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  2. Wildfire Smoke and Your Patients' Health

Wildfire Smoke Course References

Abdo M, Ward I, O'Dell K, Ford B, Pierce JR, Fischer EV, Crooks JL. Impact of wildfire smoke on adverse pregnancy outcomes in Colorado, 2007-2015. Int J Environ Res Public Health. 2019 Oct 2;16(19):3720. doi: 10.3390/ijerph16193720.

Adetona O, Reinhardt T, Domitrovich J, Broyles G, Adetona A, Kleinman M, Ottmar R, Naeher L. Review of the health effects of wildland fire smoke on wildland firefighters and the public. Inhalation Toxicology 2016; 28(3): 95–139.  

Barn P, Larson T, Noullett M, Kennedy S, Copes R, Brauer M. Infiltration of forest fire and residential wood smoke: an evaluation of air cleaner effectiveness. Journal of Exposure Science & Environmental Epidemiology 2008; 18(5): 503–511. 

Beidler J, Pouliot G, Foley K. 2004-2017 Geospatial dataset of wild and prescribed fire activity over the conterminous United States. Data in Brief 2024; 56: 110856. 

Berns K, Haertel AJ. Excess prenatal loss and respiratory illnesses of infant macaques living outdoors and exposed to wildfire smoke. Am. J. Primatol. 2024; 86(5):e23605. 

Black C, Gerriets JE, Fontaine JH, Harper RW, Kenyon NJ, Tablin F, Schelegle ES, Miller LA. Early life wildfire smoke exposure Is associated with immune dysregulation and lung function decrements in adolescence. Am J Respir Cell Mol Biol. 2017; 56(5):657-666. doi: 10.1165/rcmb.2016-0380OC .

Brook R, Rajagopalan S, Pope CA 3rd, Brook J, Bhatnagar A, Diez-Roux A, Holguin F, Hong Y, Luepker R, Mittleman M, Peters A, Siscovick D, Smith SJ, Whitsel L, Kaufman J. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation 2010; 121(21): 2331–2378.  

Brosseau, L.M., 2010. Fit testing respirators for public health medical emergencies. J Occup Environ Hygiene, 7(11), pp.628-632. 

Burke, M, Childs ML, de la Cuesta B, Qiu M, Li J, Gould CF, Heft-Neal S, Wara M. The contribution of wildfire to PM2.5 trends in the USA. Nature 2023; 622(7984): 761–766. 

Cascio WE. Wildland fire smoke and human health. Science of The Total Environment 2018; 624: 586–595. 

Casey J, Kioumourtzoglou M, Padula A, Gonzalez D, Elser H, Aguilera R, Northrop A, Tartof S, Mayeda E, Braun D, Dominici F, Eisen E, Morello-Frosch R, Benmarhnia T. Measuring long-term exposure to wildfire PM(2.5) in California: Time-varying inequities in environmental burden. Proceedings of the National Academy of Sciences USA 2024; 121(8): e2306729121.  

Childs M, Li J, Wen J, Heft-Neal S, Driscoll A, Wang S, Gould C, Qiu M, Burney J, Burke M. Daily Local-Level Estimates of ambient wildfire smoke PM2.5 for the contiguous US. Environmental Science & Technology 2022; 56(19): 13607–13621.  

China S, Mazzoleni C, Gorkowski K, Aiken AC, Dubey MK. Morphology and mixing state of individual freshly emitted wildfire carbonaceous particles. Nature Communications 2013; 4(1): 2122.  

Christianson AC, McGee TK. Whitefish Lake First Nation. Wildfire evacuation experiences of band members of Whitefish Lake First Nation 459, Alberta, Canada. Natural Hazards 2019; 98(1): 9–29.  

Cleland SE, Wyatt LH, Wei L, Naman P, Serre ML, West JJ, Henderson SB, Rappold AG. Short-term exposure to wildfire smoke and PM2.5 and cognitive performance in a brain-training game: A longitudinal study of U.S. adults. Environ Health Perspectives 2022; 130(6).  

Coffey, C.C., Lawrence, R.B., Campbell, D.L., Zhuang, Z., Calvert, C.A. and Jensen, P.A., 2004. Fitting characteristics of eighteen N95 filtering-facepiece respirators. J Occup Environ Hygiene, 1(4), pp.262-271.  

Congressional Budget Office. (2022, June). Wildfires.  

