Health, Mental Health, and Your Family

A wildfire does its damage in two waves. The first is the fire itself, the part everyone sees. The second arrives quietly, in the days and weeks after the flames are gone: the smoke that lingers in the air, the gray ash that coats everything you own, the uncertainty about whether the water is safe, and the heavy weight that settles over a family that has lost its sense of home. This chapter is about that second wave. It is general information to help you protect your body and your mind, and the bodies and minds of the people you love, while you recover. It is not medical advice and it is not a substitute for care from a doctor, a nurse, or a licensed mental health professional. When something feels wrong, please reach out to a professional. You do not have to wait until you are certain.

Wildfire smoke and the air you breathe

Wildfire smoke is not simply the smell of a campfire. It is a mix of gases and very fine particles from burning trees, brush, homes, and everything inside those homes. The U.S. Centers for Disease Control and Prevention notes that wildfire smoke irritates your eyes, nose, throat, and lungs. It can make it hard to breathe, and it can make you cough or wheeze. The smallest particles are the most concerning because they can travel deep into your lungs and even into your bloodstream. Smoke can drift for many miles, so you can be exposed even when you are far from any active fire and cannot see flames.

Common reactions to smoke include burning eyes, a runny nose, a scratchy throat, headaches, and a cough. For most healthy people these symptoms ease once the air clears. But smoke can also trigger serious problems, including chest pain, a fast heartbeat, and severe trouble breathing. If you or someone with you has chest pain, severe shortness of breath, or symptoms of a heart attack or stroke, treat it as an emergency and call 911.

It also helps to understand that smoke can keep affecting you after a fire is contained. Particles settle onto surfaces, get tracked indoors, and rise back into the air when disturbed. Recovery work itself, such as sorting through belongings or sweeping a garage, can stir up days old smoke residue. So the guidance in this chapter is not only for the height of a fire. It applies through the long tail of cleanup and return, when the danger is quieter but still real. Pay attention to how your body responds over time, and do not dismiss a cough or a tightness in your chest that lingers for days. Persistent symptoms are worth a call to your doctor.

Who is most at risk

Smoke can make anyone sick, but some people are far more vulnerable. According to the CDC, the groups who need to be especially careful about breathing wildfire smoke include:

• Children. Their lungs are still developing, they breathe in more air for their size than adults, and they often spend more time outdoors and active. The CDC reports that children with asthma or other chronic conditions may have more symptoms, including trouble breathing, when smoke or ash is present.
• Older adults. Aging lungs and hearts are less able to cope with the added strain of polluted air.
• People who are pregnant. The CDC identifies pregnancy as a condition that raises the risk of severe outcomes from smoke exposure.
• People with chronic conditions, including lung diseases such as asthma or COPD, heart disease, diabetes, and chronic kidney disease.

If you or a family member is in one of these groups, take smoke seriously even at levels that do not bother others around you.

Knowing when the air is unsafe

You cannot judge the air by how it looks or smells alone. The most reliable way to know is to check a real measurement. The federal AirNow service, run with the U.S. Environmental Protection Agency, reports the Air Quality Index, or AQI, for your area, and the California Air Resources Board provides air quality information for the state. The higher the number, the worse the air. When the AQI reaches levels labeled unhealthy for sensitive groups or higher, that is the signal for at risk people to stay indoors and for everyone to limit time outside.

When smoke is heavy, keep windows and doors closed. If you have a central air system or air conditioner, run it and, where possible, set it to recirculate so it is not pulling smoky outdoor air inside. A portable air cleaner with a HEPA filter can help keep one room cleaner, which is a good place for the most vulnerable members of your family to rest. The CDC cautions that dust masks, surgical masks, bandanas, and breathing through a wet cloth will not protect you from smoke. Only a properly fitted respirator labeled NIOSH and N95 or P100 filters out the fine particles, and well fitting respirators for small children are hard to find, which is one more reason to keep kids indoors when the air is bad.

Creating one cleaner room can make a real difference for a family riding out a smoky stretch. Choose an interior room with few windows, keep the door closed, and run a HEPA air cleaner sized for the space. Avoid adding to the indoor pollution while you are sheltering: do not burn candles, do not use a wood stove or fireplace, do not fry or broil food, and do not vacuum with an ordinary vacuum, since each of these adds particles to the air. If the heat indoors becomes dangerous because windows must stay closed, that is its own emergency, and a public cooling center or clean air shelter may be the safer choice. Many California counties open clean air centers during severe smoke events, and your local emergency management office can tell you where they are.

The hidden hazards of ash and debris

When you return to a burned property, the ash is not just dirt to be swept away. Wildfire ash is made of whatever burned, and in a community that means more than wood. Homes, garages, vehicles, electronics, and household chemicals all leave residue behind. That residue can contain fine particles that are easy to breathe in, along with heavy metals and other harmful substances. In older buildings, the dust and debris can also contain asbestos, which was used in many homes and structures built before the late twentieth century. You cannot see these hazards, so the safe approach is to treat all ash and fire debris as something to keep out of your lungs and off your skin.

