This article was originally published on September 18, 2023. 

Smoke from increasingly frequent and intense wildfires in recent years has led to widespread poor air quality alerts, raising concerns about the impact on children's health.

In 2023, two thirds of parents reported experiencing at least one day with poor or unhealthy air quality in their area, according to the University of Michigan Health C.S. Mott Children’s Hospital National Poll on Children’s Health.

Many of these parents expressed concerns about the impact of poor air quality on their children, but often felt unsure about the most effective ways to protect them from adverse effects.

"Our previous Mott Poll report suggested that poor air quality was a common issue for families. Local news and weather reports may help parents gauge their community’s air quality, but many seem unsure about how to protect their child when air quality worsens,” said Susan Woolford, M.D., M.P.H., pediatrician at U-M Health C.S. Mott Children’s Hospital and co-director of the Mott Poll. 

Children's organs are still developing, making them more susceptible to health risks from exposure to polluted air caused by wildfire smoke and other pollutants. This makes it essential to take precautions to protect their well-being when the air is unhealthy.” Susan Woolford, M.D., M.P.H.

“Children's organs are still developing, making them more susceptible to health risks from exposure to polluted air caused by wildfire smoke and other pollutants,” Woolford added.

“This makes it essential to take precautions to protect their well-being when the air is unhealthy.”

She offers six tips for parents worried about their community’s air quality.

6 ways to keep kids safe from poor air quality

1. Understand the short and long term risks

Air quality is particularly important for children’s health because they breathe faster than adults leading to their lungs being exposed to more pollution per pound of body weight than adults, Woolford says. 

Children also typically spend more time outside than adults and their developing bodies are more susceptible to the long-term impact of pollution.

For families without a history of asthma or environmental allergies, parents may be less focused on poor air quality, but small particles from pollution can get into the deepest parts of the lungs in even the healthiest kids, Woolford notes.

This exposure has been linked with a range of health risks, including childhood cancer and stroke and heart disease later in life.

2. Stay informed

Stay updated on local air quality reports and wildfire alerts to help make informed decisions about kids’ outdoor activities.

Woolford also encourages discussing the issue with their child’s health care provider and consider other recommended sources, such as AirNow.gov, for more explanations.

3. Be watchful for worrisome symptoms

Exposure to unhealthy air quality can negatively impact a child’s lungs, causing or exacerbating respiratory diseases such as asthma and bronchitis.

Parents of children with asthma need to be particularly careful to identify and act on situations where the air quality is poor.

Concerning symptoms include wheezing, coughing, and other signs of breathing difficulties. 

If these occur, parents should remove their child from the source of the poor air quality when possible and contact their child’s health care provider.

“If your child has preexisting respiratory conditions like asthma, consult their healthcare provider for advice on managing their condition during events that increase their risk of pollutant exposure,” Woolford said.

4. Limit outdoor activities and consider masks

On days with poor air quality, especially during active wildfires, reduce or eliminate outdoor activities. 

Woolford recommends parents encourage indoor play and exercise instead.

“Being outdoors is generally good for children’s physical and mental health but parents must also consider the risks of exposure to pollution,” Woolford said.

“When air quality problems are expected to be temporary, moving activities indoors or planning outdoor events for early in the day when air quality tends to be better may be warranted to prevent high levels of exposure.”

If children must be outside, ensure that they do not engage in strenuous activity that would cause them to take deep rapid breaths. 

Some may also consider having children wear a KN95 mask outdoors to filter out toxic particles.

5. Create a safe indoor environment

Keep windows closed during days with poor air quality to prevent smoke from entering the home and use filters and air purifiers to help reduce indoor pollution.

When air quality is severely compromised, consider evacuating to an area with better air quality until conditions improve.

6. Know school and youth sports policies

Just 21% of parents report being aware that their child’s school has a policy outlining action steps when the air quality is unhealthy.

Most parents say they support moving recess and physical education indoors and canceling outdoor sports and activities. 

Particularly on warmer days, schools should implement guidelines to manage students’ exposure on high pollution days based on the color-coded Air Quality Index.

School officials may also consider asking parents not to idle their car during drop off and pick up times.

“Schools play an important role in protecting children from the adverse effects of poor air quality,” Woolford said. 

“We found that most parents are supportive of protective actions, such as moving recess and physical education indoors.”

She adds that community members may also encourage local and state policymakers to take steps to mitigate the negative effects of poor air quality, such as by enacting zoning policies that keep heavy traffic away from schools or funding filters to improve air quality for schools, daycares and community organizations.

“Policymakers should consider the impact on babies and young children, particularly of long-term sources of pollution from sources such as factories and refineries,” she said.