Wildfire Smoke

Wildfire smoke is a huge threat to health, but there are ways to stay safer.
We've sorted information for patients, providers, and administrators below.

Patients

The Surprising Ways Smoke Affects Your Health:

Trouble concentrating, anxiety, and headaches.
Trouble breathing and lung diseases.
Increased risk of stroke, heart disease, and heart attacks.
Kidney damage and higher risk of diabetes.

How to Track Your Local Air Quality:

Four Senses

If you smell smoke, avoid heavy activity outside. Stay inside if possible.
If the air looks hazy and you can't see as far as usual, avoid going outside for long.
If the air tastes ashy, be aware.
Local conversations and news are a great source of information.

Local Media

Your local newspaper, radio, and weather channel might carry info on air quality. If they don't, write to them and ask them to!

Online

AirNow is a government program that depends on local air quality monitors to give you exact, live info about wildfire smoke and pollutants in your area. This is presented as the Air Quality Index.

The Air Quality Index scale connects air quality and health impacts in a way that is easy to understand and widely used. The scale runs from Good to Hazardous air quality based on the concentration of the five most concerning pollutants.

The AQI is available on many phone apps. You can also sign up for email or text alerts through AirNow's EnviroFlash program.

Breezometer, another service, shows the break down of pollen as well as pollutants, which you may want to know if you have allergies.

Protect Your Health on Bad Air Quality Days:

Stay inside (with windows closed) whenever you can.
Use a portable air cleaner or a box fan filter if you have one.
Reduce physical activity during smoky times. Take it easy.
If you can't avoid going outside to work (like many hardworking Montanans), use an N95 mask or respirator. Staying in an enclosed cab with filtered air (like an enclosed tractor) can also help. Try to limit time in the smoke whenever you can, and take breaks.

DIY Box Fan Air Filter

You will need:

A box fan
A square furnace filter (MERV 13 or FRP 10) about the size of your fan (usually 20 in. x 20 in.)
Duct tape or bungee cord

Steps:

Find the arrow on the side of the filter and point this toward the fan.
Place the filter with the arrow side on the back of the fan (the side air goes into).
Use duct tape or bungee cord to attach the filter to the fan.
Close all windows and doors to seal your home off from further smoke.
Turn on your new air filter!

Providers

Particulate Matter (PM) and Wildfire Smoke

Particulate matter 2.5 (PM 2.5) is an air pollutant of significant concern. Wildfires cause an abrupt increase in PM 2.5, which often exceeds the level found in ambient air. The tiny size of PM 2.5 allows it to permeate the bloodstream and therefore affects patients' health on every level. Learn more below about the ways PM 2.5 affects neurological, cardiac, respiratory, nephrological, and reproductive health - especially in certain key populations.

How You Can Help

Teach your patients how to wear an N95 mask correctly on smoky days.
Help your patients keep track of local air quality -- point out the Air Quality Index website and app. Encourage patients to stay indoors with a HEPA filter or air conditioner if the AQI exceeds 100.
Teach your patients the importance of not adding to indoor air pollution through smoking, gas range stoves, vacuuming, and candle use.
Consider offering patients handouts on how to make their own HEPA filter fan (instructions available in our patient section).
Ask your clinic or hospital to offer a clean air space for the vulnerable populations in your community on unsafe days. They can also fly the EPA's Air Quality Flags to give your community an easy way to know when air quality is unsafe.
Be a community advocate for policy decisions that protect air quality and reduce CO2 emissions.
Read below about the effects of wildfire smoke on specific body systems and vulnerable populations.
Download our patient handout below.

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File Size:	900 kb
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Neurological Effects

Particulate matter 2.5 can lead to oxidative stress in the body. PM 2.5 impairs mitochondrial function pathways for neuronal and astrocyte activity (Kolosowska et al, 2020). The effects of P.M 2.5 on mitochondrial function of the brain manifest as cognitive impairment, especially for children (Shang & Xue, 2023).

Cardiac Effects

Higher levels of PM 2.5 are correlated with increasing rates of cardiac arrhythmias, worsening heart failure, and other cardiovascular ischemic events such as stroke (Hadley et al, 2022; Chen et al, 2021; Murray et al, 2020).

Respiratory Effects

During wildfire season, research has shown that a spike in respiratory illness occurs for people of all ages, leading to increased hospitalizations (Stowell et al, 2019). Smaller airways may be a risk factor (Mirabelli et al, 2009). Additionally, exposure to wildfire smoke has been linked to respiratory morbidity, especially in patients under 5, patients, with asthma, and patients with COPD (Matz et al, 2020; Henry et al, 2021).

Nephrological Effects

“PM2.5 exposure in the first trimester of pregnancy and first fourteen months of life may have implications for kidney health in adolescence.” (Rosa e.al, 2019). Through a literature review on the adverse effects of PM2.5 and human kidney function, thirty-six out of forty studies showed that PM2.5 exposure worsened kidney function (Rasking et al, 2022).

Frontline Populations

Pregnant people, children, older people, people of color, people with lower incomes, and outdoor workers are put at a higher risk for health complications from wildfire smoke.

