Every breath hurts: How air pollution is taking a heavy toll on children's health in Delhi-NCR

People walking near the India Gate amidst morning smog a day after Diwali in New Delhi. (Courtesy: AP photo)

With winter approaching, Delhi is once again facing its annual pollution crisis and experiencing hazardous air quality. Smog is blurring the national capital's skyline and the toxic air is posing a major health risk to children.

Paediatric wards across Delhi-NCR are witnessing surge in respiratory illnesses, which are a combination of pollution-related issues and infections that are becoming unusually severe.

Doctors have confirmed that this season has seen an unusual spike in both viral as well as bacterial infections. Pollution, which is a silent killer, is worsening the damage and leaving children wheezing for weeks.

Pollution a silent amplifier

Physicians have noted that seasonal viruses have reemerged with greater intensity this season. "Right now, we are witnessing a surge of both familiar and emerging respiratory infections among children. Old seasonal enemies like RSV are making infants breathless once again, while newer pathogens such as mycoplasma pneumoniae have evolved ... It's no longer the mild common 'walking pneumonia' we once knew," Dr Maninder Dhaliwal, senior consultant – paediatric intensive care, Amrita Hospital, Faridabad told News18.

"Pollution acts as a silent amplifier, irritating the airways and worsening every infection, resulting in a perfect storm for young lungs already struggling to breathe," he added.

Dr Dhaliwal highlighted how the (polluted) air is resulting in persistent coughs among children and that the cause is not always an infection. "Every week, I see children whose coughs just won’t go away. It’s not always an infection; it’s the air around them. From birth to early school years, a child’s lungs are still forming. Polluted air, especially fine dust (PM2.5) and traffic gases, quietly inflames and affects the lungs. The result? Longer-lasting colds, more wheezing, and a rising risk of asthma before they even reach class six," he said.

When the air is bad, the senior paediatrician added, infections are more severe and recovery time is longer. "A simple viral cough can drag on for weeks. Pollution keeps the airways irritated, so medicines seem less effective ... If we add pollen, dust, or smog season, the problem multiplies," he explained.

A Thane-based pulmonologist said that there has been unprecedented rise in cases of asthma, chronic cough, and allergies over the last decade. "What was once seen only in older children or during certain seasons is now being observed in much younger age groups throughout the year. This trend shows how consistent exposure to polluted air is quietly shaping the respiratory health of the next generation," Dr. Jaspreet Singh Khandpur, consultant pulmonologist, KIMS Hospitals told News18.

'Air pollution greatest danger to lung development'

What is even worse is the city's air is now not just a trigger but an independent disease factor, say paediatric pulmonologists. With tiny lungs still in the developing stage, every breath exposes children to fine dust, nitrogen dioxide, and other pollutants which eventually damage growth and immunity.

"The breathing rate of children is faster than adults, which eventually means that they consume more polluted air per kilogram of body weight. The result is evident in more cases of wheezing, recurrent coughs, and early-onset asthma. Prolonged exposure to polluted air reduces the growth of lungs, making kids more vulnerable to infections and allergies later in life," said Shivaraj Ajji Kariyappala Lakshman, head of the department of pulmonology at SPARSH Hospital, Bengaluru.

The trend is no longer confined to Delhi-NCR. In cities such as Thane and Bengaluru, specialists are finding asthma and chronic cough in children far younger than a decade ago. "Air pollution has become one of the greatest dangers to the lung development of infants and young children," said Dr. Khandpur.

He explained that polluted air poses a greater threat to children’s developing lungs. “Since children breathe more rapidly than adults, they end up inhaling a higher volume of air — and therefore more pollutants — in proportion to their body weight. The ultra-fine particles and toxic gases present in polluted air penetrate deep into the lungs, irritating and inflaming the delicate tissues and hindering normal lung growth,” the Thane-based pulmonologist said.

Scientific evidence

Numerous published studies have indicated that there is a large literature supporting the connection between exposure to air pollution and negative impact on children's lung function and growth.

A study published in the journal 'Breathe', titled - Air quality and respiratory health in children - explained how air pollution is harmful even for an unborn child. "The prenatal period is one of organogenesis and organ development. The fetal cells are uniquely susceptible to the effects of air pollutants due to the prenatal period having higher rates of cell division and differentiation and increased sensitivity to surrounding signals. The pollutants inhaled by the mother can translocate to the developing fetus. Inhaled pollutants have been observed in the placenta and organs within the fetus," it mentioned.

India's public health emergency

Experts caution that long-term exposure to polluted air in childhood can trigger lasting health repercussions. "Breathing toxic air during the early years can stunt lung development, compromise immunity, and heighten the risk of chronic respiratory diseases later in life," said Ravi Shekhar Jha, director and head of pulmonology and sleep medicine at Fortis Escorts, Faridabad.

"Repeated exposure during these formative years can reduce lung function and slow physical growth",  he said.

According to Jha, while short-term steps like air purifiers and avoiding outdoor play during smog days can help, "the real solution lies in sustained public effort—cleaner energy use, reduction of vehicular emissions, and creation of green spaces around homes and schools".

“The air children breathe today will decide the quality of life they live tomorrow," he added.