Smoke and Air Pollution — How to Stay Healthy This Summer

Smoke from Canadian wildfires, combined with elevated ozone levels, has led to poor air quality across Minnesota. CentraCare Pulmonary and Critical Care physicians Ramakanth Pata, MD, and Timothy Ehle, MD, are sharing what people should know to protect themselves and their families this summer.

Many people are wondering if it's safe to be active outside. According to Dr. Ehle, the answer depends on the current Air Quality Index (AQI), which ranges from good to hazardous.

You can monitor your local AQI using the Air Quality section of most weather apps or by visiting www.AirNow.gov and entering your ZIP code. A green reading below 50 indicates good air quality, while readings above 150 are considered unhealthy.

"It is important to remember that inhaling fine particulate matter (PM2.5), such as ozone pollutants and particulate matter during wildfires, worsens symptoms associated with chronic health conditions," said Dr. Pata. "While exercise is generally encouraged, avoid outdoor activities when the Air Quality Index exceeds 150 and minimize outdoor activity when the AQI exceeds 100. Consider shifting workouts indoors during pollution events or rescheduling outdoor activities to times when the AQI is lower, which is often early in the morning."

While anyone can experience symptoms from poor air quality, some people are more vulnerable than others.

"Children, older adults, pregnant women, and people with lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, bronchitis, bronchiectasis and pulmonary fibrosis are especially susceptible to both ozone and particulate matter," Dr. Pata said. "There are also people who are very sensitive, even when the AQI is below 100."

Most healthy individuals may only experience mild, short-term symptoms such as itchy or red eyes, nasal congestion, post-nasal drainage, cough, sore throat and headaches. However, those in high-risk groups could experience much more serious complications.

"It's possible they could experience a significant worsening in their chronic diseases, such as an acute asthma or COPD exacerbation," Dr. Ehle explained. "Some people may be more prone to developing symptoms than others. In severe cases, this may become life-threatening and even require a breathing tube. Poor air quality may also increase the risk of pneumonia by damaging the lungs' natural defenses against infection."

Repeated or prolonged exposure to poor air quality can also have lasting health effects. Sensitive individuals may develop inflammation of the lungs, known as pneumonitis, which can lead to scarring. Long-term exposure has also been associated with new-onset asthma, a faster decline in lung function, irregular heart rhythms and an increased risk of heart attacks. Wildfire smoke exposure during pregnancy may also increase the risk of preterm birth and lower birth weight with prolonged exposure.

"Hopefully, the wildfire smoke exposure in Minnesota is temporary," Dr. Ehle said. "However, climate change is increasing the frequency and severity of wildfires, so this may be something we have to get used to."

Protecting Yourself During Poor Air Quality

Creating a cleaner indoor environment is one of the best ways to reduce exposure when air quality worsens.

"When the AQI exceeds 150, keep windows and doors closed and run a portable air cleaner with a HEPA filter if possible," Dr. Pata said. "If you have central air conditioning, set it to recirculate mode and install a high-efficiency filter, such as MERV 13 or higher, to help prevent outside smoke from entering your home."

Dr. Pata also recommends reducing activities that can worsen indoor air pollution while outdoor air quality is poor, including burning candles, frying foods, using gas stoves without proper ventilation and vacuuming unless using a HEPA-equipped vacuum.

For people who work outdoors or cannot avoid being outside, planning ahead is important.

"Employers have a responsibility to provide a safe working environment," Dr. Pata said. "Take breaks, especially in an air-conditioned area where the air is cleaner."

When outdoor activity cannot be avoided, wearing the right respiratory protection matters.

"Cloth masks and surgical masks offer very little protection against the fine particulate matter found in wildfire smoke," Dr. Pata said. "If outdoor activity cannot be avoided during wildfire smoke events, sensitive individuals, including those with asthma, COPD, bronchiectasis and pulmonary fibrosis, should wear a tightly fitted, NIOSH-approved N95 or P100 respirator."

Dr. Ehle noted that respirators are only effective when they fit properly.

"These respirators only work well when the fit is good," he said. "In the hospital, we are fit-tested to ensure a proper seal. Commercial N95 respirators are unlikely to provide the same fit and, as a result, may be less effective at filtering fine particulate matter."