The smoke from the wildfires that swept through Los Angeles last January smelled of plastic and was so thick it obscured the ocean. Firefighters who fought the blaze developed instant migraines, coughed up black goo, vomited and fell down dizzy.

Seven months later, some still wake up startled by attacks of wheezing during the night. It is unthinkable that urban firefighters – those American icons that occupy a dominant position in the public imagination – would enter a burning building without wearing a mask. But across the country tens of thousands of wildfire fighters spend weeks working amid toxic smoke and ash, protected only by a handkerchief or nothing at all. This is how researcher Hannah Dreier explained it in The New York Timesin late August.

In the past, wildfire fighters were seasonal workers who alternated deployments with other jobs. It is possible that they suffered only a few days of intense smoke during the year and had winter and spring to recover. Now, as drought and extreme heat increase, wildfires in the United States are starting earlier, burning longer and spreading further. As a result, firefighters often work almost year-round and, as a consequence, many of them are getting ill.

For decades, studies have consistently linked increased exposure to smoke from wildfires to increased cardiovascular and pulmonary problems, cancer and premature deaths. The Forest Service’s own investigators – the U.S. Department of Agriculture agency in charge of managing U.S. forests – have themselves warned of the effects of smoke and have called for providing firefighters with face masks, monitoring their exposures and long-term monitoring of their health status.

Countries with large wildfire seasons such as Canada, Australia and Greece have begun to distribute half-face respirators with replaceable filters, such as those used by painters and demolition crews. In laboratory tests, they puff about 99% of the toxic particles in the smoke. Disposable N95 masks are almost as effective.

But, year after year, the Forest Service sends firefighters into the smoke with nothing to prevent them from inhaling the poison. The agency has opposed equipping firefighters with masks; it publishes safety manuals that do not mention the long-term dangers of smoke exposure, and it does not allow workers to wear masks on the front line, even if they want to.

In a statement the Forest Service has said it wants to protect its crews, but the masks pose too great a risk to firefighters because they can overheat during the strenuous work they must perform to contain a wildfire. Instead, they propose that supervisors move them away from dense smoke and set up sleeping camps in places with cleaner air, when possible.

Respirators are a potential tool for reducing smoke exposure, but regulatory and logistical problems make widespread use impractical.

Researchers in countries that already use face masks have stated that they have not observed an increase in cases of heat stress. Firefighters slow down or remove their masks when it gets too hot, they said. The Forest Service continues to monitor international practices and research.

Internal records, studies and interviews with current and former agency officials reveal another motivation: adopting the masks would mean admitting the danger of wildfire smoke.

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