The Health Effects of Wildfire Smoke

How do wildfires start?

Wildfires are unplanned, uncontrolled fires that burn in forests, grasslands, and other natural areas. They can be sparked by natural causes, such as lightning strikes, or human activities, including unattended campfires, discarded cigarettes, and downed power lines. Once ignited, these fires can rapidly spread under dry conditions, high temperatures, and strong winds, releasing air pollutants into the atmosphere.

Wildfire smoke and emissions contribute significantly to air pollution and poor air quality, which can have far-reaching consequences. Wildfires release tiny particles and other dangerous air pollutants into the atmosphere, increasing the exposure of affected communities to wildfire smoke. Understanding how wildfires start is an essential aspect of environmental health sciences since these occurrences are directly associated with poor outcomes in lung illness, chronic obstructive pulmonary disease, cardiovascular disease, and general public health.

The 2025 California wildfires

In January 2025, California witnessed terrible wildfires, most notably the Palisades and Eaton fires, which destroyed over 12,000 structures and killed at least 25 people. The widespread smoke from these fires dramatically reduced outdoor air quality, increasing exposure to fine particles and other air pollutants. This decline posed serious health hazards, especially for people who had pre-existing diseases, including chronic obstructive pulmonary disease (COPD), lung disease, or cardiovascular disease.

Due to high patient volumes, healthcare facilities experienced extraordinary challenges, including clinic closures, treatment delays, and hospital overcrowding. Road closures and power outages also hindered patient transportation and medical equipment functioning, hampering disease control efforts and affecting public health.

David Lynch, a well-known director, was one of those affected by the wildfires. Lynch, a lifetime smoker, was diagnosed with COPD (emphysema) in 2020. He was forced to evacuate his Los Angeles house in January 2025 due to raging flames. The stress and increased exposure to bad air quality most certainly exacerbated his condition, resulting in his death from cardiac arrest on January 16, 2025.

This incidence highlights the increased risk for older persons and those with underlying health conditions during environmental crises, emphasizing the importance of effective public health initiatives and environmental health sciences interventions to mitigate these risks.

Wildfire smoke health effects (long term)

Long-term exposure to wildfire smoke can lead to a wide range of chronic health impacts that affect multiple systems in the body, especially in sensitive groups and individuals with pre-existing health conditions. Here are five long-term health effects of wildfire smoke exposure:

Impaired respiratory function

Prolonged exposure to wildfire smoke impairs lung function and raises the chance of acquiring chronic respiratory diseases. Fine particles and other air pollutants in smoke, such as particulate matter, sulfur dioxide, nitrogen dioxide, and polycyclic aromatic hydrocarbons, can travel deep into the respiratory tract, worsening asthma and other lung illnesses.

This is especially concerning for people with chronic obstructive pulmonary disease (COPD) and those who already have breathing problems or extreme exhaustion.

Increased risk of cardiovascular disease

Long-term exposure to wildfire smoke has been associated with harmful cardiovascular effects such as heart disease, heart failure, and premature death. Air pollution, particularly fine particulate matter and carbon monoxide, can cause systemic inflammation and oxidative stress, putting older persons and those with chronic heart disease at greater risk.

Healthcare providers should be aware of an increase in emergency room visits for chest discomfort, arrhythmias, and stroke during periods of prolonged smoke exposure.

Worsening mental health

The psychological toll of recurring wildfire incidents can result in persistent stress, anxiety, and depression, especially among relocated people or those with poor socio-economic positions. Reduced physical activity as a result of poor air quality and fear of smoke inhalation may have a negative influence on mental health.

These variables exacerbate long-term public health concerns, particularly when environmental health sciences and public health interventions are underfunded or reactive rather than proactive.

Chronic inflammation and weakened immune system

Persistent exposure to wildfire smoke can cause chronic inflammation, impairing the immune system's ability to respond effectively to infections and injuries. Fine particulate matter and other air pollutants have been demonstrated to influence cytokine expression and immunological modulation, particularly in vulnerable populations.

Long-term implications may include increased susceptibility to autoimmune diseases and slower recovery from respiratory infections.

