Children's Hospital Colorado

Wildfire Smoke and Kids: Health Effects

A boy coughs into his arm.

Fires may have been burning hundreds of miles away in California over the summer, but Coloradans paid a heavy price with their lungs. Smoke drifted east over the Rocky Mountains, creating hazy, smoggy conditions across the state. On several days, Denver had the worst air quality of any place in the world, according to IQAir.

“I’m unfortunately concerned that this is going to be a new normal,” says pediatric pulmonologist Heather Hoch De Keyser, MD. “Realistically, we have to find a balance between enjoying outdoor activities and keeping kids as safe as we can.”

What makes smoke so dangerous?

Children are not just small adults, De Keyser says. Kids breathe faster, tend to be more active outdoors and, proportionally, take in more air for their body size than their parents do. Plus, their lungs are developing, which means poor air quality can have a long-term impact on their growth. That’s a concern for all kids – not just those with underlying respiratory problems like asthma.

Wildfire smoke has the potential to be more hazardous than other kinds of smoke because of the particles of ash it carries, which can get into the small airways of kids’ lungs. Large fires can make the air smoky for days or even months on end. Plus, particulates tend to linger in the atmosphere, meaning the air could be dangerous even if it looks clear.

According to the Environmental Protection Agency, wildfire smoke can damage airways and make them susceptible to infection. Some people may experience headaches or sore, scratchy throats. High levels of ozone in the atmosphere can cause similar side effects.

Who gets symptoms from poor air quality and wildfire smoke?

Children don’t need to have asthma or an underlying respiratory issue to suffer from poor air quality, even when a wildfire is far away or the smoke is relatively less severe. Both children and adults can also be affected by ozone, the result of a chemical reaction that happens when sun and heat interact with air pollution like car exhaust. Ozone is the reason it tends to be hazy on hot, sunny summer days, and it can have just as much of an impact on air quality as wildfire smoke. Air quality gets especially bad when both are present.

Symptoms of poor air quality

Symptoms of poor air quality for kids and adults may include:

  • Burning eyes.
  • Cough.
  • Phlegm.
  • A runny nose.
  • Wheezing.

Wildfire smoke inhalation symptoms

Especially when children have an underlying condition or the wildfire is close by, parents should keep an eye out for these symptoms:

  • Increased coughing.
  • Wheezing and/or audible breathing sounds.
  • Decreased activity level.
  • Fatigue.
  • Change in color or pallor of skin.
  • Heavy, labored breathing.

Children who are having trouble breathing may breathe faster than usual. In smaller children, look for their ribs sucking in, which is known as retraction. For kids with asthma or other underlying respiratory issues, using rescue medications more than about every four hours is another sign.

What to do

Call 911 if you notice any significant changes to a child’s behavior, difficulty breathing or any change in their level of consciousness. If your child doesn’t seem to be having any trouble breathing but you’re still concerned, call your child’s care provider. Parents can also talk to a pediatric nurse Children’s Colorado’s ParentSmart Healthline at 720-777-0123, for free, anytime, 24/7.

Treating exposure to wildfire smoke and ozone

No over-the-counter medication will treat exposure to low-quality air. If you notice your child is affected, bring them inside and let them rest. Smoky air particles can cling to clothing, so change into something clean when you get indoors.

If a child gets soot in their eyes, or if they appear red and itchy, rinse them with water. Staying hydrated will keep the mucus in the lungs thinner as well, which makes it easier to clear.

Staying safe and staying active despite Colorado wildfire smoke

The easiest way to stay safe on days with poor air quality is to stay indoors. Limit your time outside and avoid strenuous physical activity. If you have to be outside, try to stick to early mornings and around sunset, when ozone levels are lower and air quality is better.

“Check air quality reports like you check the weather,” De Keyser says. “If the Air Quality Index (AQI) is above 100, that’s unhealthy for sensitive groups, including all children.”

An AQI above 150, she says, is a signal to take even greater protective measures like keeping doors and windows shut. That doesn’t mean families can’t keep moving though.

“There are ways to keep kids active and minimize risk,” De Keyser says. “Indoor scavenger hunts, obstacle courses and dance parties are all great ideas. So are indoor spaces with air conditioning, like museums.”

If your child has asthma

Wildfire smoke can prolong asthma attacks longer than normal, so it’s best to use rescue medications before leaving the house.

Finally, check in regularly with a pediatrician or lung specialist to ensure any underlying conditions are well controlled. People tend to relax their medication regimens in the summer, De Keyser says, but staying on a regular schedule can go a long way.


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