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How do wildfires create toxic haze and what does it do to your health?

Wildfire smoke is a haze of fine particles that, at the same concentration, is linked to bigger health harms than most other air pollution.

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Covers: This page explains the chemical and physical processes that turn wildfire smoke into toxic haze, including the pollutants involved, and reviews the evidence on short- and long-term health effects from exposure. It does not cover wildfire prevention, firefighting tactics, or air quality regulations.

Also answers: What is in wildfire smoke and how does it harm health? · How does wildfire haze affect your body? · Wildfire smoke health risks explained · Why is wildfire smoke toxic?

The short answer

Evidence-backed AI-prepared starting map

Wildfire smoke becomes a toxic haze because it carries fine particulate matter (PM2.5) and other combustion products that are, at equal concentrations, associated with larger health harms than PM2.5 from most other sources. In a 20-state US study, each 1 µg/m3 increase in long-term wildfire-specific PM2.5 was linked to 10% higher heart-failure…1234

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At a glance

The picture in numbers

Live · updated just now

20-state US study, 2006–2019
  • Asthma16%
  • Heart failure10%
Hospitalization rise per 1 µg/m3 of wildfire PM2.51
Southern California study
  • Wildfire PM2.51.3–10%
  • Non-wildfire PM2.50.67–1.3%
Respiratory hospitalizations per 10 µg/m3 rise in PM2.52
Same 20-state US study
  • Hypertension8.5%
  • COPD4.7%
Hospitalization rise per 1 µg/m3 of non-wildfire PM2.51

The evidence behind it

8 sources
  • Reviews of many studies3
  • Other studies and data4
  • Background1

When it was published

Newest from 2026

20162026
Sources on this page by kind and year
SourceKindYear
Wildfire smoke and health: current evidence, mechanisms, and future challenges.Other studies and data2026
Cardiopulmonary hospitalization risks from wildfire-specific and non-wildfire PM2.5 in 20 US states.Other studies and data2026
Assessing the Evidence for Differential Health Effects of Wildfire Smoke Across Fires and Populations: A Critical Review of Recent Studies.Reviews of many studies2026
Critical Review of Health Impacts of Wildfire Smoke ExposureReviews of many studies2016
Health Effects of Wildfire Smoke ExposureOther studies and data2023
Wildfire smoke impacts respiratory health more than fine particles from other sources: observational evidence from Southern CaliforniaOther studies and data2021
The mental health and well-being effects of wildfire smoke: a scoping reviewReviews of many studies2022
'Nowhere to escape' - Indonesians share footage of orange haze blanketing townsBackground2026

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In brief

  1. Wildfire smoke forms a haze of fine particulate matter (PM2.5) and other combustion products, and at equal concentrations wildfire-specific PM2.5 is associated with larger health harms than PM2.5 from most other sources.12

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  2. Respiratory harms are the best-established effect, with consistent evidence across many studies and growing evidence for all-cause mortality.34

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  3. Long-term wildfire-specific PM2.5 exposure is linked to higher cardiopulmonary hospitalizations — up to 16% for asthma per 1 µg/m3 — with stronger associations among minorities, metropolitan residents, people with fewer years of education, and more deprived communities.1

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  4. Cardiovascular and mental-health effects are less settled: cardiovascular evidence is inconsistent, and mental-health evidence is limited and largely qualitative.45

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  5. Whether wildfire PM2.5 is genuinely more toxic than other PM2.5, or whether differences reflect fuel type or study methods, remains contested.6

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Quick questions from connected pages

What it means for you

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If you have asthma or another respiratory condition

the evidence is strongest here: wildfire-specific PM2.5 is associated with up to 16% higher asthma hospitalizations per 1 µg/m3 of long-term exposure, and respiratory harms are the best-established effect of wildfire smoke.13

Evidence-backed

If you have heart failure or hypertension

long-term wildfire-specific PM2.5 exposure has been associated with 10% higher heart-failure hospitalizations per 1 µg/m3, though cardiovascular evidence overall remains less consistent than for respiratory outcomes.14

Evidence-backed

If you live in a metropolitan area, belong to a minority group, have fewer years of education, or live in a more deprived community

studies found stronger associations between PM2.5 and cardiopulmonary hospitalizations in these groups, for both wildfire-specific and non-wildfire PM2.5.1

Evidence-backed

If you are experiencing a chronic or persistent smoke event

mental health and well-being impacts may be more likely during prolonged episodes, though the evidence is inconsistent and limited and drawn largely from qualitative studies.5

Evidence-backed

If you want to know whether this smoke episode is worse than ordinary air pollution

at an equivalent concentration increase, wildfire-specific PM2.5 has been associated with greater cardiopulmonary hospitalization risks than non-wildfire PM2.5, though one critical review cautions this could be confounded by fuel type or study methods.16

