Hazy Skies Over Omaha

What does this mean for your health during wildfires?

Over the past week, residents of the Omaha Metro area have likely noticed hazy skies. This hazy phenomenon is a direct result of wildfires currently burning in Canada. The smoke particles from these fires have traveled a significant distance, reducing air quality in Omaha and the parts of the Midwest from moderate levels to unhealthy for sensitive groups. 

Monday we saw levels of 109AQI US levels. What does this mean? For most people it means generally healthy conditions. However, for some people with lung disease, heart disease, and older adults, they may experience mild to moderate symptoms such as coughing, wheezing, shortness of breath, and unusual fatigue.

Lets better understand the air quality basics, how it is measured (including the Air Quality Index or AQI), and what the smoke index signifies.

How is the Air Quality Index or AQI measured?

The Air Quality Index (AQI) is a measurement system that simplifies complex air quality data into an easy-to-understand number. Here’s a breakdown of how it’s calculated:

Monitoring Pollutants: Government agencies and environmental organizations set up air quality monitoring stations throughout the country. These stations measure the concentration of various air pollutants, including Ozone (O3), Particulate Matter (PM2.5 and PM10), Nitrogen Dioxide (NO2), Sulfur Dioxide (SO2), and Carbon Monoxide (CO)

Converting Concentrations to Sub-Indexes: Each pollutant has its own established national ambient air quality standard (NAAQS) set by the EPA. The measured concentration of each pollutant is then compared to its corresponding NAAQS. This comparison results in a sub-index score for each pollutant.

Choosing the Highest Sub-Index: The AQI reported for a specific location is based on the highest sub-index score among all measured pollutants. This ensures the AQI reflects the pollutant posing the greatest potential health risk at that time.

What is the Air Quality Index Scoring Scale?

Excellent: 0 – 19The air quality is ideal for most individuals; enjoy your normal outdoor activities.
Fair: 20 – 49The air quality is generally acceptable for most individuals. However, sensitive groups may experience minor to moderate symptoms from long-term exposure.
Poor: 50 – 99The air has reached a high level of pollution and is unhealthy for sensitive groups. Reduce time spent outside if you are feeling symptoms such as difficulty breathing or throat irritation.
Unhealthy: 100 – 149Health effects can be immediately felt by sensitive groups. Healthy individuals may experience difficulty breathing and throat irritation with prolonged exposure. Limit outdoor activity.
Very Unhealthy: 150 – 249Health effects will be immediately felt by sensitive groups and should avoid outdoor activity. Healthy individuals are likely to experience difficulty breathing and throat irritation; consider staying indoors and rescheduling outdoor activities.
Dangerous: 250+Any exposure to the air, even for a few minutes, can lead to serious health effects on everybody. Avoid outdoor activities.

What is the smoke index?

The term “smoke index” isn’t typically used in official air quality measurements like the Air Quality Index (AQI).

Here’s a breakdown of why:

  • Focus on Specific Pollutants: Smoke itself isn’t a directly measured pollutant, but it can contribute to elevated levels of particulate matter (PM2.5).
  • Complexity of Smoke: Smoke is a complex mixture of particles and gases from burning materials. It can vary depending on the type of material burning and the combustion process. A single smoke index wouldn’t effectively capture this complexity.

However, there are ways to understand smoke’s impact on air quality:

  • Particulate Matter (PM2.5): This is the key pollutant to watch when smoke is present. The AQI incorporates PM2.5 measurements, so a high AQI during wildfires often indicates significant smoke in the air.
  • Visibility: Reduced visibility due to haze is a strong indicator of smoke.
  • Real-time Air Quality Data: Websites like AirNow (https://www.airnow.gov/) provide real-time data on PM2.5 and AQI levels in your area. These can help you understand the current smoke impact.

So what does this mean for my health?

What does this mean for our health? We sat down with Lucille Woodard, MD at Think Whole Person Healthcare, to discuss the health implications of the recent smoke exposure.


Can you describe the potential health effects of wildfire smoke exposure, particularly for those with pre-existing respiratory conditions or heart problems?

