What are the health effects of exposure to wildfire smoke? How can you protect yourself and your family when air quality is unhealthy due to smoke from fires?

Understanding Air Quality and Wildfire Smoke

Wildfires burning in Canada are affecting air quality across New York State. As long as these wildfires continue, the air quality can change with wind direction and weather. It’s important to check the latest air quality information at airnow.gov and follow the tips provided when the air quality is unhealthy.

Interpreting the Air Quality Index (AQI)

The Air Quality Index (AQI) is a tool used to measure and communicate the level of air pollution. Here’s what the different AQI levels mean:

• Green (0-50): Air quality is good, and it’s a great day to be outside.
• Yellow (51-100): Air quality is acceptable, but people unusually sensitive to air pollution should consider making outdoor activities shorter and less intense.
• Orange (101-150): Air quality is unhealthy for sensitive groups, including people with heart or lung disease, older adults, children and teens, minority populations, and outdoor workers. These groups should make outdoor activities shorter and less intense.
• Red (151-200): Air quality is unhealthy for everyone, and sensitive groups should avoid long or intense outdoor activities.
• Purple (201-300): Air quality is very unhealthy, and everyone should avoid all physical activity outdoors.
• Maroon (301-500): Air quality is hazardous, and everyone should avoid all outdoor physical activities.

Protecting Yourself from Smoke Exposure

When the air quality is unhealthy due to smoke, the best way to avoid health effects is to stay indoors with windows closed. This is especially important for at-risk groups, such as young children, older adults, and people with respiratory or heart problems.

For people who need to be outdoors, wearing a well-fitting face mask, such as an N95 or KN95, is recommended. If it gets hot inside, try to cool off with air conditioning if possible.

If you have any symptoms like shortness of breath, heart palpitations, or unusual fatigue, contact your healthcare provider.

Protecting Workers and Vulnerable Populations

Long work schedules and the physical demands of outdoor work can affect workers’ health when air quality is unhealthy. Employers should adjust work schedules and provide appropriate personal protective equipment (PPE) for their employees.

Schools and child care providers should suspend outdoor activities and field trips when air quality is unhealthy, and children who spend time outdoors should wear well-fitting face masks.

Improving Indoor Air Quality

If your cooling system brings in fresh air from outside, switch it to recirculation mode to prevent outdoor smoke from getting inside. Consider using an air cleaner or an air conditioner that recirculates indoor air, as this can greatly reduce indoor particle levels.

You can also run stand-alone fans to recirculate the air in your home, but avoid using whole-house fans that draw in air from outside. If you have a central air conditioning and heating system, set it to “on” so the air is filtered constantly, rather than “auto,” which runs the system intermittently.

When air quality is good, you can open windows and doors and use fans to bring in fresh air.

Staying Informed and Seeking Help

For the most up-to-date air quality information for your area, visit airnow.gov. If you have health-related questions, you can contact the New York State Department of Health at [email protected] or 518-402-7800. For worker-related advice, you can reach out to [email protected] or 518-402-7900.

Understanding the Health Risks of Wildfire Smoke

Wildfire smoke can affect air quality in several ways. The smoke contains particulate matter, which can irritate the eyes and respiratory system, and potentially lead to more serious health issues like heart and lung disease. Exposure to wildfire smoke can also exacerbate existing conditions, such as asthma and COPD.

Certain groups, such as children, older adults, and those with underlying health conditions, are at a higher risk of experiencing adverse health effects from smoke exposure. It’s important for everyone to take appropriate precautions to protect their health when air quality is compromised by wildfire smoke.

Exposure to Smoke from Fires

Wildfires Affecting New York State – June 2023

Wildfires burning in Canada are affecting air quality across New York State. As long as wildfires continue, conditions can change with wind direction and weather so check latest air quality at airnow.gov and follow the tips below when air quality is unhealthy.

