Wildfire Smoke and Your Child: When Is It Safe to Play Outside?

Summer often means longer days, outdoor adventures, and family time outside. In California and throughout the western United States, it can also mean wildfire season. Even if a wildfire is hundreds of miles away, smoke can travel long distances and significantly affect the air your family breathes. 

One of the most common questions pediatricians hear regarding wildfires is: "Is it safe for my child to play outside today?" The answer depends less on whether you can see or smell smoke and more on the Air Quality Index (AQI).

What makes wildfire smoke harmful?

Wildfire smoke contains gases and tiny particles from burning vegetation, buildings and other materials. The greatest health concern is fine particulate matter, which can travel deep into the lungs and even enter the bloodstream. Exposure can irritate the eyes and airways, worsen asthma and other lung diseases and increase the risk of respiratory problems. 

Children are especially vulnerable because:

• Their lungs are still developing
• They breathe faster than adults, inhaling more air relative to their body size
• They spend more time being physically active outdoors

Even healthy children may develop symptoms after breathing smoky air.

Which children are at greatest risk?

Higher-risk groups include children with asthma, chronic lung disease, cystic fibrosis, congenital heart disease, neuromuscular disorders affecting breathing and immune system disorders. Infants, toddlers, pregnant individuals and older adults are also more sensitive to wildfire smoke.

How do I know if the air is safe?

The Air Quality Index (AQI) is the easiest way to determine whether outdoor air is healthy. The U.S. Environmental Protection Agency's AirNow website combines data from thousands of air quality monitors across the country and provides local recommendations based on current conditions.

Two trusted resources include:

• AirNow
• AirNow: Fire and Smoke AirNow Fire and Smoke Map

Many smartphone weather apps also display the AQI using AirNow data!

AQI Guidance for Children

How to Protect your Family

• Check the AQI daily
• Keep windows and doors closed when air quality is poor
• Consider purchasing a portable air cleaner to improve indoor air quality
• Use HEPA air filters in your HVAC system and replace as indicated
• Move activities indoors when AQI is unhealthy

What about masks?

There are no approved respirators or masks proven to protect against particulate matter for young children. Properly fitted N95 respirators may help older children when exposure is unavoidable, but staying indoors remains the best protection.

Signs wildfire smoke may be affecting your child

Symptoms include coughing, wheezing, chest tightness, shortness of breath, sore throat, burning eyes, headache, fatigue and increased use of rescue inhalers. Make sure to seek emergency care immediately for difficulty breathing, blue lips, chest pain or inability to speak in full sentences.

If your child has asthma or other chronic respiratory problems, how can you prepare?

Wildfire season is a good time to review your child's asthma action plan and medications with your pediatrician.

Before smoke arrives:

• Make sure medications are up to date
• Keep rescue inhalers readily available
• Know when to increase medications according to your asthma action plan
• Contact your healthcare provider if symptoms become more frequent

Remember, never wait until your child is struggling to breathe before taking action. Seek care as soon as any concerning symptoms arise.

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Kerrilynn Rice, MD

Pediatric Hospitalist

Learn more about Dr. Rice here.