Lucille Woodard, MD:

People who already suffer from lung issues at baseline should not do a lot outdoors with the potential of aggravating the pre-existing conditions, especially folks with asthma, which by nature is hyper-sensitivity. It can certainly worsen their breathing, but also trigger an asthma attack. It’s worth mentioning that when the air quality is poor, you want to limit your exposure time by staying indoors. It’s Spring, and we love fresh breezes, but for folks with true lung disorders, this is not the time to open windows. Also, you want to make sure that your air filters are up to date because they will be working harder to keep things clean and clear, and you are replacing your filters when we have lower air quality.

The same applies to my cardiac patients; they are in the same vein as chronic lung disease. If they have chronic heart disease and we trigger any decrease in oxygenation, we could trigger an exacerbation of heart disease. So the same things apply, take it easy, don’t spend a lot of time outside. 

Suppose you were planning a trip to a higher altitude, first of all. In that case, it should be a serious consideration for anyone with a pre-existing condition. If you are planning a trip to higher altitudes and have a pre-existing condition, it is probably not a wise idea to make that trip during poor air quality levels. It’s going to make it even worse.

The last thing I’m going to say is that some folks develop asthma as adults. If you start to notice, even if you haven’t had a history of asthma, but you are outside having a field day or picnic, and you are starting to notice it’s a little more difficult to breathe, labored breathing, or sneezing, it could be a sign of something going on. 


How can people with asthma or allergies manage their symptoms during smoky periods?

Lucille Woodard, MD:

Number one, you want to make sure you have access to up-to-date, non-expired Albuterol inhalers. Albuterol prevents and treats wheezing, difficulty breathing, chest tightness, and coughing caused by lung diseases such as asthma and chronic obstructive pulmonary disease. Anybody with lung disease and a history of asthma who has an inhaler should really make sure it is up-to-date, especially if they haven’t used it in a long time.

It has probably been sitting on the shelf, in their car, exposed to the elements, and now it’s no longer any good, or they just haven’t refilled it in a while; it’s probably good to have an up-to-date inhaler on hand. The last thing you want is to need it, but it’s unavailable. The other is to reduce your exposure to the outside. Now is not the time to open those windows. Also, ensure that all your filters are changed and up to date. 


What are some practical tips for protecting children and older adults from smoke exposure?

Lucille Woodard, MD:

We could use an N95 mask if you have to be outside. But really, the key is to reduce that exposure. I don’t care how many masks we wear; the best way is to truly avoid it. So, again, stay indoors. If there is a playtime planned, then switch play to indoors. For adults, it is the same way. If they normally go out for a walk in the mornings for exercise, try to choose an indoor track or the mall to walk indoors for their routine and regular exercise. Again, avoid trips to high-altitude areas during this time.


Do you have any advice for people who experience health problems related to smoke exposure?

Lucille Woodard, MD:

So, the hope is that the exposure is temporary. Also, removing yourself from the exposure and having a rescue inhaler is important to treat any acute symptoms. 

For the most part, it will be short-lived unless it reveals an underlying illness. But reducing exposure is really your best bet.

If they’re smoker, reducing the amount of cigarettes and with the eventual goal of stopping is probably one of the best things you can ever do for health overall, but most certainly for lung disease.


Anything you would like to add that we have not covered. 

Lucille Woodard, MD:

Please make sure you get your routine vaccination because a cough or cold that comes from a virus on top of poor air quality… for example, you get pneumonia or bronchitis, and now from things that could be prevented or reduced and now add air quality on top of this, now, an average person can be looking at hospitalization, or a prolonged illness and prolonged loss of work and precious time with family and friends. 

So, this is also just a reminder about routine vaccinations. Please make sure that we get them.

To learn more about Dr. Lucille Woodard, MD of Family Medicine, visit her profile here.


While the current air quality may improve in the coming days, it’s always wise to stay informed about air quality changes. Local news outlets and the AirNow website (https://www.airnow.gov/) are excellent resources for real-time air quality data. If you experience any concerning health symptoms like persistent cough, wheezing, or difficulty breathing, especially if you have a pre-existing respiratory condition, be sure to contact your medical provider for personalized advice. Remember, prioritizing your health is paramount.

To schedule an appointment with your think provider visit your provider page to see if there is a self-scheduling option or contact us at 402.504.9000.

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