AQI Basics for Particle Pollution

Air Quality Index	Who is at risk?	What to do?
Green: 0 to 50 Good	Air Quality is good.	It’s a great day to be outside.
Yellow: 51 to 100 Moderate	People unusually sensitive to air pollution.	Air quality is acceptable. Consider making outdoor activities shorter and less intense. Watch for coughing or shortness of breath. These are signs to take it easier. Everyone else: It’s a good day to be active outside.
Orange: 101 to 150 Unhealthy for Sensitive Groups	Sensitive (at-risk) group: people with heart or lung disease, older adults, children and teens, minority populations and outdoor workers.	Sensitive group: Make outdoor activities shorter and less intense. Take more breaks. Keep medicine handy. Everyone else is less likely to be affected.
Red: 151 to 200 Unhealthy	Everyone	Sensitive group: Avoid long or intense outdoor activities. Consider rescheduling or moving activities indoors. Everyone else: Reduce long or intense outdoor activities. Take more breaks.
Purple: 201 to 300 Very Unhealthy	Everyone: Health Alert	Sensitive groups: Avoid all physical activity outdoors. Reschedule or move activities indoors. Everyone else: Avoid long or intense outdoor activities. Consider rescheduling or moving activities indoors.
Maroon: 301-500 Hazardous	Everyone: Health Warning	Everyone: Avoid all outdoor physical activities. Sensitive groups: Keep activity levels low at home.

Contact a health care provider if you have symptoms like shortness of breath, heart palpitations, or unusual fatigue.

When Air Quality is Unhealthy

• Stay indoors with windows closed. This is the best way to avoid health effects. This is especially important for at-risk groups (“sensitive populations”), like young children, older adults, people with respiratory or heart problems, and those who exercise or do strenuous work outdoors.
• For people who spend time outdoors, wearing a well-fitting face mask is recommended.
• If it gets hot inside, cool off with air conditioning if you can.
• People with any symptom should contact their healthcare provider.

When Outdoors

• If you need to be outside use the best well-fitting face mask you have on hand. A N95 or KN95 will work best.
• Visit airnow.gov for the most up-to-date information for your area.

Workers

• Long work schedules and the physical demands of work performed outdoors can affect a worker’s health when air quality is unhealthy. Take frequent breaks and talk to your employer about adjusting your work until air quality improves. Follow advice from NIOSH.

Schools and Child Care Providers

• Continue to monitor air quality at airnow.gov.
• New York State recommends that schools and child care providers suspend outdoor activities and field trips when air quality is unhealthy.
• Children who spend time outdoors should wear a well-fitting face mask.
• When air quality is good, resume normal activities and masking is not necessary.

Filtering Air in Your Home

• If your cooling system brings fresh air into the home, close the fresh-air intake so that it operates in recirculation mode to prevent outdoor smoke from getting inside.
• If you have one, consider using an air cleaner or an air conditioner that recirculates indoor air. This can greatly reduce indoor particle levels to further reduce impacts from smoke.
• You can run stand-alone fans to recirculate in the home, but avoid using whole house fans because they draw in air from outside.
• Window or portable air conditioners are good to use if they recirculate air (check your user’s manual).
• If you have a central air conditioning and heating system, set the system to “on” so air is filtered constantly, rather than “auto,” which runs the system intermittently.
• Consider installing a high-efficiency filter (MERV 13 rating or higher) if your system can handle it based on the manufacturer’s recommendation.
• When air quality is good, you can open windows and doors and use fans to bring in fresh air.

For the most up-to-date air quality information for your area, visit airnow.gov.

Questions

• Health advice: [email protected] or 518-402-7800
• Worker advice: [email protected] or 518 402-7900
• New York State Air Quality Hotline: (800) 535-1345

More About Health Risks

How does wildfire smoke affect the air?

The smoke from any fire (forest, brush, crop, structure, tires, waste or wood burning) releases particles and chemicals when carbon-containing materials burns. All smoke contains carbon monoxide, carbon dioxide, and particulate matter (PM or soot). Smoke can also contain different chemicals, like aldehydes, acid gases, sulfur dioxide, nitrogen oxides, polycyclic aromatic hydrocarbons (PAHs), benzene, toluene, styrene, metals, and dioxins. The particles and chemicals in smoke varies depending on what is burning, how much oxygen is available, and the temperature.

