surviving smoke season

It’s super weird to write about wildfire smoke in the second half of October. It’s even weirder to need to write about wildfire smoke in the second half of October.

Hopefully, the fall rains will have truly begun by the time you read this. But as I write, the smoke levels in much of Western Oregon and Washington have gotten grim, even in places like Portland and Seattle that rarely see the worst wildfire impacts.

what’s in the air

Air quality indices (AQI) consider different pollutants. Right now the concern is small particulates — small ashy bits of former forest — and numbers are off the charts.

The US Environmental Protection Agency considers levels of small particulates (PM2.5) below 50 to be healthy. They recommend caution for sensitive folks up to 150. Between 150 and 200, even healthy people may notice symptoms. Above 200 the risk is high for everyone. The scale tops out at 300.

Portland's air quality 10/20/2022

Portland’s air quality 10/20/2022

For context, folks near the epicenters of this year’s biggest fires have lived with hazardous smoke conditions for up to 45 days — but the Cedar Creek fire has been blowing smoke at Oakridge, Oregon, for more than 2.5 months. Their air-quality-index numbers this summer have not gone below 300 during that time, routinely spiking into the 700s or even 1200s.

As I write, Oakridge’s AQI is 777. Portland is 198. Seattle is 245. According to IQAir, which monitors air quality around the world and also sells air purifiers, Seattle and Portland take the two top spots for worst air quality in the world. Even Beijing is better than we are. (Small towns in the wildfire zone are too small to make the list.)

You should care about this even if you live far away. In July 2021, New York City saw its worst air quality in years because of Oregon wildfire smoke. Folks in Indiana were warned to limit time outdoors because of it. (See reports at CNN, Bloomberg and the New York Times.)

That was in July — typical wildfire season, even if the fires were atypically large.

Welcome to October, 2022, where it’s unsafe to breathe outdoors along much of the Pacific Northwest Coast. (Even my old hometown of Newport on the Oregon Coast got into the action, seeing air quality in the moderately unhealthy range.)

PNW AQI map 10/20/2022

The PNW smoke zone, Oct. 20, 2022

wildfire smoke and your health

No amount of smoke is healthy for us. When the air is so thick that we get air-quality warnings —  you can’t check the weather without being notified right now — it’s absolutely smart to pay attention.

Wildfire smoke contains both small and large particulates, but also other harmful gases and substances such as ozone, nitric oxide, polyaromatic hydrocarbons, aldehydes and metals. Some of these are known to cause cancer.

Our lungs are super clever with larger particles. The lungs’ interior surfaces are lined with mucus and little hairs called cilia. When we inhale particulates, they stick on the snot and get waved upwards on the hairs until we can cough or spit them out. (This process has a geek-cool name, too: the mucociliary escalator!)

The smallest particles in wildfire smoke float past these defenses to lodge deeply in our lungs, cause inflammation and can migrate elsewhere in the body to do more damage.

smoke hurts more than just your lungs

We’ve long known that respiratory diseases spike after smoke exposure. But researchers are also finding wildlfire smoke harms our hearts, as well. A 2021 study suggests smoke (including particulates, gases and other compounds) turns on our fight-or flight response, increases risk of blood clots and inflames our blood vessels. Our hearts speed up, blood flow to the heart goes down, and our bodies go on high alert.

Wildfire smoke exposure also impairs the immune system — with risks potentially persisting permanently.

As if that weren’t enough, new research shows that big wildfires may spread diseases, too. When a wildfire really rages, it stirs up soils that can harbor regional pathogenic fungi. Those, in turn, waft upwards and may drift long distances with the smoke. As massive wildfires become the norm, we can expect to see the spread of diseases like Valley fever, historically limited the southwestern US and much of California.

If you find all of this depressing, it’s not just in your mind. Those small particulates that get past the lungs? They also can inflame your brain, causing neurological problems, depression and more.

protect yourself from wildfire smoke

So what’s to be done? The answers are both individual and systemic.

keep an eye on your air quality

I look at several sites because numbers vary.

reduce your exposure

  • Stay inside as much as possible.
  • Tighten up your living space: close windows and doors.
  • Buy or make an air purifier (Here’s my review of some top options, or build an effective DIY model.)
  • Use a MERV-13 filter in your furnace. (This can help lower viral counts, too.)
  • Outdoors, wear an N95 mask or better. Cloth and surgical masks do not protect against smoke.
  • Avoid outdoor exercise. If your home is smoky, reduce it indoors, as well.
  • Humidity catches particulates and drops them out of the air. This is a great time for a long shower and lots of tea.

wildfire smoke survival strategies videos from 2020:

systemic change is also required

Getting my patients healthy requires addressing root causes of disease. The same is true of the systems in which we live. What can we do to help change the conditions that lead to these problems in the first place?

getting forests healthy

Western forests evolved with fire, and require it to regenerate and stay healthy. As dramatic as these large fires are, they don’t destroy the forest. Natural fires burn in a “mosaic” pattern, with portions left nearly untouched. The areas that do burn hard aren’t lost, they’ve just shifted to start the growth cycle again. It’s still a forest, just a different stage of the forest.

This spring I got to drive through some of the big burn areas from 2020. The ground was full of flowers and baby trees were coming back. As a bioregional herbalist, some of the plants I depend on for medicine come in after fires to gather sun, fix nitrogen and prepare the land for the returning trees.

Fireweed blooming two years after major wildfires.

Fireweed blooming two years after major fires.

Still, the frequency and extent of fires have underlying human causes. Forest management and people moving to the edge of the woods have led to decades of fire suppression. So instead of smaller, frequent burns, we boost the odds of these catastrophic ones.

Native Americans burned areas intentionally, often at the wetter times of the year when fires are easier to control. Some foresters and firefighters are advocating for a return to those practices (known as “prescribed burns”) to help address the unburned backlog and keep our forests healthy. Learn more at Firefighters United for Safety, Ethics & Ecology.

it’s the climate

And global warming also is a factor. The hottest U.S. summer on record was 2021. The second hottest was during the Dust Bowl in 1936. This summer, 2022, came in third place. And yes, it’s worsened by human-caused climate change.

What to do systemically about climate change is a huge topic. But here’s the short version for this moment:

Stay safe, y’all.

—Dr. Orna


P.S. Need personalized help dealing with the smoky season? Book an appointment here.