Preparing for Smoke and Heat

Smoke events can occur without warning. Before smoke arrives, help your patients make a plan to be ready. More information is available in the Wildfire Guide fact sheet Prepare for Fire Season (pdf) (260 kb).

Steps for your patients to take before fire season:

• Know where to find alerts
• Develop a disease management plan
• Stock up on medications and food
• Know how to stay cool at home with doors and windows closed
• Check the heating, ventilation and air conditioning (HVAC) system
• Consider buying a portable air cleaner or making a DIY air cleaner
• Consider purchasing N95® respirators
• Protect pets
• Prepare for co-exposure to heat
• Make an evacuation/relocation plan

Know where to find alerts: Point patients to sources in your area for alerts and health warnings about smoke and wildfire risk, including air quality reports, public service announcements and social media alerts. The most reliable alerts come from state, local or federal government agencies. The Fire and Smoke Map includes links to current USFS Smoke Outlooks.

Develop a disease management plan: Patients with heart or lung disease should know the symptoms of disease exacerbation, medications that can help and when to call or come in for medical attention. Patients with asthma should have an asthma action plan. Advise patients to set up a cleaner air room at home.

Stock up on medications and food: Having several days of medications and food on hand will help your patients avoid having to go outside during a smoke event. At a minimum, they should buy some groceries that do not need to be refrigerated in case the power goes out. They should also buy some food that does not need to be cooked.

Know how to stay cool at home with doors and windows closed: Patients without air conditioning at home may need to purchase fans or room air conditioners. Discourage patients from choosing portable air conditioners with a single exhaust hose or from choosing evaporative swamp coolers during smoky periods because these cooling systems can bring in smoky outdoor air.

Check the heating, ventilation and air conditioning (HVAC) system: Patients should become familiar with their residence’s HVAC system so they can adjust it to keep smoke out. Important features to understand include using appropriate high-efficiency air filters and closing the fresh air intake if the central air system or room air conditioner has one. Your patients may consider having a professional check the HVAC system and walk them through these features.

During smoky periods, upgrading to an HVAC filter rated MERV 13 or higher is recommended to effectively remove fine particle pollution from smoke in the indoor air. Most furnaces and HVAC systems can accommodate a MERV 13 filter without creating equipment problems, provided the filter is replaced frequently. A professional HVAC technician can determine the most efficient filter that a system can use. In some cases, they may be able to modify the system to use a higher efficiency filter. The filter should fit correctly in the filter slot and be replaced when it appears dirty (dark brown or black), which may be more often than recommended by the manufacturer. Patients should keep extra filters on hand. EPA’s Guide to Air Cleaners in the Home provides more information about air filters and air cleaners.

Consider buying a portable air cleaner or building a DIY air cleaner: Portable air cleaners are self-contained air filtration appliances that can be used alone or with enhanced central air filtration to effectively remove particles. Securing an air cleaner before a smoke event occurs is particularly important for patients in at-risk groups.

Advise patients to choose a portable air cleaner with a HEPA filter that is the right size device for the room. Air cleaners are often labeled with a recommended room size or a Clean Air Delivery Rate (CADR). For wildfire smoke, the air cleaner should have a tobacco smoke CADR at least 2/3 the room’s area in square feet. For example, a 10’ x 12’ room (120 sq. ft.) would require an air cleaner with a tobacco smoke CADR of at least 80. If the ceiling is higher than 8’, an air cleaner rated for a larger room (i.e., with a higher CADR) will be needed. Patients who frequently experience heavy smoke may also want to purchase a larger air cleaner. For example, the Association of Home Appliance Manufacturers recommends choosing an air cleaner with a CADR equal to the room area in square feet.

Patients should ensure that the air cleaner they choose does not produce ozone, which can cause health problems, including coughing, breathing difficulty and lung damage. The California Air Resources Board maintains a list of air cleaners that have been tested and shown to emit little or no ozone. Patients may also want to consider factors that may affect how often they use the device, such as noise and the cost of replacement filters. Patients should keep extra filters on hand, because they may need to be replaced more frequently during a smoke event. Patients can also find and compare Energy Star Certified Room Air Cleaners online.

If commercial air cleaners are not available or affordable, patients can build DIY air cleaners. They are less expensive than portable air cleaners and can also reduce indoor smoke exposure. See EPA’s DIY Air Cleaner to Reduce Wildfire Smoke Indoors infographics for directions on how to build one.

Consider purchasing N95® respirators: Patients should consider having a supply of NIOSH Approved® respirators on hand and should know how to use them.

Protect pets: Your patients can reduce pets’ exposure to smoke by planning for them as well. See the Wildfire Guide fact sheet Protect Your Pets from Wildfire Smoke (pdf) (369 kb).

Prepare for co-exposure to heat: It is important to plan to reduce co-exposure to smoke and heat. Offer this advice to patients: 

• Keep an eye on weather forecasts and heat advisory information. 
• Check with your state, local or Tribal government to find out whether there are cleaner air and cooling shelters available in your community. Your patients can also call 2-1-1 for referrals to local cooling centers or see the National Center for Healthy Housing Cooling Centers by State website for more information. 
• Use the information in the Protect Yourself from Smoke and Extreme Heat fact sheet to prepare.

Make an evacuation/relocation plan: Patients in at-risk groups should plan for where they might stay if smoke and heat levels become high and are predicted to remain high.

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