Fetal-Maternal Health

Wildfire smoke increases the risk of premature birth, especially when it lasts for three days or more. Exposure to PM 2.5 from any source can have negative effects on unborn children, impacting their entire lives. Pregnant patients and young children should be encouraged to use HEPA air filters and monitor air quality using the AirNow app or EPA Air Quality Flags to avoid unsafe air.

Further Reading:
Shang et al, 2023
Rosa et al, 2022
Chen et al, 2021
Henry et al, 2021

Children

Further reading:
Mirabelli et al, 2009
Stowell et al, 2019
Henry et al, 2021

Children are more at risk because of a higher metabolic rate, smaller airways, and developing lungs. Parents should be encouraged to use the AirNow app to monitor air quality, or use the EPA Air Quality Flags. Avoid letting children play outside on smoky days.

People of Color

Respiratory conditions such as asthma and COPD are exacerbated by exposure to wildfire smoke. People of color (such as Black, Latin, and Native American people) have higher rates of respiratory conditions due to historical discriminatory policies like redlining that prevent them from accessing quality healthcare, clean air, and healthy housing. These same pressures make recovery more difficult. Note that, according to Pleis & Barnes (2009), multiple-race individuals may have higher rates of respiratory conditions than single-race individuals. Environmental justice is crucial for our health.

Further reading:
Boze et al, 2022
Davies et al, 2018
Gamble et al, 2016
Wigtil et al, 2016
Pleis & Barnes, 2008

People in Poverty

Further reading:
Berry et al, 2009
Gamble et al, 2016
Wigtil et al, 2016
Hayes et al, 2018

Families who lack financial resources often can't afford fire mitigation services, which puts them at a higher risk of suffering damage, loss, and injury due to wildfires. They may also lack insurance. Events are more traumatic when recovery is not guaranteed because our social safety net has failed. As health professionals, we must advocate for policies that strengthen our social safety nets.

Outdoor Workers

Outdoor workers (ranchers, farmers, fish & wildlife workers, outdoor tourism, construction workers) are at increased risk due to their extended time spent outdoors, often without protection from wildfire smoke. Encourage workers to wear N95 masks when smoke is present, and to follow OSHA guidelines. Encourage supervisors to follow OSHA guidelines and cancel outdoor work on days where air quality is especially unsafe. Being in a pressurized cab with filtered air conditioning may offer some protection.

Further reading:
Ney 2005
OSHA Wildfires Page
EPA Wildfire Smoke Guide
Matz et al, 2020
Xu et al, 2020

Administrators

$	A 2008-2012 health analysis in the U.S. linked 1500-2500 premature deaths to short-term wildfire smoke and an economic cost of $11-$20 billion U.S dollars. Long-term exposure to wildfire smoke showed 8700-32,000 premature deaths and an economic cost of $76-$130 billion USD. (Fann et. al, 2018).

Particulate matter 2.5 (suspended particles of smoke) & human health

PM 2.5 travels deep into the respiratory system, enters the bloodstream, and has been found in the brains, kidneys, and on the fetal side of the placenta. It also:

triggers ischemic events and cardiac dysrhythmias
aggravates asthma and all respiratory diseases
adversely affects kidney function
negatively affects cognitive function
increases risk for pre-term birth in pregnant people
decreases lung function in children

Children are more at risk because of a higher metabolic rate, smaller air ways, and still developing lungs.

The older population is more at risk due to common pre-existing diseases and declining natural defense systems from age.

Wildfire smoke increases the risk of premature birth. Exposure to PM 2.5 from any source can have negative effects on unborn children, impacting their entire lives.

Outdoor workers (ranchers, farmers, fish/wildlife, outdoor tourism, construction) are at increased risk due to their extended time spent outdoors, often with no protection from wildfire smoke.

Native folks, people of color, and people with lower income have higher rates of asthma due to environmental injustice. Asthma increases the risk for adverse health events from wildfire smoke.

How you can help

Keep the HVAC system regularly serviced.
Offer a clean air space for the vulnerable population in your community.
Assess your public building for appropriate air filtration.
Educate local residents through a wild smoke awareness week.
Consider box fan or HEPA filter distribution (and contact us to work together)!
Have easy-to-access information on how community members can track air quality. Our Air Quality Flag program might be a good fit for your community, if the flags aren't already flying!

Track your local air quality

The Air Quality Index scale connects air quality and health impacts in a way that is easy to understand and widely used. Local, up-to-date air quality data can be found at www.airnow.gov.

IS YOUR HOSPITAL IN A WILDFIRE THREAT ZONE?
Find out at hazards.fema.gov/nri/wildfire and read the US EPA's guide, Wildfire Smoke: A Guide for Public Health Officials for specific strategies to reduce smoke impacts.

Banners

We developed a series of educational banners for display in your waiting rooms. You can download our wildfire smoke banner here, or contact us to sign up for a time to host our high-quality banners in your waiting room or lobby for free!

Wildfire_Banner.pdf
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