Nine- year- old boy’s death from wildfire smoke speaks to a larger problem that could get much worse

This article was written by Kate Allen and was published in the Toronto Star on October 29, 2023.

Even after the wildfire smoke started blowing in, Carter Vigh was having a perfect summer day.

He had a picnic lunch and played at the water park. He kicked around a soccer ball. The nine- year- old loved soccer, and his asthma had never seriously interfered with his ability to play.

He found out it was free Slurpee day at 7- Eleven, and begged his mom to go.

“After dinner,” she promised. Carter, the baby of the family, helped his mom pick out a rotisserie chicken at the grocery store. They drove back to their home in 100 Mile House, B. C., where he sat next to his older brother and sister on the sofa so they could show him the virtual worlds they had built on Roblox.

That’s when he started coughing. When the coughing wouldn’t stop, his parents gave him his puffer and tried to keep him cool and calm in the bath. While concerning, this wasn’t unusual.

Carter’s parents, like hundreds of thousands of others in Canada, were accustomed to dealing with his asthma, the most common chronic disease in children.

The puffer wasn’t helping, so they bundled Carter into the car and drove to the hospital. A team of doctors, nurses and paramedics worked furiously on him.

“I stood there with him the whole time and told him, ‘ Just slow down, baby, it’s OK. I love you. Just keep trying to breathe,’ ” said Carter’s mother, Amber Vigh.

“Even until the point that the doctor asked us to leave the room to talk, I still thought there was a chance.”

Experts would later say Carter’s parents did everything right. What happened to him was part of a bigger problem.

Air pollution’s new risk

In recent decades, air pollution has receded as a public health threat. Thanks to regulations on cars, trucks and industry, emissions of some major pollutants have been slashed by more than three- quarters. But as climate change fuels the intensity and reach of wildfires, that progress is eroding. An unprecedented 18.5 million hectares burned across Canada this year, sending toxic plumes over cities across North America and darkening skies as far away as Europe.

Experts say this record- setting summer is likely a beginning, rather than a blip.

“Things will probably get worse,” says Paul Villeneuve, an environmental epidemiologist in the Faculty of Science at Carleton University.

“Sometimes the temptation is to say, ‘ Oh, this is a really bad year and things will get back to normal.’ But the larger trend is that we’re going to be seeing more of these, and they’re going to be worse.”

The contours of this emerging health threat, however, are still hard to make out. While some of the short- term consequences are well understood, wildfire smoke behaves very differently from car and truck exhaust, and the longterm effects are much less well studied. Links between air pollution and both neurological and psychiatric conditions suggest the risks extend beyond the physical.

As researchers race for answers, the public health response has been disjointed, leaving average Canadians in the dark. That day, the Vigh family had no idea how bad the air really was.

Since Carter’s death on July 11, Amber Vigh has not been able to bring herself to look at her son’s death certificate. But a few days later, the coroner told her the cause of death was asthma exacerbated by wildfire smoke, she says.

“I never thought in a thousand years I’d be talking to people about my son dying from asthma,” Vigh says.

“It was like any other day.”

Wildfire smoke is unpredictable The Vigh family moved to 100 Mile House in central B. C. so they could be closer to nature.

They fell in love with the forest and the lakes while visiting a relative, and relocated from Alberta, where all three kids were born, so they could spend more time boating, camping, ice- fishing and enjoying the outdoors.

That day, their distance from a major urban centre carried major consequences.

When they checked the Air Quality Health Index in the morning and saw a reading that indicated low risk, that number was based on air quality measurements taken almost 100 kilometres away.

There is no air- quality monitoring station in 100 Mile House, or anywhere between Williams Lake and Kamloops, a three- hour drive.

Canada’s air- quality monitoring program was designed for a different public health threat.

“The thing about wildfire smoke is that it’s very complex, and very variable,” says Angela Yao, a senior scientist at the B. C. Centre for Disease Control who has studied wildfires for the past decade.

When cars and trucks emit pollution, they are all burning roughly the same fuel source: gasoline. But the components of wildfire smoke can change from one fire and even one day to the next, as these blazes consume trees, houses, infrastructure and more.

