“Deep Breath” is an interactive report produced in 11 cities on 5 continents. It tells the story of how the life in agglomerations struggling with polluted air looks like. The idea for this reportage was awarded the Hostwriter Pitch Prize for the best international journalistic cooperation.
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Smog, which rises above agglomerations and is present in dwellings, poses an environmental and health risk. According to the World Health Organisation (WHO), 11.2% of the world’s population dies prematurely of diseases caused by poor air quality. Developing countries are at the forefront of this report. Many regions struggling with polluted air are located in the Western Pacific, the Mediterranean, the Sub-Saharan region and South-East Asia.
When smog appears in Beijing, China’s capital, the sky outside the window becomes grey and buildings are no longer visible. On such days, the Yang family turns on the air purifier at home and plugs cotton cloths in the door slits.
“In the morning, I wake up with a phlegm in my throat and my mother often coughs”, says Mr. Yang’s daughter. “Mum has been drinking herbal tea for some time to cleanse her airways. This makes her feel better but the cough doesn’t go away.”
Recently, they learned from the media and the internet that special smog-screen masks can help fight the problem. They family members have been putting them on when they leave home ever since.
Smog is a form of a mist which contains air pollution. It can be most often seen with the naked eye above the cities or near factories. Smog consists mainly of chemical compounds such as sulphur oxides, nitrogen oxides and dusts from, among many others, the combustion of coal and wood in furnaces, exhaust fumes from cars or from industrial plants. They are also released when tobacco is smoked.
High levels of nitrogen dioxide can contribute to asthma or exacerbate its symptoms. Coughing and breathing difficulties occur among people who are exposed to it.
Ozone in the atmospheric boundary layer causes nose and throat irritation.
However, the particulate matter poses the greatest health risk. The small particles and droplets of liquids that persist in the air and contain, among other things, organic compounds, heavy metals, dioxins, allergens. PM10 dust consists of particles with a diameter of less than 10 μm that can cause conjunctival, nasal and pharyngeal inflammation. The fine PM2,5 dust has a diameter of less than 2,5 μm. Sometimes it gets into the pulmonary alveoli, then it is transported to the blood vessels and from there into the bloodstream which is harmful to the cardiovascular and respiratory system.
China is one of the countries with the most polluted air in the world. It is ranked third in terms of the size of the coal resources – extracting it accounts for 65% of the country’s economy. However, the extracted raw material is of poor quality. In the vicinity of big cities there are numerous plants that burn huge amounts of this fuel, releasing toxic substances. In China, the number of cars is also growing every year. Increased road traffic contributes to the fact that exhaust fumes float over the city for many days.
“Smog was not such a big problem in the 90s”, believes Mr. Yang. “It was only later the that air quality deteriorated. Some wealthier people leave Beijing and spend the winter in the city of Sanya, in southern China.”
In Beijing, a four-colour system has been in place since 2013 to inform people about the quality of the air. In 2015, for the first time, a red alert (the highest smog hazard), was issued. At that time, the authorities reduced car traffic, closed schools and kindergartens. Some factories had to stop production.
“Back then, half of the city’s cars (around 2.5 million) were still on the road”, says Roger Wu, an inhabitant of Beijing. “The restrictions did not affect the functioning of the city too much. Luckily, some people could work from their homes”
Smog is not a new phenomenon. The English were the first to use coal on a large scale and complained about breathing problems as early as in the 16th century. During the Industrial Revolution, this problem was only exacerbated by the fact that factories which were keen to use raw materials were often located in the cities. In December 1952, when dense fogs struck London, the world became aware of the dangers of polluted air. The temperature in the city has decreased and people started burning more fuel in furnaces. The resulting dust did not disperse in the fog and sulphuric acid was generated. Within the next five days between 4000 and 12000 people died and 150,000 were hospitalised.
There are two types of smog. Photochemical smog, known as “the Los Angeles smog”, occurs between June and September at high temperatures. It is a result of low winds and high traffic levels. Sunlight reacts to pollution and creates a poisonous ozone gas. On windless days, harmful particles often remain close to the earth’s surface instead of rising above. The second most polluted city struggling with the same phenomenon is Mexico City.
