Air pollution is more dangerous than smoking

Despite public awareness and relentless media coverage, Kathmandu’s air quality has worsened in the past two years. But public outrage does not seem to translate into action to clean up the air.

A road-widening spree, earthquake destruction and delays in fixing streets dug up to replace water mains has turned the Valley into a dust bowl. There has also been a 25% increase in the number of vehicles on the roads.

The theme for World Environment Day (5 June) is #BeatAirPollution. China will be the host nation and will showcase its dramatic progress in cutting pollution.

In Nepal, 35,000 people die annually due to illnesses caused by polluted air. Average life expectancy is reduced by at least four years in the worst-affected areas like Kathmandu Valley, Chitwan and other parts of the Tarai. 

“Air pollution is a silent killer and while it is difficult to quantify its heath impact, hospitalisation due to serious respiratory diseases has increased sharply in recent years,” says chest specialist Raju Pangeni at HAMS Hospital in Kathmandu. “It is now causing heart attacks, kidney diseases, osteoporosis and dementia. Air pollution is more dangerous than smoking cigarettes.”

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Non-smokers in Kathmandu are now suffering from diseases that you would expect to see afflicting chain smokers. And residents of the capital who smoke get a double whammy.

“Controlling tobacco in Nepal is already such a big challenge, but  Kathmandu’s degrading air quality has doubled the disease burden,” says health activist Shanta Lall Mulmi. 

Ironically, World No Tobacco Day falls on 31 May, just four days ahead of Environment Day. 

Because Nepal’s national government and municipalities have done little to reduce risk, citizens have adopted their own methods of personal protection: wearing masks, installing air purifiers at home and office, cancelling morning walks, and monitoring air pollution levels on apps before allowing children to play outside.

There are dozens of varieties of masks available in the market, along with air purifiers that cost more than Rs130,000. But public health specialists discount their efficacy and stress that the best solution is to reduce air pollution at sources. 

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Bad Air

“A mask at best is a temporary solution and does not block harmful gases. Their effectiveness also varies depending on the work place, environment and fitting. Because indoor air pollution levels are also high, ideally you would have to wear a mask 24 hours a day,” says Pangeni. 

Air pollution is also the main environmental risk factor for non-communicable diseases like cancers and lung diseases, concludes a recent report by the NCD Alliance and the Forum of International Respiratory Scientists: ‘The challenge is great, but the cure is straight-forward... it must be met by national, regional, local and personal responses. Collective action from many sectors is needed to assure that everyone can breathe clean air.’

Indeed, a long-term solution requires policy level intervention and coordination between all branches of government. 

Electrified public transport would have been a good place to start, but 6 months after Prime Minister KP Oli launched an electric mobility action plan to turn at least 20% of public vehicles into battery-operated ones by 2020, progress has been slow. 

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How to clean up Kathmandu’s air, Anil Chitrakar

Poisoning the air we breathe, Sonia Awale

The government slashed taxes on electric vehicles, but much of the supporting infrastructure required, like charging facilities, uninterrupted electric supply and adequate parking lots, has not even been planned.

“The first step in controlling air pollution is with electric public transport because vehicular emissions make up the majority of pollutants in Kathmandu’s air,” says environmentalist Bhushan Tuladhar.

With neighbouring India and China committed to manufacturing only electric automobiles by 2030, Nepal will be forced to go electric. Getting prepared now will make that transition smoother.

The US government held a meeting in Kathmandu this month of its embassy staff specialising in air pollution based in 30 Asian countries. On hand was Marcia Bernicat of the US Bureau of Oceans and International Environment and Scientific Affairs. “Dealing with a problem that is transboundary in nature requires strong regional cooperation,” she said. “When you can frame the problem in terms of how many people are dying and how much productivity is lost, then it becomes much more urgent.”

Quantifying the socio-economic impact of air pollution on a country will be vital in raising awareness among the public as well as policy makers and leaders, but as we have seen in Nepal it does not immediately lead to policy change.   

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There are dozens of types of masks available in Kathmandu. There are cloth masks and surgical ones, some are disposable but many use replaceable filters. Prices range from Rs10 to Rs10,500. Most make various performance claims based on lab tests but factors like the mask’s fit play important roles. Take your pick, but remember the best thing is to reduce the source of pollution. 

Costly is not better

Researchers at the University of Edinburgh recently concluded that surgical masks blocked 80% of particles sized 0.007 microns. Similarly, a University of Massachusetts study found that the good old surgical mask blocked 60% of 0.03 micron particles, and over 90% of 1 micron and 2.5 micron particles. Of course, a mask’s effectiveness depends on how well it fits on the face, but a simple, disposable surgical mask can be more cost-effective than those fancy looking expensive ones.

Sonia Awale


Sonia Awale is Executive Editor of Nepali Times where she also serves as the health, science and environment correspondent. She has extensively covered the climate crisis, disaster preparedness, development and public health -- looking at their political and economic interlinkages. Sonia is a graduate of public health, and has a master’s degree in journalism from the University of Hong Kong.