ir pollution is rising in Peshawar. With it, a spike has been reported in the number of patients facing lung and chest complications.

Every day is a busy day at the Lady Reading Hospital, the province’s largest hospital, located south of the Grand Trunk Road. The pulmonology ward is the busiest, treating 300 patients daily. As temperatures fall next month, the daily footfall is expected to cross 500, officials say.

The Hayatabad Medical Complex is also seeing a growing influx of patients suffering from respiratory complications. Officials from the treatment facility estimate that the Outpatient Department is receiving up to 80-100 patients daily who complain of breathing difficulties.

This is alarming given that exposure to hazardous air shortens life expectancy. Air pollution shortens the average Pakistani resident’s life expectancy by 3.9 years, relative to what it would be if the World Health Organisation guidelines were met. According to a report on the Air Quality Life Index, published by the University of Chicago, air pollution is shortening lives by almost seven years in Pakistan’s most polluted urban cities, among them Peshawar, Lahore, Sheikhupura and Kasur.

Once known as the city of flowers, the haze-covered Peshawar was declared the third most polluted city in Pakistan and the 9^th most polluted in the world in the 2021 World Air Quality Report. In 2022, the Peshawar Clean Air Alliance launched a report on the State of Air Pollution in Peshawar. It described the trends in air quality along with reasons for deterioration and proposed interventions for mitigating high levels of particulate matter in the Peshawar region.

The report showed that the highest contribution among sources of pollution comes from the Transport sector (58.46 percent) followed by the presence of high amounts of dust particles (17.67 percent). Other sources included domestic burning activity, industry, waste-burning and commercial establishments.

According to the Pakistan Bureau of Statistics 2023 digital census, 4.7 million people live in the city. Provincial government’s policy brief on targeted interventions for improving the air quality management in Peshawar notes that high concentrations of nitrogen dioxide were found in the air surrounding all the major roads of the city.

Associate Professor Dr Zafar Iqbal, head of the pulmonology department at the LRH and president of the KP chapter of the Pakistan Chest Society, says air pollution is a pressing global health issue that affects people of all ages. He says it can have severe consequences for respiratory health. “Air pollutants include a mixture of harmful substances including particulate matter, ground-level ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. When these pollutants are inhaled, they can cause immediate harm to the respiratory system,” says the doctor.

“Nitrogen dioxide and carbon monoxide can irritate the airways, leading to coughing, wheezing and throat irritation. Individuals with pre-existing respiratory conditions of asthma or chronic obstructive pulmonary disease are particularly vulnerable. Air pollution can trigger acute exacerbations, making it harder for them to breathe and potentially leading to need for hospitalisation,” Dr Zafar says.

Short-term exposure to air pollution in healthy individuals can temporarily reduce lung function making physical activity more difficult. “Air pollution contains carcinogens, including benzene and formaldehyde. Long-term exposure significantly increases the risk of lung cancer. Children exposed to air pollution may experience stunted lung growth, which can have lifelong consequences for their respiratory health. Studies have shown that long-term exposure to high levels of air pollution can shorten life expectancy, primarily due to its impact on cardiovascular and respiratory health,” he explains. “Exposure to air pollution during pregnancy can harm fetal lung development and lead to long-term health issues for the child,” Dr Zafar says.

The global air pollution epicentre

Air pollution continues to increase in South Asia. Sustained exposure to particulate pollution is reducing the life span of South Asians by 5.1 years. The toll is even greater in the most polluted areas”, according to the latest Air Quality Life Index report.

The report says that if the current pollution levels persist, the Punjab, Islamabad and Khyber Pakhtunkhwa’s 165.5 million residents or 69.5 percent of Pakistan’s population are on track to lose between 3.7 and 4.6 years of life expectancy on average, relative to the WHO guidelines and between 2.7 to 3.6 years relative to the national standard.

Every year, 9 million people die due to air pollution, making it the largest environmental threat to human health. Pollution-related deaths have increased by 66 per cent over the last two decades UN Environment data says. In October 2021 The UN Human Rights Council recognised access to a clean and healthy environment as a fundamental right. Like many basic rights, the residents of Peshawar are also denied clean air.

The writer is a freelance multimedia journalist. He tweets @daudpasaney