As wildfires continue to rage throughout Northern California, much of the Bay Area remains blanketed in smoke and the ensuing unhealthy air quality. While changes in wind and weather can bring a temporary reprieve to some areas, it’s an unfortunate reality that the region could face the challenge of poor air for months to come as we head into wildfire season in a state plagued by drought. Parents already frazzled by the coronavirus pandemic and school shutdowns now face the added stress of keeping their kids shuttered indoors to avoid the smoky air.
While children are more at risk of complications from wildfire smoke, there are steps you can take to protect your family, says Mary Prunicki, M.D., Ph.D., director of air pollution and health research at the Sean N. Parker Center for Allergy Research at Stanford University and Lucile
Packard Children's Hospital.
"Try not to go out," Prunicki says, "but if you have to go out, come in and take a shower and stay in well-purified air if you can."
In addition to people with chronic respiratory and cardiac problems, "we know that the very young and very old are more susceptible to wildfire smoke," as are pregnant women, says Prunicki, a mother of three children whom she has been keeping mostly indoors.
"Even within an hour of someone inhaling wildfire smoke, you can see increases in ambulance calls for respiratory and cardiac issues. At two days of exposure (depending on the levels), you see increases in ER visits and hospitalizations for asthma exacerbation, chronic COPD (chronic obstructive pulmonary disease) and acute bronchitis." Pregnant women may give birth early or to babies with decreased birth weight.
In addition to the acute effects, researchers are finding long-term effects, such as increased flu rates in communities that have been exposed to wildfire smoke – a particular concern with COVID-19, which has higher incidences in areas with air pollution, Prunicki says.
"We know that PM 2.5 (the fine particulate matter in wildfire smoke) causes the immune system to be dysregulated and not work as well," she says. "My expectation is that COVID rates are going to increase after these horrible wildfires, and we’re just getting into the season."
More mild symptoms include burning eyes and throats, as well as a cough. While symptoms can be treated with antihistamines, the best approach is to avoid the smoke as much as possible, Prunicki says.
Outdoor Air Quality
She suggests people visit AirNow to check their outdoor air quality but adds that crowd-sourced sites including PurpleAir and IQAir can provide helpful information if you don’t live close to an official monitoring station.
Prunicki says she would avoid outdoor activity even during moderate air quality "but some people don’t have the luxury. And people have been talking about the mental health balance. Sometimes at night it does seem like when the sun goes down, the air quality improves. You could put on a mask and go for a short walk for your own mental health."
"If there’s any concern that you’re one of the people in sensitive groups, really follow the (Air Quality Index) guidelines," she says. "If you’re out and it says it’s OK to be out, and you’re experiencing symptoms, come in."
While a cloth mask can’t fully protect you from wildfire smoke, Prunicki says there is some research showing it filters out about 50 percent of particles, with surgical masks providing more protection and N95 masks providing the most – though they have been in short supply and needed by medical professionals dealing with COVID-19.
Indoor Air Quality
Especially if you live in an older home without airtight windows or don’t have central air conditioning, Prunicki recommends purchasing an air purifier. The California Air Resources Board offers advice for consumers as well as a list of certified air cleaning devices.
It is also possible to make your own device from a box fan and filter, which can be useful for those who can’t purchase an air filter, she says. There are lots of DIY videos on YouTube, like thisone
In addition, Prunicki recommends considering creating a "clean room" in your home to keep smoke out and clean air in. The Environmental Protection Agency has someguidelines
"For parents with small children, try to keep them in such a room and sleep in a room like that," she says.
COVID or Smoke?
Complicating matters is that some of the symptoms of smoke exposure – shortness of breath, cough, headache – are also symptoms of COVID. How can parents tell the difference?
"I don’t think you really can at home. The recommendation is to consult your physician," Prunicki says. "If you get indoors in good air quality and the symptoms seem relieved or go away, that’s a good sign."