Who is most at risk?

Everyone should avoid smoky areas and limit physical exertion when high levels of smoke can’t be avoided. People with cardiovascular or respiratory conditions like asthma, young children, and older adults may be more at risk of health effects from smoke. If you must be exposed to smokey conditions for long periods of time, proper use of respiratory protection will reduce exposure to the fine particles and gases in smoke.

What symptoms can occur?

Inhaling smoke for a short time can cause immediate effects. Smoke irritates the eyes, nose, and throat, and its odor can be nauseating. Studies show that some people exposed to heavy smoke have temporary changes in lung function that makes breathing more difficult. People can also have changes in heart function.  Carbon monoxide and small particles are two common substances in smoke responsible for these health effects.

Inhaling carbon monoxide decreases the body’s oxygen supply and causes headaches, reduces alertness, and aggravates a heart condition known as angina. Fine particles from smoke (fine particulate matter, or PM 2.5) can travel deeply into the respiratory tract, reaching the lungs. Inhaling fine particles can cause a variety of health effects, like respiratory irritation and shortness of breath. It can also worsen medical conditions such as asthma and heart disease. Physical exertion can make these health effects worse. Once exposure stops, symptoms may last for a couple of days, but will likely improve.

When should I speak to a health care provider?

Anyone with symptoms from smoke or bad air quality should contact their health care provider. You may also want to talk with a health care provider about your health risk when smokey air or poor air quality cannot be avoided.

What about long-term health effects?

Exposure to smoke can also increase your risk for long-term (chronic) health effects. People who live in areas with higher fine particulate air pollution and those who breathe air containing fine particles over long periods have a higher risk of cardiovascular disease and mortality. Frequent exposure to smoke even for brief periods can also increase your risk for long-term health effects. Scientists have studied the risk of long-term health effects in firefighters who frequently breathe smoke. Some of these show a higher rate of cancer, lung disease, and cardiovascular disease, while others do not.

More Information

Air Quality

• Get todays forecast: Airnow.gov
• New York State AQI information
• Fine Particles Q&A
• Ozone
• Carbon Monoxide
• Wildfires and Indoor Air Quality in Schools and Commercial Buildings

Other Important Resources

• What You Should Know about Fires
• Children’s Health and Wildfires
• Get Help for Mental Health
• How to Use a Disposable Respirator
• Wildfire Smoke – A Guide for Public Health Officials

News & Advisories

• June 26, 2023: Governor Hochul Updates New Yorkers on Statewide Air Quality for Wednesday, June 28
• June 15, 2023: Governor Hochul Updates New Yorkers on Statewide Air Quality for Friday, June 16
• June 11, 2023: Air Quality Health Advisory Issued for Western New York
• June 9, 2023: Governor Hochul Updates New Yorkers on Statewide Air Quality Issues and Provides Guidance for Safe Weekend Activities
• June 8, 2023: Air Quality Health Advisory Issued for Long Island, New York City Metro, and Western New York (In Effect for Friday, June 9, 2023)
• June 7, 2023: Air Quality Health Advisory Issued for Long Island, New York City Metro, Lower Hudson Valley, Upper Hudson Valley, Eastern Lake Ontario, Central New York and Western New York
• June 7, 2023: B-Roll, Video, Audio, & Rush Transcript: Governor Hochul Updates New Yorkers on Dangerous Air Quality
• June 7, 2023: Governor Hochul Announces One Million N95 Masks to be Made Available to New Yorkers as Effects of Canadian Wildfires Continue to Impact Air Quality in New York State
• June 7, 2023: Press Availability on Air Quality with NYS Health Commissioner McDonald and NYS DEC Commissioner Seggos
• June 7, 2023: New York State Department of Health Advises New Yorkers to Take Precautions as Unhealthy Air Quality Continues to Impact Much of the State
• June 7, 2023: Governor Hochul Recommends School Districts Cancel Outdoor Activities Due to Ongoing Impact of Canadian Wildfires
• June 6, 2023: Air Quality Health Advisory Issued for Long Island, New York City Metro, Eastern Lake Ontario, Central New York and Western New York
• June 6, 2023: Air Quality Health Advisory Issued for Long Island, New York City Metro, Lower Hudson Valley, Upper Hudson Valley, Adirondacks, Eastern Lake Ontario, and Central New York
• June 6, 2023: Governor Hochul Updates New Yorkers on Canadian Wildfires Impacting State’s Air Quality
• June 2, 2023: Air Quality Health Advisory Issued for Long Island, New York City Metro, and Western New York In Effect for Friday, June 2, 2023