In Mexico City the levels of ozone, carbon monoxide, nitrogen dioxide and sulphur dioxide are measured in various locations using IMECA points. The results are published on an hourly basis. The first hazard level is registered when measurements are above 150 points. On May 2nd 2016 it reached 168, which meant that the quality of the air was very poor and people could have experienced breathing problems. Two days later the result was 192 points. The authorities have then decided that 2 million cars (almost 40% of all the vehicles in the city), would be banned from traffic for a period of three days.
“My friends could not get to their offices because public communication couldn’t handle such a large number of people in the city”, says Ruben Breton, a Mexican citizen. “A lot of people were late for work, some of them had to take taxis, which raised the prices of their trips several times that day.”
In 1989, Mexico introduced the “No service today” programme which reduced the car traffic during the winter in Mexico City and state of Mexico by 20%. Depending on the last number on the license plate, the cars were allowed or forbidden to drive on given days. The idea has evolved and today all passenger cars are verified twice a year for their exhaust emissions. If the cars do not meet the standards or are technologically obsolete, they cannot go out on the streets for one or two days a week. However, according to the locals, this programme does not yield results yet.
“The number of cars on the streets has not decreased and people have replaced many old cars with new ones in order to be able to use them every day”, says Alejandro Lopez, who travels around the city in a car. “More than 20 million people live in and around Mexico City and this number is growing all the time because people from all over the country come here to work. There is no good and safe public communication they can use. We don’t have trains either and the underground doesn’t take people to their homes”, adds Lopez.
Mario Medrano has been living on the outskirts of Mexico City ever since he was a child. Every member of his family has a car.
“Buses in Mexico state are 20 to 30 years old, packed and uncomfortable to travel on because they are not air-conditioned”, he says. “They are privately owned and pollute a lot. Just like old trucks, they do not have to be verified for exhaust fumes emissions. The government only requires this from the owners of passenger cars which I find incomprehensible. In addition, buses are dangerous. When travelling by them, I can’t take my computer with me because someone can steal it.”
Mario noticed that in recent years he needed more and more time to get to the city centre as the number of cars has increased and traffic jams start at an earlier time.
“More and more flats are being built and people do not want to use the overcrowded public transport”, he explains. “Besides, the roads are often blocked in the city center by demonstrators so cars spend a lot of time on the streets and consume more fuel.”
Car exhaust fumes pollute the air in many countries and the authorities do not always know how to deal with this problem. In Kathmandu, Nepal, the number of vehicles has increased several-fold over the last 10 years. Old motorcycles and cars ride on the streets, many roads are under construction which generates a lot of dust. Some people put on masks to avoid inhaling smog.
“Today the air is not so polluted because it rained yesterday. But it was difficult to breathe the day before yesterday”, admits one of the police officers.
The second type of smog is the so-called classic, “London smog”. It occurs mainly between November and January in the temperate climate zone and consists of sulphur, nitrogen and carbon oxides mixed with dust and soot. Poland, among other countries, is struggling with it. According to the European Environmental Agency, six out of ten European cities with the highest level of air pollution are located in Poland.
Research carried out in the 1970s in the Małopolskie Voivodeship in Poland shows that back then the smog concentration was similar to today’s levels but it had different causes. At that time, industrial pollution prevailed while household exhaust emissions were half as big because coal was of better quality and no plastic rubbish was used as a fuel. The emission of car exhaust gases was also lower. Granted, the engines were polluting more but there were fewer vehicles on the road.
“When I was young, I didn’t know about smog at all because nobody talked about it”, says Mateusz Zmyślony from the Smog Busters organisation. They form an organisation which campaigns for clean air. “In the 1980s cigarettes were smoked in rooms, on buses, trains and airplanes. What we back then called the romantic fog was far worse”, he adds.
