Everything from the flu to lung cancers can be linked to poor air quality. The latest State of the Air Report from the American Lung Association shows Montana’s air quality getting worse, and the use of the phrase “smoke season” is increasingly common. Health professionals around the state are implementing air quality flag programs, hoping to alert people to poor air quality so they can close windows, turn on HEPA filters, and breathe safely.
Marian Kummer, a retired pediatrician, has lived in Montana since 1981. “When I practiced in Billings, there was not much wildfire smoke concern,” Kummer says. “Now the wildfire smoke season is longer and seems more intense.” She and her husband retired to Big Sky in 2019. They have air purifiers and air quality monitors in their home, but after her husband’s lung disease diagnosis, they are not sure they can continue to live somewhere with such intense smoke seasons.
The American Lung Association grades each county in the US on the particulate pollution in the air. Montana’s “report card” went from 8 Fs, 3 Ds, 2 Cs, and one B (Richland county) in 2022 to all Fs except for Richland county (now a C) in 2025. Our worsening air quality is expected. The Montana Climate Assessment in 2017 predicted increasingly intense droughts, which create dust, especially in areas with agricultural tillage, as well as increasing frequency and intensity of wildfires. In addition to wildfire smoke, Montanans still breathe a lot of wood smoke in the wintertime from fireplaces and wood stoves.
“As you can imagine, a microscopic shard of wood smoke is not something our lungs like. It causes irritation and for those with lung disease, can trigger asthma episodes and worsen COPD. Some of the tiniest particles can even pass through our lungs into our bloodstream and impact our heart and brain health,” says Marcy Ballman, Division Director of the American Lung Association.
That’s where the air quality flags come in. Jenny Ellis, Public Health Emergency Preparedness Coordinator for Butte-Silver Bow Health Department, keeps an eye on the air quality and gets prepared to communicate bad air quality using AQI flags. Utilizing Butte’s air quality sensors, she runs a colored flag up the pole, updating their digital sign that corresponds with the flag. The flag colors correspond to the levels of the EPA’s Air Quality Index, which runs from green (good, healthy air) to purple (hazardous). Residents may have noticed these flags change color recently due to smoke.
Ellis shares: “ I’ve lived in Montana almost my whole life, so I’ve experienced the increasing fires and increasing smoke over the past few decades.” Ellis recalls her first memory of a bad smoke day: “I always tried to avoid it…I remember one of the first really bad fire years that I experienced was 2001. I remember that I was a kid, and it was the first time in my childhood where our parents and everyone were trying to keep us from going outside.” She continued that they managed with indoor crafts and games. However, she recounts the strange feeling of seeing the dark orange sunset that we often experience during harmful wildfire smoke events.
Since starting this work, she has gained a much deeper understanding of the severe impacts wildfire smoke has on human health, as one of her main projects focuses on wildfire smoke preparedness in Butte. If and when the smoke comes in, she is ready to share educational materials with her community partners to get the word out to as many Butte resistance groups as possible.
Some of this work also includes the health department's Air Purifier Loan Out Program. This program prioritizes lending out HEPA air purifiers to the most vulnerable individuals affected by wildfire smoke, such as older adults, children, and pregnant individuals. While the smoke season isn’t here yet, 41 of the 45 units available in this program have been given out.
“By the time you add everyone up, that’s a huge amount of the population that can have adverse health effects,” Ballman notes. “The American Lung Association’s State of the Air report has also found that people of color are 2.3 times more likely than white people to live in a county with especially poor air quality, so there is an environmental justice and health equity piece to air pollution as well.”
Elli’s states, “ Because Butte is a historic town, a lot of our buildings are not updated, it is super rare for any building, public or private, to have HVAC systems. That's a challenge because our infrastructure isn’t set up for smoke readiness.” Ellis shares that since the $20 million EPA grant for a Community Resiliency Hub in Butte has been cut, they are seeking alternatives to clean indoor air shelters to meet the needs of their residents.
Ellis hopes that by next year, she could help get flags in all “corners of Butte.” Since her flag is on a main road, she hopes even more people will see it and know how to protect themselves. Ellis’s flag location is one of two in Butte, with the other being located a five-minute bike ride away at Southwest Montana Community Health Center.
For Dr. Allison Young, who moved to Montana in 2010, wildfire season was one of the first experiences she had of the state. “I had a one year old daughter. One of the years was so bad that we could not go outdoors for days in August and ash rained down in Missoula.” In addition to her own child, Dr. Young worries for her patients. “Each year I care for kids in the late summer who experience exacerbations of their underlying asthma due to wildfire smoke,” she says. Dr. Young also sees the impact the smoke has on young athletes, who either practice in unsafe smoke (which many school districts and coaches now discourage) or are unable to practice at all.
Young started an air quality flag program four years ago, at both her pediatric clinic and her daughter’s school. “Whenever a family catches me in clinic and either asks me what the colored flags mean or let me know that the flag needs to be changed, this opens the door to a broader discussion about air quality and sensitive groups,” Dr. Young notes. She has seen interest, especially from young people like the environmental club at her daughter’s school, in searching for solutions to this growing problem.
“We have to be honest about climate change and CO2 emissions, and elect people who can encourage green energy business growth,” says pediatric nurse practitioner Lynne Foss. Her experience in Montana has also been colored by the smoke in her fourteen years here. “We have experienced severe enough air quality that it is affecting children of all ages, no matter of lung disease predisposition. It also affects family dynamics when gets can’t go outside or are sick more often.” Foss worries that this can even affect job security for parents. She encourages every patient to get or make a HEPA air filter for their home.
