The air that we breathe in is slowly becoming a silent carrier of long-term complications, especially for people living in the metropolitan hubs. The complaints about “poor air quality” are no longer a seasonal headline but have become a year-round issue.

Experiencing occasional shortness of breath might not warrant a serious outlook, but if these symptoms keep piling up, becoming part of your daily routine, that’s where you need to pay close attention.

This guide highlights insights from our experts at Jindal Chest Clinic, exploring why breathlessness is a key warning sign and when it becomes important to consult a chest physician.

Air Pollution and What We Are Breathing In?

To better understand the implications of air pollution and its impacts on breathlessness and other respiratory symptoms, you first need to understand what you are breathing in.

Air pollution is a mixture of solid particles and gases suspended in the air. Some of the most harmful components in this mixture include:

• Particulate matter (PM2.5 and PM10)
• Nitrogen dioxide (NO₂)
• Sulphur dioxide (SO₂)
• Ozone (O₃)
• Carbon monoxide (CO)

Among the list of these many compounds, PM2.5 is particularly dangerous, primarily because it bypasses the body’s natural defences in the nose and throat and lodges deep in the lung tissue. So, when you are exposed to the air pollution on a prolonged basis, it causes inflammation of the airways, damages the lung cells and also reduces the lungs’ ability to transfer oxygen efficiently.

How Do These Pollutants Breach Your Respiratory Defenses?

If you are experiencing breathlessness due to the extended exposure to air pollution, you need to understand the physiology of these pollutants and how they breach your respiratory defenses.

When you inhale, your upper respiratory tract, which includes the nose and throat, acts as a filter. However, PM2.5 is small enough that it ends up bypassing these defenses, travelling down to the alveoli, aka the air sacs in your lungs responsible for the gaseous exchange. Once the chemicals reach this part of your lung, it causes the following cascade of activities:

• It starts with oxidative stress. These particles create reactive oxygen species, which damage the cellular lining of the lungs.
• Your body’s immune response to these “invaders” is to cause systemic inflammation. This causes your airways to swell and narrow, causing chest tightness and discomfort.
• These pollutants also paralyse the tiny hair-like structures (cilia) that normally clear mucus and germs, making you more susceptible to infections like bronchitis and pneumonia.

So, these complications combine together to contribute to the symptoms that you likely experience, including breathlessness, chest tightness, etc., especially when exposed to prolonged air pollutants.

How Does Air Pollution Affect the Lungs Over Time?

Our lungs are designed to handle only a certain amount of environmental stress, but when you experience chronic air pollution, it overwhelms these defenses, leading to long-term complications, including:

• Chronic airway inflammation
• Increased mucus production
• Narrowing of airways
• Reduced lung capacity
• Weakened immunity

For children, polluted air can impair lung development. For adults, it accelerates lung aging. For the elderly or those with existing conditions, it significantly increases the risk of hospitalisation.

So, irrespective of your age, air pollution affects your respiratory function in one way or another. Breathlessness usually becomes the first noticeable and alarming symptom of this damage.

When Is Breathlessness Not "Normal"?

As we previously mentioned, if you are experiencing breathlessness “every now and then” or occasionally, it might not be as serious. However, if the symptom becomes chronic, to a point that it is affecting the quality of your life, that’s where you need to take things seriously.

If you live in a polluted area, you must differentiate between transient irritation and a developing chronic condition, and here’s what to look out for:

1. The persistence factor

If you find yourself “gasping” for air when climbing a single flight of stairs or even when walking to your car, it is not normal. At Jindal Chest Clinic, we often consult patients who have “adapted” to their breathlessness by slowing down their life. But the truth is that if your breathing does not return to normal within minutes of resting, it is an alarming sign that your lung function is compromised.

2. Experiencing the “smoker’s” cough without smoking

At times, air pollution causes “pollution cough”, which is quite similar to the rough cough that smokers have. It is characterised by a persistent, dry hack that tends to worsen during the night time. This is your body’s desperate attempt to clear the particulate matter settled in your bronchi. If this cough lasts more than three weeks, it has moved from "acute" to "sub-acute", requiring a specialist's evaluation.

3. Wheezing and noisy breathing

If you hear a high-pitched whistling sound when you breathe out, it is a classic sign of inflamed, narrowed airways. This is often the first sign of pollution-induced asthma or an exacerbation of COPD (Chronic Obstructive Pulmonary Disease). The primary reason behind wheezing is constricted airways, which reduces the volume of oxygen that’s reaching your vital organs.

While exertion, anxiety, or temporary illness can cause shortness of breath, pollution-related breathlessness tends to have certain characteristics:

• It worsens on high pollution days
• It appears during activities that were previously easy
• It improves indoors or with air purification
• It is accompanied by cough, wheezing, or chest heaviness

If you keep ignoring these symptoms, it will eventually lead to progressive lung disease, leaving permanent damage.

What a Chest Specialist Evaluates During Consultation?

More than simply treating your symptoms, a chest specialist will first identify the root cause behind the symptoms and then work on eliminating them.

With our specialists at Jindal Chest Clinic, evaluation will include:

• Detailed clinical history focused on pollution exposure
• Lung function tests (spirometry) to assess airflow limitation
• Imaging such as chest X-ray or CT scan when required
• Oxygen level assessment
• Allergy and inflammation markers
• Evaluation of infection or chronic lung disease

The main objective behind this comprehensive approach ensures that the treatment is not only targeted but also not generic. Also, the earlier you see a chest specialist for your symptoms, the more accurate is the diagnosis, and it also prevents irreversible damage to the lungs.

Why is Self-Medication Risky for Breathing Problems?

When you are experiencing symptoms like breathlessness and respiratory-related problems, the last thing you want is to self-medicate, despite how lucrative it might sound.

Using over-the-counter inhalers, cough syrups, or antibiotics without medical advice can mask symptoms without addressing the underlying condition. Some of the most common risks associated with it are:

• Delayed diagnosis of serious lung disease
• Incorrect inhaler technique leading to poor control
• Steroid misuse causing side effects
• Antibiotic resistance from unnecessary use

With experienced chest specialists and their consultation, you get the assurance that the medication and treatment would be appropriate, effective and safe as well.

Listen to Your Breath!

Air pollution has quietly become one of the biggest threats to respiratory health. Breathlessness is often its first and most important warning sign. Ignoring it can lead to chronic lung disease that affects daily life and long-term health.

At Jindal Chest Clinic, led by renowned experts like Dr. S.K. Jindal and Dr. Aditya Jindal, we combine decades of clinical experience with the latest in pulmonary science.

Don't wait for the next "red" AQI day to take your lung health seriously. Scheduling a timely consultation could make the difference between manageable symptoms and lasting lung damage.