Today the poor air quality in Poland is caused by, among other things, high costs of gas heating. It leads to situations when some residents use waste to heat their homes. Waste is burned at low temperatures and the chimneys do not have appropriate filters. It means that they produce more pollution than waste incinerators would. Many harmful substances such as carbon dioxide, sulphur dioxide, heavy metals, hydrogen chloride, cadmium are released with the smoke. Additionally, incineration of humid waste can lead to soot clogging of the flue duct. In such case, carbon monoxide can retreat and may lead to poisoning.
“If smoking low quality fuel was banned in Poland in 1990s, as it was in other EU countries, today our smog emissions would be 50% lower”, says Mateusz Zmyślony.
Rabka-Zdrój is one of the most popular Polish pulmonological health resorts. It is located in the south of Poland. Children with respiratory diseases, coughing and allergic diseases come here to be treated.
“There are such concentrations of smog in this town that it is a crime to send children there”, adds Zmyślony, outraged. “In addition, southern villages of this region which charge special resort taxes, do not meet any standards and should lose their status. It’s frightening that this problem has been underestimated for so long”, he adds.
According to the UN Global Compact report, out of 45 health resorts in Poland, only six have air monitoring stations. Despite the lapses in meeting deadlines or violations of the exhaust emission standards, they have not lost their status and still receive subsidies from the Polish government.
The gap in air quality between the rich and poor countries is growing steadily.
“Air pollution threatens us all, but the poorest and most marginalized people bear the brunt of the burden,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “It is unacceptable that over 3 billion people – most of them women and children – are still breathing deadly smoke every day from using polluting stoves and fuels in their homes.”
Dharavi is the largest slum in Asia, located on the outskirts of the financial capital of India, Mumbai. Narrow streets lead to small houses covered with sheet metal. Next to many of them there are workshops where residents have tanneries and burn pots. A grey cloud hovers above the whole district.
“Few people in the slums realize how dangerous the smoke is to their health because they go to doctors only when they are ill”, says Rajesh Prabhakaran. He has studied poor communities in various parts of Asia.
In his opinion, people living in the poorest neighbourhoods are largely responsible for generating the smog due to a lack of knowledge.
Harish Shyamji Singhadia and his 30 family members live in this district in a small two-bedroom shanty. The majority of the inhabitants produce ceramics at home in a traditional way. For this purpose, they beat the clay then form vessels, dry them in an oven at a high temperature and finally paint them. They throw almost everything into the oven and do not protect themselves against smoke in any way.
“We’ve been doing this business since my grandfather’s time and it’s been almost 50 years since”, says Harish. “About 1000 families live in the area and our neighbors make dishes, too”, he adds.
Josua works in a small craft company called Victorious Bones Crafts in the Kibera slum on the outskirts of Nairobi, Kenya. Most of the locals have to survive on less than a dollar a day. Many people are unemployed. There are a few schools in Kibera but hardly anyone can send their children there because they have to earn money.
Josua and his colleagues make jewellery and other souvenirs made of bone, wood and brass. During the processing of the material a lot of dust floats over them and enters their lungs. Men are aware of the fact that this dust is hazardous to health but they are not worried about it because they have already become accustomed to polluted air. Some of them work without any protection for most of the day.
People all over the world organize protests, marches and create organizations to make city dwellers aware of what air pollution is and how it affects their health. They try to put pressure on local governments and force them to react.
–”I have always felt that smog was a problem because when I came home from the street, my hair and clothes smelled of smoke. When the Smog Alarm was launched at the end of 2012 in Krakow, I found out how to channel my anger”, says Magdalena Kozłowska from the audit committee of the Smog Alarm organisation in Krakow.
The Smog Alarm was set up by activists in response to the air measurement results. The organization quickly found allies and was approached by an advertising agency which organised a campaign mobilising them to sign a petition to the local government. It considered the ban on the use of solid fuels. The organisation also runs other events such as a funeral march in the memory of clean air. It attracted about a thousand people.
The initiative has been successful. The petition has been approved and the ban comes into force in Krakow in September 2019. The city has also created an assistance programme for those who will replace the furnaces. It initially covered 100% of the costs, in 2017 it will be 80% and 60% in 2018. In addition, the poorest people receive subsidies for their heating bills.
