Where there’s Fire, there’s Smoke: Poor air quality, smoke and asthma treatment


The ongoing wildfire season has reached unprecedented levels, surpassing previous records for the size of the affected area. The impact of these fires extends far beyond the immediate vicinity of the flames. The smoke produced by these wildfires travels great distances, affecting the air quality in regions across both Canada and the United States.

Predictably, children with asthma will be showing up in emergency rooms and urgent care centers to get breathing treatments for their increased wheezing. And three weeks later there will be an increase in cases of pneumonia and lower respiratory tract infections*.

Smoke and Asthma Treatment

Let’s address why humans wheeze in the first place. Wheezing is an adaptive, protective mechanism. It’s a cool feature of the human body. When we encounter something toxic in the air (historically, most often smoke from fires, but now also toxic fumes from chemicals) the muscles around breathing tubes tighten to decrease airflow to the delicate tissues of the lung. Mucus production in the breathing tubes increases to trap particles on the way in. The lining becomes inflamed to destroy those particles. All of this combines to narrow the caliber of the breathing tubes and create the wheezing sound you hear.

Normal wheezing protects the lungs. Asthma is what we call it when people wheeze repeatedly when they don’t need to for protection.

When the smoke arrives, many kids with asthma will be getting extra breathing treatments to open up their lungs, according to the guidelines. But it’s great to avoid that if practical!

Treating Kids with Asthma Exposed to Poor Air Quality

Wouldn’t it be better if kids with asthma avoided exposure?

  • Stay home from school while the air quality was at its worst
  • Stay indoors with an air filter on if possible.
  • Don’t exercise during brief episodes of poor air quality
  • Enjoy a game or movie day instead (and, of course, keep up with homework!)

I’ve seen it work. We protected kids’ lungs from increased exposure to harsh toxins and none of them needed extra breathing treatments. And they weren’t part of the observed spike in infections afterward.

Simple and powerful. Working with the body, not against it.

References and Resources

Short-term Elevation of Fine Particulate Matter Air Pollution and Acute Lower Respiratory Infection. Horne BD, et al. Am J Respir Crit Care Med. 2018 Apr 13. — Link accessed Feb. 1, 2019

*Each short-term increase of 10 micrograms per cubic meter in PM2.5 is associated with a 15 to 23 percent increase in serious respiratory infections

There is another way.

Photo credit: Luke Flynt from Unsplash

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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