The way wildfire smoke behaves is also very different. Car- related air pollution tends to build slowly and predictably, peaking at rush hour and lingering near busy roadways. But wildfire smoke can billow in rapidly and unpredictably, spiking pollution in areas far from the source of the blaze. Environment and Climate Change Canada has tweaked the Air Quality Health Index to respond better to the behaviour and type of pollutant in wildfire smoke. B. C. pioneered the new system, but not all provinces have adopted it. The B. C. Environment Ministry also issues “Smoky Skies Bulletins,” advisories that use smoke modelling and other data, and said in a statement that one was issued on July 11 for 100 Mile House. The Vigh family never saw it: “I didn’t even know that was a thing,” Amber Vigh says.

Ultimately, there are big gaps in where air quality is measured and significant lags in how that information gets to the public. There is also misunderstanding about when and how to act.

This past summer, media stories and public attention focused on episodes when Canadian wildfire smoke drove air pollution levels staggeringly high, crowning cities like Toronto, Montreal and New York City the worst in the world.

But research by Yao and others suggest the public should be concerned long before pollution ever reaches these sky- high maximums.

Since wildfire smoke can vary hugely in a single day, Yao and her colleagues looked at hourly pollutant readings during wildfire season in B. C. and compared that with emergency medical services dispatches.

They discovered that ambulance calls for respiratory concerns such as asthma and cardiovascular problems such as heart attacks increased in the first hour of a bad air episode.

This means people at risk — children, seniors, pregnant women, anyone with respiratory conditions, and more — need to react well before the index hits the maximum 10- plus.

And it means communities need to plan, Yao says, equipping buildings with air filtration systems to provide the pollution equivalent of a heat- relief network.

Installing more air quality sensors locally would also be a big benefit, and these are becoming much easier to obtain with the proliferation of low- cost off- the- shelf systems like Purple Air.

To regular Canadians, Yao has this message: “Get prepared.”

“The first time you actually see this, you’re probably shocked and panicked at what’s happening. But over time, then people will understand that this is something we will have to live with. It’s something we need to get prepared for every year. Being prepared can reduce the anxiety and the fear.”

What should the public do?

This summer showed “that the public health messaging and guidance needs to be improved,” says Eric Lavigne, a research scientist at Health Canada’s Environmental Health Science and Research Bureau.

“There were sometimes conflicting messages about which type of air quality index to look for,” Lavigne adds.

But beyond that, more research is needed to inform those public health messages, like what type of mask to wear and when, and at what point it’s unsafe to be outside for different at- risk groups and for the general public.

The public also had questions about the long- term effects of living with wildfire smoke, Lavigne says — a question researchers are increasingly trying to answer.

A major study of millions of Ontarians, published in the Lancet, showed that living closer to heavy traffic was associated with a higher incidence of dementia. Other studies have shown that both short- and long- term exposure to air pollution affected users’ cognitive performance on brain- training games. Exposure to air pollution has also been linked to increased emergency visits for mental health disorders in young people and increased risk of suicide.

Most of these studies looked at typical, ambient air pollution; not as many studies on long- term exposure to wildfire smoke have been done, says Villeneuve, who was a co- author on the dementia and suicide studies. “The focus tends to be on, you know, what goes on in the few days or maybe the week around the increased exposure from the wildfire.”

But with exposure to wildfire smoke increasing, studies of longterm effects need to increase too, Villeneuve says.

In July, the B. C. Coroner’s Service issued a bulletin saying it was investigating Carter Vigh’s death, which was “related to an existing medical condition aggravated by wildfire smoke.” That investigation is continuing, a spokesperson says.

The bulletin also added that “as the province experiences greater impacts from the effects of climate change, British Columbians are learning more about the risks associated with wildfire smoke, extreme heat and other environmental factors. This greater awareness can help us respond when risks are identified.”

Reliving Carter’s death is incredibly painful for Amber Vigh, but she says it’s worth it if it will help even one person with asthma — a condition that about 15 per cent of Canadian kids live with, and whose prevalence is increasing. The family partnered with the B. C. Lung Foundation to launch Carter’s Project, which will raise money to install more air quality monitors in 100 Mile House and other B. C. communities.

“Even though the smoke wasn’t bad that morning, the air quality was obviously horrible,” she says. “But we didn’t have that information.”

Every day, she puts one foot in front of the other. “We do it because we have two more kids that deserve to have us here.”

The night of Carter’s death, a friend took Carter’s brother out to get a Slurpee, an attempt to cheer him up. They got one for Carter, too, even though he would never taste it.