N.C. Public Health, Health and Human Services
DHHS DPH Epidemiology Occupational and Environmental Climate and Health

Epidemiology: Occupational and Environmental

Climate and HealthNorth Carolina is experiencing hotter temperatures, sea-level rise, impaired air quality and more frequent and intense hurricanes and precipitation events as a result of climate change. These hazards diminish health by causing or exacerbating heat-related illness, asthma, respiratory illness, cardiovascular illness, impaired mental health, and other conditions. Existing inequities in environmental health exposures are exacerbated by climate change – older adults, children, low-income earners, outdoor workers, Spanish speakers, indigenous communities, and communities of color are disproportionately affected.

According to the 2020 North Carolina Climate Science Report, most parts of North Carolina are projected to see at least 2-3 additional weeks of very hot days (maximum temperature of 95°F or higher) for 2021-2040.

The NC Climate and Health Program collaborates with partners to build community resilience against climate change and its impact on public health by implementing adaptation actions, leading climate and health trainings, conducting epidemiological analyses, and providing technical expertise. Previous funding has been used to address health effects from heat and wildfires through heat syndromic surveillance, heat-health alert systems, education campaigns and wildfire health curriculum. The next 5 years will build on this adaptation work while incorporating climate justice and focusing on flooding effects around the state. Activities respond to Executive Order No. 80, the NC Climate Risk Assessment and Resilience Plan, and an extensive literature on the health effects of climate change. Much of the program’s adaptation work is focused in the Sandhills region of southeastern North Carolina due to its combination of complex hazards, health conditions, historical injustice, and historical resilience.

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 Climate and Health Resources

 Facts and Figures

Extreme Heat

In North Carolina, heat-related illness (HRI) is an annual concern. According to the 2020 North Carolina Climate Science Report, most parts of North Carolina are projected to see at least 2-3 additional weeks of very hot days (maximum temperature of 95°F or higher) for 2021-2040. On average, there are approximately 4,000 emergency department visits for HRI during heat season (May 1 – September 30) in North Carolina. The majority of emergency department visits for HRI are among males, particularly those between the ages of 25-34 years of age. Though anyone can be affected by complications from HRI, older North Carolinians ( > 65 years) are more likely to be hospitalized for HRI.

Learn more about heat-related illnesses and injuries in North Carolina and how to prevent them: Summer Heat Emergency Data and Prevention Tips.

Air Quality

Compound climate hazards from increasing pollen, ozone, and PM 2.5 levels outdoors and moisture in homes from flood damage can trigger asthma, allergies, and respiratory symptoms for sensitive individuals. Impaired air quality from wildfire smoke may contribute to increased emergency department (ED) visits for asthma, cardiovascular disease, and diabetes in North Carolina. For example, the 2008 wildfire season saw an increase in cardiovascular and respiratory ED visits by 42-66%. Eastern North Carolina, the area of the state most affected by floods and wildfires as well as extreme heat, has the highest rates of emergency department visits for asthma.

Sample Messages

The sample messages and graphics below can be used to share wildfire and prescribed burn smoke safety tips and air quality alerts with your loved ones, community,  or organization. Follow the guidelines below for message compatibility across communication platforms. Click on the graphics in the right column to download.

Wildfire Smoke and Health Messaging

Written samples below are compatible with X (formerly Twitter), Facebook, Instagram, WhatsApp, email, etc.

Sample Post

Wildfire smoke spreading and can’t filter your air at home? If the air quality in your area is poor, seek cleaner air in public buildings with air filtration systems, like community centers, libraries, or shopping malls.

#IndoorAirQuality #WildfireSmoke #Wildfires


Sample Post

¿El humo de los incendios forestales se propaga y no puede filtrar el aire en casa? Si la calidad del aire en su zona es mala, busque aire más limpio en edificios públicos con sistemas de filtración de aire, como centros comunitarios, bibliotecas o centros comerciales.

#IndoorAirQuality #WildfireSmoke #Wildfires


Sample Post

During wildfire smoke events, keep indoor air clean by using a HEPA filter in your home. Or make your own air filter and choose one or two rooms to keep free of air pollution. Learn how: https://www.youtube.com/watch?v=V8DqzogXcVg.

