What health impacts did last year's wildfire smoke have on Wisconsin? New data tell the story

By Caitlin Looby (Milwaukee Journal Sentinel) and Melba Newsome (Climate Central)

This story was produced through a collaboration between the Milwaukee Journal Sentinel and science and news group Climate Central. Kaitlyn Weber (Climate Central) contributed data reporting.

For Dr. Emily Walz and her three boys, summer days are normally spent playing outside and digging for bugs. But that all changed last year when wildfire smoke blanketed Wisconsin.

As the Waukesha-based psychiatrist saw the mental health of her patients suffer amid suffocating smoke connected to warming temperatures, she kept her kids — now ages 2, 4 and 7 — indoors and wore a mask even for her hourlong drive to work.

Wisconsin's air last summer was punctuated by alien moonscapes of hazy orange skies, pervasive odors and gasps triggered by tiny smoke particles inside lungs. Days stuck inside were unwelcome reminders of months of isolation during the start of the COVID pandemic, Walz said.

It is hard to know the extent of the health impacts the smoke has had on people in Wisconsin. But an unpublished analysis concluded that last year's smoke killed a dozen people in Milwaukee County, according to Alistair Hayden of Cornell University, part of a team of scientists developing an online tool to publish estimated deaths from smoke across the U.S.

The Walz family repeated their new safety rituals this summer when smoke again invaded the region. Local air quality this summer has declined amid farflung fires but hasn't reached the same extremes as last year, with less smoke present and much of it staying high in the atmosphere.

Wildfire smoke is a veritable stew of chemicals and microscopic particles that can travel vast distances. It contributes to long lists of maladies, with seniors, young and unborn children and those with existing health problems most vulnerable.

Those who have asthma and other lung diseases can be profoundly affected, often driven indoors for prolonged periods. Outdoor workers and occupants of drafty homes, schools and businesses without air filters can inhale more of it. Mental health also suffers.

The sun is seen in a haze behind the steeple at Hill Point Christian Church on West Brown Deer Road in River Hills in July 2019. Wildfire smoke is a stew of chemicals and microscopic particles that can travel vast distances. It contributes to long lists of maladies, with seniors, young and unborn children and those with existing health problems most vulnerable. Mike De Sisti/Milwaukee Journal Sentinel

Smoke from wildfires burning in Canada and along the West Coast returned to Milwaukee during the second half of July, analyses of satellite and air quality monitors show. The fires were stoked by high temperatures that Climate Central's Climate Shift Index show were made twice as likely because of climate change.

“From the birth outcomes to respiratory and cardiovascular issues, wildfire smoke is a big problem in public health,” said Dr. Jonathan Patz, a professor and former director of the Global Health Institute at the University of Wisconsin-Madison.

Studies have shown that particles released by wildfires can be more dangerous for children and pregnant women than other sources of air pollution. Smoke also makes it more likely that pregnant women will develop preeclampsia, a blood pressure condition that can turn deadly.

“There is a wealth of epidemiological studies that link air pollution to adverse birth outcomes,” Patz said. “Even short-term exposure to wildfire smoke is a danger to pregnant women and their fetuses.”

The analysis by the team of scientists from Cornell showed more than 100 people were estimated to have been killed across Wisconsin by last year's smoke. Hayden said the team used the same approach employed by the federal government to estimate health impacts from air pollution.

With heat-trapping pollution and other environmental changes combining to fuel worsening wildfire seasons globally, the National Bureau of Economic Research found that under a high-pollution scenario worsening wildfire smoke could kill up to 27,800 Americans nationwide each year by 2050.

An unpublished analysis concluded that last year's smoke killed a dozen people in Milwaukee County, according to Alistair Hayden of Cornell University, part of a team of scientists developing an online tool to publish estimated deaths from smoke across the U.S. This photo shows how last year's wildfire smoke blanketed Milwaukee. Mike De Sisti / Milwaukee Journal Sentinel

Air quality is already poor in many rural communities because of dust whipped up from tilling and the spraying of herbicides and pesticides. This pollution is often worse during the same times of year when wildfire smoke reaches Wisconsin, said Dr. Beth White, a family physician in Viroqua, a city of 4,500 people in rural western Wisconsin.

White said rural communities are often comfortable with fire because of the use of prescribed burns, so they can underestimate health impacts from wildfire smoke. She said she saw patients last year suffering from respiratory illnesses for the first time in their lives.

“People are coming in sicker and sicker from a respiratory standpoint,” White said.

