Haze Raises Health Concerns, Calls For Stronger Enforcement

For Setiawangsa resident Muhammad Syahir Azali, 35, few things are more heartbreaking than watching his nine-year-old daughter struggle to breathe, leaving him feeling helpless as she battles chest tightness and pain.

He still remembers the fear and anxiety he experienced when his daughter, Puteri Hannah Amelia, developed breathing difficulties and had to be hospitalised for five days after her condition worsened during a prolonged haze episode.

“At first, she had been coughing for two days due to throat inflammation, so I took her to a nearby clinic to consult a doctor and get some medication.

“However, her condition did not improve. By the third day, it had worsened, and she began experiencing breathing difficulties and chest pain.

“I immediately rushed her to the hospital for treatment. She had to be hospitalised for five days after doctors diagnosed her with a mycoplasma infection and bronchitis, which they linked to the haze,” he told Bernama, adding that the medical bills amounted to nearly RM10,000.

Muhammad Syahir said this was the first time his daughter had been hospitalised due to a haze-related illness, adding that doctors had confirmed the link between her mycoplasma infection, bronchitis and exposure to the haze.

He said the haze had aggravated his daughter's respiratory problems to the extent that she was unable to attend school. He was also advised to ensure that she wore a face mask at all times, even indoors.

Paediatricians said children were particularly vulnerable to haze because their lungs were still developing

Meanwhile, running enthusiast Syahirah Atikah, 36, experienced breathing difficulties after participating in a marathon event in the city recently, despite the Air Pollutant Index (API) reading being below 100.

“The event went ahead as usual, and we continued to monitor the API readings. I felt confident about running because the API was below 100, which indicated that outdoor activities were still possible.

“However, the haze worsened that morning, and after completing my run, I experienced chest tightness and difficulty breathing.

“The following day, I had to take sick leave after developing a headache and a severe cold, which I believe were caused by running in the haze,” she said.

HIGH API READINGS

Their experiences highlight how haze can affect Malaysians differently, from children suffering respiratory illnesses to otherwise healthy adults experiencing breathing difficulties after outdoor activities.

Although air quality is monitored through the API, concerns remain over the health risks associated with prolonged exposure to polluted air, particularly among vulnerable groups and those who spend long hours outdoors.

According to the Department of Environment (DOE), API readings of 0–50 indicate good air quality, 51–100 moderate, 101–200 unhealthy, 201–300 very unhealthy, while readings above 300 are considered hazardous.

As of Thursday (Oct 15), the DOE’s Air Pollutant Index Management System (APIMS) portal showed that eight areas in Johor recorded unhealthy API readings, led by Larkin at 187, followed by Batu Pahat (182), Pasir Gudang (181), Tangkak (177), Pengerang (170), Kluang (165), Kota Tinggi (162) and Segamat (161).

Several schools in the Klang Valley and other states were closed due to haze

In Selangor, Klang recorded an API reading of 191, followed by Shah Alam (179), Banting (170), Petaling Jaya (168) and Kuala Selangor (161), in addition to Johan Setia.

In Negeri Sembilan, Nilai recorded an API reading of 187, followed by Seremban (182) and Port Dickson (176).

In Melaka, Bukit Rambai recorded an API reading of 184, followed by Melaka City (178) and Alor Gajah (176). Putrajaya recorded 175, while in Kuala Lumpur, Cheras registered 172 and Batu Muda 162.

In a statement issued on Oct 10, the Health Ministry (MOH) said cases of upper respiratory tract infections had increased by 10.43 per cent, while conjunctivitis cases rose by 26.47 per cent, according to its haze-related disease surveillance at 78 selected health facilities nationwide.

The ministry said upper respiratory tract infection cases increased from 3,509 in Epidemiological Week (EW) 39 to 3,875 in EW40, while conjunctivitis cases rose from 102 to 129 over the same period.

However, asthma cases fell by 13.64 per cent, from 535 to 462.

PROLONGED EXPOSURE MAY AFFECT LUNG HEALTH

Sunway Medical Centre consultant paediatrician and paediatric respiratory physician Dr Noor Zehan Abdul Rahim said prolonged or repeated exposure to haze could cause persistent inflammation of the respiratory tract, as fine particles such as PM2.5 penetrate deep into the lungs.

“This can lead to persistent coughing, increased mucus production, wheezing, chest tightness and breathlessness. Repeated exposure is concerning, especially for children with existing respiratory conditions such as asthma, as it can trigger flare-ups and worsen their symptoms.

 “Over time, repeated exposure to air pollution may contribute to declining lung function and increase the risk of respiratory complications,” she told Bernama.

Sunway Medical Centre consultant paediatrician and paediatric respiratory physician Dr Noor Zehan Abdul Rahim

She said children were particularly vulnerable because their lungs were still developing, while older adults might have reduced lung capacity and a diminished ability to clear inhaled particles.

While running is widely recognised as a healthy activity, exercising outdoors during periods of haze can increase exposure to air pollution, particularly in busy urban areas where vehicle emissions add to the problem.

University of Cambridge clinical professor and chair of Global Public Health and Sustainable Urban Development Professor Tolullah Oni said that although regular exercise played an important role in preventing non-communicable diseases (NCDs), the quality of the air people breathed while exercising was equally important.