Health system burden and disease control challenges

From a public health perspective, recurring wildfire seasons create sustained pressure on healthcare systems. Increased emergency room visits, hospital admissions, and the need for specialized respiratory care can overwhelm facilities, particularly in rural or under-resourced areas.

How are wildfire smoke health effects treated?

Effective treatment of wildfire smoke health effects involves clinical management, environmental interventions, and public health strategies tailored to reduce exposure and mitigate long-term consequences. Here are some of them:

Respiratory symptom management

Healthcare providers frequently utilize bronchodilators, corticosteroids, and supplemental oxygen to treat respiratory symptoms induced by wildfire smoke exposure, such as asthma attacks, trouble breathing, and COPD exacerbations. Individuals with pre-existing health issues, such as other lung disorders, are more likely to experience negative side effects and must be closely monitored.

For sensitive groups, including older adults and pregnant women, clinicians should focus on symptom control, pulmonary function assessments, and exposure assessment to prevent complications from particulate matter and fine particle pollution.

Cardiovascular disease monitoring and support

Wildfire smoke can worsen heart disease and chronic heart conditions through inflammation triggered by carbon monoxide and other air pollutants. Patients may require medication adjustments, increased monitoring for arrhythmias, and rapid intervention during emergency room visits related to heart failure or chest pain.

Long-term exposure to ambient air pollution and fine particulate matter is also associated with an increased risk of cardiovascular events, especially in populations with poor underlying health status and limited access to care.

Indoor air quality improvements

Improving interior environments is an essential aspect of reducing smoke exposure. Public health interventions stress using air conditioning and high-efficiency particulate air (HEPA) filters to reduce indoor air pollution.  Individuals, particularly those in at-risk groups, should stay indoors, use the air quality index to check current air quality, and limit physical activity during wildfire events when forest fires and burning trees harm outdoor air quality.

Addressing mental health impacts

Extended exposure to wildfire smoke and the associated displacement, economic stress, and disruption can cause anxiety, depression, and post-traumatic stress. Mental health services, including counseling, stress management therapies, and community-based outreach, are critical for immediate alleviation and long-term resilience.

Mental health care should be included in disaster response plans, especially for people who have pre-existing mental health disorders, are low-income, or have been exposed to wildfires on multiple occasions.

Public health surveillance and outreach

Public health officials play an essential role in disease control by issuing air quality alerts, organizing emergency shelters with clean air spaces, and educating the general public on how to avoid exposure.  Outreach initiatives focus on vulnerable groups such as elderly people, pregnant women, and people with respiratory or cardiovascular diseases to reduce harmful health impacts.

Long-term surveillance also aids environmental health sciences specialists in investigating health implications, such as low birth weight and weight shifts.

Long-term health monitoring and research

Long-term exposure assessment is vital for understanding the effects of particle pollution and polycyclic aromatic hydrocarbons on the respiratory system and cardiovascular effects. Collaborative efforts between public health, clinical medicine, and environmental protection agencies are crucial to addressing these health risks amid increasing climate change and wildfire frequency.

Educating victims of wildfire smoke exposure

Healthcare professionals play an essential role in teaching patients about the possible consequences of wildfire smoke inhalation, particularly those who are deemed vulnerable, such as elderly adults, children, people with respiratory difficulties, and pregnant women. Education should be on recognizing early symptoms, comprehending the risks of chronic smoke inhalation, and planning for future instances.

Emphasizing personalized care is essential, particularly for patients with pre-existing conditions and those from lower socio-economic status communities who may lack access to protective resources.

To help patients prepare for wildfire events and protect their health, clinicians can:

• Encourage the use of clean air shelters or safe rooms during forest fires
• Recommend portable HEPA air purifiers for homes
• Educate on minimizing outdoor activities during high smoke days
• Help develop emergency kits with medications and asthma action plans
• Discuss the importance of maintaining a healthy body weight and respiratory fitness to reduce vulnerability
• Offer tailored guidance for pregnant people to mitigate risks to fetal health

By incorporating preparedness and prevention into routine health care, physicians can boost resilience and reduce the long-term effects of wildfire smoke exposure.