Public Health Advisory - Wildfire Smoke and Intermittent Poor Air Quality (7/31/2026)

Summary

Recent wildfires in and around the region have intermittently affected air quality in Marin County. Smoke conditions may change rapidly depending on fire activity, wind direction, and weather conditions. Wildfire smoke contains fine particles and gases that can irritate the eyes and respiratory tract, worsen asthma and other lung conditions, and increase cardiovascular risk. Healthcare providers and community organizations should help patients and staff monitor local air quality, reduce smoke exposure, and recognize symptoms that require medical attention.

Actions Requested of Healthcare Providers and Organizations

1. Advise patients and staff to monitor current air quality and adjust outdoor activities based on local conditions and the Air Quality Index.
2. Identify people at increased risk from wildfire smoke, including:
   • Children and older adults
   • Pregnant people
   • People with asthma, chronic obstructive pulmonary disease, or other respiratory conditions
   • People with heart disease or other chronic medical conditions
   • Outdoor workers
   • People who are unhoused or have limited access to clean indoor air
3. Encourage patients with asthma, heart disease, and other chronic conditions to follow their treatment plans, continue prescribed medications, and keep rescue medications readily available.
4. Review facility plans for poor air quality, including indoor air filtration, outdoor activity restrictions, staff communication, and support for medically vulnerable patients or residents.
5. Educate patients about when to seek medical care for symptoms related to smoke exposure.

Key Clinical Points

• Wildfire smoke conditions can change quickly and may vary across Marin County.
• Fine particulate matter in smoke can travel deep into the lungs and may worsen respiratory and cardiovascular disease.
  • Reducing exposure is the most effective way to protect health.
  • People should move indoors and reduce physical activity when smoke is present, or air quality is poor.
  • A well-fitting N95, KN95, or similar respirator can reduce exposure to smoke particles when outdoor activity cannot be avoided.
  • Cloth masks, bandanas, and loose-fitting surgical masks do not provide reliable protection from fine smoke particles.

Clinical Guidance: Health Effects

Common symptoms of wildfire smoke exposure include:

• Eye, nose, or throat irritation
• Coughing
• Wheezing
• Shortness of breath
• Chest tightness
• Headache
• Fatigue

Smoke exposure may worsen asthma, chronic obstructive pulmonary disease, heart disease, and other chronic health conditions.

Reducing Smoke Exposure

Advise patients and community members to:

• Check current and forecasted air quality before outdoor activity.
• Reduce time outdoors and avoid strenuous outdoor exercise when air quality is poor.
• Remain indoors with windows and doors closed when smoke is present.
• Use air conditioning on recirculation, when available, so outdoor air is not drawn inside.
• Use a portable high-efficiency particulate air cleaner in the room where they spend the most time, when available.
• Avoid activities that worsen indoor air quality, including smoking, burning candles or incense, frying food, and vacuuming without a HEPA-filtered vacuum.
• Consider temporarily relocating to a cleaner-air location if indoor air remains smoky or symptoms persist.

Respiratory Protection

When outdoor exposure cannot be avoided:

• Use a well-fitting N95, KN95, or similar particulate respirator. 
• Ensure the respirator covers both the nose and mouth and fits closely to the face.
• Recognize that respirators may be difficult to tolerate for people with certain heart or lung conditions.

Do not rely on cloth face coverings, bandanas, or loose-fitting surgical masks for protection from wildfire smoke.
Children should use only respirators that fit properly and can be worn safely. Respirators should not be placed on children younger than 2 years of age.

Patients with Chronic Health Conditions

Patients with asthma or other lung disease should:

• Follow their asthma or respiratory action plan.
• Continue prescribed controller medications.
• Keep quick-relief medication readily available.
• Contact their healthcare provider if symptoms worsen or are not controlled with their usual treatment plan.

Patients with cardiovascular disease should reduce exertion and seek medical advice for new or worsening symptoms.

When to Seek Medical Attention

Advise patients to contact a healthcare provider if symptoms do not improve after moving indoors or to an area with cleaner air, including:

• Persistent shortness of breath
• Wheezing
• Chest tightness
• Palpitations
• Unusual fatigue
• Nausea
• Lightheadedness or feeling faint

Call 911 for severe difficulty breathing, chest pain, loss of consciousness, confusion, or another medical emergency.

Facility and Community Preparedness

Healthcare facilities, residential care facilities, schools, employers, and community organizations should:

• Monitor changing air quality throughout the day.
• Identify indoor spaces with effective air filtration.
• Limit or reschedule strenuous outdoor activities when air quality is poor.
• Ensure staff know how poor-air-quality decisions will be communicated.
• Check on individuals who may need assistance obtaining medications, respirators, transportation, or access to cleaner indoor air.
• Confirm that emergency plans address power outages affecting air-conditioning, filtration systems, oxygen equipment, or other powered medical devices.

Resources

• AirNow — Current Air Quality Index and Fire and Smoke Map
• ReadyMarin — Air Quality and Wildfire Smoke Guidance
• Bay Area Air Quality Management District — Air Quality Advisories
• California Department of Public Health — Wildfire Smoke and Ash Safety
• CAL FIRE — Current Wildfire Incidents
• Marin County Emergency Portal — Current Local Emergency Information