How to clean up safely

If you decide to clean up ash yourself, protect your body and avoid stirring the ash into the air. The CDC and EPA agree on the core practices:

• Cover your skin. Wear gloves, a long sleeved shirt, long pants, and shoes with socks. Add goggles to protect your eyes.
• Protect your lungs. Wear a NIOSH approved N95 respirator, which the packaging should clearly label. Choose a particulate respirator marked NIOSH and N95 or P100.
• Wet it down first. The EPA strongly recommends wet methods over dry ones. Lightly mist ash with water before you sweep, then follow with wet mopping or a damp cloth. Misting keeps the ash from becoming a cloud you breathe.
• Never dry sweep or use a leaf blower. Both throw ash into the air. The EPA specifically warns against dry sweeping and leaf blowers. If you vacuum, use a HEPA filter vacuum rather than an ordinary one.
• Wash off ash promptly. Rinse any ash off your skin, and out of your eyes or mouth, as soon as you can. Wash work clothing separately from the rest of your laundry.
• Keep children and pets away from ash, debris, and the cleanup work entirely. Their smaller bodies are more sensitive, and they are more likely to put ash covered hands and objects in their mouths.

Treat the ash as you would treat smoke: something to keep out of your lungs, off your skin, and away from your children.

Water safety after a fire

One of the least visible dangers after a wildfire is in the tap. When a fire damages a water system, or when the pressure in the pipes drops during a fire, contaminants can be drawn into the lines. The California State Water Resources Control Board has documented that systems which lost pressure during a fire can be contaminated with benzene and other volatile organic compounds. These chemicals can soak into plastic pipes and release slowly over time, so water can remain unsafe even after the visible emergency has passed.

Because of this, water utilities and local health departments issue advisories. You may see two kinds:

• A do not drink notice means the water is not safe to drink or cook with, even after boiling. Boiling does not remove chemicals like benzene and can make some worse by concentrating them.
• A do not use notice is stronger still, meaning you should not drink, cook, brush teeth, or in some cases bathe with the water until the system is cleared.

Honor these notices exactly, and wait for your utility to confirm in writing that the water is safe again before you go back to using it normally. Use bottled or an officially approved alternative water source in the meantime. After the 2025 Los Angeles firestorms, water systems had to complete extensive testing before the Water Board confirmed that safe drinking water was restored. That careful process is there to protect you, even when it is inconvenient.

Returning home with your children

Coming home is emotional, and it can be hazardous. The CDC advises returning during daylight hours so it is easier to see and avoid dangers, especially if the power is still off. Before children come back to a property touched by fire, walk through it yourself, or have it cleared by officials, so you can manage the risks first.

• Keep children away from ash, charred debris, downed power lines, and any structure that may be unstable.
• Do not let children play in or near ash. Their natural curiosity and hand to mouth habits put them at higher risk.
• Make sure smoke residue and ash are cleaned, and the air is cleared, before children spend time indoors.
• Keep a NIOSH N95 respirator on while you do cleanup, and change out of ashy clothes before you hug your kids.

Children also read your face and your tone. They will take their cues from how the adults around them are coping, so part of bringing them home safely is tending to your own steadiness too. If you are searching for belongings together, decide in advance what the children will and will not handle, and have a plan for the moment a child finds something meaningful that did not survive. Those moments come, and meeting them with calm and honesty helps more than shielding a child from every loss.

Give some thought, too, to what a child sees and breathes the first time they return. Soot stained walls, the smell of smoke, and a home that no longer looks like home can be frightening. If the structure is damaged or the air is not yet clear, it is reasonable to keep a first visit short, or to wait until the worst of the cleanup is done. There is no prize for rushing children back into a space that is still being made safe.

Caring for the mind: trauma and grief

Losing a home, a neighborhood, or a sense of safety is a profound loss, and grief is a normal response to it. So is the lingering stress that follows a frightening event. In the days and weeks after a fire, many adults notice trouble sleeping, a racing mind, irritability, sadness, exhaustion, difficulty concentrating, or a feeling of being on edge. You may replay the evacuation, or feel numb, or swing between the two. None of this means something is wrong with you. It means you lived through something hard.

Give yourself permission to recover slowly. Rest when you can, eat as regularly as your circumstances allow, move your body even a little, and lean on the people around you. Limit how much disaster news and imagery you take in, because a constant feed can keep the alarm bells ringing. Reach out to friends, family, neighbors, or a faith or community group. Connection is one of the strongest protections there is.

