Hazardous air is causing a jump in emergency department visits in Multnomah County

September 11, 2020

Wildfire smoke and a lack of wind have caused the area’s most unhealthy air conditions on record. Air monitors show most of Multnomah County with air quality ranging from very unhealthy to hazardous. And  emergency department visits for asthma and shortness of breath sharply increased Thursday, to nearly double the typically expected number.

Smoke over the Willamette River, Sept. 11, 2020

“This is the worst air quality I’m aware of in our history. This is significantly worse air quality than we saw during the Eagle Creek Fire,” said Andrea Hamberg, a program supervisor at Multnomah County Environmental Health. “When we have periods of bad air quality, we see an increase in asthma attacks and other respiratory health problems. This is like smoking a lot of cigarettes.”

Air quality has declined across Multnomah County since Thursday, leaving the city of Portland breathing “very unhealthy” and “hazardous” air, according to Oregon’s air quality index. (Learn more about the air quality index here)

County residents woke Friday morning engulfed in smoke. There is hope in the latest forecasts that winds will slowly push smoke out starting Saturday, but unhealthy conditions are likely to persist until Monday. Early next week, additional improvement to air quality is expected with some moisture and light winds.

Yet health officials worry that the hazardous air is already making people sick and could put some residents at increased risk of dying from respiratory and vascular illnesses.

“This air pollution is bad for you even if you are healthy. We know it’s related to short-term effects even for people who are healthy,” Hamberg said. “But it can also be severe.”

Hospital records show more people are visiting emergency departments with asthma and shortness of breath. Records showed a sharp increase Thursday.

The number of people reporting asthma-like symptoms jumped 88 percent over the average on recent smoke-free days. People reporting those symptoms accounted for 10 percent of all emergency department and urgent care visits. 

“This is a very similar pattern to what we saw during the Eagle Creek Fire in 2017,” Hamberg said.

Know the symptoms

The symptoms of wildfire smoke most reported in Oregon this week include scratchy throat, stinging or watery eyes, stuffy nose, sinus irritation, coughing, trouble breathing, and tiredness or dizziness.

Mild symptoms of smoke exposure often include:

  • Cough

  • Headache

  • Burning eyes

  • Sore throat

  • Phlegm production

  • Changes in breathing

Dry cough, sore throat, and difficulty breathing are common to both wildfire smoke exposure and COVID-19. Contact your doctor if you believe you are experiencing symptoms of COVID-19.

But smoke exposure can also cause serious and life-threatening respiratory distress, including heart attacks and strokes. If you’re in distress, you should immediately dial 9-1-1.

People at risk

People at the greatest risk of complications from smoke exposure include pregnant women, children, people with pre-existing heart disease, people with chronic lung disease, and older individuals.

People who work outdoors are also at elevated risk. For those who must work, wear a properly fitted N95-rated mask and take breaks inside a structure or even in your car.

What should you do

Stay inside with windows and doors closed.

  • Avoid spending time outside, and certainly avoid exercise outdoors. 

  • If available, set AC to recirculate and or use an air cleaner with a HEPA filter

  • Also avoid being on the roads as visibility worsens.

  • For the latest information from Multnomah County, go to multco.us/fires2020

Keep an eye on air quality near you:

  • The Oregon Department of Environmental Quality  has a phone app to track air quality. 

  • If that is overwhelmed, you can find other links to air quality maps below or on our website.

Create a clean room

Creating a “clean room” is a good idea especially for those with pre-existing conditions. Choose an interior room with few windows and doors and do the following:

  • Keep windows and doors closed.

  • Set up an air cleaner to help remove particles from the air 

  • Run an air conditioner or central air conditioning system. Make sure the filter is clean.

  • Use a damp mop or and dust with a damp cloth. Do not vacuum. 

Long-term smoke events usually have periods when the air is better. When air quality improves, even temporarily, air out your home to reduce indoor air pollution. People in homes that are too warm to stay inside with the windows closed, or who are at-risk of smoke-related health effects, should seek shelter elsewhere.

For additional information, see the EPA’s tips to create a clean room.

Gauging air quality

Wildfires have swept the West Coast, engulfing many areas of the Oregon Cascades. Some air quality monitors have lost power, while others can’t be reached for cleaning, and still others have been damaged or destroyed, leading to less information on air quality. Air quality web systems are also periodically overwhelmed by traffic, causing web-based maps to slow or fail to load.

Air quality data:

  • Oregon Smoke Blog: Local, state, tribal and federal organizations coordinate to share information about wildfires and smoke.

  • Oregon Air Quality map: The state Department of Environmental Quality updates a map of current air quality. Due to high traffic, the site can slow or crash. The sites below offer good alternatives.

  • EPA Air Quality map: The U.S. Environmental Protection Agency pulls real-time air quality data from Oregon and Washington States. 

  • State of Oregon Fires Map: The Oregon Office of Emergency Management updates a map of active fires, air quality and closures.


The Oregon Department of Environmental Quality shares this 5-3-1 visibility index helps estimate smoke levels:

  • Five miles: air quality is generally good.

  • Three to five miles: air quality is unhealthy for young children, older adults, pregnant women, and people with heart or lung disease, asthma or other respiratory illness. 

  • Less than three miles: air quality is unhealthy for everyone.

  • Less than one mile: the air quality is unhealthy for everyone.

Your body

Healthy people affected by smoke may have only mild symptoms. But healthy people may also have underlying health conditions that put them at risk. Listen to your body’s cues:

If your eyes are burning, if your throat is sore, if your lungs are having a hard time expanding, if you are coughing, stay inside and focus on creating a “Clean Room” where the air is as clean as possible.