I have the honor of speaking at Chest 2026 at a session entitled Climate Change as a Mass Casualty Threat: Implications for Critical Care Systems. I always appreciate the opportunity to further review the medical literature and put together resources for my colleagues. I have put together this post for those working to help people survive critical illness, especially as it relates to climate disasters such as wildfires. The studies I reviewed in the talk and additional resources are available as the References for this post.
I will also be speaking about advocacy and the importance of healthcare workers getting involved not just for the patient in front of them, but also their community as a whole. We all can’t do everything, but we can all do something.
Understanding the impacts of wildfire smoke on death and disease in the United States is vital. This handout includes key references and resources for the session at Chest in “References” section at the end.
For those who may not yet know me, I am a pulmonary and critical care medicine physician in Portland, OR and also host the Air Health Our Health podcast. The podcast and website have a variety of resources on understanding health impacts of wildfire smoke and what can be done. I love working with others in healthcare about making invisible problems visible.
Podcast Resources–
For general information- “Our Health in Wildfire Season”
For prescribed burns and community resilience- “Fighting Fire with Fire” with Native American wildland firefighter Bodie Shaw
There are a host of other wildfire related podcast episodes, including on wildfires and changes in infectious patters with an Emergency Management physician in -”Fungus, Fires and Fixes.”
For more on PM2.5- “What’s in a Standard” PM2.5 and Our Health”
For more on kids and the AQI- “What’s in an Index?” with a pediatric pulmonologist
Reduce Healthcare Emissions–
The health care sector is responsible for 8.5 percent of greenhouse gas emissions in the United States and around 4.6 percent globally.
- Listen to the ATS Breathe Easy Podcast on Lessening Healthcare’s contribution to climate change– targeted to Pulm, Critical Care, Sleep and Research community
Add Advocacy to your Life–
Add advocacy to your journey! There are many opportunities for those in healthcare. Chest Advocates also can point you in the right direction!
Clean Air and Climate Advocacy for Busy People– originally a talk at Chest in 2023!
Bypass Toxic Politics- Local and State Action for Healthy Air and Communities
Your Little Grain of Sand- with Moms Clean Air Force/EcoMadres
Feel more comfortable talking about tobacco or vaping? That can ALSO tackle the climate crisis- win-win! The tobacco industry also has outsized climate impact.
TLDR= Don't Light Things on Fire and Breathe them into your Lungs
References
- Adibi A, Barn P, Shellington EM, Harvard S, Johnson KM, Carlsten C. High-Efficiency Particulate Air Filters for Preventing Wildfire-related Asthma Complications: A Cost-Effectiveness Study. Am J Respir Crit Care Med. 2024 Jan 15;209(2):175-184. PMID: 37917367.
- Carlsten C, Salvi S, Wong GWK, Chung KF. Personal strategies to minimise effects of air pollution on respiratory health: advice for providers, patients and the public. Eur Respir J. 2020 Jun 4;55(6):1902056. PMID: 32241830.
- Chen K, Ma Y, Bell ML, Yang W. Canadian Wildfire Smoke and Asthma Syndrome Emergency Department Visits in New York City. JAMA. 2023 Oct 10;330(14):1385-1387.
- Chen G, Xu R, Yu P, Liu Y, Henderson SB, Johnston FH, Yue X, Bell ML, Saldiva PHN, Jalaludin B, Jaakkola JJK, Amegah AK, Tantrakarnapa K, Woodward A, Ji JS, Abramson MJ, Li S, Guo Y. Wildfire smoke and health: current evidence, mechanisms, and future challenges. Lancet. 2026 Sep 19;408(10560):1129-1142.
- Hansel NN, Putcha N, Woo H, Peng R, Diette GB, Fawzy A, Wise RA, Romero K, Davis MF, Rule AM, Eakin MN, Breysse PN, McCormack MC, Koehler K. Randomized Clinical Trial of Air Cleaners to Improve Indoor Air Quality and Chronic Obstructive Pulmonary Disease Health: Results of the CLEAN AIR Study. Am J Respir Crit Care Med. 2022 Feb 15;205(4):421-430. PMID: 34449285.
- Holder AL, Halliday HS, Virtaranta L. Impact of do-it-yourself air cleaner design on the reduction of simulated wildfire smoke in a controlled chamber environment. Indoor Air. 2022 Nov;32(11):e13163. PMID: 36437679
- Landguth et al. “The delayed effect of wildfire season particulate matter on subsequent influenza season in a mountain west region of the USA.” Environment International. Vol 139. June 2020.
- Muanprasong S, Aqilah S, Hermayurisca F, Taneepanichskul N. Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial. J Multidiscip Healthc. 2024 May 24;17:2613-2622. PMID: 38813091
- Orr A et al. Sustained Effects on Lung Function in Community Members Following Exposure to Hazardous PM2.5 Levels from Wildfire Smoke. Toxics. 2020;8(3):53. Published 2020 Aug 5.
- Qiu, M., Li, J., Gould, C.F. et al. Wildfire smoke exposure and mortality burden in the USA under climate change. Nature 647, 935–943 (2025).
- Jared Radbel, Emily Brigham, Hasan Bayram, Alexander S Rabin, Gary Ewart, Mary Rice, Elizabeth Cerceo, Erika Moseson, Heather Baid, Louise Trent, Robert J Laumbach, Hari Shankar, Refiloe Masekela, Aesha M Jobanputra, Ilyssa O Gordon, Cecilia Sorenson, Jenny Keroack, Forbes McGain, Amy Collins, Stephanie Maximous, Franziska Rosser, Eric Balaban, Alison G Lee, Hardeep Singh, American Thoracic Society Environmental Health Policy Committee and the American Thoracic Society Assembly on Environmental, Occupational, and Population Health , Strategies to meaningfully reduce healthcare sector emissions in pulmonary, critical care, and sleep practice: an official American Thoracic Society Workshop Report, Annals of the American Thoracic Society, Volume 23, Issue 6, June 2026, Pages 837–860
- Sin DD, Doiron D, Agusti A, Anzueto A, Barnes PJ, Celli BR, Criner GJ, Halpin D, Han MK, Martinez FJ, Montes de Oca M, Papi A, Pavord I, Roche N, Singh D, Stockley R, Lopez Varlera MV, Wedzicha J, Vogelmeier C, Bourbeau J; GOLD Scientific Committee. Air pollution and COPD: GOLD 2023 committee report. Eur Respir J. 2023 May 11;61(5):2202469. PMID: 36958741.
- US Environmental Protection Agency; Service, U. F.; California Air Resources Board. Wildfire Smoke: A Guide for Public Health Officials; 2019.
- Wang W, Li L, Zhu Q, D’Souza RR, Zhang D, Zhang H, Ebelt S, Chang HH, Alonso A, Liu Y. Differential Effects of Wildfire Smoke Fine Particulate Matter Exposure on Respiratory Disease Emergency Department Visits in the Western United States. Am J Respir Crit Care Med. 2025 Nov;211(11):2086-2095. doi: 10.1164/rccm.202502-0350OC. PMID: 40929521; PMCID: PMC12618982.
- Wang Y, Chen J, Huang Y, Wang J, Xiong Y, Xue T, Yue X, Qian F, Wang M. Associations of wildfire-derived particulate matter with hospitalization, emergency department visits and mortality: A systematic review and meta-analysis. Environ Res. 2025 May 15;273:121221.
- Washington Department of Ecology. “DIY Ecology: Breathe better by easily making a clean air fan.” Sept 2020. Accessed 9.12.2024
