Spain’s Ministry of Health has released its first dedicated guide on the health risks of wildfires

Madrid, June 27, 2026

“Health Recommendations for Wildfire Situations 2026,” coordinated by the Sub-Directorate General for Environmental Health and Occupational Health. The move responds to a threat that is growing more severe as climate change lengthens fire seasons and intensifies extreme heat.

Why smoke is the biggest concern is the guide’s starting point, since wildfire smoke is a complex mix of gases and particles, including fine particulate matter (PM2.5 and PM10), carbon monoxide, nitrogen oxides, ozone, volatile organic compounds like formaldehyde and benzene, and even lead. Of these, PM2.5 is considered the greatest threat because it’s small enough to penetrate deep into the body.

A large European study cited in the guide found that even small increases in these particles are linked to measurable rises in mortality: a 0.7% increase in deaths overall, 0.9% specifically from cardiovascular causes, and 1.3% from respiratory disease. The guide notes that failing to account for this toxicity would cause death tolls from wildfire smoke to be underestimated by more than 90%.

Short-term smoke exposure can trigger a wide range of symptoms: runny nose, eye and throat irritation, persistent cough, headaches, fatigue, dizziness, breathing difficulty, chest pain, rapid heartbeat, vomiting, asthma attacks, and in more severe cases, confusion or altered consciousness.

Beyond the immediate symptoms, the guide details longer-term risks:

Respiratory system: worsening of asthma, bronchitis, COPD, and emphysema; temporary and, with prolonged exposure, progressive decline in lung function; greater susceptibility to infections like flu or pneumonia; and an association with increased lung cancer risk.

Cardiovascular system: fine particles promote arterial inflammation and can destabilize existing arterial plaques, raising the risk of heart attack, heart failure, stroke, and arrhythmia.

Pregnancy: increased risk of preterm birth and low birth weight.

Neurological effects: fine particles and inflammatory compounds can reach the brain, with chronic inflammation linked over the long term to stroke, Alzheimer’s, and Parkinson’s risk, plus short-term attention deficits in adults.

Cancer risk: smoke can contain carcinogens and mutagens; exposure has been associated with leukemia, non-Hodgkin lymphoma, and cancers of the larynx, pharynx, and bladder.

Direct injuries and mental health round out the physical picture, since beyond smoke, people near the fire itself face burns, acute inhalation of toxic gases and heat (including carbon monoxide), and trauma from falls, collapsing structures, or escape attempts.

The psychological toll is also significant, even for people who suffered no physical harm. The guide highlights PTSD (especially among those who lost homes or loved ones or were evacuated), anxiety and depression, sleep and eating disturbances, and grief over lost property, memories, and the transformed landscape. Children may show irritability, social withdrawal, sleep problems, nightmares, and declining school performance.

Who’s most at risk is a question the guide answers directly, flagging several groups as especially vulnerable: people over 65, pregnant women, children under 5 (especially infants), outdoor workers, people with pre-existing respiratory conditions (asthma, COPD), people with heart disease, those needing oxygen therapy, and people with diabetes, cancer, or weakened immune systems.

When heat and smoke combine, the danger compounds, since wildfires often coincide with drought, heat waves, and strong winds, and climate change is intensifying all three, drying out vegetation into ready fuel and extending fire seasons. Heat alone can cause a spectrum of illness, from heat rash and muscle cramps to heat exhaustion and, in the most severe cases, heatstroke, marked by body temperature above 40°C, confusion, seizures, or coma, with a high risk of multi-organ damage and death if untreated. Heat also worsens existing conditions: heart events, acute kidney failure, asthma/COPD flare-ups, and even psychiatric symptoms like anxiety, aggression, and increased suicide risk.

