United States
Environmental Protection
m m Pediatric Environmental
American Academy
of Pediatrics

Health Specialty Units
Protecting Children from Wildfire
Smoke and Ash
•	Children are especially at risk for health effects
from exposure to wildfire smoke and ash,
mostly because their lungs are still growing.
•	Wildfire concerns include the fire itself, the
smoke and ash, and the chemicals from
materials that have burned, such as furniture.
•	Smoke can travel hundreds of miles from the
source of a fire. Pay attention to local air
quality reports during fire season, even if no
fire is nearby.
Health Effects from Wildfire
Smoke and Ash
•	Children who breathe in wildfire smoke and ash
can have chest pain and tightness; trouble
breathing; wheezing; coughing; nose, throat,
and eye burning; dizziness; or other symptoms.
•	Children with asthma, allergies, or chronic health
issues may have more trouble breathing when
smoke or ash is present.
Preparing for Wildfires
•	Pay attention to local air quality reports. Stay
alert to smoke-related news coverage and
public health advisories.
•	Look up your local Air Quality Index (AQI) on the
AirNow (www.airnow.gov) web site.
•	If Enviroflash is available for your area, sign up
for air quality alerts.
•	Create a "clean room" in your home. Choose a
room with few windows and doors. Buy a
portable air cleaner you can use in this room.
Never use an ozone-generating air cleaner.
•	Stock up on food, medicine and child care
supplies before the threat of a wildfire.
•	Remember that you may need to leave your
home. Plan for it and prepare your children.
During Wildfires
•	Continue to listen to local reports and public
health warnings.
•	Keep children indoors with the doors and
windows closed. Use your "clean room". If you
have an air conditioner, run it with the fresh-
air intake closed to keep outdoor smoke from
getting indoors. Use your portable air cleaner
as well. Reduce health risks by avoiding
strenuous activities.
•	Keep the indoor air as clean as possible. Do not
smoke. Do not use gas, propane, or wood-
burning stoves, fireplaces, or candles. Never
use ozone-generating air cleaners. Never use
natural gas or gasoline-powered generators
indoors. Do not use spray cans. Do not fry or
broil meat. Do not vacuum. All of these can
lead to poor air quality.
•	A good time to open windows to air out the
house and clean away dust indoors is once air
quality improves (check AirNow for updates).
•	Use common sense to guide your child's activity.
If it looks or smells smoky outside, if local air
quality is reported as poor, or if local officials
are giving health warnings, wait until air
quality improves before your family is active

Special considerations:
•	If your child has any problem breathing, is very
sleepy, refuses food and water, or other health
concerns, reduce his/her exposure to smoke
and seek medical help right away.
•	If your child has asthma, allergies, or a chronic
health condition, he/she is at high risk from
health effects related to wildfire smoke and
ash. Seek medical advice as needed. For
children with asthma, follow the asthma action
•	Do not rely on masks for protection from smoke.
Paint, dust and surgical masks, even N95
masks, are not made to fit children and will not
protect children from breathing wildfire
smoke. Humidifiers or breathing through a wet
washcloth do not prevent breathing in smoke.
• Seek shelter in another place (e.g., public air
shelter) if your family does not have an air
conditioner OR air cleaner OR if it is too warm
in your home to stay inside with the windows
closed. Plan to take the quickest route to the
shelter to limit exposure to smoke.
•	Bring all medication (taken by each family
member) with you.
•	Reduce smoke in your vehicle by closing the
windows and vents and operating the air
conditioning with the fresh intake closed to
keep outdoor smoke from getting into car.
Never leave children in a car or truck alone.
After a Wildfire
•	Make sure ash and debris have been removed
before bringing your child back to home or
•	Children should not be doing any cleanup work.
Fires may deposit large amounts of ash and
dust with harmful chemicals.
Avoid bringing polluted ash and dust back to
areas used by children (such as a home or car).
Remove shoes at the doorway, wash clothing
separately, and change out of clothing before
you have contact with your children.
For more information:
Learn more about wildfire smoke: Wildfire Smoke, A Guide for Public Health Officials:
https://www3.epa.qov/airnow/wildfire mav2016.pdf
Get air quality information: Check the airnow.gov website, or your state air quality agency's website.
Air Quality Flag Program: This visual tool alerts schools and organizations and their communities to the
local air quality forecast, https://airnow.gov/flaq
Learn about home air cleaners: https://www.epa.gov/indoor-air-guality-iag/guide-air-cleaners-home
Find certified air cleaning devices: http://www.arb.ca.gov/research/indoor/aircleaners/certified.htm
Contact Poison Control at 1-800-222-1222 for emergency concerns regarding ingestion or exposure to
Contact your Pediatric Environmental Health Specialty Unit with children's environmental health
questions: www.pehsu.net
Document Authored by Marissa Hauptman, MD, MPH, Laura Anderko, PhD, RN, Jason Sacks, MPH, Lora Strine, Scott Damon MAIA, Susan Stone, MS,
Wayne Cascio, MD, Martha Berger, MPA. Aspects of this fact sheet were adapted from 2011 PEHSU Factsheet: Health Risks of Wildfires for Children -
Acute Phase Guidance by James M. Seltzer, M.D., Mark Miller, M.D., M.P.H, and Diane Seltzer, M.A.—Region 9 Western States Pediatric
Environmental Health Specialty Unit.
This document was supported in part by the American Academy of Pediatrics and the American College of Medical Toxicology and funded (in part) by
the cooperative agreement award number FAIN: U61TS000237 and UG1TS000238 from the Agency for Toxic Substances Disease Registry (ATSDR). The
U.S. EPA supports the PEHSU by providing funds to ATSDR under Inter-Agency Agreement number DW-75-92301301. Neither U.S. EPA not ATSDR
endorses the purchase of any commercial products or services mentioned in PEHSU publications.
This factsheet is dedicated in memory of Dr. James M. Seltzer as well as the first responders and others who have been affected by wildfires.
y|| U.S. Environmental Protection Agency • EPA- 452/F-18-006