She explained that people tended to breathe faster and more deeply when running, potentially inhaling greater amounts of polluted air than they would while resting.

Speaking to Bernama on the sidelines of the Global Tipping Points Conference organised by Sunway Centre for Planetary Health Malaysia, Oni said the risks could be greater for those exercising near busy roads, where vehicle emissions contributed to higher levels of air pollution.

University of Cambridge clinical professor and chair of Global Public Health and Sustainable Urban Development, Professor Tolullah Oni

“Research has shown that pollution levels from vehicle emissions can decrease significantly with distance from the source, making the location of running paths an important consideration in urban planning.

“Just having separate physical activity infrastructure that is a couple of metres from the road makes a huge difference in terms of the dose you take in,” she said.

Oni stressed that unlike vehicle emissions, which tend to be concentrated near their sources, transboundary haze could affect a much wider area, making it difficult for people to avoid exposure simply by choosing a different outdoor running location.

“Under severe haze conditions, exposure would undoubtedly be worse. It is not something I would recommend for outdoor running,” she said.

She added that exposure to high levels of air pollution could affect more than just the lungs, potentially worsening asthma and increasing the risk of cardiovascular problems, including heart-related events, stroke and high blood pressure, particularly among children, older adults and people with existing medical conditions.

EL NINO COULD WORSEN HAZE

While the haze continues to raise public health concerns, changing weather patterns and the possible onset of El Nino could affect the duration and severity of the problem in Malaysia.

Malaysian Meteorological Department (MetMalaysia) meteorological officer Mimi Adilla Sarmani said forecasts of a strong El Nino, or ‘Super El Nino’, coupled with climate change and global warming, pointed to the possibility of prolonged hot and dry conditions in the country.

 She said Malaysia was expected to experience intense heat between March and May 2027, with temperatures potentially exceeding 40.1 degrees Celsius.

Mimi Adilla Sarmani (Pix credit to MetMalaysia)

She added that Malaysia was currently in the inter-monsoon period, characterised by generally light and variable winds that could carry smoke from forest and land fires in neighbouring countries, including Indonesia, into Malaysia, resulting in transboundary haze.

“If there are hotspots or forest fires in Sumatra or Kalimantan, for example, and the winds blow towards Malaysia, the smoke can be carried into our country, resulting in transboundary haze,” she said during a pocket talk organised by MetMalaysia in conjunction with the International Greentech and Eco Products Exhibition and Conference Malaysia (IGEM) 2026 here recently.

However, Mimi Adilla said conditions could improve with the expected arrival of the Northeast Monsoon in November, when prevailing winds generally blow from the northeast.

Rainfall during the monsoon transition could also help ease the situation by reducing the concentration of pollutants in the atmosphere.

“However, there is still a possibility of haze if weather systems cause the winds to change direction and carry smoke towards Malaysia again, although the likelihood is very low,” she said.

Rainfall during the monsoon transition could also help ease the haze by reducing the concentration of pollutants in the atmosphere.

Meanwhile, Sunway Medical Centre consultant respiratory physician and internal pulmonologist Dr Syed Ajmal Syed Ali said extreme heat and haze could place additional stress on the respiratory system, particularly among individuals with existing lung conditions.

“Haze exposes the lungs to fine particles such as PM2.5, which can trigger inflammation and increase mucus production, leading to coughing, wheezing, chest tightness and breathlessness.

“When these conditions coincide with prolonged periods of extreme heat, the additional strain on the body may make it more difficult for vulnerable individuals to tolerate poor air quality,” he said.

He said prolonged hot and dry conditions during El Nino events could also increase the risk of vegetation fires, potentially worsening haze and extending exposure to airborne pollutants.

“This combination is particularly concerning when people continue outdoor activities or work outdoors for extended periods.

“We therefore advise limiting outdoor exposure during periods of poor air quality, avoiding strenuous outdoor activities, staying hydrated during hot weather and continuing prescribed medication for existing respiratory conditions.

“Anyone experiencing worsening breathlessness, wheezing or chest tightness should seek medical attention,” he said.

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STRONGER LAWS NEEDED TO TACKLE TRANSBOUNDARY HAZE

While changing monsoon patterns and rainfall may provide temporary relief, environmental groups say stronger legislation and enforcement are needed to address the recurring haze problem.

On Oct 7, Greenpeace Malaysia and other civil society groups called on the government to expedite efforts to introduce a transboundary haze law that would allow action to be taken against companies found responsible for forest and land fires that cause haze across national borders.

They also urged the government to take action against companies proven to be responsible for the fires and called for greater transparency from Indonesia, particularly regarding the locations of fires, investigation findings and companies potentially linked to the incidents.

Greenpeace Malaysia campaign manager Heng Kiah Chun said Malaysia could no longer afford to delay efforts to strengthen its legal framework while communities continued to suffer the health consequences of haze year after year.

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“A transboundary haze law cannot remain on the drawing board while communities continue to bear the health consequences of haze year after year.

“The Malaysian government announced it is considering legislation. Now, we need to see that consideration translated into swift and urgent action that is concrete and time-bound.

“We must have the legal power to investigate and hold companies accountable where credible evidence links them to environmental harm beyond our borders. The haze crosses borders; accountability must be able to do the same,” he said.