Wildfires continue to affect much of the West Coast, as we are all aware.  But what exactly is the health impact of these fires?  The biggest culprit – and the one on everyone’s mind – is the smoke and what it does to our air quality.  Portland, Oregon has had the worst air quality in the world this past week, clocking in at an Air Quality Index (AQI) of 516 on September 13, 2020.  The number looks huge, especially considering Oregon is usually home to some of the best air quality in the world with AQI numbers consistently in the lowest bracket possible, below 50.


Due to the smoke and hazardous air quality of the past few weeks, clinics across the state have seen large numbers of acute asthma and COPD (emphysema and chronic bronchitis) exacerbations.  Infants, the elderly, and pregnant women are also at increased risk when air quality gets to be 101-150 on the AQI, or the “Unhealthy for Sensitive Groups” range.  For pregnant women, unhealthy air quality – be in from air pollution or wildfire smoke – increases the risk of low birth weight, premature birth, and stillbirth.  It also increases the risk that the child will later have a learning disability or have respiratory complications in childhood.


Just how bad is an AQI of 500 for a pregnant woman?  I do not have an advanced degree in environmental science, so it was hard to grasp just how bad 500 is (well minus the dizzying smell, low grade headaches, sore throats, and burning eyes that patients have been reporting).  An AQI of 401-500 is equivalent to a PM2.5 of 350.5-500.  And smoking one cigarette a day approximates a PM2.5 of 22μg/m3.  This means an AQI of 500 is roughly equivalent to smoking a pack (20) of cigarettes a day.


So, if you are expecting, or are in another sensitive group: what can you do about these hazardous air quality levels?


  • You could try to find cleaner air. The AirNow app and the Weather app both list AQI for your location.


  • Stay inside. Let your pets out to do their business but Fido needs to forgo his walk for the time being. Rinse your pet off with water before bed to get the smoke of her fur. Try to keep doors closed as much as possible and definitely keep windows shut.


  • If you do need to go outside, wear an N-95 mask or a respirator that can filter out particulate matter such as a P100.  You can find these at hardware stores. Cloth or surgical masks will not filter out the hazardous smoke particles.


  • Use your central air, mini split, or air conditioning unit all day and night.  These units recirculate air and have filters.


  • Run your HEPA filter if you have one.  If you do not own one, you can tape a 20 x 20 furnace filter to the back of a box fan.  Point the air flow arrows to the front and run it 24 hours a day and continue to run it long after the smoke clears outside – as there are still likely many particles floating around your house. You will need a MERV rating of at least 13 to filter smoke particles.


  • Wash your face and rinse your hair and body before bed.


  • Change sheets, pillowcases, and blankets twice weekly.


  • And my favorite tip: avoid vacuuming as it will stir up particles that have already settled.


If you have asthma or other underlying health conditions, and would like to discuss an integrative approach to protecting yourself and your lungs during this time, please call 503-222-2322 to schedule with Rachel Surprenant, ND or any of the other wonderful providers at A Woman’s Time.



  1. Air pollution. Accessed September 16, 2020. https://www.marchofdimes.org/pregnancy/air-pollution.aspx
  2. Air Pollution and Cigarette Equivalence. Berkeley Earth. Accessed September 16, 2020. http://berkeleyearth.org/archive/air-pollution-and-cigarette-equivalence/
  3. Abdo M, Ward I, O’Dell K, et al. Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015. Int J Environ Res Public Health. 2019;16(19). doi:10.3390/ijerph16193720
  4. Kelly KE, Kotchenruther R, Kuprov R, Silcox GD. Receptor model source attributions for Utah’s Salt Lake City airshed and the impacts of wintertime secondary ammonium nitrate and ammonium chloride aerosol. J Air Waste Manag Assoc. 2013;63(5):575-590. doi:10.1080/10962247.2013.774819
  5. Talhelm T. What Is the Difference Between the PM2.5 and AQI Measurements? Smart Air. Published April 29, 2019. Accessed September 16, 2020. https://smartairfilters.com/en/blog/difference-pm2-5-aqi-measurements/
  6. Wildfire Smoke and COVID-19 | CDC. Published August 25, 2020. Accessed September 16, 2020. https://www.cdc.gov/disasters/covid-19/wildfire_smoke_covid-19.html