“We were aware that the issue was not present in Kraków only”, Magdalena Kozłowska explains. “In the course of time, we were approached by the inhabitants of other regions, who said that they faced the same problem. That is why a network of alarms in Poland called Polski Alarm Smogowy (Polish Smog Alarm) was established. We act as a secretariat. Thanks to the involvement of activists, antismog bills were adopted in Małopolska and in 5 other voivodeships”, she added.
“Local policy-making at the local and regional level must be supported by a central policy-making. At the beginning of last year, Polish Prime Minister Beata Szydło announced a 14-point “Clean Air” programme. For the time being only one of the points has been implemented – standards for new furnaces have been introduced. At the moment, we are monitoring the actions of the government and demand that the programme is implemented effectively. First of all, there are the coal quality standards. We do not know what is sold to individual customers, as coal does not have any certificates”, adds Kozłowska.
Mateusz Zmyślony became interested in the subject a few years ago thanks to his daughter who had health problems. A year ago he founded the Smog Busters initiative. He is now, among other things, conducting trainings on air pollution in schools.
“Every major change begins with knowledge. I take props to classes with children, for example, an air purifier with a filter that was in use for several weeks. Then you can clearly see what gets into your lungs if you don’t have air purifiers at home”, says Zmyślony.
He himself also started taking care of what kind of air he and his loved ones inhale. He has a portable smog sensor, uses air purifiers at home, at work and at school. He also wears a smog mask on worse days.
“This is the smoke-free barrier. Air purifiers, used in a closed area, purify the air almost completely. I see the results because my daughter has always been ill 5 or 6 times during the winter and not even once this year. I was not taking any sick leave this winter, either. It is quite optimistic that these ad hoc actions give something”, adds Zmyślony.
“These air problems have been around for 300 years”, says Marcin Sędziński, the owner of an oxygen bar in Kraków. “Previously, there were no exhaust fumes in the cities. Today we live completely differently from people 1000 years ago and our organisms defend themselves against polluted air. We breathe unconsciously, but in a shallow way. On smog days, we use about 20% of our lungs capacity. The bronchial tubes swell, limiting the oxygen flow to the pulmonary alveoli. These, in turn, are clogged up with particulate matter. This causes our body to have huge problems with oxygen. Then our organisms slow down, metabolize and it can have serious consequences for health and well-being.”
Marcin has been inhaling oxygen for three years. The first oxygen machine he bought with himself in mind, when he found out that they were very popular in China and Japan. With time, he noticed that thanks to inhalation he feels better, more relaxed, focused and is more resistant to diseases.
“These devices do not fight smog but its effects. Now I want to help other people get oxygenated. An oxidized organism is a relief for the liver and kidneys which are the organs that cleanse the body and the cardiovascular system. People who suffer from chronic, migraine headaches come to me for help”, says Sędziński.
Doctor Alejandra Fonseca from the Institute of Atmospheric Sciences of the National Autonomous University of Mexico (UNAM) advises government agencies on how to combat air pollution.
“While working, I am reminded that when I was in my primary school, teachers asked us not to play outside because of smog”, she recalls walking around the Pedregal de San Angel, an ecological reserve located on 237 hectares of land in the southern part of Mexico City.
Alejandra has a close family member who had to move out of the capital because of her deteriorating health condition. She herself would also be happy to leave but it would be hard for her to find a good job in her profession in another city.
Now Alejandra and her colleagues are waiting for the rainy season. Then they will be able to collect samples and see if the acid rain caused by polluted air affects the ecosystem.
“This is a vicious circle. We not only breathe polluted air but these compounds are absorbed by the soil, enter the sea, and then end up in the water which we drink. We must be aware that the air is also moving. Smog from the north, where many factories are located, comes to the south of Mexico City. Pollution from the United States can reach Campeche”, says Alejandra.
The doctor hopes that her team will be able to obtain evidence that the green areas are helping to combat smog and that we will begin to take better care of them.