Can Wildfire Smoke Cause Headaches? What to Know

U. S.|Why Wildfire Smoke Might Lead to Headaches

https://www.nytimes.com/2023/06/07/us/wildfire-smoke-headaches.html

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If you’re in pain, here’s how to mitigate it.

If you need to go outside, you may want to wear a tightfitting mask, like an N95, says Dr. Raj Fadadu of University of California, San Francisco School of Medicine.Credit…Gregg Vigliotti for The New York Times

• June 7, 2023

Breathing in wildfire smoke can cause a headache right away, according to the Centers for Disease Control and Prevention, and short-term exposure to particulate matter from wildfires has been linked to an increase in emergency room visits for headaches.

Researchers are not entirely sure why wildfire smoke causes headaches, but one reason may be that it can alter the sensitivity of certain neurons, which in turn can increase the risk of headaches, said Dr. Raj Fadadu, a researcher at the University of California, San Francisco School of Medicine who has studied the health effects of wildfire smoke.

Wildfire smoke can lead to lower oxygen levels if you have an underlying lung condition like asthma, which can contribute to a headache, said Dr. Panagis Galiatsatos, a pulmonary and critical care medicine physician at Johns Hopkins Medicine. Inhaling wildfire smoke can also lead to inflammation, which can itself induce headaches.

If you are outside in an area with poor air quality and you feel a headache coming on, that’s most likely a sign you should head indoors, said Dr. Fadadu. To ward off headaches — and any other effect from smoke — restrict the amount of time you spend outdoors, he said, and try to optimize the quality of your indoor air. If you have access to an air purifier, like one with a HEPA filter, that can help. You should also steer clear of smoking or vaping.

If you do need to go outside, consider wearing a tightfitting mask, like an N95. While wearing a mask indoors is not typically recommended to reduce smoke exposure, if you believe you are encountering poor air quality, putting on a mask may lower your risk of inhaling polluted air, and therefore could help address headache symptoms, Dr. Fadadu said.

The most effective treatment for headaches can vary from person to person, but over-the-counter medications like Tylenol or Advil can help. Staying hydrated is also critical, Dr. Fadadu said. If you can, try to avoid looking at screens while your headache persists; at the least, consider reducing the brightness of your screen, which can ease the strain on your eyes. If your headache is not responding to treatments at home, or is becoming more intense, you may want to go to an urgent care center or emergency department, he added. A physician may prescribe stronger medications to better manage the pain.

If you have underlying pulmonary issues and you are experiencing a headache after exposure to wildfire smoke, consider testing your oxygen levels and contacting your doctor, Dr. Galiatsatos said.

There’s another possible reason for your wildfire-smoke headache: stress. A growing body of research shows that environmental disturbances take a toll on mental health, and stress can contribute to tension headaches, which are mild, throbbing headaches typically felt on both sides of the head.

The anxiety that people may feel looking at the orange-tinged haze, or assessing whether to put on a mask before leaving their homes, might itself contribute to headaches — particularly on the East Coast, where people are not used to grappling with the tangible impact of wildfire smoke, Dr. Fadadu said.

“That ecological stress that we’re seeing with wildfires is, for sure, a real phenomenon that a lot of people are experiencing,” Dr. Fadadu said.

Dani Blum is a reporter for Well.

Attention, smoke! | Surgut City Clinical Polyclinic No. 4

Due to burning forests and peat bogs, the content of various suspensions, especially coal dust and nitrogen oxide, sharply increases in the air. As a result, a person has a headache, increased fatigue, absent-mindedness, lacrimation is possible, etc., which is explained by a lack of oxygen for the body as a whole. It is especially difficult to endure “smoke” for people suffering from diseases of the respiratory system (bronchial asthma, obstructive pulmonary disease), the cardiovascular system, where acrid smoke, smog is a trigger for the development of exacerbations.

