Karachi’s air pollution crisis looms as watchdogs appear rudderless — Part 2

Pulmonologists link rising respiratory cases to unchecked emissions and neglected monitoring

By Mukhtar Alam

KARACHI: While Karachi’s residents continue to breathe polluted air, medical experts warn that the health effects are showing up sharply across hospitals — with lung and allergy clinics reporting growing numbers of patients suffering from chronic respiratory illnesses and pollution-induced complications.

According to senior pulmonologist Dr Sohail Akhter, the connection between respiratory disease and poor air quality is “an age-old understanding.” Asthma, respiratory infections, and other respiratory diseases spike in winters and during dry weather. “It is the experience of most pulmonologists; similarly, a surge of asthma admissions is seen in Islamabad in spring, coinciding with raised pollen count,” he notes.

He emphasises that the trend is not merely anecdotal. “Cases certainly increase during smog, winter months, and dust storms — this has been documented,” he explains. Yet, despite the scale of the problem, interest in air pollution and its effects remains weak. “There is a lack of interest in air quality across the country, and unfortunately this includes health professionals. We can only assume based on weather reports and media coverage. There have been just a handful of studies, and the subject is not discussed in scientific conferences according to its magnitude.”

Dr Sohail Akhter

For Dr Akhter, this indifference is worrying. “Respiratory diseases linked to pollution — asthma, bronchitis, recurrent infections — surge in winters and smog. Yet, there’s little scientific research or policy focus. Doctors must lead awareness efforts, because we see these effects daily and cannot afford indifference,” he urges.

He adds that public awareness is “severely lacking” and policymakers “least bothered.” “Only doctors, with their unique position of trust, can bridge the gap between science, society, and decision-makers in the governments,” he concludes.

Dr Javed A Khan, senior pulmonologist at the Aga Khan University Hospital and President of the Pakistan Chest Society (Sindh Chapter), says the link between pollution and lung disease is beyond doubt. “We’ve observed a clear correlation between poor air quality and respiratory illnesses,” he says.

“Specifically, the smog in Lahore and air pollution in Karachi have contributed to a rise in respiratory diseases, including pneumonia, asthma, COPD, and interstitial lung disease, over the past few years. The common thread among these cases is poor air quality.”

He highlights a troubling trend: hypersensitivity pneumonitis linked to urban pigeon populations. “In Karachi and other major cities, we’re observing a rising trend of hypersensitivity pneumonitis. This is an allergic reaction in the lungs triggered by allergens released from pigeons. The widespread practice of feeding seeds to pigeons has contributed to their proliferation. In my clinic, I see four to five cases daily, underscoring the urgency of addressing this public health concern.”

Dr Javed A Khan

Seasonal variations are also evident. “Such cases increase during the winter months,” he says. “Those at extremes of age — under five or over 65 — are most affected, with mortality also higher in these groups.”

A major limitation is the absence of reliable air quality monitoring. “We do not have air quality monitors at public places where we can check the Air Quality Index. There is no mechanism to confirm exposure, so it remains an observation. For example, when there is smog in Lahore, hospitals start seeing large numbers of respiratory patients.”

Dr Javed is also critical of the lack of public awareness. “People are unaware of the impact of environmental factors on their health. A striking example is the burning of garbage on streets, which releases toxic fumes from polythene bags. Inhaling these toxins can cause severe lung damage. There is an urgent need for greater awareness,” he adds.

Prof Siddiqui emphasising allergic responses, Dr Akhter highlighting systemic neglect, and Dr Khan raising alarms over new diseases like hypersensitivity pneumonitis — all three physicians converge on one message: Karachi’s polluted air is already harming health, straining hospitals, and threatening the city’s most vulnerable residents. Each warns that without urgent intervention, the medical burden will deepen, leaving citizens to pay the price with their lungs, their livelihoods, and, in too many cases, their lives.

This is Part 2 of our series on Karachi’s worsening air pollution crisis, originally published in the weekly Social Track, Karachi.

Next (tomorrow) in Part 3: Experts call for real-time air quality monitoring, open data, and public accountability.