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Wildfire Smoke Poses Danger to Older Adults, Others

People over 65, those with lung and heart disease, face higher risk

spinner image skyline of mountains filled with wildfire smoke
Plumes of smoke rising from wildfire in Grizzly Creek, Glenwood Canyon, Colorado USA.
Getty Images/iStockphoto

While it makes for spectacular sunsets, smoke from wildfires is a potential health hazard, especially for those who are older or have certain underlying health conditions. 

In California, where every ZIP code is exposed to wildfire smoke each year, researchers estimate that more than 52,000 premature deaths between 2008 and 2018 were due to chronic, long-term smoke exposure, at a cost of at least $432 billion to the economy.

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“Our numbers are higher than previous estimates because previous measurements considered the harms from short-term smoke exposure, but wildfire smoke is becoming an ongoing problem and, as a result, contributing to long-term disease formation,” said researcher Rachel Connolly, of the University of California, Los Angeles, who was the lead author of a study published June 7 in the journal Science Advances.

Connolly suggests the health burden is likely growing in California and across the country.

spinner image air quality table which shows the colors and quality descriptors; AQI values 0-50 are good/code green, 51-100 are moderate/code yellow, 101-150 are unhealthy for sensitive groups/code orange, 151-200 are unhealthy/code red, 201-300 is very unhealthy/code purple, and anything above that is hazardous/code maroon
Understanding the AQI can help you protect your health.

“Our study looked at California, using data from 2008 to 2018, but there have been several record-setting fire years since, both within and outside the state,” she said in a statement. “Like we saw with the Canadian fires last year and impacts on the East Coast of the U.S., massive fires can produce so much smoke that even regions that are not as fire prone experience wildfire smoke exposures — and their populations are vulnerable to health impacts.”

Indeed, researchers at the University of California, Davis, found that nearly 90 percent of the lakes in North America were exposed to wildfire smoke for at least 30 days in each of three years (2019, 2020 and 2021) they studied, according to a report published June 5 in the journal Global Change Biology.

Last year’s wildfire smoke led to a spike in people with asthma visiting emergency rooms, particularly among those 5–17 and 18–64 years old, according to two studies published by the Centers for Disease Control and Prevention (CDC).

A national study, drawing data from 4,317 health facilities, found ER visits averaged 17 percent higher than normal on days when wildfire smoke pushed the air quality index (AQI) above 101, a level categorized as “Unhealthy for Sensitive Groups.” A second study found an increase in asthma-associated emergency visits across New York. It noted that on the worst AQI day (June 7), asthma-associated emergency department visits increased 81.9 percent statewide, excluding New York City. On that day, the Associated Press reported, the “New York City skyline could barely be seen across the Hudson River from New Jersey, while the Washington Monument and National Mall were enveloped in a rainless gray haze.”

The American Lung Association cautions that certain groups should monitor their breathing and exposure to wildfire smoke: those over age 65 or under age 18, those who work outdoors, and those who have asthma, chronic obstructive pulmonary disorder (COPD) or other lung diseases, chronic heart disease or diabetes.

The color-coded AQI from the Environmental Protection Agency (EPA) measures how clean or polluted the air is, and what associated health effects might be of concern, especially for ground-level ozone and particle pollution. EPA’s website allows users to enter a zip code to get an air quality forecast.

What do the AQI colors and numbers mean?

The EPA has developed the AQI to show harmful particle pollution on a scale of 0 to 500. Anything above 150 is considered unhealthy for everyone. The smoke from wildfires contains fine particles 2.5 micrometers in diameter and smaller.


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Here’s how the EPA breaks it down by color:

Green. Good air quality — from 0 to 50 — when “it’s a great day to be active outdoors.”

Yellow. Moderate air quality — from 51 to 100 — when people who are unusually sensitive to particle pollution should consider shorter and less intense outdoor activities.

Orange. Air quality is unhealthy for sensitive groups — from 101 to 150 — when older adults; people with asthma, heart or lung disease; children and teenagers; minority populations; and outdoor workers should take more breaks outdoors and watch for coughing or shortness of breath.

Red. Air quality is unhealthy — from 151 to 200 — when everyone should consider avoiding intense or long outdoor activities, and maybe move activities indoors.

Purple. Air quality is very unhealthy — from 201 to 300 — when people sensitive to particle pollution should avoid all physical activity outdoors.

Maroon. Air quality is hazardous — from 301 to 500 — when everyone should avoid all outdoor physical activity.

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Protecting yourself from poor air quality

While air quality may be concerning, you can take simple measures to reduce your exposure. First, know what you are facing. Stay up to date on weather reports, check your state or local air quality agency website, or go to for information. If air quality is a concern, these simple precautions from the EPA can help:

  1. Stay indoors where possible, and keep doors and windows closed.
  2. If you are running an air conditioner, check the filter and be sure to use high-efficiency filters that can capture fine particles from smoke.
  3. Resist the urge to vacuum, fry or broil meat or burn candles, which can increase indoor air pollution.
  4. If you go outside, consider wearing an N95 mask, which can filter fine particles less than 0.3 micrometers wide.
  5. Avoid strenuous activities such as mowing the lawn or going for a run.
  6. When driving, close the windows and vents and run the air conditioner in recirculate mode.
  7. Follow advice from your health care provider, particularly if you have lung or heart disease, or asthma.
  8. Don’t forget your pets. Minimize their exposure to hazardous air conditions.

Doug Brugge, chair of the Department of Public Health Sciences at the University of Connecticut School of Medicine, notes that good ventilation and air filtration are important protections against wildfire smoke.

“Staying indoors may seem like a way to protect yourself, and it might be if you live or work in a building that has a good ventilation system with recirculation and high-grade filters, but most buildings do not meet this standard. An additional protection could be to add an air purifier, either a high-quality commercial one if you can afford it, or build your own Corsi Rosenthal Box from air filters and a box fan. Instructions can be found online,” he says.

Editor's note: This story, originally published June 7, 2023, has been updated to reflect new information.

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