Precautions and protection against the negative effects of smoke

(reminder for the public)

What to do:

1. If possible, it would be a rational decision to go outside the city to places where there is no “smoke”. If this is not possible, then the following must be observed:

2. Do not go outside during the hours of greatest smoke.

3. “Seal” the windows in the house well and efficiently, this can partly protect you from inhaling suspended particles and acrid smoke from entering the home. Indoors, the concentration of smoke can be one third less than outdoors. However, the most harmful fine particles (PM 10) penetrate into any room. Especially at night and early in the morning, when the smoke reaches its maximum.

4. Do not dust or smoke at home additionally:

• do not burn candles and incense;
• do not vacuum;
• do not use gas stoves;
• turn on forced exhaust during cooking;
• Never smoke at home.

5. Do not use the air conditioner during peak smoke hours unless it is equipped with special filters (HEPA type).

6. Limit physical activity. Physical activity makes you breathe faster and deeper, which greatly and permanently harms your health in a smoky environment. No jogging in the morning and cycling!

7. Minimize the number of cigarettes you smoke. Although the only real help is complete cessation of smoking. Passive smokers, stay away from smoky rooms!

8. Persons with diseases of the respiratory and cardiovascular systems should strictly follow the recommendations of doctors.

9. For those who suffer from bronchial asthma and chronic bronchitis, it is recommended:

10. Persons suffering from arterial hypertension:

• measure blood pressure at least 2 times a day;
• with persistent arterial hypertension – taking antihypertensive drugs, if there is no effect, you should consult a doctor.

11. Persons suffering from angina pectoris:

• carry medicines containing nitrates;
• if seizures become more frequent, call a doctor at home.

Additional measures:

1. Do medical masks help? Ordinary medical masks not only do not help, but also harm. They have enough gaps to let smoke through and pores to keep out the most harmful PM10 particles. But the masks create an additional respiratory barrier, forcing you to breathe more often and deeper. Only special respirators that filter fine particles (such as R-2, R-3) can really help, but they should be worn only during hours of maximum smoke. If you decide to take an eight-layer cotton-gauze bandage, be sure to moisten it with water. And remember: no masks will separate harmful gases (carbon monoxide, nitrogen oxides, etc.) from normal air gases.

2. Humidify the air in your home in every possible way. If there are no special humidifiers, spray water from a spray bottle. In the heat, do not allow the mucous membranes of the respiratory tract to dry out!

3. Drink plenty of fluids! Together with humidifying the air in the room, this will help to avoid drying of the mucous membranes and effectively remove suspended particles with sputum.

4. Remove soot deposited on the floor and furniture as often as possible with damp cloths.

5. If it is not possible to keep the windows closed due to the heat, cover them with nets or gauze, which must be constantly moistened.

6. In case of eye irritation, use preparations such as natural tears. It is recommended not to wear contact lenses (switch to glasses).

7. Eat more plant foods, drink green tea and fresh juices instead of coffee and fizzy drinks. The antioxidants they contain help inactivate harmful peroxide substances in the body.

Information prepared according to
Department of Disaster Medicine and Medical Rescue Service
MBUZ “City ambulance station”.

Carbon monoxide poisoning – Symptoms, diagnosis and treatment death. Approximately 1-3% of poisonings are fatal.

Poisoning can occur as a result of the incomplete combustion process when smoke from fires, car exhaust and other engine exhaust gases is inhaled in poorly ventilated areas, as well as from various industrial sources.

Early symptoms are non-specific and include headache, dizziness and nausea.

If carbon monoxide poisoning is suspected, leave the building or premises immediately and seek emergency medical attention.

Higher exposure leads to the development of cardiovascular manifestations, including myocardial ischemia, myocardial infarction, cardiac dysfunction, dysrhythmia and cardiac arrest.

