Smog Effects on Health (Smog Ke Nuqsanat) in Pakistan: Symptoms, Masks and When To See a Doctor

Smog's fine particles irritate the eyes, throat and lungs and can trigger asthma attacks, heart attacks and strokes. Children, older people, pregnant women and anyone with heart or lung disease are most at risk. How to read the AQI, which masks filter smog, and when to see a doctor.

By DoctorOS Team · November 5, 2026

Smog is air loaded with fine particles. Breathing it irritates the airways and can trigger asthma attacks, heart attacks and strokes, according to the US Environmental Protection Agency (EPA). At 8am on 2 November 2026, IQAir recorded an air quality index (AQI) of 535 in Lahore, with fine particles at 343 micrograms per cubic metre in that hourly reading (Dawn). In the week before 2 November, six government hospitals in Lahore saw more than 35,000 patients with flu-like symptoms as the smog thickened and seasonal viruses spread, The Nation reported.

At a glance

Punjab's Environment Protection Department put Lahore's average AQI at 338 on 5 November 2026, with some areas above 500

Most of the harm comes from PM2.5, particles so small that a human hair is about 30 times wider than the largest of them

Children, older adults, pregnant women, outdoor workers and people with heart or lung disease are most at risk

Cloth masks, wet or dry, do not filter smog. A well-fitted N95 respirator cuts what you breathe in

For chest pain, severe breathlessness or a child struggling to breathe, call Rescue 1122 or Edhi 115

Smog kya hai, aur yeh dhund se kaise alag hai?

Fog (dhund) is cloud at ground level, made of tiny water droplets, says the UK Met Office. Smog is pollution. In Lahore it comes from vehicle exhaust, factories, brick kilns, power plants, generators, household fuels, rubbish burning and dust, according to a November 2026 report by the monitoring project Hamari Hawa (Dawn). These sources run all year. Even in June 2026, the cleanest month of the past year, Lahore averaged 40 micrograms per cubic metre of fine particles, above the national 24-hour limit of 35.

Winter traps the pollution. The layer of air it can spread into shrinks from about 830 to 860 metres deep in May and June to about 260 metres in November and 190 in December, so the same smoke fills less air. Crop burning adds more. In every season since 2019, a third to two-thirds of crop fires seen by satellite on the Pakistani side came after 1 November. Pollution also thickens fog, because the thickest fogs form where the air holds more particles (Met Office).

The particles that do most harm are PM2.5, which are 2.5 micrometres across or smaller (US EPA). The World Health Organization says they get deep into the lungs and can enter the bloodstream.

Smog ke nuqsanat kya hain?

A study of 400 adult outpatients at a major Lahore hospital, run from October 2024 to January 2025, found that 98% had at least one symptom (Ali and colleagues, 2026). The commonest were:

shortness of breath (saans phoolna), 74%
eye irritation (aankhon mein jalan), 56%
cough (khansi), 53%
sore throat (gala kharab), 50%

Many people call these symptoms "smog allergy". The patients in this study were at a hospital, so the figures describe them, not all of Lahore. Smokers had more symptoms.

The US EPA also links particle pollution to wheezing, reduced lung function, asthma attacks, heart attacks (dil ka daura), strokes (falij) and early death in people with heart or lung disease. Worldwide, outdoor air pollution caused 4.2 million early deaths in 2019, 68% of them from heart disease and stroke, by the WHO's estimate. In children, the WHO links it to slower lung growth, chest infections and worse asthma.

Who is most at risk?

The US EPA lists people with heart or lung disease, older adults, children and teenagers, pregnant women and outdoor workers.

Children. Young children breathe twice as fast as adults, with smaller lungs and less developed immunity. In November 2024, UNICEF said over 11 million children under five were breathing smog in Punjab's worst-hit districts, and that about 12% of deaths in under-fives in Pakistan were due to air pollution (UNICEF Pakistan).
Pregnancy. Pregnant women who breathe polluted air are more likely to give birth early, and their babies may be born underweight (UNICEF). See our pregnancy guide for danger signs.
Asthma and COPD, a long-term lung disease. Follow your action plan and keep your reliever inhaler with you (US EPA). See our asthma guide.
Heart disease. Palpitations, breathlessness or unusual tiredness on polluted days may signal a serious problem, and the EPA advises calling your doctor.

AQI ka kya matlab hai?

The AQI turns pollution readings into one number, and higher means dirtier air. Pakistani news quotes readings from Punjab's Environment Protection Department and from IQAir, and their labels differ. Punjab's chart calls 301 to 400 "very unhealthy" and keeps "hazardous" for 401 to 500 (Punjab EPA). The US EPA calls anything above 300 hazardous. So Lahore's average of 338 on 5 November (Daily Times) was "very unhealthy" on one chart and "hazardous" on the other. Go by the number. The US EPA's advice for its own scale is a rough guide:

101 to 150. Sensitive groups keep outdoor activity shorter and lighter.
151 to 200. Sensitive groups avoid long or intense outdoor activity, and everyone else cuts down.
201 to 300. Sensitive groups avoid all outdoor physical activity, and everyone else avoids long or intense activity.
301 and above. Everyone avoids all outdoor physical activity, and sensitive groups stay indoors.

