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smoky days

How to keep kids safe on smoky days | Ask the Pediatrician

When wildfire smoke comes, be ready

Summer in the Pacific Northwest is undoubtedly gorgeous. Unfortunately, it is also our wildfire season, which means some days we will experience potentially dangerous air conditions. An estimated 7.4 million children in the U.S. are impacted by wildfire smoke each year.

While wildfire smoke is uncomfortable for everyone, children and children with underlying medical conditions are at highest risk of health impacts.

Let’s talk about how to stay safe during wildfire days so we can feel great and enjoy our beautiful days.


Smoky days: why they’re dangerous

Wildfire smoke is more dangerous than smoke from other causes because it contains small particles of pollution that can penetrate deep into the lungs. This can trigger respiratory symptoms and increase visits to the Emergency Department or hospital. One study looked at 17,000 emergency visits from 2011-2017 and found that visits to the emergency room were 10 times higher as a result of air pollution from wildfire compared to general air pollution.

Why are children at higher risk? Children are particularly impacted by wildfire smoke. They are at a time in their lives when they are growing and developing rapidly. Particulate smoke exposure can lead to lung damage and can cause long term health consequences. Children are also at greater risk because:

  • They are generally more active than adults.
  • They breathe more air relative to their size than adults do.
  • Their noses do not filter out particulates as well as adult noses do.
  • They spend more time outside than adults do.

What symptoms to look for: Children have a variety of symptoms in response to wildfire smoke exposure depending on air quality index, age and underlying medical conditions. The most common symptoms are:

  • Burning or stinging in the nose eyes and throat
  • Coughing
  • Shortness of breath or difficulty taking a full breath
  • Wheezing
  • Chest pain
  • Feeling dizzy or lightheaded
  • Anxiety


Tips for staying safe

Keep track of air quality:

  • The most common metric is the Air Quality Index (AQI). There are a number of online sites that allow you to look up your specific air quality by ZIP code.
  • If the AQI is greater than 150, outdoor activity should be stopped. This includes stopping sports and PE until the air quality improves.
  • Younger children are more sensitive and reduced activity recommendations may apply at lower AQI levels.
  • Children with underlying medical conditions including asthma are at increased risk and will need activity restrictions in place at lower AQI levels.

Staying indoors on smoky days is the best way to minimize smoke exposure. Closing the windows and doors can improve indoor air quality. In the Pacific Northwest, most of us do not have air conditioners but if you happen to be one of the lucky few, set it to recirculate so that it is bringing less air in from the outside. A HEPA (high-efficiency particulate air)  filter can also be helpful.

If you are in the car, remember to keep your windows closed and turn the car air conditioning to recirculate.

Smoky days: What about masks?

Medical masks or N95 respirators may be helpful if they are properly fitted and worn correctly. It’s good to remember that a properly fitting N95 mask is preferable to a medical mask. A child’s age, developmental stage and ability to wear the mask properly are factors in whether the mask fits appropriately. Cloth facemasks or breathing through a wet washcloth have not been shown to be protective against wildfire smoke.

Summer wildfire smoke is unfortunately part of our seasonal pattern these days. Understanding what to look for and how to stay safe is the key to a healthy and fun summer.

Taking steps to reduce greenhouse emissions also makes a difference. Whether it’s recycling, walking rather then driving or planting trees — these are all things we can do to make a collective impact.


More from Dr. Block and Kaiser Permanente in Seattle’s Child:

Helping kids navigate friendships

What parents need to know about adolescents and acne

Keeping kids safe in the summer sun


About the Author

Susanna Block

Dr. Susanna Block, MD, MPH, is a pediatrician with Kaiser Permanente in Seattle and lives with her family in Queen Anne.