New research reveals prolonged heart, lung, and systemic health effects for Malibu residents

A year after the Palisades Fire tore through Malibu and Pacific Palisades, new research suggests its health impacts were deeper, broader, and longer-lasting than previously understood. Local residents may continue to feel the effects long after the smoke has cleared.

A study published in the Journal of the American College of Cardiology found sharp increases in heart attacks, lung illnesses, and unexplained medical symptoms among residents living in or near wildfire burn areas following the January 2025 Palisades and Eaton fires. The analysis was conducted by researchers at Cedars-Sinai Medical Center, the largest hospital system in Los Angeles County, using emergency department data spanning seven years for comparison.

While Malibu-specific data was not isolated in the study, Malibu neighborhoods were among those directly affected or adjacent to the Palisades Fire burn zone, making the findings especially relevant to the community.

According to the study, emergency department visits for heart attacks increased by 46 percent in the three months following the fires, compared with the same period in previous years. Visits for pneumonia and other pulmonary illnesses rose 24 percent. Even more striking was a 118 percent increase in patients arriving with serious symptoms — such as chest pain, dizziness, or abdominal pain — that could not immediately be linked to a clear diagnosis.

“These weren’t just respiratory complaints,” said Dr. Susan Cheng, vice chair for research affairs at Cedars-Sinai’s Smidt Heart Institute and the study’s senior author. “We saw evidence of biochemical and metabolic stress affecting multiple organ systems.”

Blood tests from these patients showed unusual abnormalities at more than double the normal rate, including electrolyte imbalances and subtle changes in kidney and liver function. While the total number of emergency visits did not increase overall, the nature of those visits shifted sharply toward acute and serious conditions.

For Malibu residents, the findings raise concerns about prolonged exposure to wildfire smoke, particularly from fires that burn not only vegetation but also homes, vehicles, electronics, and other common man-made materials.

“The Palisades Fire was unique,” said Dr. Joseph Ebinger, a Cedars-Sinai cardiologist and the study’s lead author. “It wasn’t just trees and brush burning. It was cars, batteries, plastics, electronics — a toxic stew that exposed a very large population to complex pollutants.”

Wildfire smoke is a major source of fine particulate matter known as PM2.5 — particles small enough to penetrate deep into the lungs and even cross into the bloodstream and brain. Researchers say smoke from urban-interface fires like the Palisades Fire contains a higher proportion of ultrafine particles than smoke from traditional wildland fires, increasing the potential for systemic health effects.

Previous studies have linked wildfire smoke to respiratory illness and cardiovascular events, but the Cedars-Sinai research identified something new: a sustained rise in unexplained illnesses lasting for at least three months after the fires.

“This tells us we’ve probably been missing a lot of illness that hasn’t been appropriately attributed to smoke exposure,” said Dr. Mary Johnson, a principal research scientist at Harvard’s T.H. Chan School of Public Health, who was not involved in the study. “We’re just beginning to understand how these mixed-material fires affect human health.”

The length of the impact also stood out. Many wildfire health studies show spikes in emergency visits lasting about a week. In this case, elevated rates persisted for 90 days.

“That’s a substantial length of time,” said Joan Casey, an environmental epidemiologist at the University of Washington. She noted that evacuation stress, disrupted healthcare access and prolonged poor air quality likely compounded the effects.

“There are people who are still coming to our clinics and saying, ‘I still don’t feel quite right,’” Cheng said.

Officially, 31 people are known to have died directly from injuries sustained in the Palisades and Eaton fires. However, researchers believe the true toll is significantly higher when accounting for deaths linked to smoke exposure and healthcare disruptions.

A separate analysis published earlier this year in the Journal of the American Medical Association estimated 440 excess deaths in Los Angeles County in the weeks following the fires. A Stanford University team attributed at least 14 additional deaths specifically to smoke exposure.

Over the past decade, wildfire-related air pollution has reversed years of air quality improvements achieved under the Clean Air Act. For coastal communities like Malibu, where topography can trap smoke and evacuation routes are limited, the health risks can be particularly acute.

The Cedars-Sinai study is part of a 10-year research collaboration tracking the long-term health consequences of the Palisades and Eaton fires. Researchers hope the findings will inform public health planning, emergency response, and long-term monitoring for communities repeatedly exposed to wildfire smoke.

Filmmaker asks ‘What happened on day two?’

In the midst of a series of blistering articles published in the Los Angeles Times revealing watered-down revisions to the Los Angeles Fire Department’s after-action report on the deadly Palisades Fire, it comes as no surprise that the City of Los Angeles is facing intense public scrutiny. Now, nearly a year after the cataclysmic Palisades Fire reshaped one of Los Angeles’ most historic neighborhoods and then continued to change the face of Malibu, wiping out more than 700 homes, a new independent documentary is reigniting a debate many residents say never truly ended: Why were so many homes lost after the fire’s first day — and why has there been so little transparency from the Los Angeles Fire Department about what happened next?

