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How can healthcare professionals educate parents about the dangers of wildfire smoke?

As the year 2023 draws to a close, many people (especially here in North America) will remember it as a smoky one. Although regions across the western US and Canada have contended with smoke from wildfires for some time, 2023 saw this health hazard blanket communities who had rarely—if ever—experienced such dangerous levels of air pollution before.


While remarkable images of city skylines painted orange and national landmarks surrounded by dense haze quickly made headlines around the world, about 70 million people suddenly found themselves under air quality alerts from the wildfire smoke. They were told to protect themselves and reduce their smoke exposure because breathing in particulate matter and other harmful compounds found in wildfire smoke can exacerbate many health conditions like asthma or heart disease, among other health effects.


But the health impacts from wildfire smoke especially affect sensitive groups like children, who tend to experience higher rates of hospitalization for respiratory issues (e.g., wheezing, asthma, infections) following exposure to wildfire smoke. With wildfire smoke events set to increase in frequency and intensity due to climate change, more parents in more places will need to know how to protect their children from exposure. As trusted messengers, healthcare professionals are well positioned to provide advice to parents about the potential health impacts of wildfire smoke and how to minimize harm among children. So we teamed up with Dr. Rebecca Philipsborn, a pediatrician at Children’s Healthcare of Atlanta and an Associate Professor at Emory University’s School of Medicine, to put together strategies for healthcare professionals to communicate to families about wildfire smoke and children’s health risks.


Based on foundational principles from the behavioral sciences, we recommended three strategies healthcare professionals could use to increase parents’ understanding of wildfire-smoke risks and promote actions to keep kids safe; we recently published this work in BMJ Paediatrics Open.


The strategies were:


1. USE VISUALS AND STORIES TO MOTIVATE THE USE OF AIR QUALITY INDICES.

Since visuals effectively capture people’s attention, they can serve as powerful communication tools to motivate the adoption of smoke-safe behaviors like checking daily air quality levels during wildfire smoke events. An Air Quality Index (AQI) is a numeric scale used to inform people how clean or polluted the air near them is, often using a simple color-coded visual to communicate that information. We recommend that healthcare professionals become familiar with the AQI used in their jurisdiction and point parents toward these visuals, available on government websites and through smartphone apps (e.g., weather apps). High AQI values correspond to higher levels of health risk, and healthcare professionals can help guide parents’ decision making about what actions to take (discussed in Strategies #2 and 3 below) when the AQI reaches harmful levels. When communicating about wildfire smoke, clinicians should draw on their personal experiences using the AQI as a tool to decide what activities are safe and use stories to make examples of actions more concrete, real, and personally relevant to families.


2. EMPHASISE NEAR-TERM HEALTH BENEFITS OF REDUCED EXPOSURE TO WILDLIFE SMOKE.

The best way to eliminate children’s exposures to smoke is to relocate to areas with better air quality. However, this option can be impractical, especially during long-term smoke events. Still, we believe that healthcare professionals can recommend other alternatives. For example, time spent outdoors should be reduced, and outdoor events can be rescheduled or relocated whenever possible. Masking is another option. However, clinicians should guide parents on how to use well-fitted N95 respirator masks since medical and cloth masks provide limited protection from wildfire smoke. When discussing these options, healthcare professionals should emphasize how actions will benefit children’s health, for example, by reducing respiratory symptoms like cough and wheezing, as discussing specific risks and solutions can help parents understand smoke harms and motivate protective actions.


3. IDENTIFY AND REDUCE PATIENT BARRIERS TO ACCESSING CLEAN INDOOR AIR SPACES.

Much of the guidance around protecting children from wildfire smoke directs parents to keep their children indoors; thus, ensuring indoor spaces are safe is extremely important. Healthcare professionals should advise families about ways to improve the quality of indoor air at home or where they can access clean air spaces in their community. While ventilation and air purification systems using high efficiency particulate air filters are highly effective at reducing people’s exposure to wildfire smoke indoors, they can also be costly. As a result, healthcare professionals should become familiar with low-cost alternatives (e.g., box-fan systems) and any local programs that provide people access to clean air spaces. We also recommend for healthcare professionals to become advocates for and champions of healthy air quality policies. The medical community has a strong voice that can shape guidelines and standards for indoor air quality or influence what actions schools take when AQIs reach a certain level during smoke seasons.


To learn more about these strategies, check out our piece here!


This work was supported in part by The Banting Postdoctoral Fellowships program of Canada and the US National Science Foundation (SES-2017651).



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