Patients with moderate or severe carbon monoxide poisoning should be evaluated for cardiac lesions using ECG and cardiac biomarker measurements to determine acute myocardial injury, as this may be a predictor of adverse long-term outcomes.

Neurological symptoms include acute stroke-like symptoms, altered mental status, confusion, coma, and syncope.

Up to 40% of people who survive carbon monoxide poisoning suffer from neurocognitive deficits that can become permanent.

Diagnosis is based on the clinical triad of history of carbon monoxide exposure, elevated carboxyhemoglobin, and symptoms consistent with carbon monoxide poisoning.

High flow oxygenation, hyperbaric oxygen therapy and symptomatic therapy are key elements of treatment.

Hyperbaric oxygen therapy is associated with a number of problems, including difficult care of critically ill patients in some centers, logistical obstacles to timely transportation to facilities where hyperbaric therapy is performed.

Complications of hyperbaric oxygen therapy include seizures due to oxygen toxicity, pulmonary edema, and ear barotrauma.

Definition

Carbon monoxide (CO) poisoning is the most common type of poisoning in humans. [1]Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med. 2017 Mar 1;195(5):596-606.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363978/

http://www.ncbi.nlm.nih.gov/pubmed/27753502?tool=bestpractice.com
[2] Hampson NB, Piantadosi CA, Thom SR, et al. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012 Dec 1;186(11):1095-101.
http://www.atsjournals.org/doi/full/10.1164/rccm.201207-1284CI#.VXHCJ8-jMyo

http://www.ncbi.nlm.nih.gov/pubmed/23087025?tool=bestpractice.com
CO is formed as a result of incomplete combustion, with the most common causes of exposure being inhalation of smoke from fires, vehicle and other engine exhaust.[1]Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med. 2017 Mar 1;195(5):596-606.
https://www.ncbi.nlm.nih. gov/pmc/articles/PMC5363978/

http://www.ncbi.nlm.nih.gov/pubmed/27753502?tool=bestpractice.com
The increased affinity of CO for hemoglobin leads to a decrease in systemic oxygen delivery, and the effect of CO on cytochrome c oxidase leads to impaired cellular respiration.

Symptoms of carbon monoxide poisoning vary widely and are mostly non-specific. Symptoms can range from headache, nausea and dizziness to severe cardiovascular and nervous system symptoms, depending on dose and duration of exposure. Mortality from severe carbon monoxide poisoning is approximately 1–3%.[3]Hampson NB. U.S. Mortality due to carbon monoxide poisoning, 1999-2014. Accidental and intentional deaths. Ann Am Thorac Soc. 2016 Oct;13(10):1768-74.
https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201604-318OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

http://www.ncbi.nlm.nih.gov/pubmed/27466698?tool=bestpractice.com
The greatest risk of death is noted in elderly patients; in cases where the source of CO was fire; if the patient lost consciousness; in patients with very high carboxyhemoglobin levels and respiratory failure. [4] Hampson NB, Hauff NM. Risk factors for short-term mortality from carbon monoxide poisoning treated with hyperbaric oxygen. Crit Care Med. 2008 Sep;36(9)):2523-7.
http://www.ncbi.nlm.nih.gov/pubmed/18679118?tool=bestpractice.com
Survivors of carbon monoxide poisoning have a higher long-term mortality rate than their non-CO poisoning peers, with 15–40% suffering almost permanent neurocognitive consequences.[5] Hopkins RO, Weaver LK, et al.; Undersea & Hyperbaric Medical Society 2008 Annual Scientific Meeting. Cognitive outcomes 6 years after acute carbon monoxide poisoning [abstract]. June 2008 [internet publication].
http://archive.rubicon-foundation.org/xmlui/handle/123456789/7822
[6] Hsiao CL, Kuo HC, Huang CC. Delayed encephalopathy after carbon monoxide intoxication–long-term prognosis and correlation of clinical manifestations and neuroimages. Acta Neurol Taiwan. 2004 Jun;13(2):64-70.
http://www.ncbi.nlm.nih.gov/pubmed/15478677?tool=bestpractice.com
[7] Weaver LK, Hopkins RO, Churchill SK, et al.