The 22-minute film, “The Palisades Fire: They Gave Up,” was released on YouTube earlier this month by filmmaker Rob Montz, CEO of Good Kid Productions. The documentary has already drawn roughly 50,000 combined views across two channels and is generating renewed scrutiny of official narratives surrounding the January fire.

Montz, 42, is not a detached observer. He grew up in Pacific Palisades, where his family moved in the mid-1980s, and his mother’s home — owned for roughly 40 years — burned to the ground. Though Montz now lives on the East Coast, his personal connection to the neighborhood fuels the film’s urgency and emotional weight.

“This is the motherland for me,” Montz said. “When the fire happened, it felt like there was an alignment between what the universe needed — a rigorous investigation into what went wrong — and the skill set that I have.”

While much of the public coverage of the Palisades Fire has focused on extreme weather, climate change and heroic firefighting efforts, Montz’s documentary zeroes in on a largely unexamined period: the second day of the fire. According to the film, approximately 1,000 structures were still standing after day one — only to be lost by the end of day two.

The film’s central, unsettling question is simple: why?

“What got ignored or underreported was what happened on day two, when the Palisades was functionally abandoned,” Montz said. “There were a lot of homes that were self-evidently savable.”

The documentary combines timeline reconstruction, aerial footage, on-the-ground visuals, and Palisades residents’ testimony to argue that firefighting efforts were dramatically reduced on the second day, even as conditions suggested, according to the filmmaker, many homes could still have been protected. Montz contends that residents who defied evacuation orders and returned to the area were able to save homes themselves — underscoring, in his view, that the destruction was not inevitable.

Perhaps most striking is what the film says is missing, echoing the LA Times: clear answers from authorities.

Montz said repeated attempts to interview firefighters and officials were met with silence or deflection. Requests were routed to media relations representatives, calls went unanswered, and potential sources “ghosted” after seeking approval from supervisors.

“That’s really the most frustrating part,” Montz said. “There has been no real transparency or accountability about what happened on day two.”

This lack of explanation, he argues, has created a growing rift between Palisades residents and the fire department.

“There was enormous heroism,” Montz emphasized. “But for the people who live there, they also saw firefighters stop fighting fires on day two. And they want to know why.”

Montz also questions how quickly city leadership has pivoted toward rebuilding narratives without fully addressing the causes of the destruction. He points to official messaging that frames the fire as unavoidable — a product of climate change or bad luck — and says residents do not accept that explanation.

“They shouldn’t buy it,” he said. “Because it’s not true.”

The documentary arrived during the holiday season when the Palisades and Malibu remains scarred physically and emotionally. Montz describes returning for Thanksgiving as surreal, likening the landscape to “World War II Dresden, but with perfect weather.” His childhood home remains a flattened dirt lot.

His mother is among a shrinking group of long-time residents trying to rebuild. Many others, Montz said, were underinsured or uninsured and have been forced to sell their lots and leave the area. The film challenges perceptions of the Palisades as uniformly wealthy, emphasizing that a significant share of homeowners were middle-class families whose primary asset was their home.

“The Palisades Fire: They Gave Up” may eventually include a Part 2. Interest in a follow-up is growing, and Montz hopes future installments can answer the questions the first film could not: who made the decisions on day two, and why?

 “The Palisades Fire: They Gave Up” is available for free on YouTube. 

While fire victims weigh whether to rebuild or sell, local policymakers and Chamber reps look for ways to help

As the one-year anniversary of the Palisades Fire is upon us, those who need to rebuild their homes face daunting decisions regarding how to make the math in order to do so. For many, insurance covering loss of the use of their homes, which has been funding their temporary housing for the last year, is rapidly dwindling, if it hasn’t already been exhausted. For many, their lawsuits against Southern California Edison or the Los Angeles Department of Water and Power (LADWP) or insurers are glacially proceeding through the discovery and litigation processes with no end in sight, uncertainty as to their success and concerns regarding how much such efforts will render and when. 

Should I stay or should I go?

For many, their fears continue to escalate due to the escalating costs of building materials amidst ever-changing tariff rates and the increasing price of soft costs such as design, permits, and professional services add to their increasingly confusing calculus as they weigh their options and wonder whether to stay or go.  