Evidence-backed

The full explanation

Evidence-backed AI-prepared starting map

Wildfire smoke becomes a toxic haze because it carries fine particulate matter (PM2.5) and other combustion products that are, at equal concentrations, associated with larger health harms than PM2.5 from most other sources. In a 20-state US study, each 1 µg/m3 increase in long-term wildfire-specific PM2.5 was linked to 10% higher heart-failure hospitalizations and 16% higher asthma hospitalizations, versus 4.7% (COPD) to 8.5% (hypertension) for non-wildfire PM2.5. A Southern California study found a 10 µg/m3 rise in wildfire-specific PM2.5 was associated with 1.3–10% more respiratory hospitalizations, against 0.67–1.3% for non-wildfire PM2.5. Reviews consistently find respiratory harms and growing evidence of all-cause mortality, with cardiovascular and mental-health effects less settled.1234

What this rests on8 independent sources
  • Evidence 22

The full story · 5 chapters

01

How wildfire smoke becomes toxic haze

AI summary:Wildfire smoke is a mix of fine particles and combustion products, and studies suggest it may be more toxic than other particle pollution at equal doses.

Evidence-backed

Evidence-backed: Wildfires emit fine particulate matter (PM2.5) along with other combustion products, and this mixture is what forms the visible and breathable haze. A 2026 review synthesises global evidence on the physical and chemical characteristics of wildfire smoke and explores potential biological mechanisms by which it harms health, while noting that health risk assessment for these mixtures remains challenging.7

Evidence-backed

Evidence-backed: A central question is whether wildfire PM2.5 is more harmful than PM2.5 from other sources at the same concentration. Toxicological studies have suggested wildfire particulate matter may be more toxic than equal doses of ambient PM2.5, and air quality regulations have generally assumed toxicity does not vary by emission source — an assumption this evidence puts in question.2

Evidence-backed

Evidence-backed: The severity of haze events can be extreme. In October 2026, thick orange smog descended on Palangka Raya, Indonesia, as wildfires burned nearby, with residents describing having nowhere to escape the haze.8

02

Respiratory harms and mortality

AI summary:Respiratory harms are the best-established effect, with growing evidence for all-cause mortality, and wildfire particles show larger effects than other particles.

Evidence-backed

Evidence-backed: Respiratory effects are the best-established outcome. A 2016 critical review found consistent evidence from a large number of studies linking wildfire smoke exposure to respiratory morbidity, with growing evidence for an association with all-cause mortality. A 2023 systematic review and meta-analysis likewise found positive impacts on all-cause mortality and respiratory hospitalizations.34

Evidence-backed

Evidence-backed: The size of the effect appears larger for wildfire-specific PM2.5 than for other PM2.5. In Southern California, a 10 µg/m3 increase in wildfire-specific PM2.5 was associated with increases in respiratory hospitalizations ranging from 1.3% to 10%, compared with 0.67% to 1.3% for non-wildfire PM2.5.2

03

Cardiopulmonary hospitalizations and who is most affected

AI summary:Long-term wildfire particle exposure is linked to higher heart and lung hospitalizations, with stronger links for minorities, city residents, less-educated and more deprived communities.

Evidence-backed

Evidence-backed: A 2026 study across 20 US states examined 2-year average exposures during 2006–2019. Per 1 µg/m3 increase, wildfire-specific PM2.5 was associated with significantly higher hospitalization risks for all cardiopulmonary diseases, with relative risks from 10% for heart failure to 16% for asthma. Non-wildfire PM2.5 showed smaller elevations, from 4.7% for chronic obstructive pulmonary disease to 8.5% for hypertension. At an equivalent concentration increase, long-term wildfire-specific PM2.5 posed greater cardiopulmonary hospitalization risks than non-wildfire PM2.5.1

Evidence-backed

Evidence-backed: The same study found stronger associations for both wildfire-specific and non-wildfire PM2.5 among minorities, metropolitan residents, people with fewer years of education, and more deprived communities.1

Evidence-backed

Evidence-backed: Cardiovascular evidence is less consistent. A 2023 review found less consistent evidence on cardiovascular morbidity, and a 2016 review called for more research to clarify whether cardiovascular outcomes are associated with wildfire smoke at all.43

04

Mental health and well-being

AI summary:Mental health effects are suggested, especially during long smoke events, but the evidence is inconsistent, limited and largely qualitative.

Evidence-backed

Evidence-backed: A 2022 scoping review suggests wildfire smoke exposure may have mental health impacts, particularly during chronic and persistent smoke events, but the evidence is inconsistent and limited. Qualitative studies reveal a wider range of impacts across multiple mental health and well-being domains, and potential pathways operate at multiple interacting levels: individual, social and community networks, living and working conditions, and ecological levels.5

05

What remains contested

AI summary:It remains unclear whether wildfire particles are truly more harmful or whether fuel type or study methods explain the difference.

