New York State Department of Health Publishes Study on Asthma-Related Emergency Visits During June Wildfire Smoke Event

Study Finds Smoke from Eastern Canadian Wildfires Led to Spike in Asthma-Related Medical Emergencies

Visit the DOH Led Study Here

ALBANY, N.Y. (August 24, 2023) – The New York State Department of Health has published a study in the CDC's Morbidity and Mortality Weekly Report on the increase in asthma attacks requiring emergency care during the initial wildfire smoke event that occurred in the state due to the Eastern Canadian Wildfires. The study, "Notes from the Field: Asthma-Associated Emergency Department Visits during a Wildfire Smoke Event – New York, June 2023," is the first state study of its kind for this event and found that asthma-related emergency department (ED) visits markedly increased June 7 when air quality reached its poorest levels.

"Wildfires are likely to become more common with climate change, so it is critical that we examine public health impacts and risks associated with these events," State Health Commissioner Dr. James McDonald said. "The research conducted by the Department's team demonstrates our commitment to providing evidence-based recommendations to protect New Yorkers. We are proud to work with the CDC to provide this important information and we look forward to continuing this collaboration in the future."

From June 6 to 8, 2023, smoke from Eastern Canadian wildfires caused poor air quality across New York. Air quality index (AQI) levels of "unhealthy" or "very unhealthy" from wildfire smoke can increase the risk for medical emergencies, including asthma attacks. Investigators compared asthma-related ED visits during the wildfire smoke event to those during the preceding five-day period.

Compared with averages from June 1 to 5, asthma-associated ED visits on June 7 increased 82 percent statewide and at least 35 percent for all regions (as categorized by the New York State Department of Environmental Conservation) except the Adirondacks. ED visits in the Eastern Lake Ontario and Central regions more than doubled, and ED visits across New York nearly tripled among older children and young adults.

"The intersection of climate change and public health has recently been demonstrated across New York State as we experienced a major wildfire smoke event that affected public health," Center for Environmental Health Director Dr. Gary Ginsberg, Ph.D. said. "Our Center for Environmental Health works with other areas of the State Health Department and with the New York State Department of Environmental Conservation to assess health risks and alert the public to risk-reduction methods. We will continue to safeguard the public in these ways, document the impacts of climate change, and work towards making New York more resilient to these impacts."

"My job is to respond to emerging health problems with evidence-based solutions for New York State," CDC Epidemic Intelligence Service Officer and lead author Dr. Haillie Meek, DVM, MPH, said. "This analysis shows that New Yorkers across the state were adversely affected by this wildfire smoke event and highlights populations that were most impacted. The State Department of Health will use this information to enhance our response and communication to protect those most at risk during future wildfire events."

The study authors note that as wildfire smoke events become more frequent and widespread, attention should be focused on people at increased risk for asthma attacks. In particular, children and Black people disproportionately experience asthma attacks requiring emergency care, and extreme weather events might worsen these health inequities.

Air quality conditions can change with wind direction and weather, so the Department urges people to check the latest air quality conditions by visiting DEC's air quality forecast website or and then follow the following tips based on the AQI to reduce risk:

  • When AQI is greater than 100 ('Unhealthy for Sensitive Groups'), New Yorkers in at-risk groups should avoid exertion outdoors and watch for symptoms when exposed to the outdoors. At-risk individuals include those with cardiovascular disease (e.g., congestive heart failure, history of prior heart attack) or lung disease (e.g., asthma, chronic obstructive pulmonary disease), as well as children under 18, adults 65 and older, and pregnant people.
  • When AQI is greater than 150 ('Unhealthy'), all New Yorkers should avoid strenuous outdoor activities, and those in at-risk groups should avoid exposure to the outdoors, especially pregnant individuals who may become short of breath more easily. In addition, some employees who are at-risk should work indoors and camp directors should know their local AQI forecast and alert level and follow AQI guidance.
  • When AQI is greater than 200 ('Very Unhealthy'), at-risk groups should avoid all physical activity outdoors, and reschedule or move activities indoors. All others should avoid long or intense outdoor activities.
  • When AQI is greater than 300 ('Hazardous'), all New Yorkers should avoid outdoor physical activities.

Additional tips are also recommended when air quality is unhealthy:

  • Spend more time indoors. This is especially important for at-risk groups ("sensitive groups"), like children and teenagers, older adults, people with heart or respiratory problems, pregnant people, and those who exercise or work outdoors.
  • If it gets hot inside, cool off with air conditioning if you can. Find a place to get cool.
  • People who must spend time outdoors should consider wearing a mask (use the best well-fitting face mask you have on hand. A N95 or KN95 will work best), take frequent breaks, and adjust work or exercise schedules for when air conditions improve.
  • People with any symptom should contact their health care provider.
  • Filter air at home using an air cleaner, air conditioner and/or stand-alone fans.
    Central air conditioning and heating systems should be set to "on" so air is constantly filtered, rather than "auto," which intermittently runs the system.
  • Get the latest air quality conditions by visiting DEC's air quality forecast website or

For more information about exposure to smoke from fires, visit the Department of Health website here.