Dodd W, Scott P, Howard C, Scott C, Rose C, Cunsolo A, Orbinski J. Lived experience of a record wildfire season in the Northwest Territories, Canada. Canadian Journal of Public Health 2018; 109(3): 327–337.  

Duling M.G., Lawrence R.B., Slaven J.E., and Coffey C.C., 2007.  Simulated workplace protection factors for half-facepiece respiratory protective devices. J Occup Environ Hygiene, 4(6), pp.420-431.  

Eisenman DP, Galway LP. The mental health and well-being effects of wildfire smoke: a scoping review. BMC Public Health 2022; 22(1): 2274.  

Eykelbosh A. Do-it-yourself (DIY) air cleaners: Evidence on effectiveness and considerations for safe operation. Vancouver, Canada: National Collaborating Centre for Environmental Health. 2023. 

Fann N, Alman B, Broome RA, Morgan GG, Johnston FH, Pouliot G, Rappold AG. The health impacts and economic value of wildland fire episodes in the U.S.: 2008–2012. Science of The Total Environment 2018; 610–611: 802–809.  

Fisk WJ, Chan WR. Health benefits and costs of filtration interventions that reduce indoor exposure to PM2.5 during wildfires. Indoor Air 2017; 27(1): 191–204.  

Gao Y, Huang W, Xu R, Gasevic D, Liu Y, Yu W, Yu P, Yue X, Zhou G, Zhang Y, Liu H, Song J, Guo Y, Li S. Association between long-term exposure to wildfire-related PM2.5 and mortality: A longitudinal analysis of the UK Biobank. Journal of Hazardous Materials 2023; 457: 131779.  

Gao Y, Huang W, Xu Z, Xu R, Gasevic D, Liu Y, Yue X, Zhou G, Zhang Y, Song J, Liu H, Guo Y, Li S.  Wildfire-related PM2.5 and cause-specific cancer mortality. Ecotoxicology and Environmental Safety 2024; 285: 117023. 

Heft-Neal S, Driscoll A, Yang W, Shaw G, Burke M. Associations between wildfire smoke exposure during pregnancy and risk of preterm birth in California. Environmental Research 2022; 203: 111872.  

Holden ZA, Swanson A, Luce CH, Jolly WM, Maneta M, Oyler JW, Warren DA, Parsons R, Affleck D. Decreasing fire season precipitation increased recent western US forest wildfire activity. Proceedings of the National Academy of Sciences 2018; 115 (36) E8349–8357.  

Holder AL, Halliday HS, Virtaranta L. Impact of do-it-yourself air cleaner design on the reduction of simulated wildfire smoke in a controlled chamber environment. Indoor Air 2022; 32(11): e13163.  

Humphreys A, Walker EG, Bratman GN, Errett NA. What can we do when the smoke rolls in? An exploratory qualitative analysis of the impacts of rural wildfire smoke on mental health and wellbeing, and opportunities for adaptation. BMC Public Health 2022; 22(1): 41.    

Lan Q, Weinberger K, Luke S, Lavigne E, Weichenthal S, Henderson SB. Wildfire seasons, prenatal PM2.5 exposure, and respiratory infections by age 1 year: A population-based case-control analysis of critical developmental windows. ACS EST Air. 2024; 1(11):1483-1494. doi: 10.1021/acsestair.4c00213  

Landguth EL, Holden ZA, Graham J, Stark B, Mokhtari EB, Kaleczyc E, Anderson S, Urbanski S, Jolly M, Semmens EO, Warren DA, Swanson A, Stone E, Noonan C. The delayed effect of wildfire season particulate matter on subsequent influenza season in a mountain west region of the USA. Environment International 2020; 139: 105668.  

Liang Y, Sengupta D, Campmier MJ, Lunderberg DM, Apte JS, Goldstein AH. Wildfire smoke impacts on indoor air quality assessed using crowdsourced data in California. Proceedings of the National Academy of Sciences 2021; 118(36): e2106478118.  

Liu JC, Pereira G, Uhl SA, Bravo MA, Bell ML. A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke. Environmental Research 2015; 136: 120–132.  

May NW, Dixon C, Jaffe DA. Impact of wildfire smoke events on indoor air quality and evaluation of a low-cost filtration method. Aerosol and Air Quality Research 2021; 21(7): 210046.  

