Three University of Arizona graduate students had a unique opportunity on July 5, 6, and 7 to assess the health impact of Arizona's worst recorded fires as they worked on a project conducted by the U.S. Centers for Disease Control (CDC) in partnership with the Arizona Department of Health Services (ADHS).

The damage to homes, businesses, and forests during the Rodeo-Chedeski fires has been calculated in the millions of dollars but, until last weekend, the health impact on residents of the White Mountain communities of Snowflake and Showlow had not been assessed.

Jason Cianciotto, a graduate research assistant at The University of Arizona School of Public Administration and Policy's Community Rehabilitation Division (CRD) and University of Arizona College of Medicine students Cliff Martin and Brian Manjarres were enlisted by CRD Director Michael Shafer, Ph.D., to travel to the White Mountains on July 5 to conduct a three-day community health survey.

They joined two CDC representatives from the Atlanta headquarters and nine ADHS employees and were divided into two units – one covering the Showlow area, whose residents had been ordered by the U.S. Forest Service to evacuate their homes; the second covering Snowflake, where residents had the option of staying in their homes.

The White Mountains are rugged terrain – paved roads often disappear into dirt, which then deteriorates into mere tracks. Residences are scattered and vary from large, luxurious vacation homes to tiny, crowded trailers. Elderly retired persons make up a large part of the population. The four-wheel drive vehicle rented by CRD proved invaluable for the students to reach homes on nearly non-existent roads.

Maps were distributed and the area divided into "clusters." Teams of two – one male, one female – were instructed to count the houses in each cluster. If an area contained more than 20 homes, the team would begin surveys – one reading, the other recording responses. Residents' participation was purely voluntary and the interview could be stopped at any point. The goal in each cluster was to complete seven interviews, with an overall goal of 100 surveys each for Showlow and Snowflake.

What were the data designed to show? Residents were asked to describe their general health status, using criteria such as the presence of diabetes, heart disease, lung disease/emphysema or asthma; stress level; the use/need for of prescription drugs; the presence and severity of fire/smoke-related symptoms such as shortness of breath, coughing, itchy sore throat, chest pain, eye irritation, and allergies.

Showlow had been evacuated, so residents of that area might be expected to have had higher levels of stress, but lower levels of smoke affects on their health. Snowflake residents, on the other hand, were not ordered to evacuate, but many could not breathe because of the heavy smoke and ash fall. Few homes in the area are air conditioned and the smoke prevented the use of "swamp coolers." So, in the summer heat, residents had to close their windows and rely on fans.

The majority of people interviewed by Cianciotto and his partner reported experiencing moderate to severe eye irritation, scratchy sore throat, chest pain or difficulty breathing. "Stress levels were quite high," he said.

Cianciotto described one interviewee who said she had only one lung and had throat cancer who had to leave her home because she couldn't breathe. Another elderly woman said she had smoked cigarettes for forty years, "but the smoke from the fire was so bad that she finally realized the danger of smoke and decided to quit smoking," Cianciotto said.

Graduate students are assigned research papers using existing data, but rarely do they have an opportunity not only to collect data first-hand, but also to work with the U.S. Centers for Disease Control in assessing a potential public health crisis. "This experience opened my eyes dramatically because it was so different – at the street level, going door-to-door – not just sitting back and viewing best practices or research methodology," said Cianciotto. He described the Snowflake residents he interviewed as "open, friendly people – culturally interesting." One unexpected difficulty was interviewing Spanish speaking residents and the dearth of bilingual interviewers.

Medical students Martin and Manjarres said participation in the project helped them hone the interview skills they will need with patients."This was a great opportunity for UA students to get out of the classroom and into the field," Cianciotto said, "especially to work on a project in conjunction with federal and state agencies.