LITITZ — Karen Schaeffer decided to keep all children at St. Paul Christian Early Learning Center indoors on July 17 due to hazardous air quality conditions in Lititz, Pennsylvania. The Environmental Protection Agency’s air quality index in the area reached 270 on that date, a level deemed very unhealthy for everyone.

Schaeffer runs the center, which cares for 130 children ranging from infants to elementary school-aged students. She has worked at the facility for 39 years and faced the decision without specific state mandates governing outdoor activities during such events. AirNow.gov rated the air quality in Lititz as Code Purple on July 17, indicating serious health risks for the general population.

While Schaeffer restricted outdoor access, dozens of children at another summer camp program played outdoors at a community pool despite the visible haze. This contrast shows how decisions about how to act on weather guidance are made by the people running the childcare centers rather than by uniform regulatory requirements. The Pennsylvania Department of Human Services regulates childcare centers through its Office of Child Development and Early Learning and shares weather guidance with these facilities, but it does not enforce mandatory closures or indoor restrictions.

Children are particularly affected by poor air quality because they breathe more rapidly and can absorb more pollution than adults. The pollutants in wildfire smoke include PM2.5 particles, which are many times smaller in diameter than a human hair. These particles can be inhaled deeply into the lungs where they cause negative short-term health impacts like asthma attacks. Longer-term exposure can lead to chronic bronchitis, and the particles can pass from the lungs into the bloodstream to contribute to illnesses like cardiovascular disease and dementia.

Nicholas Muller, who studies the intersection of environmental policy and economics at Carnegie Mellon University, emphasized the severity of these health risks. "Exposure over periods of time to elevated PM2.5 increases our risk of death," Muller said. He noted that the impact worsens as concentration levels rise, stating, "The relationship between impact—whether it’s illness or a premature death, just gets worse as the concentration gets higher." Muller co-authored a paper in the journal Communications Earth & Environment estimating that wildfire and prescribed burn smoke caused $200 billion in health damages in the U.S. in 2017. That same year, the smoke was associated with 20,000 premature deaths in the U.S. with impacts disproportionately affecting socially vulnerable groups including people of lower socioeconomic status, senior citizens, and people of color.

Muller lives in Pittsburgh, a city considered to have some of the dirtiest air among major U.S. cities under normal conditions. "PM2.5 readings [in Pittsburgh] are often between 10 and 15 micrograms [per cubic meter of air]," Muller said. However, during the recent smoke event, levels spiked dramatically.

"The readings I’ve seen were over 200 micrograms [in mid-July]," he said. "That’s 20 times higher concentration." Muller described these levels as extremely dangerous and explained that populations with higher baseline mortality face worse impacts from the exposure. "It exacerbates existing risks," he said.

Alex Bomstein, executive director of the Clean Air Council who lives in Philadelphia, observed that current air quality levels are historically abnormal. "I’m in my 40s now and growing up this was not a usual thing—getting a blanket of wildfire smoke over the region that will last for days," Bomstein said in a podcast interview. He took personal protective measures during the incident, noting, "During these incidents, when I went outside I wore an N95 mask." However, he saw limited adoption of such precautions among the general public. "I saw several other people wearing masks, but the vast majority were not, and that’s dangerous," Bomstein said.

The warming climate, largely caused by burning fossil fuels, is the main driver of hotter, dryer conditions that make wildfires more likely and more intense. As the climate heats up, the vapor pressure deficit increases, allowing the atmosphere to suck more moisture out of vegetation and soils. Vapor pressure deficit is the difference between the amount of moisture in the air and the amount of moisture the air could hold at saturation. In the summer of 2023, thick smoke from Canadian wildfires caused similar air quality conditions in the region as the event in 2026, suggesting a recurring pattern tied to these climatic shifts.

Despite the health risks, there are no laws or regulations in Pennsylvania specific to outdoor work during poor air quality events. The Pennsylvania Department of Labor and Industry has guidance for employers to keep people safe during weather events, but it lacks the force of law. The federal Occupational Safety and Health Administration requires employers to have a place of employment that is free from recognized hazards, yet specific air quality mandates remain absent at the state level. Several bills have recently been proposed in the Pennsylvania legislature to provide workers more protections from heat, give paid leave during climate-related emergencies, and create a basic income program for people impacted by extreme weather events, but these proposed bills regarding worker protections from heat and climate-related emergencies have not been enacted.

State Rep. Greg Vitali, who chairs the House Environmental and Natural Resource Protection committee and has served in the Pennsylvania legislature for 35 years, noted a lack of political discourse connecting these events to broader policy changes. "I don’t hear that connection being made with people—with citizens generally or with political people in Harrisburg," Vitali said. "People aren’t saying, ‘God, we can’t even breathe the air now. Isn’t it time we start addressing climate change?’" Vitali stated he is unaware of any recently proposed legislation related to keeping people safe during poor air quality events specifically.

Pennsylvania industrial air pollution was significantly curbed decades ago with the passage of the federal Clean Air Act and the Pennsylvania Air Pollution Control Act. Section 4(27) of the Pennsylvania Air Pollution Control Act grants the Pennsylvania Department of Environmental Protection the legal authority to implement all measures necessary to enforce the act. However, this authority has not been applied to create specific regulations for wildfire smoke exposure in childcare or outdoor work settings.

Muller suggested that managing information is a key short-term strategy. "My view is we should be managing information and guidance about what people should and shouldn’t do," he said. "At least in the short term, when we’re dealing with a smoke event, that’s about all you can do in a distant community."

Why It Matters

The absence of state mandates for outdoor activities during hazardous air quality events leaves childcare providers to independently assess risks for children, who absorb more pollution than adults. This regulatory gap results in inconsistent safety measures, as seen when one center kept 130 children indoors while another allowed outdoor play despite Code Purple conditions. With wildfire smoke linked to $200 billion in health damages and 20,000 premature deaths in 2017, these discretionary decisions directly impact exposure to PM2.5 particles that cause asthma, cardiovascular disease, and dementia.