Smog se bachne ka tarika

Wear the right mask, properly

Cloth masks, wet or dry, paper masks and tissues will not filter out fine smoke particles, says the US EPA. Use a respirator marked N95 or P100. It should cover your nose and chin, with the nose strip pinched to shape and both straps on. It should pull in slightly as you breathe in, with no air leaking at the sides. A beard stops it sealing. Throw it away when it is dirty or hard to breathe through.

Respirators are not designed to fit children, and people with heart or lung disease should ask a doctor before using one. The EPA puts masks after staying indoors and cutting activity. In the Lahore study, people who routinely wore masks did not report fewer symptoms, though its summary does not say which masks they used.

Keep the air indoors cleaner

When particle levels are high outdoors, they can be high indoors too (US EPA). On bad days, close the windows and stay inside as much as you can, advises the American Academy of Ophthalmology. Don't smoke or burn candles indoors, or burn leaves, rubbish or plastic outside (US EPA). A portable air cleaner with a HEPA filter, sized for the room, reduces indoor particles. Avoid models that deliberately make ozone, which irritates the lungs (US EPA).

Don't shut yourself in with a gas heater or angeethi. Gas or paraffin heaters and wood, gas or coal fires can produce carbon monoxide, a gas you cannot see or smell that builds up indoors and can kill (CDC). Headache, dizziness, nausea, tiredness or confusion in a heated room are warning signs. Switch the appliance off, go outside and get medical advice (NHS).

Ease your eyes, throat and cough

Eyes. Use artificial tears, rest with a cold compress over closed eyes, and wear close-fitting glasses outdoors (American Academy of Ophthalmology). If that doesn't bring quick relief, see an eye doctor, who may prescribe a short anti-inflammatory course.
Throat. Drink plenty of water, eat soft or cool foods and avoid smoky places. Adults can gargle with warm salty water, but children should not (NHS).
Cough. Rest and drink fluids. Hot lemon and honey may help, though the evidence is limited. Don't give honey to babies under one, or hot drinks to small children. Some cough medicines are not for children under 12, so ask a pharmacist first (NHS).

Smog hai ya flu?

Smog, flu and COVID-19 can all cause a dry cough, a sore throat and breathlessness. This week Lahore doctors urged people with flu-like symptoms to see a qualified doctor rather than treat themselves (The Nation). The US CDC says fever or chills, muscle or body aches and diarrhoea are not caused by smoke. If you have them, something else, such as an infection, is going on.

Doctor ko kab dikhana chahiye?

See a doctor if:

A cough has lasted more than three weeks (NHS). Our TB guide explains when a long cough needs a TB test.
A sore throat hasn't improved after a week (NHS).
Sore eyes don't settle quickly with artificial tears.
You have a fever, chills or body aches with your cough.

Browse general physicians, child specialists and eye specialists on DoctorOS, or find a doctor near you and book directly.

When to call Rescue 1122 or Edhi 115

Go to the nearest emergency department, or call Rescue 1122 or Edhi 115, for:

Chest pain, or any heart attack or stroke warning sign.
Severe difficulty breathing, being unable to swallow, drooling, or a high-pitched noise on breathing in (NHS).
An asthma attack that gets worse, or doesn't ease with the reliever inhaler (NHS).
Coughing up blood (NHS).
A child breathing fast or with the lower chest pulling in on each breath, or a baby who cannot feed or drink, becomes unconscious or has a fit (WHO).
Sudden confusion, collapse or chest pain in a room where a heater or fire was burning (NHS).

Frequently asked questions

Kya kapre ka mask smog se bachata hai?

Nahi. US EPA ke mutabiq kapre ka mask, chahe geela ho ya sookha, kaghaz ka mask aur tissue dhuen ke bareek zarron ko nahi rokte. N95 ya P100 respirator in zarron ko rokta hai, lekin sirf tab jab chehre par achhi tarah fit ho. Daarhi ho to yeh theek se seal nahi hota. Yeh respirator bachon ke liye nahi banaye gaye, aur dil ya phephron ke mareez pehle doctor se mashwara karein.

Smog mein subah ki walk karni chahiye?

Pehle AQI dekhein. US EPA ke mutabiq AQI 150 se upar ho to bachay, buzurg, hamila khawateen aur dil ya phephron ke mareez bahar lambi ya sakht warzish na karein. AQI 300 se upar ho to kisi ko bhi bahar warzish nahi karni chahiye. Aise dinon mein ghar ke andar halki warzish karein aur masroof sarkon se door rahein.

Do I need antibiotics for a smog cough?

No. Irritation from smog is not a bacterial infection, so antibiotics do nothing for it. The NHS says antibiotics are not normally prescribed for coughs, only when a doctor finds a bacterial infection or a risk of complications. See our guide to antibiotics and self-medication.

Should children go to school on bad smog days?

Closures are an official decision, so follow your school's and the government's notices. For health, children are among the groups the US EPA says should avoid all outdoor physical activity once the AQI passes 200. On those days, ask the school to move assembly, sport and play indoors.

Sources

For practitioners. If you treat patients in Pakistan, list your practice free on DoctorOS and take bookings.

Cover image: The Mall in fog by Khalid Mahmood, licensed under CC BY-SA 3.0.

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