Wildfire smoke has socked in Puget Sound this week. Low visibility isn't the worse issue. Some may feel adverse health effects.

The American Lung Association says smoky air can indeed make you sick.

"It is very, very dangerous for anybody who has lung health issues, asthma specifically," said Allison Hickey, American Lung Association's Executive Vice President of the Mountain Pacific Region. "The particulate count that we are experiencing right now is a very, very small particulate. It actually gets through all of your normal defense systems as you are breathing, and it goes directly into your lungs. If it is small enough, it can actually go into your bloodstream as well."

Hickey said it can cause headaches, nausea, and coughing. For those with existing health problems, it can be even worse.

"We are damaging our lungs is what's happening," said Hickey. "This is really serious air quality that we have going on right now. It is deadly. So the worst thing you can do is be outside, especially exercising."

When the air quality is unhealthy, the American Lung Association recommends staying inside with doors and windows closed.

The Washington State Department of Health posted the following information online:

What health problems can smoke cause?

  • Eye, nose, and throat irritation (burning eyes and runny nose)
  • Wheezing, coughing, shortness of breath, and headache
  • Aggravation of existing lung, heart and circulatory conditions, including asthma and angina

Who is especially sensitive to smoke?

Inhaling smoke is not good for anyone, even healthy people. People most likely to have health problems from breathing smoke include:

  • People with lung diseases such as asthma or chronic obstructive pulmonary disease (COPD), including bronchitis and emphysema.
  • People with respiratory infections, such as pneumonia, acute bronchitis, bronchiolitis, colds, or flu.
  • People with existing heart or circulatory problems, such as dysrhythmias, congestive heart failure, coronary artery disease, and angina.
  • People with a prior history of heart attack or stroke.
  • Infants and children under 18 because their lungs and airways are still developing and they breathe more air per pound of body weight than adults.
  • Older adults (over age 65) because they are more likely to have unrecognized heart or lung diseases.
  • Pregnant women because both the mother and fetus are at increased risk of health effects.
  • People who smoke because they are more likely to already have lower lung function and lung diseases.
  • People with diabetes because they are more likely to have an undiagnosed cardiovascular disease.
  • For more information, visit the DOH Smoke From Fires Toolkit.

How can I tell if smoke is affecting my family?

  • Smoke can cause coughing, scratchy throat, irritated sinuses, shortness of breath, chest pain, headaches, stinging eyes, and runny nose.
  • If you have heart or lung disease, smoke might make your symptoms worse.
  • People who have heart disease might experience chest pain, a rapid or irregular heartbeat, shortness of breath, and fatigue.
  • If you have a pre-existing respiratory condition such as asthma, COPD (including chronic bronchitis and emphysema), or allergies, smoke may worsen symptoms (inability to breathe normally, cough with or without mucus, chest discomfort, wheezing, and shortness of breath).
  • When smoke levels are high, even healthy people can have symptoms or health problems.

Contact your health care provider if you have heart or lung problems when around smoke. Dial 911 for emergency assistance if symptoms are serious.

What can I do to protect myself and my family from outdoor smoke?

  • Check local air quality reports and listen to news or health warnings for your community.
  • Avoid physical exertion outdoors if smoke is in the air.
  • If you have asthma or other lung diseases, make sure you follow your doctor's directions about taking your medicines and follow your asthma management plan. Call your health care provider if your symptoms worsen.
  • Stay indoors and keep indoor air as clean as possible. Take the following steps when indoors:
    • Keep windows and doors closed. Track the air quality and open your windows for fresh air when the air quality improves. Pay attention to the heat indoors and follow guidance in the section below if it's too hot.
    • Run an air conditioner, set it to re-circulate and close the fresh-air intake. Make sure to change the filter regularly.
    • Use an air cleaner with a high-efficiency particulate air (HEPA) filter to reduce indoor air pollution. A HEPA filter will reduce the number of irritating fine particles in indoor air. A HEPA filter with charcoal will help remove some of the gases from the smoke. Do not use an air cleaner that produces ozone. See California's air cleaning devices for the home fact sheet (PDF).
    • Don't add to indoor pollution. Don't use food boilers, candles, incense, fireplaces, or gas stoves. Don't vacuum unless your vacuum has a HEPA filter, because vacuuming stirs up particles already inside your home. Don't smoke, because smoking puts even more pollution into the air.
    • Consider leaving the area if the air quality is poor and it's not possible to keep indoor air clean, especially if you or those you are caring for are having health problems or are in a sensitive group. See section above titled, who is especially sensitive to smoke.
    • For more information about keeping indoor air free of smoke: Improving Ventilation and Indoor Air Quality during Wildfire Smoke Events (PDF).

What if I don't have air conditioning and it's hot indoors?

Even when the air quality is poor, it's always important to pay attention to the heat and stay hydrated-overheating is dangerous. If it's too hot indoors to keep your windows and doors closed, first consider leaving the area or going to an indoor place with air conditioning, like a friend or relative's home. If it's hot indoors during poor air quality, these steps can reduce the heat:

  • Close curtains to reduce heat gain during the hottest part of the day.
  • Use fans to circulate the air.

Should I use a face mask when there is outdoor smoke?

If you cannot leave the smoky area or find other ways to reduce your exposure, certain types of face masks can provide some protection. Respirator masks labeled N95 or N100 filter out fine particles but not hazardous gases (such as carbon monoxide). These masks can be found at many hardware and home repair stores and pharmacies. Face masks will not work for everyone.

  • Masks do not work on people with beards because they do not seal well enough to provide protection.
  • Masks are not currently approved for infants or small children.
  • Anyone with lung disease, heart disease, or who is chronically ill should consult a health care provider before using a mask. Wearing a mask makes it more difficult to breathe, which may worsen existing medical conditions.
  • More information

Can I use an air filter in my home to improve indoor air quality?

Some room air cleaners can reduce indoor air pollution if they have the proper filter. The most effective air cleaners have a HEPA filter. HEPA filters can reduce the smoke particulates in indoor air. HEPA filters with charcoal can also remove or reduce the amount of some other harmful gases from indoor air. These air cleaners should be used in the room where you spend most of your time, which is often a bedroom.

Should I exercise when it's smoky?

Exercise is very important for health. When you exercise your air intake is increased, which means inhaling more pollution when the air quality is bad.

  • Avoid outdoor exercise when air quality is in the Unhealthy, Very Unhealthy, or Hazardous categories.
  • When the air quality is in the Very Unhealthy or Hazardous categories, consider the indoor air quality and consider limiting indoor exercise.

If you are sensitive to smoke, you should limit your activities when air quality is in the Unhealthy for Sensitive Groups category. People with asthma and lung and heart conditions may be very sensitive to poor air quality and may start to have symptoms when air quality is in the Moderate category and they should consider reducing indoor and outdoor activities.

What should I do if I have to drive when it's smoky?

Avoid driving, when possible. If you must drive, keep the windows closed. Use the air conditioner. Most vehicles can re-circulate the inside air which will help keep particle levels lower, however carbon dioxide levels can build up and cause sleepiness. You may have to open the vents periodically. Maintain your car intake filters.

What can schools do to protect students during smoky conditions?