McArdle CE, Dowling TC, Carey K, DeVies J, Johns D, Gates AL, Stein Z, van Santen KL, Radhakrishnan L, Kite-Powell A, Soetebier K, Sacks JD, Sircar K, Hartnett KP, Mirabelli MC. Asthma-associated emergency department visits during the Canadian wildfire smoke episodes - United States, April-August 2023. MMWR Morb Mortal Wkly Rep 2023; 72(34): 926–932.  

Meo SA, Abukhalaf AA, Alomar AA, Alessa OM, Sami W, Klonoff DC. Effect of environmental pollutants PM-2.5, carbon monoxide, and ozone on the incidence and mortality of SARS-COV-2 infection in ten wildfire affected counties in California. Science of The Total Environment 2021; 757: 143948.  

Mirabelli MC, Vaidyanathan A, Pennington AF, Ye D, Trenga CA. Wildfire smoke and symptoms affecting mental health among adults in the U.S. state of Oregon. Preventive Medicine 2022; 164: 107333.  

O’Dell K, Bilsback K, Ford B, Martenies SE, Magzamen S, Fischer EV, Pierce JR. Estimated mortality and morbidity attributable to smoke plumes in the United States: Not just a western US problem. GeoHealth 2021; 5(9): e2021GH000457.  

O’Dell K, Ford B, Burkhardt J, Magzamen S, Anenberg SC, Bayham J, Fischer EV, Pierce JR. Outside in: the relationship between indoor and outdoor particulate air quality during wildfire smoke events in western US cities. Environmental Research: Health 2023; 1(1): 015003.  

Orr A, Migliaccio CAL, Buford M, Ballou S, Migliaccio CT. Sustained effects on lung function in community members following exposure to hazardous PM2.5 levels from wildfire smoke. Toxics 2020; 8(3): 53.  

Picciotto S, Huang S, Lurmann F, Pavlovic N, Ying Chang S, Mukherjee A, Goin DE, Sklar R, Noth E, Morello-Frosch R, Padula AM. Pregnancy exposure to PM2.5 from wildland fire smoke and preterm birth in California. Environ Int. 2024; 186:108583. doi: 10.1016/j.envint.2024.108583. Epub 2024 Mar 16.

Prichard SJ, O'Neill SM, Eagle P, Andreu AG, Drye B, Dubowy J, Urbanski S, Strand TM. Wildland fire emission factors in North America: synthesis of existing data, measurement needs and management applications. International Journal of Wildland Fire 2020; 29(2): 132–147.  


Reid CE, Brauer M, Johnston FH, Jerrett M, Balmes JR, Elliott CT. Critical review of health impacts of wildfire smoke exposure. Environmental Health Perspectives 2016; 124(9): 1334–1343.  

Rodney RM, Swaminathan A, Calear AL, Christensen BK, Lal A, Lane J, Leviston Z, Reynolds J, Trevenar S, Vardoulakis S, Walker I. Physical and mental health effects of bushfire and smoke in the Australian Capital Territory 2019–20. Frontiers in Public Health 2021; 9.  

Sacks JD, Holder AL, Rappold AG, Vaidyanathan A. At the intersection: Protecting public health from smoke while addressing the U.S. wildfire crisis. American Journal of Respiratory and Critical Care Medicine 2023; 208(7): 755–757.  

Sacks JD, Migliaccio CT, Reid CE, Montrose L. Shifting the conversation on wildland fire smoke exposures: More smoke within and across years requires a new approach to inform public health action. ACS ES&T Air 2025; 2(2): 122–129.  

Schwarz L, Dimitrova A, Aguilera R, Basu R, Gershunov A, Benmarhnia T. Smoke and COVID-19 case fatality ratios during California wildfires. Environmental Research Letters 2022; 17(1): 014054.  

Shrestha PM, Humphrey JL, Carlton EJ, Adgate JL, Barton KE, Root ED, Miller SL. Impact of outdoor air pollution on indoor air quality in low-income homes during wildfire seasons. International Journal of Environmental Research and Public Health 2019; 16(19): 3535.  


U.S. Department of Agriculture Forest Service. Confronting the Wildfire Crisis (pdf) (14.6MB). Accessed February 12, 2025.

U.S. Environmental Protection Agency. Integrated Science Assessment (ISA) for Particulate Matter (Final Report, Dec 2019). Washington, DC: EPA/600/R-19/188.  

U.S. Environmental Protection Agency. Integrated Science Assessment (ISA) for Ozone and Related Photochemical Oxidants (Final Report, Apr 2020). Washington, DC: EPA/600/R-20/012.  

