, but we are taking the next steps to better understand the situation and inform our community.”