For more information regarding wildfire smoke and how to remain healthy, visit the local site, the Butte-Silver Bow Health Department’s wildfire smoke information page: https://www.co.silverbow.mt.us/3239/Montana-Wildfire-Smoke-Information
For more resources about clean indoor air, visit: https://www.montanawildfiresmoke.org/
Marian Kummer, a retired pediatrician, has lived in Montana since 1981. “When I practiced in Billings, there was not much wildfire smoke concern,” Kummer says. “Now the wildfire smoke season is longer and seems more intense.” She and her husband retired to Big Sky in 2019. They have air purifiers and air quality monitors in their home, but after her husband’s lung disease diagnosis, they are not sure they can continue to live somewhere with such intense smoke seasons.
The American Lung Association grades each county in the US on the particulate pollution in the air. Montana’s “report card” went from 8 Fs, 3 Ds, 2 Cs, and one B (Richland county) in 2022 to all Fs except for Richland county (now a C) in 2025. Our worsening air quality is expected. The Montana Climate Assessment in 2017 predicted increasingly intense droughts, which create dust, especially in areas with agricultural tillage, as well as increasing frequency and intensity of wildfires. In addition to wildfire smoke, Montanans still breathe a lot of wood smoke in the wintertime from fireplaces and wood stoves.
“As you can imagine, a microscopic shard of wood smoke is not something our lungs like. It causes irritation and for those with lung disease, can trigger asthma episodes and worsen COPD. Some of the tiniest particles can even pass through our lungs into our bloodstream and impact our heart and brain health,” says Marcy Ballman, Division Director of the American Lung Association.
That’s where the air quality flags come in. Jenny Ellis, Public Health Emergency Preparedness Coordinator for Butte-Silver Bow Health Department, keeps an eye on the air quality and gets prepared to communicate bad air quality using AQI flags. Utilizing Butte’s air quality sensors, she runs a colored flag up the pole, updating their digital sign that corresponds with the flag. The flag colors correspond to the levels of the EPA’s Air Quality Index, which runs from green (good, healthy air) to purple (hazardous). Residents may have noticed these flags change color recently due to smoke.
Ellis shares: “ I’ve lived in Montana almost my whole life, so I’ve experienced the increasing fires and increasing smoke over the past few decades.” Ellis recalls her first memory of a bad smoke day: “I always tried to avoid it…I remember one of the first really bad fire years that I experienced was 2001. I remember that I was a kid, and it was the first time in my childhood where our parents and everyone were trying to keep us from going outside.” She continued that they managed with indoor crafts and games. However, she recounts the strange feeling of seeing the dark orange sunset that we often experience during harmful wildfire smoke events.
Since starting this work, she has gained a much deeper understanding of the severe impacts wildfire smoke has on human health, as one of her main projects focuses on wildfire smoke preparedness in Butte. If and when the smoke comes in, she is ready to share educational materials with her community partners to get the word out to as many Butte resistance groups as possible.
Some of this work also includes the health department's Air Purifier Loan Out Program. This program prioritizes lending out HEPA air purifiers to the most vulnerable individuals affected by wildfire smoke, such as older adults, children, and pregnant individuals. While the smoke season isn’t here yet, 41 of the 45 units available in this program have been given out.
“By the time you add everyone up, that’s a huge amount of the population that can have adverse health effects,” Ballman notes. “The American Lung Association’s State of the Air report has also found that people of color are 2.3 times more likely than white people to live in a county with especially poor air quality, so there is an environmental justice and health equity piece to air pollution as well.”
Elli’s states, “ Because Butte is a historic town, a lot of our buildings are not updated, it is super rare for any building, public or private, to have HVAC systems. That's a challenge because our infrastructure isn’t set up for smoke readiness.” Ellis shares that since the $20 million EPA grant for a Community Resiliency Hub in Butte has been cut, they are seeking alternatives to clean indoor air shelters to meet the needs of their residents.
Ellis hopes that by next year, she could help get flags in all “corners of Butte.” Since her flag is on a main road, she hopes even more people will see it and know how to protect themselves. Ellis’s flag location is one of two in Butte, with the other being located a five-minute bike ride away at Southwest Montana Community Health Center.
For Dr. Allison Young, who moved to Montana in 2010, wildfire season was one of the first experiences she had of the state. “I had a one year old daughter. One of the years was so bad that we could not go outdoors for days in August and ash rained down in Missoula.” In addition to her own child, Dr. Young worries for her patients. “Each year I care for kids in the late summer who experience exacerbations of their underlying asthma due to wildfire smoke,” she says. Dr. Young also sees the impact the smoke has on young athletes, who either practice in unsafe smoke (which many school districts and coaches now discourage) or are unable to practice at all.
Young started an air quality flag program four years ago, at both her pediatric clinic and her daughter’s school. “Whenever a family catches me in clinic and either asks me what the colored flags mean or let me know that the flag needs to be changed, this opens the door to a broader discussion about air quality and sensitive groups,” Dr. Young notes. She has seen interest, especially from young people like the environmental club at her daughter’s school, in searching for solutions to this growing problem.
“We have to be honest about climate change and CO2 emissions, and elect people who can encourage green energy business growth,” says pediatric nurse practitioner Lynne Foss. Her experience in Montana has also been colored by the smoke in her fourteen years here. “We have experienced severe enough air quality that it is affecting children of all ages, no matter of lung disease predisposition. It also affects family dynamics when gets can’t go outside or are sick more often.” Foss worries that this can even affect job security for parents. She encourages every patient to get or make a HEPA air filter for their home.
For more information regarding wildfire smoke and how to remain healthy, visit the local site, the Butte-Silver Bow Health Department’s wildfire smoke information page: https://www.co.silverbow.mt.us/3239/Montana-Wildfire-Smoke-Information
For more resources about clean indoor air, visit: https://www.montanawildfiresmoke.org/