More:'This is on our doorstep now': Wildfire smoke a reminder that climate change impacts human health

Milwaukee air monitors tell residents when it's safe to be outside

Monitoring the Air Quality Index, or AQI, is one way people can help make informed decisions about whether it’s safe to be outside when hazy skies persist. The index is a color-coded guide that determines air quality based on six different pollutants, one of which is the particle pollution present in wildfire smoke.

On the color-coded guide, green (0-50) is good; yellow (51-100) is moderate; orange (101-150) is unhealthy for sensitive groups; red (151-200) is unhealthy; purple (201-300) is very unhealthy; and maroon (300+) is hazardous.

Last summer around Milwaukee the AQI soared into “very unhealthy,” which set a record for the state. So far this summer, the AQI has gone up to the “moderate” range. The most recent alert from wildfire smoke was in late July

And in Milwaukee, these data are about as local as it gets.

There are 20 air quality monitors in neighborhoods throughout the city thanks toMKE FreshAir Collective. The nonprofit organization was created by Langston Verdin after he saw a map that monitored air quality in real time during the devastating 2019-20 Australian bushfires.

Langston Verdin created the nonprofit MKE FreshAir Collective, which has helped place 20 air quality monitors in neighborhoods throughout the city. Verdin has one of the air sensors (upper right of photo) in the backyard of his home in Milwaukee. Max Correa / Milwaukee Journal Sentinel

Verdin, who has a child with asthma, said he wanted to bring this approach to Milwaukee to help keep his family and community safe. He worked with IQAir, a Swiss technology company, to get the air monitors placed on homes, businesses and schools throughout the city.

Milwaukeeans can use the IQAir app to get notifications when the air quality is bad in their neighborhood, Verdin said.

A top suggestion during smoky days is to stay inside. But a lot of patients struggled figuring out the best thing to do because if there isn’t air conditioning or good quality windows, the air inside may not necessarily be safer, said Alex Zielinski, a primary care nurse practitioner who also teaches at Marquette University.

The U.S. Environmental Protection Agency recommends that people in the Great Lakes region keep a supply of N95 masks or respirators, which can filter out soot and particle pollution. And if they can't keep in a cool and clean environment to seek shelter with friends or relatives, or local public buildings that serve as clean-air shelters.

More:Asthma afflicts 6 million children, many of whom grow up in poor neighborhoods. Most frustrating: It can be controlled.

When climate change, health and anxiety collide

Health care providers all over the state — from Milwaukee to the countryside and everything between — saw wildfire smoke affecting their patients last year. And many saw connections between declining air quality and rising temperatures caused by atmospheric pollution, which are helping to stoke the flames.

Every community had a different story last summer, Zielinski said, but they all had “a foundation of concern over climate change.” Drawing the connection between wildfire smoke, climate change and health was a challenge, Zielinski said, which is why climate-informed health care is becoming increasingly important.

Last year when wildfire smoke blanketed Wisconsin, Alex Zielinski, a primary care nurse practitioner who also teaches at Marquette University, said that every community had a different story, but they all had "a foundation of concern over climate change." Max Correa / Milwaukee Journal Sentinel

Rising temperatures, the drying out of landscapes and declines of yearly snowpacks are making North American forests more susceptible to wildfires, leading to record-breaking poor air quality.

“We know that last summer was not a one-off event. It is going to happen again,” Walz said. “So, I think the concern is repeated exposure to events like this.”

Last summer's smoke arrived in Waukesha with a stark realization that “this is climate change," said Walz, the psychiatrist with three young sons. "This is climate change affecting my family, our community. And it’s happening now."

From camping trips and hikes to cookouts and outdoor concerts, many of Wisconsinites’ favorite summer pastimes were postponed — or canceled — last summer due to the pervasive smoke.

It was a huge lifestyle shift for rural parts of the state, where residents can spend most of their waking lives working and socializing outside, White said. Isolation can take a heavy toll in rural communities where people may live miles from their closest neighbors, she said.

In children, asthma and mental illness symptoms can go hand-in-hand. Children hospitalized for asthma were 53% more likely to experience symptoms of anxiety and depression afterward, according to a 2021 study published in Hospital Pediatrics.

And the effects of climate change on mental health are far-reaching.

A 2021 study published in The Lancet Planetary Health, which surveyed 10,000 young adults aged 16-25 around the world, found that more than half felt sad, anxious, angry, powerless, helpless and guilty regarding climate change. More than 45% said that these feelings had an impact on their daily life.

Nearly 60% of young adults who responded felt very or extremely worried about climate change.

“That’s a lot of young people that are afraid,” Walz said. “What we need is our federal, state and local government officials to encourage clean energy transitions to support the physical and mental health of our communities."