#IndoorAir #WildfireSmoke


Sample Post

Durante los eventos de humo de incendios forestales, mantenga limpio el aire interior usando un filtro HEPA en su hogar. O haga su propio filtro de aire y elija una o dos habitaciones para mantenerlas libres de contaminación atmosférica. Aprenda cómo hacerlo en https://www.youtube.com/watch?v=V8DqzogXcVg.

#IndoorAir #WildfireSmoke


Written messages below are compatible with Facebook, Instagram, WhatsApp, email, etc.

Sample Post

Code Orange! Due to wildfire smoke, air quality is unhealthy [today/tomorrow] in [list areas/counties] for people with heart or lung disease, older adults, children, and people who are pregnant. Symptoms include itching eyes, irritated sinuses, headache, and coughing. If you belong to one of these groups or you are experiencing symptoms, make outdoor activities shorter and less intense, seek cleaner air indoors, and take more breaks indoors. Learn more here: https://epi.dph.ncdhhs.gov/oee/ climate/ WildfireSmokeandHealthFactSheet.pdf.

Check the air quality in your area at https://airquality.climate.ncsu.edu/. Stay up-to-date on air quality in your area by signing up for alerts at https://www.enviroflash.info/signup.cfm

#CodeOrange #AirQualityAlert #WildfireSmoke


Sample Post

¡Código naranja! Debido al humo de los incendios forestales, la calidad del aire no es saludable [hoy/mañana] en [enumere las áreas/condados] para las personas con enfermedades cardíacas o pulmonares, los adultos mayores, los niños y las mujeres embarazadas. Los síntomas incluyen picazón en los ojos, irritación de los senos paranasales, dolor de cabeza y tos. Si pertenece a uno de estos grupos o tiene síntomas, disminuya el tiempo y la intensidad de las actividades al aire libre, busque aire más limpio en el interior y tome más descansos en el interior. Obtenga más información aquí: https://epi.dph.ncdhhs.gov/oee/ climate/ WildfireSmokeandHealthFactSheet-Spanish.pdf.

Verifique la calidad del aire en su zona en https://airquality.climate.ncsu.edu/. Manténgase actualizado sobre la calidad del aire en su zona inscribiéndose para recibir alertas en https://www.enviroflash.info/signup.cfm

#CodeOrange #AirQualityAlert #WildfireSmoke


Sample Post

Code Red! Due to wildfire smoke, air quality is unhealthy for EVERYONE [today/tomorrow] in [list areas/counties]. Anyone experiencing symptoms, such as itching eyes, irritated sinuses, headache or coughing, should stay indoors if possible, especially sensitive groups. Everyone should make outdoor activities less intense and take frequent breaks indoors. Learn more here: https://epi.dph.ncdhhs.gov/oee/ climate/ WildfireSmokeandHealthFactSheet.pdf.

Check the air quality in your area at https://airquality.climate.ncsu.edu/. You can also stay up-to- date on air quality in your area by signing up for alerts at https://www.enviroflash.info/signup.cfm

#CodeRed #AirQualityAlert #WildfireSmoke


Sample Post

¡Código rojo! Debido al humo de los incendios forestales, la calidad del aire es dañina para TODOS [hoy/mañana] en [enumere áreas/condados]. Cualquier persona que experimente síntomas, como picazón en los ojos, irritación de los senos paranasales, dolor de cabeza o tos, debe permanecer en el interior si es posible, especialmente los grupos sensibles. Todos deben reducir la intensidad de las actividades al aire libre y tomar descansos frecuentes en el interior. Obtenga más información aquí: https://epi.dph.ncdhhs.gov/oee/ climate/ WildfireSmokeandHealthFactSheet-Spanish.pdf

Verifique la calidad del aire en su zona en https://airquality.climate.ncsu.edu/. También puede mantenerse al día sobre la calidad del aire en su zona suscribiéndose a las alertas en https://www.enviroflash.info/signup.cfm

#CodeRed #AirQualityAlert #WildfireSmoke


Sample Post

Smoke from wildfires increases air pollution and can affect your health. Children, pregnant people, older adults & those with heart or lung disease are at greatest risk of health impacts from smoke exposure. Reduce outdoor activity, limit indoor air pollution, and monitor your health. Learn more about how to keep yourself and loved ones safe:  https://www.cdc.gov/air/wildfire-smoke/default.htm

