A baby drinking less than usual or an older parent becoming unusually breathless during a familiar walk may not immediately suggest a respiratory problem. But when haze blankets the air, even small changes in breathing, feeding or energy level can be easy-to-miss warning signs that the lungs are being affected.
Main image: Haze exposure can trigger inflammation and increased mucus production in the airways, leading to symptoms such as coughing, wheezing, chest tightness and breathlessness.
According to Dr Syed Ajmal Bin Syed Ali, Consultant Physician, Respiratory Physician & Int. Pulmonologist and Dr Noor Zehan Abdul Rahim, Consultant Paediatrician and Paediatric Respiratory Physician at Sunway Medical Centre, Sunway City (SMC), vulnerable individuals need extra attention when air quality deteriorates[1].
“People often expect haze-related breathing problems to be obvious, but the earliest warning signs can be subtle, especially for vulnerable adults or older people,” says Dr Syed. Dr Noor Zehan adds, “Becoming unusually breathless, or noticing changes in a child’s feeding or breathing patterns, may be among the earliest signs that haze is affecting the lungs.”
Why Haze Hits Some Lungs Harder
One of the main concerns during haze is PM2.5, fine particles small enough to penetrate deep into the respiratory tract[2]. Dr Syed explained that when these particles reach the smaller airways and air sacs, they can trigger inflammation and increase mucus production, causing symptoms such as coughing, wheezing, chest tightness and breathlessness.
Certain groups face higher risks, such as:
- Older adults: Aging reduces lung capacity[3] and the ability to clear inhaled particles[4].
- Children: Smaller airways and developing lungs leave them more susceptible to breathing difficulties.
- Asthma and COPD patients: Even well-controlled conditions can flare up when exposed to polluted air.
Both Dr Syed and Dr Noor Zehan also shared that patients with asthma or COPD should not assume they are protected simply because their symptoms are under control. Dr Syed said patients should continue taking prescribed medications and keep reliever inhalers accessible. For parents, Dr Noor Zehan advised, be fully familiar with their child’s asthma action plan.
Watch for Subtle Changes
The most useful warning sign, says Dr Syed, may simply be a change from what is normal for that person. For older adults, paying attention to changes during everyday activities can help identify when haze may be affecting their breathing. This may include increased coughing or phlegm, wheezing, chest tightness or becoming unusually short of breath during routine activities.
In babies and young children, the signs may be less obvious and sometimes show up through changes in their usual behaviour or routines. Dr Noor Zehan explained that coughing and nasal congestion can progress to breathing or feeding difficulties. A baby who becomes unusually irritable or drinks less due to a blocked nose may already be showing early signs of respiratory distress.
“Don’t wait until a child is visibly struggling to breathe before seeking help,” said Dr Noor Zehan. “Early signs such as reduced feeding, unusual irritability or increasing breathing difficulties should not be ignored.”
Beyond Home Precautions
While air-quality readings can help families decide when to reduce exposure, both specialists emphasised that changes in symptoms are equally important to monitor. Dr Syed advised seeking medical attention if breathlessness, coughing or wheezing worsens, or if usual medication no longer provides adequate relief. Dr Noor Zehan similarly advised parents to seek medical attention if a child’s cough or congestion begins interfering with breathing or feeding.
Stay Indoors but Stay Active
Both doctors recommended staying indoors as much as possible and avoiding strenuous outdoor activities. Instead, maintain movement indoors, children can play indoors and older adults can opt for light indoor movement.
When outdoor air quality deteriorates, families should keep windows and doors closed. Air purifiers that filter fine particles may help, while air-conditioning and air-purifier filters should be maintained regularly. Dr Noor Zehan also cautioned against using essential oils as a haze remedy, as they do not remove pollutants from the air and may introduce additional substances into the indoor environment. If going outdoors is unavoidable, Dr Syed recommended wearing a properly fitted N95 or K95 mask.
Protecting our family’s health during haze goes beyond staying indoors. It includes noticing early symptoms, limiting exposure and knowing when to seek medical attention.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC11036283/
[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC4740125/
[3] https://www.lung.org/lung-health-diseases/how-lungs-work/lung-capacity-and-aging
[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC9435381/
Dr Syed Ajmal Bin Syed Ali,
Consultant Physician, Respiratory Physician & Int. Pulmonologist,
Sunway Medical Centre, Sunway City (SMC).
Dr Noor Zehan Abdul Rahim,
Consultant Paediatrician and Paediatric Respiratory Physician,
Sunway Medical Centre, Sunway City (SMC).