Be alert to ways of coping that quietly make things worse. Many people reach for alcohol or other substances to dull the stress, and while that may feel like relief in the moment, it tends to deepen anxiety and low mood over time. Notice, too, if grief and stress are tipping into something heavier: a sadness that does not lift, hopelessness, an inability to handle daily tasks, or thoughts of harming yourself. Those are signals to reach for help right away, not later. The free helplines listed at the end of this chapter exist for exactly these moments, and a counselor will talk with you whether your distress is large or small.

Recovery is rarely a straight line. People often feel they are coping in the first rush of activity, then hit a harder stretch weeks or months later, sometimes around an anniversary or a milestone like the demolition of a home. That delayed wave is normal. If it arrives, treat it the way you would treat any other injury surfacing: with attention and care, not judgment.

Signs of stress in children

Children often show distress through their bodies and behavior rather than words. Depending on their age, you might see:

• Clinginess, fear of separation, or not wanting to be alone
• Trouble sleeping, nightmares, or a return to bedwetting
• Stomachaches, headaches, or other physical complaints
• Irritability, outbursts, or unusual quietness and withdrawal
• Trouble focusing at school, or acting out the disaster in play

The most powerful thing you can offer a child after a disaster is steadiness. Keep routines as consistent as you can, even small ones: regular meals, a bedtime ritual, school when it is available. Reassure children that they are safe now and that the adults are working to take care of them. Answer their questions simply and honestly, give them extra patience and physical closeness, and let them know that their feelings make sense. If a child's distress is severe or does not ease over time, talk with their doctor or a school counselor.

For both children and adults, the antidote to chaos is routine. Small, predictable rhythms help a shaken family feel the ground again.

Caring for older adults and people with chronic conditions or disabilities

Disaster recovery is harder on people whose health is already fragile. Older adults, people with heart or lung disease, people with diabetes or kidney disease, and people with disabilities all face greater risk from smoke, from disrupted routines, and from the loss of medications and medical equipment.

• Protect medication supplies. If prescriptions were lost in the fire, contact the prescribing provider or pharmacy quickly to replace them. The CDC suggests keeping a supply of essential medications on hand where possible.
• Keep electricity dependent equipment in mind. Oxygen concentrators, CPAP machines, and refrigerated medicines like insulin all depend on power. Plan ahead for outages and ask your utility about medical baseline programs.
• Give them the cleanest air. Set up a room with filtered air and keep at risk family members in it during heavy smoke.
• Check in often. Older adults who live alone may not ask for help. Visit, call, and watch for confusion, breathing trouble, or signs they are not eating or drinking enough.
• Plan for accessibility. People who use wheelchairs, are blind or deaf, or need extra time should have their specific needs built into any return or relocation plan.

Protecting and reuniting with pets and livestock

Animals are family, and they are also vulnerable to the same smoke and ash that affect people. Keep pets indoors with you when air quality is poor, and keep them away from ash and debris, since they breathe it in and lick it off their fur and paws. Provide clean, safe water, and remember that water advisories that apply to your family apply to your animals too.

If you became separated from a pet during the fire, do not give up. Local animal rescue organizations, shelters, and groups work with fire and law enforcement agencies to rescue and care for displaced animals. A microchip with current contact information, along with a collar and tags, gives you the best chance of being reunited, because it links the animal back to you. Check local shelters and reunification efforts regularly and in person where you can.

For horses and livestock, reuniting and recovery take planning. Make sure animals carry identification, line up trailers and experienced handlers, and confirm that any place sheltering them has food, water, and veterinary care available. Reach out to your county agricultural office and local animal response groups, which often coordinate large animal sheltering after California fires.

Where to find free mental health help

You do not have to carry the emotional weight of a wildfire alone, and you do not need to be in crisis to reach out. Free, confidential support is available around the clock. Asking for help is a sign of strength, not weakness.

• SAMHSA Disaster Distress Helpline. Call or text 1-800-985-5990. This free, confidential, multilingual service from the Substance Abuse and Mental Health Services Administration offers crisis counseling for anyone experiencing emotional distress related to a natural or human caused disaster. It is available 24 hours a day, 7 days a week.
• 988 Suicide and Crisis Lifeline. Call or text 988, or chat online at 988lifeline.org. The Lifeline connects you with a trained, compassionate counselor for any emotional distress, not only thoughts of suicide. It is free, confidential, and available at all times.
• CalHOPE. California's CalHOPE program offers free, confidential crisis counseling and peer support to Californians recovering from disasters, including wildfires. You can learn more and find current services at calhope.org. CalHOPE is funded through federal disaster recovery programs and run by the California Department of Health Care Services.

If you or someone you love is in immediate danger, call 911. For ongoing support, talk with your primary care provider, who can connect you with counseling and care. Recovery from a wildfire is not only about rebuilding walls. It is about rebuilding the health, the calm, and the sense of safety of the people inside them. Be patient with yourself and your family, take the protective steps in this chapter one at a time, and lean on the help that is there for you. You will not always feel the way you feel right now.