 #AirPollution #WildfireSmoke #Health


Sample Post

El humo de los incendios forestales aumenta la contaminación del aire y puede afectar su salud. Los niños, las mujeres embarazadas, los adultos mayores y las personas con enfermedades cardíacas o pulmonares corren el mayor riesgo de sufrir impactos en la salud debido a la exposición al humo. Reduzca la actividad al aire libre, limite la contaminación del aire interior y controle su salud. Obtenga más información sobre cómo protegerse a sí mismo y a sus seres queridos: https://www.cdc.gov/air/wildfire-smoke/default.htm

#AirPollution #WildfireSmoke #Health


Sample Post

Did you know? Wildfire smoke increases air pollution and can affect your health, even thousands of miles from the wildfire location! Be prepared for wildfire smoke events. Talk with your healthcare provider to develop a personal plan to protect your health when there is smoke in the air. Prepare an emergency kit with N95 respirator masks, medications, and other essential supplies. Have a plan for creating a safe indoor air environment or where to go to seek cleaner air. Stay informed about air quality in your area by signing up for alerts at https://www.enviroflash.info/signup.cfm. For more information about how to prepare for wildfires and wildfire smoke events go to  https://www.cdc.gov/disasters/ wildfires/beforefire.html

#BePrepared #AirQuality #WildfireSmoke #ClimateChange


Sample Post

Información útil El humo de los incendios forestales aumenta la contaminación del aire y puede afectar su salud, incluso a miles de millas del lugar del incendio forestal. Prepárese para el humo de los incendios forestales. Hable con su proveedor médico para elaborar un plan personal para proteger su salud cuando haya humo en el aire. Prepare un kit de emergencia con mascarillas respiratorias N95, medicamentos y otros suministros esenciales. Tenga un plan para crear un ambiente de aire interior seguro o un lugar adonde ir para buscar aire más limpio. Manténgase informado sobre la calidad del aire en su zona suscribiéndose a las alertas en https://www.enviroflash.info/signup.cfm. Para obtener más información sobre cómo prepararse para los incendios forestales y los eventos de humo, visite https://www.cdc.gov/ disasters/ wildfires/beforefire.html

#BePrepared #AirQuality #WildfireSmoke #ClimateChange


Sample Post

Children are at increased risk of health impacts from wildfire smoke. Take extra care to protect them by checking air quality reports and following recommendations about exercise and going outside for “sensitive individuals.” If your child has asthma, allergies, or chronic health issues, plan how they can stay indoors more often during poor air quality days. Learn more: https://www.cdc.gov/air/ wildfire-smoke/children.htm

#AirQuality #WildfireSmoke #ProtectChildHealth #ClimateChange


Sample Post

Los niños corren un mayor riesgo de sufrir impactos en la salud por el humo de los incendios forestales. Extreme las precauciones para protegerlos al comprobar los informes sobre la calidad del aire y seguir las recomendaciones sobre ejercicio y salidas al aire libre para “personas sensibles”. Si su hijo tiene asma, alergias o problemas de salud crónicos, planifique cómo puede permanecer en el interior con más frecuencia durante los días de mala calidad del aire. Obtenga más información en https://www.cdc.gov/air/wildfire-smoke/children.htm

#AirQuality #WildfireSmoke #ProtectChildHealth #ClimateChange


Sample Post

Fine particles in wildfire smoke can get deep into your lungs and cause or make worse a range of health problems. People with heart or lung disease should talk to their healthcare provider to develop a personal plan to protect their health when there is smoke in the air. Learn more: https://www.cdc.gov/air/wildfire-smoke/chronic-conditions.htm

#WildfireSmoke #PM2.5


Sample Post

Las partículas finas del humo de los incendios forestales pueden penetrar profundamente en los pulmones y causar o empeorar una serie de problemas de salud. Las personas con enfermedades cardíacas o pulmonares deben hablar con su proveedor médico para elaborar un plan personal que proteja su salud cuando haya humo en el aire. Obtenga más información en https://www.cdc.gov/air/wildfire-smoke/chronic-conditions.htm

 #WildfireSmoke #PM2.5


Sample Post

Wildfire season is approaching in the United States. Wildfire smoke increases air pollution and can affect your health, even thousands of miles from the wildfire location! Be prepared by checking the air quality in your area at https://airquality.climate.ncsu.edu/.  Stay up-to-date on air quality in your area by signing up for alerts at https://www.enviroflash.info/signup.cfm