Water and soil contamination after a fire is one of the more technical, and less obvious, sections of the guide. After a wildfire, ash and debris can contaminate water supplies for months or even decades, depending on fire severity, terrain, and post-fire rainfall. Key concerns include:

Sediment and ash reducing reservoir capacity and harming aquatic life.
Nitrates and other nutrients released from burned vegetation, which can cause algae blooms and are a particular danger to infants, since high nitrate levels can cause methemoglobinemia (“blue baby syndrome”), which impairs the blood’s ability to carry oxygen.
Heavy metals and radionuclides (aluminum, manganese, copper, zinc) mobilized from burned soil, which can be neurotoxic and harm kidneys and liver.
oxic organic compounds, polycyclic aromatic hydrocarbons, dioxins, and furans, linked to cancer risk.
Cyanide, released both by combustion and by some fire retardants, which can cause dizziness, confusion, and collapse within minutes at high concentrations.
Bacterial and cyanobacteria growth, raising risk of gastrointestinal illness and, in some cases, liver or neurological toxins from algae blooms.
Firefighting chemicals themselves, since retardants often contain ammonia-based nitrogen compounds that can reach toxic levels for aquatic life.

Burned, exposed soil is also far more prone to erosion once rain returns, since vegetation that would normally slow runoff is gone. This degrades the most fertile topsoil, a process that takes centuries to reverse, with knock-on effects for food security and water resources.

The Ministry’s recommendations cover general precautions, specific indoor and outdoor guidance, care for vulnerable groups, burn treatment, and information sources, as set out below.

General:
– Stay calm; avoid panic.
– Stay indoors when safe, without opening windows or ventilating directly with outside air.
– Drink plenty of water; avoid alcohol and caffeine.
– Cut unnecessary travel; use headlights during the day if you must drive.
– Wear FFP2/N95 masks when exposed to smoke, since surgical masks and cloths/scarves do NOT protect against smoke particles. FFP2 masks with activated carbon filters also help against toxic gases.
– Follow official sources for updates.

Indoors:
– Close doors, windows, and all ventilation sources (chimneys, extractor fans, vents).
– Stay in the coolest room, ideally with air conditioning.
– Avoid other indoor air pollution sources, such as smoking, gas/wood stoves, aerosols, vacuuming, frying/grilling.
– Don’t sweep or shake dust from surfaces, since this resuspends particles. Use damp cloths instead.

Outdoors:
– Avoid open areas or getting within 300 meters of an active fire.
– Reduce physical activity, indoors and out.
– If you must go outside in smoke or ash, wear a mask (preferably FFP2/N95), and if possible, protective glasses and long sleeves.

Vulnerable groups and warning signs:
– Pay special attention to older adults, children, pregnant women, and those with chronic conditions.
– Seek emergency care for breathing difficulty, chest pain, rapid pulse, burns, or if you need medication for a chronic condition and can’t access it.

Burns:
– Call for emergency help; only give first aid if it’s safe to do so.
– Remove burning clothing and put out flames (rolling on the ground, using a blanket or extinguishing liquid, avoiding water, which risks steam burns).
– For minor burns, run cool water over the area for 20–30 minutes.
– For severe burns, don’t try to remove clothing stuck to the skin; cover with a clean, dry cloth to prevent shock.
– Never apply ice, ointments, or oils to burns.

Information sources:
– Call 112 to report or respond to a fire.
– Check air quality at ica.miteco.es or regional government sites.
– Verify information before sharing it, since misinformation during emergencies can lead to harmful decisions.

After the fire:
– Only ventilate your home once authorities confirm outdoor air quality is safe.
– Avoid contact with ash; wash any exposed skin promptly.
– Clean surfaces with a damp cloth, not by sweeping.
– Confirm water safety with local authorities before use; avoid unconnected natural springs.
– Don’t eat food that was directly exposed to smoke or ash; wipe down sealed packaging with safe water before opening.
– Seek psychological support if stress, anxiety, or grief persist, through primary care or public support services.

Source: Ministerio de Sanidad (Spain), “Recomendaciones sanitarias en actuaciones de incendios forestales 2026,” published June 27, 2026.

Please note: The information provided is based upon our understanding of current legislation. It is not legal advice but is provided freely to enable you to be properly informed. We recommend that if you are considering taking action, you should seek professional advice.