U.S. Environmental Protection Agency. Comparative assessment of the impacts of prescribed fire versus wildfire (CAIF): A case study in the western U.S. 2021. Washington, DC: EPA/600/R-21/197.  

U.S. Environmental Protection Agency. Supplement to the 2019 Integrated Science Assessment for Particulate Matter (Final Report, 2022). Washington, DC: EPA/635/R-22/028.  

Underwriters Laboratories Inc. An evaluation of DIY air filtration (pdf) (1,285 KB). Marietta, GA: UL Research Institutes. 2021. 

Vincent GE, Aisbett B, Wolkow A, Jay SM, Ridgers ND, Ferguson SA. Sleep in wildland firefighters: what do we know and why does it matter? International Journal of Wildland Fire 2018; 27(2): 73–84.  

Walker ES, Stewart T, Jones D. Fine particulate matter infiltration at Western Montana residences during wildfire season. Science of The Total Environment 2023; 896: 165238.  

Wettstein ZS, Hoshiko S, Fahimi J, Harrison RJ, Cascio WE, Rappold AG. Cardiovascular and cerebrovascular emergency department visits associated with wildfire smoke exposure in California in 2015. Journal of the American Heart Association 2018; 7(8): e007492.  

Xiang J, Huang C-H, Shirai J, Liu Y, Carmona N, Zuidema C, Austin E, Gould T, Larson T, Seto E. Field measurements of PM2.5 infiltration factor and portable air cleaner effectiveness during wildfire episodes in US residences. Science of The Total Environment 2021; 773: 145642.  

Yao J, Brauer M, Raffuse S, Henderson SB. Machine learning approach to estimate hourly exposure to fine particulate matter for urban, rural, and remote populations during wildfire seasons. Environmental Science & Technology 2018; 52(22): 13239-13249.  

Zhang B, Weuve J, Langa KM, D'Souza J, Szpiro A, Faul J, Mendes de Leon C, Gao J, Kaufman JD, Sheppard L, Lee J, Kobayashi LC, Hirth R, Adar SD. Comparison of particulate air pollution from different emission sources and incident dementia in the US. JAMA Intern Med. 2023; 183(10):1080-1089. doi: 10.1001/jamainternmed.2023.3300 .

Zhou X, Josey K, Kamareddine L, Caine MC, Liu T, Mickley LJ, Cooper M, Dominici F. Excess of COVID-19 cases and deaths due to fine particulate matter exposure during the 2020 wildfires in the United States. Science Advances 2021; 7(33): eabi8789.  
 

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Wildfire Smoke and Your Patients' Health

  • Wildfire Smoke and Your Patients' Health
  • Public Health Impacts of Wildlife Smoke Exposure
    • Wildfire Smoke and Why it is a Health Concern
      • Wildfire Smoke - A Growing Public Health Concern
      • Wildfire Smoke - A Complex Mixture
      • Why is Smoke a Health Concern
    • Health Effects Attributed to Wildfire Smoke
      • Durations of Smoke Exposure
      • Symptoms of Mental Health Effects from Smoke Exposure
    • Who is at Increased Risk of Health Effects from Wildfire Smoke Exposure
  • Co-exposure to Wildfire Smoke and Heat
  • Protecting Public Health from Smoke
    • Increasing Impacts of Wildfire Smoke
    • Key Components of Reducing Smoke Exposure
    • Importance of Educating Patients and Health Care Professionals Before Smoke is in the Air
    • Wildfire Smoke and Your Patients' Health: The Air Quality Index
      • Communicating Air Quality Conditions - Air Quality Index (AQI)
      • Where to Find Air Quality Smoke Reports - Fire and Smoke Map
      • Where to Find Air Quality Smoke Reports - Air Resource Advisor Smoke Outlooks
      • Using the Air Quality Index (AQI) to Plan Daily Activities
  • Reducing Exposure to Wildfire Smoke and Heat
    • Preparing for Smoke and Heat
    • Strategies to Reduce Exposure to Smoke and Heat
      • Strategies to Reduce Exposure Outdoors
      • Strategies to Reduce Exposure Indoors
      • Cleaner Air Shelters and Spaces
      • Evacuation
  • Resources
  • Compilation of Knowledge Check Questions
  • References
Contact Us About Wildfire Smoke and Your Patients' Health
Contact Us About Wildfire Smoke and Your Patients' Health to ask a question, provide feedback, or report a problem.
Last updated on September 30, 2025
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