Evidence-backed

Evidence-backed: A 2026 critical review documents how further research is needed to determine whether larger health risks from wildfire-derived versus non-wildfire-derived PM2.5 are confounded by the type of fuel burned, reflect methodological concerns, or are true. It also concludes more research is needed on smoke constituents other than PM2.5 and on burning of different fuels, and encourages a shift away from further documenting respiratory impacts — already very well established — toward less-studied health endpoints, wildland-urban-interface versus wildland fires, and remaining uncertainties.6

Evidence-backed

Evidence-backed: The 2026 Lancet review similarly identifies persistent gaps in long-term health effects, interactions with pre-existing health conditions, and health disparities, and argues that safeguarding public health requires an interdisciplinary approach to assess and mitigate the burden from wildfires.7

Before you go

What to remember

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  1. Long-term wildfire-specific PM2.5 exposure is linked to higher cardiopulmonary hospitalizations — up to for asthma per 1 µg/m3 — with stronger associations among minorities, metropolitan residents, people with fewer years of education, and more deprived communities.

  2. Wildfire smoke forms a haze of fine particulate matter (PM2.5) and other combustion products, and at equal concentrations wildfire-specific PM2.5 is associated with larger health harms than PM2.5 from most other sources.

  3. Respiratory harms are the best-established effect, with consistent evidence across many studies and growing evidence for all-cause mortality.

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City skyline obscured by haze on a misty dayUp nextHow does wildfire smoke and haze affect air quality and health?How does wildfire smoke and haze affect air quality and human health?

