Wildfire smoke raises respiratory concerns across Northeastern US

Contemporary PEDS JournalAugust 2023
Volume 40
Issue 07

After this summer’s Canadian wildfires, should we be concerned about future air quality emergencies? This article was originally published on our sister publication’s website, Drug Topics®.

Wildfire smoke raises respiratory concerns across Northeastern US | Image Credit: © Anton - © Anton - stock.adobe.com.

Wildfire smoke raises respiratory concerns across Northeastern US | Image Credit: © Anton - © Anton - stock.adobe.com.

For days this past June and July, a thick haze of smoke had blanketed the East Coast of the United States. The smoke has traveled thousands of miles from Canada, where wildfires were raging across Quebec and Ottawa, with more than 9.3 million acres burned.

Wildfire smoke contains fine particulate matter, measuring at 2.5 µ or less in diameter (or PM2.5)—the smallest particles that pose the highest risk to health.1 When inhaled, these particles can penetrate lung tissue and enter the bloodstream, exacerbating respiratory conditions and causing a litany of long-term health problems.2

Air quality warnings had been put in place from New England to Georgia and as far west as Chicago, Illinois.1 These warnings urged caution for members of “sensitive groups,” including children, older adults, immunocompromised individuals, as well as those living with asthma, chronic obstructive pulmonary disorder, or other pulmonary diseases.3 On Twitter, the National Weather Service shared a graphic outlining the symptoms of exposure to air pollutants, including headaches, difficulty breathing, chest pains, asthma attacks, fatigue, increased coughing, and irritated eyes, sinuses, and throats.

“If you can see or smell smoke, know that you’re being exposed,” William Barrett, national senior director of clean air advocacy at the American Lung Association, told CNN.1 “It’s important that you do everything you can to remain indoors during those high pollution episodes, and it’s really important to keep an eye on your health or any development of symptoms.”

Resources from the American Lung Association include a wildfire safety fact sheet,4,5 which pediatricians can share with concerned patients to be prepared for future events like this—a sobering reality as we experience record-breaking heat throughout the United States this summer, which experts say is a part of climate change activity. In addition to staying aware of local air quality through tools like airnow.gov, pediatric health care providers should counsel patients to stay indoors and use clean air rooms when possible. Air conditioners set to recirculate will keep from pulling outside air in, and devices that contain high efficiency particulate air filters will provide added protection.

Cloth masks, such as those used to prevent the spread of COVID-19, may not provide much protection from smoke, as they will not filter PM2.5 particles. Although N95 masks are more suited to the task, they are difficult for individuals living with lung disease to use. Patients with lung disease should consult with their health care provider before using an N95 mask.

Individuals living with any kind of respiratory disorder should be directed to check in with their health care provider regarding any potential changes in medications that may need to be made in response to smoky conditions. Patients on oxygen should also consult with their health care provider before making any adjustments to their oxygen levels.

For more from the August, 2023 issue of Contemporary Pediatrics®, click here.


  1. Van Dam D, Ramirez R. New York City’s air pollution among the world’s worst as Canada wildfire smoke shrouds Northeast. CNN. Updated June 7, 2023. Accessed June 7, 2023. https://www.cnn.com/2023/06/06/us/new-york-air-pollution-canada-wildfires-climate/index.html
  2. Particulate matter (PM) basics. US Environmental Protection Agency. Accessed June 7, 2023. https://www.epa.gov/pm-pollution/particulate-matter-pm-basics
  3. McCormack K. Why is it so smoky outside? Canada wildfires lead to air-quality alerts in Northeastern US. AP National News. June 6, 2023. Accessed July 17, 2023. https://abc17news.com/news/2023/06/06/why-is-it-so-smoky-outside-canada-wildfires-lead-to-air-quality-alerts-in-northeastern-us/
  4. Wildfires. American Lung Association. Accessed June 7, 2023. https://www.lung.org/clean-air/emergencies-and-natural-disasters/wildfires
  5. Protect your health during wildfires. American Lung Association. June 7, 2023. https://www.lung.org/getmedia/695663e2-bdb8-4a61-9322-02657f530b99/Protect-Your-Health-During-Wildfires-5-29-2020-(1).pdf
Recent Videos
Juanita Mora, MD
Lauren Flagg
Traci Gonzales, MSN, APRN, CPNP-PC
Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
Samir Gautam, MD, PhD | Image Credit: Yale School of Medicine
Related Content
© 2024 MJH Life Sciences

All rights reserved.