“Under the Dome”, is a 2015 documentary by the Chinese journalist Chai Jing on air quality in China. She came up with the idea of making a documentary when she was pregnant and worried about the health of her unborn child. The movie was made available for free on the internet and has been viewed by millions of people.
“I think this work plays an important role in promoting public awareness of environmental issues, so I am particularly pleased with this event”, said the Chinese Minister of Ecology and Environment Chen Jining at a press conference when he was asked about her film. However, when the movie attracted more public attention, the authorities ordered to stop its viewings.
Protests have started taking place in China. In December 2016, masked students took to the streets of Chengdu, the city of 15 million in the province of Sichuan. “Yesterday there was so much smog that we couldn’t see anything when we got up in the morning”, one of the protesters wrote on Sina Weibo, the Chinese equivalent of Twitter. The protesters put on bronze sculpture masks depicting working Chinese people and called on to take part in the picket through social media, demanding an immediate solution to the problem. However, the demonstrators were chased out by the police.
National governments are looking for solutions. Last year in Delhi, a city which is growing very fast, PM2.5 was 70 times higher than the standards considered safe. In recent years, attempts have been made to combat smog in the city. The authorities started to check the level of car exhaust emissions and imposed a tax on diesel trucks which enter the city. The number of cars driving in the city in winter, when the air quality is particularly bad, has been reduced. The burning of leaves and garbage in the town were also banned. In addition, an Indian government programme has helped 37 million women living below the poverty line to get free access to LPG energy.
In China anyone with a smartphone can check the air quality and report violations to their local law enforcement agencies through social media. Recently, the Chinese people have had to give up heating their homes with coal in favour of gas which meant that some of the poorer people ended up freezing in cold weather. The country is also investing in renewable energy.
“It seems to me that, thanks to various government actions, the air in Beijing has become a little better over the last two years”, says Mr Yang, a resident of the Chinese capital.
A strong trend involving electric car is developing. From 2019, the electric vehicles will have to constitute at least 10% of the total cars sold in China.
In Cairo, the capital of Egypt, the smog problems began in 1997. The government puts part of the blame on the local farmers who burn rice straw in their fields because they do not know how to transport it to the recycling sites. For years, the authorities have been trying to solve this problem. They teach farmers about what they can do with the waste and they use satellites to locate where the straw is burning. Local people can also report law violations by social media or call the hotline. Governments are looking for ideas on what to do with waste and have recently entered into an agreement with a local company that uses rice straw for cement manufacturing.
Many European countries have also taken up the fight against smog. In 1990, Dublin introduced a total ban on burning of hard coal which reduced air pollution with particulate matter by 70%. By 2015, 28 cities in Ireland introduced a similar ban.
The Czech Republic, on the other hand, is trying to eliminate the furnaces of the worst quality. Since 2016, only fourth class furnaces have been available for purchase. The country has also introduced a ban on the sale of coal waste: flotoconcentrates and coal sludge. It is not possible to buy such fuels under the threat of high penalties. In addition, for the last two years only petrol cars with a green badge and yellow diesel cars have been allowed to enter the centre of Prague. The colours of the stickers indicate that the car meets the relevant standards.
In Germany, zones with limited emissions have been in place since 2007. Drivers can enter the centres of around 50 cities only if their cars meet certain standards. The government, on the other hand, focuses on education. It encourages people to use bicycles and public transport. As a result, air quality in Berlin has improved by over a dozen percent within a year after the changes were introduced.
England has also learned its lessons from the 1952 tragedy. Four years later, the Clean Air Act was introduced. The government insisted on the use of good quality coal and encouraged a switch to gas or electricity. The chimneys were ordered to be raised so that the pollution would not float over the heads of the passers-by. The power plants would have to be relocated from the cities. In the 1990s, a total ban on smoking with coal came into force. Efforts have also been made to reduce vehicle exhaust emissions. In London, people have to pay to enter the city centre by car, unless it is an electric car, hybrid or Euro 5 vehicle.
