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10 worst cities for asthma & air pollution

Posted on June 7, 2016 by Kelly Johnstone
Smog over Los Angeles

If you have asthma and love to travel, there are a few things you need to consider from medication and air travel requirements all the way through to managing your exposure to allergens.

One thing that you may want to think about adding to this list when preparing for your holiday is air pollution, which research shows can worsen asthma symptoms.

Air pollution consists of naturally occurring and man-made gases, smoke from fires, volcanic ash and dust particles and the quality of air can vary significantly from location-to-location. For people travelling with asthma, this means that a bit of research when planning a holiday could make a real difference to their comfort and enjoyment while away.

Which are the worst cities for people with asthma?

The World Health Organisation (WHO) monitors air pollution levels around the world and produces the Global Urban Ambient Air Pollution Database which includes 3000 cities across 103 countries. The WHO monitors the level of small particles of matter which include pollutants such as sulphate, nitrates and black carbon that penetrate into lung tissue and travel on through the cardiovascular system.

Any particles smaller than 10 microns in diameter are called PM10, and anything below 2.5 is PM2.5. The WHO’s guidelines state that when the amount of PM10 particles per cubic metre of air exceeds 20, the air quality is deemed unhealthy.

The 2016 database showed that the following 10 countries were home to the worst cities in the world for air pollution levels:

Location Particles of PM10 per cubic metre
Nigeria, Onitsha 594
Pakistan, Peshawar 540
Iran, Zabol 527
Saudi Arabia, Riyadh 368
Afghanistan, Mazar-e Sharif 334
India, Gwalior 329
Bahrain, Hamad Town 318
China, Shijiazhuang 305
Kuwait, Al-Shuwaikh 212
Bangladesh,Narayangonj 191

While the majority of the worst cities for air pollution are in heavily industrialised emerging countries, it is important to note that a few popular tourist destinations also exceed the recommended level. Kingston, Jamaica (48), Salerno, Italy (45) and Zagreb, Croatia (36) are just a few notable inclusions.


Mature lady using an inhaler

How can air pollution affect my asthma?

Ozone gas

Ozone is a very common air pollutant and contributes to smog or haze. Higher levels of ozone occur in cities with lots of vehicles, and at times of low winds and longer sunlight hours.

It is believed that higher ozone concentrations can trigger asthma symptoms because it irritates the airways and reduces lung function.

Airborne particles

Small airborne particles found in haze, smoke and airborne dust, have the potential to make asthma worse. People with asthma are not only at greater risk of breathing in the small particles, but exposure to poor quality air can cause health problems such as reduced lung function and more frequent asthma attacks.

Think about medical cover for your asthma if you’re heading on holiday.