Indeed, according to an article that dropped today in Westside Today, entitled “Investors Snap Up Nearly Half of Vacant Lots in Fire-Damaged Palisades and Malibu,” 19 of 43 lots sold in the 90265 ZIP code in the third quarter of last year were purchased by investors. At first blush, many may wonder what is wrong with investors purchasing lots. After all, it’s a free country. However, such statistics engender profound sadness for those who continue to hope that destroyed neighborhoods will one day be re-inhabited by long-established locals rebuilding their homes because those are who make Malibu special. Many locals worry that investor-purchased properties will not be occupied by families, but instead by a combination of addiction rehabilitation facilities and short-term rentals, neither of which fill Malibu’s schools and makefor a neighborhood in the traditional sense. 

Amidst such consternation, The Malibu Pacific Palisades Chamber of Commerce hosted a brainstorming session on Dec. 17 featuring panelists California State Sen. Ben Allen, Malibu Mayor Marianne Riggins, the new Chamber CEO Maryam Zar, who founded the Palisades Recovery Coalition and is Chair Emeritus of the Pacific Palisades Community Council, as well as representatives from the offices of Congressman Brad Sherman, LA County Supervisor Lindsey P. Horvath and various Los Angeles County and City of Los Angeles agencies. Several things were discussed and explored that merit further consideration by elected officials and civic leaders.

Things that could happen to help rebuild efficiently and effectively

Economies of scale can be applied to communal wildfire procurement, thereby saving costs of rebuilding and of the costs of procuring wildfire disaster supplies and mitigation resources. Commonly known as bulk purchasing, the concept is quite simple although implementation for rebuilding homeowners might be a bit tricky. The concept is simple: If those rebuilding pool resources to purchase supplies, they can purchase more and save some costs, as in, “To build in Malibu, we all need to utilize fire-resistant materials, windows, doors and exteriors, so why don’t we all buy those materials in bulk together?” This also could apply to coordinating construction services, as in “why don’t we all share the costs of the crane we all need to install caissons on a coastal lot?” 

Similarly, communities and local governments can pool resources to buy equipment such as personal protective equipment, hoses etc. as well as to procure services and technology in bulk, thereby freeing up funds to assist those rebuilding. 

Simply stated, rather than being boxed in by the overwhelming process of rebuilding hundreds of homes, why don’t we all think outside the box collectively?

FEMA reimbursements  

In September, city staff provided the City Council a breakdown of the fire-related costs submitted to FEMA for reimbursement. Those include $1.86 million for debris removal for the city clearing burned material from roads, parks and its properties.  Another $5.16 million was expended for the emergency operations center, City Hall smoke cleanup, sandbags, guardrail protection, septic tank abatement and emergency security. Yet another $1 million was spent on fire-related roadway and bridge repairs. Repairing storm drains and deep-water systems, especially in Big Rock, cost $3.16 million. Repairs at Las Flores Creek Park and other recreation centers amounted to $2.1 million. 

FEMA covers 100% of emergency work for the first 180 days. After that, 75% of any expenses are reimbursed by FEMA, while the State of California covers $18.75% and the city remains responsible for 6.25% of the costs.

“Tens of billions of dollars in FEMA claims that would have been paid out to other states remain unreimbursed,” a frustrated Allen shared. If the reimbursements were forthcoming, then municipalities such as the City of Malibu and the City of LA, as well as Los Angeles County and the state might be more amenable to proposals such as that proffered by Jeremy Padawer, a long time Palisades homeowner who lost his home in the fire and who filed a petition on Change.orgfive months ago proposing that there be no state or local sales taxes imposed on building materials and supplies for those who are rebuilding. 

At first, that idea seems equitable — and, indeed, it certainly would help those rebuilding. However, the proposal no doubt gives policy makers and elected officials great hesitancy because the fire-related expenditures by cities, towns, the county, and the state are astronomical and, especially as they await FEMA reimbursements, those political entities are strapped for funding even as they still have to provide ongoing essential services. This reality was addressed by Malibu City Councilmember Doug Stewart recently in a council meeting wherein he noted that before the fire, Malibu had ample funds and was fortuitously flush, but the city is now using reserves to operate until it is reimbursed by FEMA. That is not helpful to those who are rebuilding!

Padawer’s blog at pacificpalisades.com also proposes that no property taxes be imposed on parcels until those rebuilding obtain a certificate of occupancy. Sounds fair. After all, why pay taxes for a property you cannot use? However, one wonders whether that is tenable from a public fiscal perspective. That is unclear without further analysis.

However, what is clear is that, as the one-year anniversary of the fire is upon us, those rebuilding need answers concerning their rebuilding time-lines and costs, municipal and county jurisdictions and the state all need answers concerning when FEMA reimbursements will be forthcoming and everyone must be steadfastly dedicated to working on an individual and communal level to mitigate the risks of such devastation occurring in the future.