Air Pollution's Indoor Enemies In Pakistan

Pakistan has some of the worst air pollution levels in the world, with many of its megacities creating vast amounts of smoke, haze, and deadly smog. In 2019, Pakistan had a PM2.5 reading of 65.81 μg/m³, which was nearly double that of China's. The main sources of indoor air pollution include household energy sources such as biomass, wood, coal, tobacco, and low temperatures, which produce particulate matter (PM), dust particles, smoke, COx, noxious gases, bioaerosols, airborne microflora, and flame retardants. Indoor air pollution in Pakistan causes 40 million cases of acute respiratory infections and 28,000 deaths per year.

Household energy sources

Biomass fuels, such as wood, are commonly used for cooking and heating in rural regions of Pakistan, leading to high indoor PM concentrations. Studies have found PM2.5 levels in rural areas to be as high as 4000–9000 μg/m3, far exceeding the permissible limits set by the Environmental Protection Agency Pakistan of 35 µg/m3 for PM2.5. This puts the health of rural inhabitants at risk, particularly those with pre-existing respiratory conditions.

In urban areas, the use of coal and other fossil fuels for energy generation and household needs also contributes to indoor air pollution. While coal may not be directly burned in homes, the emissions from coal-fired power plants can infiltrate indoor spaces, leading to increased levels of harmful pollutants. Additionally, the indoor burning of tobacco products, such as cigarettes, further exacerbates air quality issues, particularly in poorly ventilated spaces.

Indoor air pollution from household energy sources is not limited to residential buildings but also affects public spaces such as hospitals and schools. In hospitals, high PM concentrations have been detected, putting patients, especially those with compromised immune systems, at risk of repeated infections. Schools, too, can be impacted by indoor air pollution, affecting the health and well-being of students and staff.

To mitigate the impact of household energy sources on indoor air quality, it is essential to promote alternative energy sources, improve ventilation in indoor spaces, and raise awareness about the health risks associated with indoor air pollution. Additionally, the implementation of air quality monitoring and management strategies, with the support of the government and relevant agencies, is crucial to address this pressing issue in Pakistan.

Outdoor air pollution

The main causes of outdoor air pollution in Pakistan are mobile and stationary sources. Mobile sources include heavy-duty vehicles, motorized two- and three-wheelers, and an increasing number of vehicles on the road. The country's 23.6 million transport vehicles are the primary source of NOx emissions, a major contributor to smog formation. Industrialization and urbanization are also key factors, with industrial emissions accounting for 34% of NOx emissions. Poor fuel quality, crop burning, brick kilns, and deforestation further exacerbate the problem.

The effects of outdoor air pollution are far-reaching, with serious health, economic, and environmental consequences. According to a study by Purohit et al. (2013), current emission control standards will lead to a decrease in life expectancy by more than 100 months by 2030. The World Bank estimates that air pollution costs Pakistan approximately 6.5% of its GDP annually.

Pakistan has implemented several plans and regulations to address this issue, including the National Environment Action Plan in 2001 and the Pakistan Clean Air Program (PCAP) in 2006. The PCAP aims to control the health and economic impacts of air pollution by directly tackling emissions from vehicles, industries, solid waste burning, and natural dust. However, more significant efforts and public cooperation are still needed to combat this alarming situation effectively.

Poor sanitation

Water sanitation, in particular, has been a pressing issue across Pakistan, with both rural and urban areas facing the consequences of an unclean water supply. The water is contaminated with pollutants such as fecal matter, microbes, metallic toxins, industrial waste, antibiotics, and other harmful drugs. This contamination is exacerbated by the close proximity of sewage pipes to water sanitation pipes, which can lead to leakage and further expose individuals to waterborne diseases. The situation is more severe in rural areas, where over 50% of village households rely on groundwater from hand pumps as their primary drinking water source.

The lack of access to clean water and proper sanitation facilities disproportionately affects women and young girls in Pakistan. Due to a shortage of menstruation supplies and inadequate sanitation infrastructure, many women and girls opt to stay at home during menstruation rather than engage in their regular activities. This highlights how insufficient sanitation and hygiene facilities can disrupt daily life and contribute to gender inequality.

The impact of poor sanitation extends beyond health concerns, threatening Pakistan's agricultural and environmental systems as well. The country is facing one of the most severe climate change challenges, with recent flooding further exacerbating water management issues. The rising water crisis in Pakistan demands urgent action and sustainable solutions to prevent a further increase in waterborne diseases and protect vital societal and environmental resources.

To address these challenges, Pakistan requires comprehensive strategies for treating and preventing waterborne diseases. This includes improving water sanitation capabilities, investing in the management and disposal of fecal matter and wastewater, and promoting proper hygiene practices. By collaborating with government and local officials, organizations like WaterAid are working to provide toilet facilities in disadvantaged communities, taking crucial steps toward improving the sanitation crisis in Pakistan.

Tobacco smoke

Indoor smoking in Pakistan leads to high levels of PM2.5, which can cause pulmonary infections. The impact is felt in both rural and urban areas, with smoking contributing to poor indoor air quality. The use of biomass fuel as an energy source, combined with smoking, exacerbates the problem. In rural regions, the indoor use of biomass fuels, including wood, has resulted in high PM concentrations, further worsened by tobacco smoke.

The health impact of indoor air pollution in Pakistan is significant. It is estimated that indoor air pollution accounts for approximately 28,000 deaths per year and 40 million cases of acute respiratory illness. The economic burden is also substantial, costing Pakistan around 1% of its GDP annually. Despite the growing evidence of the detrimental effects of indoor air pollution, policymakers have been slow to address the issue.

To address the problem of tobacco smoke contributing to indoor air pollution, various interventions have been proposed. These include the implementation of legislation prohibiting tobacco smoking in public places, the adoption of safer fuels, the use of improved cooking stoves, and the design of houses with separate kitchens to improve ventilation. Public awareness campaigns are also crucial in educating the population about the health risks associated with indoor smoking and the importance of creating smoke-free environments.

In addition to the direct impact on health, tobacco smoke, along with other sources of indoor air pollution, contributes to Pakistan's ranking as the third-highest country in the world in terms of mortality attributable to air pollution. This highlights the urgent need to tackle indoor air pollution, including tobacco smoke, through a combination of policy interventions, improved fuel choices, and public education.

Vehicular pollution

Pakistan is ranked as the third most polluted country in the world, with Lahore, Multan, Peshawar and Sialkot among the 15 most polluted cities in Central and South Asia. Vehicular pollution is a major contributor to this poor air quality. Pakistan has around 23.6 million transport vehicles, which emit dangerous levels of NOx, the primary cause of smog formation. Vehicular emissions are responsible for the majority of the smoke, haze and pollution that fills the air in Pakistani cities.

The COVID-19 lockdowns of 2020 provided a stark example of the impact of vehicles on air quality. During this period, with far fewer vehicles on the road, pollution levels in Lahore gradually decreased. However, once the restrictions were lifted, smog quickly returned, and the air quality deteriorated once again.

The problem of vehicular pollution is not limited to one city or region in Pakistan. In addition to Lahore, the cities of Peshawar, Islamabad, Rawalpindi and Faisalabad have all seen a rise in their annual average pollution levels. Islamabad, the capital city, ranked as the fifth most polluted capital in the world.

Vehicular emissions are not the only cause of Pakistan's poor air quality. Industrial emissions, brick kilns, construction dust, crop burning and general waste burning also play a significant role. However, it is clear that vehicular pollution is a major factor, and reducing vehicle emissions is critical to improving the air quality in Pakistan.

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