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Not Just the Lungs: Wildfire Smoke May Increase Heart Risks

The haze isn’t just harmful to your airways. Research suggests it’s a cardiac hazard too


spinner image Wildfire Smoke Behind Residential Homes
Smoke from Canadian wildfires and similar natural disasters poses heart health risks.
David Parsons / Getty Images

Most people know that breathing in wildfire smoke can do a number on your airways, triggering everything from a coughing fit to a serious asthma attack. But inhaling the noxious air can be hazardous for your heart too.

A 2020 study published in the Journal of the American Heart Association found that breathing in heavy smoke from California wildfires increased the risk of out-of-hospital cardiac arrest (when the heart suddenly stops pumping) by up to 70 percent. Additional research has linked wildfire smoke to a significant increase in emergency room visits, particularly among older adults, for heart-related issues like irregular heart rhythm, heart failure, heart attacks and stroke.

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“Most people think of breathing problems and respiratory health dangers from wildfire smoke, but it’s important to recognize the impact on cardiovascular health, as well,” Comilla Sasson, M.D., vice president for science and innovation for emergency cardiovascular care at the American Heart Association and an emergency medicine physician, said in a news release.

“Too often we leave that as a side story,” says Gaurab Basu, M.D., a health equity fellow at Harvard T.H. Chan School of Public Health’s Center for Climate, Health, and the Global Environment. “And it really is one of the things I think most about in terms of the impacts of air pollution.”  

What is wildfire smoke?

Wildfire smoke is a mix of gases and fine particles from burning trees and plants, buildings and other material.

Source: CDC

Wildfire smoke is chock full of pollutants — just think of everything a fire engulfs — including tiny pieces of liquids and solids, called fine particle pollution, that can lodge themselves deep in the lungs and possibly the bloodstream. Once in the body, researchers say, these microscopic particles can prompt an inflammatory response that can affect the cardiovascular system, especially in people who already have cardiovascular disease.

“So, people who have any preexisting respiratory or heart-related conditions should take extra precautions because they are likely extra sensitive to the particles in the smoke,” says Katelyn O'Dell, an atmospheric scientist and a postdoctoral research scientist at George Washington University, who studies air pollution exposure and its health impacts.

According to the Environmental Protection Agency (EPA), people with chronic heart disease may experience the following symptoms after exposure to fine particle pollution:

  • Heart palpitations
  • Unusual fatigue
  • Light-headedness
  • Shortness of breath
  • Chest tightness or pain in the chest, neck or shoulder

Approximately 127.9 million U.S. adults had some form of cardiovascular disease between 2017 and 2020, statistics from the American Heart Association show. Heart disease remains the leading cause of death for Americans. 

Lower your risks when there’s smoke

Wildfires are nothing new, but they are becoming more frequent and more intense, experts say. “And those trends are projected to continue due to a drying and warming climate,” O’Dell adds. So it’s important to be prepared should the smoke from a blaze blanket your area.

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Here’s what the experts recommend:

Check the air quality before venturing out. You can find updated air quality forecasts at airnow.gov or on your phone’s weather app. Depending on the index, adjust your activities accordingly — especially if it's hot out. A study published July 24 in the journal Circulation found that the risk of experiencing a fatal heart attack may be twice as high on days when it's both hot out and when there are high levels of fine particulate pollution in the air.

Wildfire smoke can make anyone sick, says the Centers for Disease Control and Prevention (CDC), but older adults, pregnant women, children and people with preexisting respiratory and heart conditions are at higher risk when the air quality is poor. If you’re unsure of your risks, talk to your doctor.

Take air-quality alerts seriously. “It can't bleed into the background,” says Basu, noting that air pollution kills an estimated 7 million people globally each year. “It’s a serious thing that we need to be very conscious of.”

If you’re at high risk for a health issue from wildfire smoke and the air quality is worsening, stay indoors with the windows closed and avoid activities that contribute to poor air quality, like frying or burning candles.

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Be in touch with your doctor. The American Lung Association advises people with heart disease, lung disease and diabetes to talk to their doctor about any changes in medications that may be needed to help them cope with smoke.

If you need to go out, mask up. One helpful tool that many people have on hand from the pandemic is an N95 mask or similar respirator. Cloth and paper masks won’t cut it when it comes to wildfire smoke. Make sure your mask has a good seal. Take a deep breath in: If the masks collapses when you inhale, you’re good to go.

Use a portable air filter. Like masks, portable air filters became more popular during the height of the COVID-19 pandemic. “We learned a lot of lessons from COVID,” Basu says. One being: “The health of the air we breathe is critical to our health,” he says.

The American Heart Association’s 2020 scientific statement on air pollution exposure ranks portable air cleaners as one of the most effective ways to deal with air pollution. “Given their modest upfront cost ($50 to $200) and potential benefits in reducing cardiopulmonary outcomes, this measure has a high benefit for the cost,” the American Heart Association’s Sasson said.

In the market for one? O’Dell recommends checking the California EPA’s website of certified air cleaners. You can also DIY one — called the Corsi-Rosenthal box — using a box fan, air filters and some duct tape.

Stay hydrated. “Maintaining adequate oral hydration by drinking water and other fluids is also important to preserve the function of cilia, the microscopic broomlike cells in the airways that help sweep out particulate contaminants inhaled from the environment,” Clayton Cowl, M.D., a Mayo Clinic pulmonologist and clinical toxicologist, said in a news release.

Know the warning signs of heart attack and stroke. Symptoms of chest discomfort, shortness of breath, numbness on one side, sudden speech difficulty and weakness all warrant emergency attention. There are several other warning signs of a heart attack or stroke — get familiar with them and call 911 if you or anyone around you experiences them.

Editor's Note: This story, originally published June 9, 2023, has been updated to include new information. 

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