People's physical and mental health could be affected by Maui wildfires

Dangerous wildfires -- fueled by dry conditions and strong winds -- are continuing to sweep across Maui, ravaging the small Hawaiian island.

At least 55 people have been killed and a majority of the historic town of Lahaina, which was once the capital of the Kingdom of Hawaii, has been destroyed, according to officials.

During a press briefing on Thursday, Gov. Josh Green called the wildfires "likely the largest natural disaster in Hawaii's state history."

But the impacts go beyond evacuations and damaged buildings. Experts say the fires are also affecting residents' and tourists' physical health and could have impacts on their mental health.

Small particles from smoke can travel into lungs

Wildfire smoke is a mixture of gases, pollutants and particles that people can inhale, penetrating the lungs and even entering the bloodstream. Perhaps the biggest concern is fine particulate matter.

Fine particulate matter known as PM2.5, which is 30 times smaller in diameter than a human hair, is of particular concern.

Because these particles are too small to be seen with the naked eye, they can easily enter the nose and throat and can travel to the lungs, with some of the smallest particles even circulating in the bloodstream, according to the Environmental Protection Agency.

PM2.5 can cause both short-term health effects, even for healthy people, including irritation of the eyes, nose and throat; coughing; sneezing; and shortness of breath. Conditions such as asthma and heart disease can become worse.

It doesn't just affect people who are nearby, but also those who are thousands of miles away, said Dr. Kai Chen, an assistant professor of environmental health at Yale's School of Public Health.

"We saw that evidence actually just two months ago. [Smoke from] the Canadian wildfires in Quebec impacted us here in New Haven, New York City and then further south to D.C.," he told ABC News. "The reason we're having so many frequent wildfires is climate change," Chen said. "Climate change is literally like fuel to the fire."

Wildfires can increase rates of anxiety, depression

In addition to physical health, there are also mental health impacts. Research has shown wildfires and the subsequent smoke can lead to increased rates of anxiety and depression and become worse among people who already have these conditions.

Dr. Steve Berkowitz, a professor of psychiatry at the University of Colorado Anschutz Medical Campus, said wildfires and other natural disasters may also impact the ability of people with mental health conditions to receive care.

"After [Hurricane] Sandy in New York, one the biggest issues was getting people their methadone because all the clinics are closed," he told ABC News.

Additionally, people can develop post-traumatic stress disorder (PTSD), which can include intrusive thoughts and nightmares. Leaving mental health disorders untreated can have devastating consequences.

"People who develop any of these issues are at very high risk for suicide," Berkowitz said. "People with PTSD or any of these trauma-related disorders will often be more irritable, have angry outbursts and that can lead to physical aggression and issues. Substance dependence is not an uncommon outcome of this."

Avoidance is another hallmark of PTSD, but Berkowitz said this is not something that necessarily needs to be treated because it can be a coping mechanism.

"If avoidance is working, we don't want to mess with it," he said. "If it works, it works."

Hospitals caring for patients

Hospitals on and around Maui say they have been caring for patients for burns, smoke inhalation and other fire-related injuries.

Dr. Art Chasen, trauma medical director at Maui Memorial Medical Center, described to ABC News what it's been like treating patients who have been injured by the devastating wildfires.

He said staff saw about 40 patients throughout Tuesday night and into the morning. Chasen described a fireman who had become seriously injured while trying to save people from a burning structure.

"He just kept going back until he ran out of oxygen," Chasen said. "He ended up somehow taking off his mask and collapsing in the fire. His fellow firefighters went in and rescued him. He had severe burns on his legs at the scene He coded, his heart hard stopped and so he received CPR for three to five minutes...and they brought him back and he was in our ICU overnight."

The fireman was transferred to Queen's Medical Center in Oahu. In total, nine patients were transferred to Queen's and Straub Medical Center, also in Oahu.

Maui Memorial has seen about 60 patients total as of Friday morning, and Chasen expects a second wave of injured patients now that roads are reopening, but insisted that the hospital is not overwhelmed or struggling to accommodate patients.