#AirQuality #WildfireSmoke


Sample Post

Se acerca la temporada de incendios forestales en los Estados Unidos. El humo de los incendios forestales aumenta la contaminación del aire y puede afectar su salud, incluso a miles de millas del lugar del incendio forestal. Prepárese comprobando la calidad del aire en su zona en https://airquality.climate.ncsu.edu/. Manténgase actualizado sobre la calidad del aire en su zona suscribiéndose a las alertas en https://www.enviroflash.info/signup.cfm 

#AirQuality #WildfireSmoke


Prescribed Burn Smoke and Health Messaging

Sample Post

Not all forest fires are bad! Prescribed burns are controlled fires set by trained professionals to reduce vegetation, restore ecosystems, and reduce wildfire risk. Protect yourself from smoke during prescribed burn events by staying inside and turning on your HVAC system or using a portable air filter. Learn more about prescribed burns here.

#AirPollution #AirQuality #PrescribedBurns


Sample Post

No todos los incendios forestales son malos. Las quemas controladas son incendios controlados provocados por profesionales capacitados para reducir la vegetación, restaurar los ecosistemas y reducir el riesgo de incendios forestales. Protéjase del humo durante los eventos de quema controlada al permanecer adentro y encender su sistema de calefacción, ventilación y aire acondicionado (HVAC) o usar un filtro de aire portátil. Obtenga más información sobre las quemas controladas aquí.

#AirPollution #AirQuality #PrescribedBurns


Sample Post

There will be prescribed burns in [insert area/county] on [insert day(s)]. Prescribed burns are important for ecosystem health and reduce wildfire risk. Smoke from prescribed burns may cause some people to experience symptoms. Children, older adults, people with heart or lung disease and people who are pregnant should take extra care to protect themselves. If you live near this area and are sensitive to smoke, stay inside, turn on your HVAC system or use a portable air filter. Monitor your symptoms and seek medical care if needed. Learn more about prescribed burns here.

#AirPollution #AirQuality #PrescribedBurns


Sample Post

Habrá quemas controladas en [insertar zona/condado] el [insertar días]. Las quemas controladas son importantes para la salud del ecosistema y reducen el riesgo de incendios forestales. El humo de las quemas controladas puede hacer que algunas personas experimenten síntomas. Los niños, los adultos mayores, las personas con enfermedades cardíacas o pulmonares y las mujeres embarazadas deben tener especial cuidado para protegerse. Si vive cerca de esta zona y es sensible al humo, permanezca en el interior, encienda su sistema de calefacción, ventilación y aire acondicionado (HVAC) o utilice un filtro de aire portátil. Controle sus síntomas y busque atención médica si es necesario. Obtenga más información sobre las quemas controladas aquí.

#AirPollution #AirQuality #PrescribedBurns


Extreme Weather Events

Increasing frequency and intensity of precipitation and extreme weather events, specifically hurricanes, has caused extensive and widespread flooding along the coast and in the southeastern region of NC. These events can have a myriad of short-term and long-term public health impacts, including storm-related injuries, transportation fatalities, carbon monoxide poisonings, exposures to floodwaters containing pathogens, respiratory illness, and mental health impacts.

 Climate and Health Funding

The North Carolina Climate and Health Program is part of a national public health effort to anticipate and prepare for human health effects related to global and local climate change. The program has been supported by the Centers for Disease Control and Prevention's Climate and Health Program since 2010 and was recently awarded funding to continue and expand climate and health adaptation work through 2026.

 Publications

Guidry, V.T., Thie, L., & Money, E. B. (2020). Health Benefits of North Carolina's Transition to Clean Energy . North Carolina Medical Journal, 81(5), 334-335.

Thie, L., & Tart, K. T. (2018). On the front lines of climate health effects in North Carolina . North Carolina Medical Journal, 79(5), 318-323.

Sun, X., Waller, A., Yeatts, K. B., & Thie, L. (2016). Pollen concentration and asthma exacerbations in Wake County, North Carolina, 2006–2012 . Science of the Total Environment, 544, 185-191.

 Additional Information

Climate and Health

Related OEEB Programs

Last Modified: 10-03-2024