Pakistan needs to consider air pollution as a crisis . While research has shown that poor air quality has an impact on morbidity and mortality for more serious conditions, its insidious effects are underplayed.

The figures for Pakistan paint a bleak picture. Pakistan was the second most polluted country in 2018, according to the World Air Quality report. At the time of writing, Karachi and Lahore were among the top ten polluted cities in the world, with Lahore’s AQI (Air Quality Index) at 188 and Karachi’s at 182.

Impact of Air Pollution

An AQI of up to 50 is considered healthy. Further, an AQI of 100-150 becomes detrimental to health of children and people with heart and lung disease after that. An AQI of 150 or higher is considered unhealthy for everyone, while levels of 300 or higher constitute a health emergency.

In the month of November, data from Lahore and Peshawar demonstrates an AQI of more than 300 on multiple days. In November, there was not a single day in the country’s cultural capital that could be described as healthy.

Air pollution in Pakistan has become a more serious health emergency than smoking, tuberculosis, and unsafe water and sanitation, reducing our life expectancy more than any of the three listed causes.

Children are especially vulnerable in this circumstance, and air pollution kills one out of every ten children under the age of five. Air pollution aggravates children’s and adults’ respiratory problems, causes childhood cancer, and has an impact on healthy brain development.

Air Pollution and Psychological Health

Air pollution has also been linked to negative effects on the psychological health of those who are exposed to it. Particulate matter in the atmosphere can enter the bloodstream and disrupt the functioning of our brain and nervous system. This can include difficulties with concentration, memory, and emotional stability, ultimately leading to decreased workforce productivity and causing the national exchequer to lose billions of rupees each year.

Mental health professionals in Pakistan have also noticed a rise in the rate of relapse in patients suffering from mental illnesses as the weather and air quality have changed. While some may attribute it to the cold, it is highly likely that excessive air pollution during the winter months is increasing the risk of relapse in patients suffering from mental health issues. While more data is needed to back up this claim, there have been enough anecdotal reports from mental health professionals disclosing an increased rate of relapse in patients living in more polluted parts of Karachi during the winter season.

Pakistan would have to deal with air pollution as a crisis, and the country’s response will have to be multi-tiered and vary in time, because we need short-, medium-, and long-term changes. We would leave the medium- and long-term remedies to experts in that field, such as environmental engineers, energy professionals, and other industry experts, as healthcare professionals. However, we can implore them to act now and quickly.

How to handle Air Pollution in Pakistan?

Pakistan needs comprehensive short and long term plans to deal with this crisis. There needs to be a set of indigenous approaches with strong engagement of local communities.

In the short term, we must encourage citizens to take responsibility for the health and well-being to the best of their abilities. Some simple steps they should take include purifying the air in places where they spend the majority of their time, such as their homes and offices. Invest in air purifiers; there are many low-cost but effective local options on the market now, and the difference in your sense of well-being will be immediate. Furthermore, if your job requires you to spend a significant amount of time outside, wearing a mask can only be beneficial. An n95 mask would be ideal for this application.

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This is what one can do to safeguard themselves and their loved ones. As physicians, we urge those with the ability to affect change, such as those who run industries, work in the energy sector, or work in policy, to consider the cost of enabling economic growth. Members of our society, particularly those with access to resources, must consider the future we are constructing for ourselves and our children.