According to Ready.gov, a wildfire is an unplanned fire that burns in areas such as a forest, grassland, or prairie. An increasing number of families live in areas prone to wildfires. The National Interagency Coordination Center has a Predictive Services Program that provides wildfire forecasts. It is important to note that a "Fire Weather Watch" means that dangerous fire weather conditions are possible over the next 12 to 72 hours. Extreme temperatures or tendencies toward hotter and drier climates (due to climate change), have led to increased wildfire activity and an intensifying of wildfires, all of which impact families and communities. Preparing in advance for potential wildfires can improve health outcomes and living situations for children and their families.
Protecting Children from Wildfires
Children are especially vulnerable to environmental hazards from wildfires. They eat more food, drink more liquids, and breathe more air than adults on a pound for pound basis. Children are in a critical period of development when toxic exposures can have profound negative effects and their exploratory behavior often places them in direct contact with materials that adults would avoid. (AAP policy: Ensuring the Health of Children in Disasters.)
Wildfires expose children to various environmental hazards (eg, fire, smoke, and the byproducts of combustion of wood, plastics, and other chemicals released from burning structures and furnishings). While wildfires are burning (acute phase), the major hazards to children are fire and smoke. In the aftermath of wildfires (recovery phase) children may be exposed to a different set of environmental hazards involving not only their homes, but also nearby structures, land, and recovery activities. The environment can include many potentially hazardous conditions and situations. Some of these are easy to see, such as broken glass and exposed electrical wires, and others are not visible, such as soil contaminated with hazardous materials like lead or persisting hot spots which can flare without warning.
Wildfires have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. (AAP clinical report: Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises).
Recommendations for Children and Masks
Wildfires can produce ashes, debris, or toxic chemicals in the air. These chemicals are especially challenging for children with asthma or other respiratory issues. This is similar to what happens when volcanic ash is in the environment after a volcano erupts. If the chemicals in the air make it not safe to breathe outdoors, public health officials might recommend that people stay indoors (in well-sealed and airconditioned facilities), limit trips outside, or briefly use masks or N95 respirators. However, the use of these masks in children is not recommended, as there could be a potential risk of asphyxiation and other poor outcomes, especially in infants/toddlers (see Disposable Respirator Q&A or e-mail DisasterReady@aap.org for additional information on the use of masks in children).
When Should Children Return to Areas Hit by Wildfires?
Children should be the last group to return to areas where there has been a natural disaster such as a wildfire. Key requirements for children to return to an area include restored drinking water and sewage removal, safe road conditions, removal of debris and damaged building materials, and structurally sound homes. Early education and child care facilities, schools, and outdoor play areas should be cleaned, cleared of hazards and made ready for use. Persisting hazards should be isolated and made inaccessible to children. Children, and whenever possible, teens, should only be permitted to return after affected areas have been cleaned up. Direct supervision of children by adults in these situations is important.
To address the health risks to children from wildfires, the Pediatric Environmental Health Specialty Units (PEHSU), with input from the AAP Council on Environmental Health, have developed the following fact sheets:
Contact your regional PEHSU to talk to an expert.
Free Online Couse – Wildfire Smoke and Your Patients' Heath
The US Environmental Protection Agency (EPA) partnered with the Centers for Disease Control and Prevention (CDC) to develop an online course, Wildfire Smoke and Your Patients' Heath. This course updates participants about the health effects associated with wildfire smoke and actions for people to take before and during a wildfire to reduce exposure. This course is intended for physicians, registered nurses, and others involved in clinical or health education. Continuing education credit is available.