Billowing smoke and particulate matter spreading south from the wildfires scorching Canada are creating dangerous air quality across the eastern United States.

An estimated 98 million Americans from New Hampshire to South Carolina were under air quality alerts Wednesday, and health experts urge caution in the days ahead.

Wildfire smoke is estimated to be 10 times more toxic than pollution from burnt fossil fuels, said Dr. Lisa Patel, a physician based in California.


Chart by Vanessa Dennis/PBS NewsHour

Under Red and Orange alerts for unhealthy air quality, remaining outdoors could cause negative health effects, and “activate and aggravate pre-existing conditions,” said Dr. Comilla Sasson, an emergency medicine physician and a vice president for science and innovation at the American Heart Association.

People should avoid strenuous outdoor activities, reduce what time is spent outdoors or reschedule activities for a future date when it is less hazardous to breathe outdoor air. Continue to check your local air quality index. If your eyes are burning or it hurts to breathe, “this is a good reminder that it is probably best to head indoors.”


Chart by Vanessa Dennis/PBS NewsHour

Smoke is a “big irritant to the lungs,” explained Dr. Juanita Mora, an allergist and immunologist who also serves as a spokesperson for the American Lung Association. The fine particulate matter that makes up wildfire smoke can measure only a third of the diameter of a single strand of hair, Mora said, making it easy for those tiny particles to enter the smallest airways in people’s lungs.

In places where people are experiencing Red or Orange alerts, Mora said, “it’s like smoking eight-to-10 cigarettes at once – that’s how bad it is.”


Chart by Vanessa Dennis/PBS NewsHour

For young children, older adults and people with respiratory conditions, these fires are especially dangerous. The air pollution they cause can trigger asthma attacks, empty playgrounds, fill hospital emergency rooms and make it difficult for people to breathe and go about daily life.

Children under age 5 are especially vulnerable to the harmful effects of wildfire smoke, said Patel, who serves on the American Academy of Pediatrics Council on Environmental Health and Climate Change executive committee. That is because their young lungs are developing rapidly, plus they often play outdoors or participate in outdoor activities, like T-ball or soccer.

“Pound for pound, they’re breathing in more of that pollution than an adult would be,” Patel said.


Chart by Travis Daub/PBS NewsHour

If you must go outside, health experts advise you to wear a mask and limit your outdoor time as much as possible. An N95 for adults or KN95 for children works best, but a well-fitted surgical mask can work if no other options are available, Patel said. While surgical masks don’t offer the best protection, Patel said, “Something is better than nothing.”

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