WILDFIRE SMOKE TOOLKIT

Dealing with Air Pollution from Wildfire Smoke

Hotter temperatures and drier ground conditions due to climate change can lead to wildfires. Smoke from such fires can affect us at the time we’re exposed to it and in the longer term, harming air quality and impacting both our physical and mental health. The resources on this page will give you information about those impacts and provide guidance on what to do during an air quality emergency.

How Wildfire Smoke Affects Us

Breathing wildfire smoke is similar to inhaling cigarette smoke without the nicotine, says John Balmes, MD, prominent UCSF pulmonologist and member of the California Air Resource Board. Smoke from wildfires contains microscopic particles that can lodge deep in our lungs and can even make their way into our bloodstream, cross the blood-brain barrier, and access our central nervous system. This fine and ultrafine particulate matter is referred to as PM2.5 because the particles are 2.5 microns or less in diameter. Ultrafine particles are so small that more than 500 of them fit into the diameter of a human hair. When we see wildfire smoke, we’re seeing high concentrations of those particles. 

Anyone, including healthy people, can be affected by exposure to wildfire smoke, even if the fire itself is far away. In addition to causing symptoms like coughing and wheezing, and irritation to our eyes, throats, noses, and lungs, breathing wildfire smoke has been linked to increased risk of cardiovascular and respiratory effects, including heart attacks, strokes, and asthma attacks. People at high risk include those with respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD), with heart disease, or who are pregnant. Older adults and children are also at high risk, as are outdoor workers. Children in particular may inhale more smoke, and particles may reach their lungs more easily. Lower socioeconomic status increases risk as well.

Aside from wildfire smoke, air pollution in general is the biggest environmental cause of premature death and poor health around the world. And long-term exposure to urban air pollution has been associated with neurological disorders like Parkinson’s disease, Alzheimer’s disease, and dementia. 

When it comes to our mental health, directly or indirectly experiencing wildfires themselves can lead to post-traumatic stress disorder, depression, and anxiety. But even being exposed to only wildfire smoke may be anxiety-producing and cause us to fear for or worry about our safety or the safety of those in our care. Staying indoors can be isolating. Anxiety, fear, grief, emotional overwhelm, or other feelings related to climate change may also surface for people. One study has shown that longer duration of wildfire smoke exposure is linked to increased worry. In addition to distress responses, wildfire smoke can affect the brain, with impacts on thinking and behavior. Exposure to air pollution also can exacerbate mental health conditions in adults and children and is linked to increased risk of suicidal behaviors and depression.

Limiting Impacts to Physical Health

It can be hard to find evidence-based recommendations about how to protect your health during an air quality emergency. Here are some handy links and tip sheets from reputable health authorities with suggestions about how to limit impacts to physical health during wildfire smoke exposure: 

Here are several common themes from the recommendations above:

  • Stock up on medications if you have advance warning of an air quality emergency, which may require contacting your doctor’s office.

  • Stay indoors as much as possible.

  • Monitor air quality in your area through use of monitoring apps or websites like Purple Air or AirNow. 

  • Use an N95 mask–not a dust mask–if you must go outside.

  • Protect the air in your home by closing windows, blocking gaps around windows and doors with damp towels, and setting AC units to recirculate the indoor air rather than bringing in air from outside.

  • Use a certified HEPA filter indoors. If you’re unable to access a HEPA filter, you can construct a homemade filtration device. 

  • Monitor for medical symptoms of cardiovascular or respiratory distress, particularly for people who have chronic conditions, and stay in touch with your healthcare providers.

  • Take extra precautions for kids because they can breathe in more pollutants for their size than adults. Children should not play outside during periods of unhealthy air quality.

  • Pets are also at risk, so limit their outdoor exposure time.

Limiting Impacts to Mental Health

For many people, mental health is as much of a concern during an air quality emergency as physical health. People with clinical anxiety and depression, as well as those with serious, persistent mental health conditions, are especially vulnerable. Here are some basic coping skills that may help limit the negative mental health impacts of an air quality emergency.

  • Write it down to slow it down

Keep a pen and paper in a visible location. When you can, take a few minutes to write out the stream of thoughts in your head, almost as if you were listening to the radio and writing down everything you hear. If it is still hard to come up with what to write, consider writing a letter from your present self to your future self about what’s happening in the present moment and what you think about it all. Writing your thoughts by hand is slower and requires different cognitive processes than keeping your thoughts in your head. This can help you screen out the most irrational and unnecessary thoughts, which may be especially useful if you sense you are at the top of a downward spiral. It can also help you create more space to process complex and intense thoughts and feelings more deeply, such as anger about climate change, sadness about the loss of a beloved place in the world, or fear about what comes next.

  • Manage panic attacks using ice and a rag

Keep a handful of ice in a bag in your freezer and a clean rag or old T-shirt nearby. If you feel a panic attack building, take the ice out of the bag, bundle it up in the cloth, and close it tight with one hand. Press the rag to your nose and inhale, focusing on the sensation of the air hitting your nose and lungs. The cool humid air can help prevent hyperventilation and hot flashes, and coaching yourself through the activity may make it easier to keep your mind focused on a simple task long enough to let the panic symptoms diminish.

  • Turn a breathing exercise into a game

This technique is geared towards elementary-age children. If your child is especially upset or showing signs of panic, ask them to join you in the room with the cleanest air to play a breathing game with you. Invite them to focus on you and mirror your movements. Make a closed fist with one hand, like you’re holding the world’s tiniest microphone. Then purse your lips together, place your fist loosely against your lips, and inhale through your fist. The air rushing through your fist will sound like a vacuum. Ask your child if they can make the same vacuum sound using their own fist. Then ask them if they can make their vacuum sound louder or longer than you can. This challenge is designed to recruit a child’s play drive to help them practice intentional breathing, which in turn can help them learn to self-regulate their stress response.

  • Use a behavior chain analysis to map out a coping strategy ahead of the next emergency

Sometime after the current emergency and before the next one, set a timer for ten minutes to do a behavior chain analysis. The purpose of this technique is to practice making a map of the chain of events that led up to a specific moment when you felt particularly distressed. A visual representation of the sequence of events can make it easier to identify where in the chain you could intervene to prevent the distress from worsening, if you were to encounter a similar situation in the future. Start at the moment when you felt particularly distressed and work backward. What were the thoughts, feelings, and action urges you remember from that moment? What were the events that led up to that moment? How did you choose to deal with the distress? What were the results of those choices? Can you make a complete list of all the factors that made you especially stressed out that day? Looking at a list like that, there will typically be some items that are more difficult for a person to control, and some that are easier. Of the factors you feel you can control, is there anything you can do for yourself now that will make it easier to control them later?

This toolkit was created with contributions from Robin Cooper and Jacob Lee of Climate Psychiatry Alliance, and Laura Carter Robinson and Dan Murphy of Climate Psychology Alliance of North America.