Who is most at risk from wildfire smoke?

Dr. Colin Little

Dr. Colin Little

MD, FAWM, Chief Medical Officer, GOES Health

The short answer

The people most at risk from wildfire smoke are those with lung disease (asthma, COPD) or heart disease, children under 18, adults 65 and older, and pregnant people, along with outdoor workers and people with fewer resources. For them, smoke can trigger attacks that need emergency care and can be fatal.

Wildfire smoke reaches everyone, but it doesn't hit everyone the same. The people most at risk are those whose heart and lungs are already under strain. In someone with asthma or COPD (a serious long-term lung disease), smoke can set off severe breathing trouble that ends in the emergency room, and it can be fatal.1 In someone with heart disease, or a related condition like diabetes or obesity, it can trigger a heart attack or stroke.1

Age matters at both ends. Children up to 18 are more vulnerable because their lungs are still growing, they breathe more air for their body size, and they're more likely to have asthma.1 Adults 65 and older are at higher risk too, because they more often already have chronic heart and lung disease.1

The list also takes in pregnant people, outdoor workers, and people with fewer resources or in some minority groups, who often breathe more smoke with less access to care.1

So know who these people are. If you or someone in your home is one of them, treat a smoky day differently: watch the air quality closely and get to cleaner indoor air early. When smoke rolls in, they are the ones to check on first.

Sources

  1. [1] U.S. EPA / USFS / CDC / CAPCOA / NPS / CARB. Wildfire Smoke: A Guide for Public Health Officials (Revised 2026). June 2026. Accessed August 6, 2026. https://www.epa.gov/system/files/documents/2026-06/wildfire-guide-for-public-health-officials-2026.pdf

About the author

Dr. Colin Little

Dr. Colin Little

MD, FAWM, Chief Medical Officer, GOES Health

  • Board Certified Emergency Physician
  • Fellow of the Academy of Wilderness Medicine (FAWM)
  • Wilderness Medicine Fellowship, University of Utah
  • Emergency Medicine Residency and Chief Resident, Stanford / Kaiser
  • Doctor of Medicine, University of Arizona College of Medicine – Phoenix