Meanwhile, more than seven million people die every year because of polluted air. Almost 90% of the victims come from poorer countries (two thirds from South-East Asia and the Western Pacific). The most common causes of premature deaths are stroke (25%), myocardial infarction (24%), chronic obstructive pulmonary disease (43%), lung cancer (29%). Young children, adolescents, the elderly and pregnant women are most exposed to smog. In case of infants, toxic effects may interfere with proper nutrition and cause placenta hypoxia.
“In Krakow, children are born lighter, shorter, with smaller head circumference due to polluted air. In cognitive tests conducted at a later stage, they score worse than children born in unpolluted environments”, says Magdalena Kozłowska from the Smog Alarm about the results of research conducted by Professor Wiesław Jędrychowski in cooperation with Columbia University.
On the other hand, the lungs of older people are less flexible, their chests are stiff and muscle atrophy causes oxygen to pass from the lungs to the tissues with resistance. Dusts can cause breathlessness, breathing difficulties and even heart attacks.
“Yesterday I was on the street and I had the feeling that I was about to suffocate. I couldn’t catch the air. I entered the house and everything passed”, says Grażyna Misterska, a retiree from Łódź.
She started having problems with asthma two years ago. Its symptoms always intensify in winter. The woman is not being treated because, as she says, she has no time for this. She can’t make ends meet with her pension which is why she takes care of elderly and sick people as a part-time job.
“I feel good at home but I start coughing when I go out on the street”, she says. “I was ill with pneumonia twice, the last time in July last year. I spent two weeks at the hospital. The doctors told me that the air was “what it was” and advised that I should be careful about myself”, she says.
“When my son was little, I fed him at work”, says Phyllis Omido who was doing office work in a steel mill in the Mombasa area in Kenya. “Tests have shown that he was poisoned by lead in my milk. At that time, I ran medical examination on three other kids from the area. It turned out that they were also poisoned by lead so I decided to mobilise people to start protesting against the pollution”, she concludes.
Phyllis is the founder of the Centre for Justice which is fighting for the right to a clean and safe environment. It declared a war against the government and the two companies responsible for air pollution. She has led to the closure of the factory where she worked and now she is demanding compensation for the local residents. The case is now in court.
“Because of my environmental work, I was arrested by the police. There are also attacks on other members of my community who are involved”, says Phyllis.
Dr. Jamshid Shams Alam is an intern at the Al-Hayat Hospital in Kabul, Afghanistan. Over the past six years he noticed that more and more people have breathing problems.
“The city is overcrowded, cars and factories have a bad impact on air quality, just as people who burn wood and even plastic in their furnaces in winter, depending on what they find”, he says. “Children in particular are at risk of diseases because their lungs are not fully developed and do not have the same resistance as those of aduls”, he comments.
In Kabul the air pollution is 4.6 times higher than WHO standards. In 2014 the local Ministry of Health reported that around eight people die of poor air quality every day in the country and more than 30,000 people die of poor air quality diseases in the course of one year. The most common cause of death was heart disease.
John Mohamed works in the traffic police in the Afghan capital in a 12-hour shift system. It is not his dream job. He is exposed to the inhalation of smog every day. Some of his colleagues are fighting lung cancer. In recent years, many villagers have moved to cities in search of work and safety. And thus, more cars have appeared on the streets.
Samuel, 45, is working as a a plastic recycling machine operator in Manshiyat Naser, Cairo. It is a slum located on a hill, in the south of the city, which the locals call the “city of rubbish”.
Since the 1940s, people have been collecting rubbish in this approximately 20-million-strong urban complex, known as the Grand Cairo, where it is hard to breathe in the summer. They throw the waste into a trailer towed by donkeys or onto a truck and return to their village. At home, they sort the rubbish with whole families. Women look for plastic bottles in one room and for beverage cans in another. Glass products are sold, metal melted and paper and plastic recycled.
“It’s a well-paid job, but I spend a lot of time on the street and I know I’m putting my health at risk”, says Samuel. “I want to quit it soon”, he adds.