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Dr. Akshit Gupta, Pulmonology and Respiratory Medicine Specialist at Apollo Multispeciality Hospitals, Kolkata, explains that although it is difficult to equate a specific AQI level to the number of cigarettes smoked, it is not unwise to assume that an AQI above 300 can be extremely harmful. Fine particulate matter, especially PM2.5, penetrates deep into the lungs in a way similar to cigarette smoke. This deep penetration makes the lungs vulnerable to inflammation and long-term damage, especially with repeated exposure.
Air pollution is known to have a detrimental effect on asthma control and is also a major trigger for exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD). Dr. Gupta points out that these exacerbations are often mistakenly labelled as allergic reactions or viral infections, when pollution itself may be a significant underlying cause. He adds that polluted air can produce similar symptoms even in healthy individuals, including persistent cough, breathlessness, and chest tightness.
Doctors in metropolitan cities like Kolkata and Delhi have consistently observed an increase in patients visiting pulmonary outpatient departments during peak pollution periods. According to Dr. Gupta, while seasonal changes and viral infections do contribute to this rise, anyone who has worked in emergency or pulmonary care will acknowledge that air pollution plays a substantial role in worsening respiratory symptoms. The winter months, in particular, see a marked surge in such cases.
Although air pollution affects everyone, it has been observed that children, elderly adults, and pregnant women are particularly vulnerable. Their respiratory systems are either still developing or more sensitive, making them more susceptible to the harmful effects of polluted air. Extra caution is therefore essential for these groups during days of poor air quality.
Dr. Gupta advises that during high pollution periods, outdoor activities such as morning walks can be avoided, and exercising at home is a safer option. If stepping out is unavoidable, wearing a surgical mask can help reduce exposure, provided it is worn properly and discarded after use. Improper usage and reuse of masks is a common issue seen among people. In the absence of a surgical mask, using a clean handkerchief is better than no protection at all.
Persistent respiratory symptoms should never be ignored. Dr. Gupta stresses that any cough lasting more than two weeks must be evaluated by a pulmonologist to rule out underlying lung conditions and to initiate timely treatment. Early intervention can prevent complications and long-term damage.
Air purifiers have increasingly been marketed as a solution to indoor air pollution, and while the idea is not unreasonable, Dr. Gupta urges people to be cautious. The quality of such equipment varies widely, and there is limited scientific data strongly supporting their effectiveness. Additionally, they are often expensive, making it important for consumers to make informed decisions rather than relying solely on marketing claims.
Another challenge faced by doctors is the hesitation among patients to use inhalers when prescribed for asthma or COPD exacerbations triggered by pollution. There is a widespread fear that inhalers are addictive or have severe side effects. Dr. Gupta clarifies that these concerns are unfounded. Inhalers are safe, effective, and play a critical role in managing respiratory conditions when used under medical supervision.
Vaccination is another important aspect of respiratory health, especially during periods of high pollution. Vaccines help protect against respiratory infections that can further worsen lung conditions and increase hospitalisation risk. Doctors strongly recommend that vulnerable individuals and those with existing respiratory illnesses stay up to date with their vaccinations.
As Kolkata continues to face the challenge of deteriorating air quality, awareness, timely medical consultation, and preventive care remain essential. While broader solutions require sustained collective efforts, individual responsibility and informed health choices can go a long way in reducing the impact of this silent but serious public health threat.