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Sources

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  1. 1
    Cardiopulmonary hospitalization risks from wildfire-specific and non-wildfire PM2.5 in 20 US states.
    Nature communications (Zhang et al.)Published Sep 17, 2026Checked Oct 15, 2026
    “Using a self-controlled design, we examine associations between 2-year average wildfire-specific and non-wildfire PM2.5 and cardiopulmonary hospitalization risks across 20 US states during 2006-2019. Per 1 µg/m3 increase, wildfire-specific PM2.5 is associated with significantly higher hospitalization risks for all cardiopulmonary diseases, with relative risks ranging from 10% for heart failure to 16% for asthma. In contrast, a 1-µg/m3 increase in non-wildfire PM2.5 is associated with smaller risk elevations, ranging from 4.7% for chronic obstructive pulmonary disease to 8.5% for hypertension. Stronger associations for both wildfire-specific and non-wildfire PM2.5 are observed among minorities, metropolitan residents, those with fewer years of education, and more deprived communities. Overall, at an equivalent concentration increase, long-term exposure to wildfire-specific PM2.5 poses greater cardiopulmonary hospitalization risks than non-wildfire PM2.5, underscoring wildfire smoke as a growing public health threat that requires targeted mitigation alongside conventional air quality control strategies.”
  2. 2
    Wildfire smoke impacts respiratory health more than fine particles from other sources: observational evidence from Southern California
    Nature Communications (Aguilera et al.)Published Mar 5, 2021Checked Oct 15, 2026
    “Wildfires are becoming more frequent and destructive in a changing climate. Fine particulate matter, PM 2.5 , in wildfire smoke adversely impacts human health. Recent toxicological studies suggest that wildfire particulate matter may be more toxic than equal doses of ambient PM 2.5 . Air quality regulations however assume that the toxicity of PM 2.5 does not vary across different sources of emission. Assessing whether PM 2.5 from wildfires is more or less harmful than PM 2.5 from other sources is a pressing public health concern. Here, we isolate the wildfire-specific PM 2.5 using a series of statistical approaches and exposure definitions. We found increases in respiratory hospitalizations ranging from 1.3 to up to 10% with a 10 μg m −3 increase in wildfire-specific PM 2.5 , compared to 0.67 to 1.3% associated with non-wildfire PM 2.5 . Our conclusions point to the need for air quality policies to consider the variability in PM 2.5 impacts on human health according to the sources of emission.”
  3. 3
    Critical Review of Health Impacts of Wildfire Smoke Exposure
    Environmental Health Perspectives (Reid et al.)Published Apr 15, 2016Checked Oct 15, 2026
    “Consistent evidence from a large number of studies indicates that wildfire smoke exposure is associated with respiratory morbidity with growing evidence supporting an association with all-cause mortality. More research is needed to clarify which causes of mortality may be associated with wildfire smoke, whether cardiovascular outcomes are associated with wildfire smoke, and if certain populations are more susceptible.”
  4. 4
    Health Effects of Wildfire Smoke Exposure
    Annual Review of Medicine (Gould et al.)Published Sep 22, 2023Checked Oct 15, 2026
    “We review current knowledge on the trends and drivers of global wildfire activity, advances in the measurement of wildfire smoke exposure, and evidence on the health effects of this exposure. We describe methodological issues in estimating the causal effects of wildfire smoke exposures on health and quantify their importance, emphasizing the role of nonlinear and lagged effects. We conduct a systematic review and meta-analysis of the health effects of wildfire smoke exposure, finding positive impacts on all-cause mortality and respiratory hospitalizations but less consistent evidence on cardiovascular morbidity. We conclude by highlighting priority areas for future research, including leveraging recently developed spatially and temporally resolved wildfire-specific ambient air pollution data to improve estimates of the health effects of wildfire smoke exposure.”
  5. 5
    The mental health and well-being effects of wildfire smoke: a scoping review
    BMC Public Health (Eisenman & Galway)Published Dec 5, 2022Checked Oct 15, 2026
    “Our review suggests that exposure to wildfire smoke may have mental health impacts, particularly in episodes of chronic and persistent smoke events, but the evidence is inconsistent and limited. Qualitative studies disclose a wider range of impacts across multiple mental health and well-being domains. The potential pathways connecting wildfire smoke with mental health and well-being operate at multiple interacting levels including individual, social and community networks, living and working conditions, and ecological levels. Priorities for future research include: 1) applying more rigorous methods; 2) differentiating between mental illness and emotional well-being; 3) studying chronic, persistent or repeated smoke events; 4) identifying the contextual factors that set the stage for mental health and well-being effects, and 5) identifying the causal processes that link wildfire smoke to mental health and well-being effects.”
  6. 6
    Assessing the Evidence for Differential Health Effects of Wildfire Smoke Across Fires and Populations: A Critical Review of Recent Studies.
    Current environmental health reports (Reid & Magzamen)Published Jun 30, 2026Checked Oct 15, 2026
    “Although some recent studies have documented larger health risks from wildfire-derived as compared to non-wildfire-derived PM2.5, we document how further research could evaluate whether these findings are confounded by type of fuel burned, due to methodological concerns, or are true. We also conclude that more research is necessary to elucidate potential differences in health risks of constituents of wildfire smoke other than PM2.5 or from burning of different fuels. Wildfire smoke is projected to continue to increase. We encourage future research to move away from further documentation of respiratory health impacts of wildfire smoke, which has been very well established, into studies of other health endpoints that have been less well studied to date, more exploration into health effects from wildfire smoke constituents other than PM2.5 and from different types of fires (i.e., wildland urban interface (WUI) fires versus wildland fires), and additional exploration of remaining uncertainties with a goal of further supporting public health protection from wildfire smoke.”
  7. 7
    Wildfire smoke and health: current evidence, mechanisms, and future challenges.
    Lancet (London, England) (Chen et al.)Published Sep 8, 2026Checked Oct 15, 2026
    “Although previous studies have shed light on health effects of wildfire smoke, crucial research gaps persist, including long-term health effects, interactions with pre-existing health conditions, and health disparities. Closing these gaps is vital to enhancing the ability to safeguard public health during wildfire events and to formulate effective strategies for prevention, mitigation, and response. This Review synthesises global evidence on the trends, health effects, and physical and chemical characteristics of wildfire smoke, exploring potential biological mechanisms and challenges in health risk assessment. Acknowledging the global impact of wildfires and their health effects is essential for mitigating environmental, social, and economic challenges. Safeguarding public health requires an interdisciplinary approach to comprehensively address the public health burden from wildfires. This integrated strategy is essential to systematically assess and mitigate the substantial public health burden posed by wildfires, as well as promoting resilience and sustainable solutions for affected communities.”
  8. 8
    'Nowhere to escape' - Indonesians share footage of orange haze blanketing towns
    BBC NewsPublished Oct 15, 2026Checked Oct 15, 2026
    “Thick orange smog descended on the Indonesian city of Palangka Raya as wildfires continue raging nearby.”

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Open questions

  • What are the long-term health effects of repeated or chronic wildfire smoke exposure, beyond the acute and 2-year windows studied so far?

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  • Are the larger health risks seen for wildfire PM2.5 caused by the smoke itself, by the type of fuel burned, or by study methods — and what role do smoke constituents other than PM2.5 play?

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  • Do wildland-urban-interface fires produce different health risks than purely wildland fires?

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  • What causal processes link wildfire smoke to mental health and well-being effects, and how do chronic or repeated smoke events differ from single episodes?

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  • Which populations are most susceptible, and how do pre-existing health conditions modify the risk from wildfire smoke?

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