Dr Mattias Larsson*

Have you ever woken up to a hazy morning, felt an itch in your throat and eyes, and noticed a runny nose? This is often the case for many people in Việt Nam, particularly in Hà Nội and Hồ Chí Minh City (HCMC), where air pollution has become a serious public health issue.

At Family Medicine Practice (FMP), we regularly see patients, both children and adults, with symptoms such as a runny nose, coughing, itchy eyes and asthma, common signs of allergic rhinitis, an immune response against inhaled allergens. The place and time of exposure, as well as allergy tests, may identify the cause, such as pollen. However, air pollution, a mix of harmful chemicals, is not detected by allergy tests. Unfortunately, except for some pollen, there is no cure for such allergies and treatment typically focuses on avoiding exposure and managing symptoms using antihistamines. 

Air pollution is linked to a wide range of health problems. Particulate matter, PM2.5 (fine particles 2.5 microns or smaller), can penetrate deep into the lungs and bloodstream, raising the risk of asthma, pneumonia, heart attacks, strokes and lung cancer. Other pollutants, like ozone, nitrogen dioxide (NO2) and sulfur dioxide (SO2), contribute to respiratory conditions like chronic obstructive pulmonary disease (COPD), emphysema and exacerbated asthma or bronchitis, especially in children and vulnerable groups. Studies from HCMC and northern Việt Nam show that high pollution levels are correlated with increased hospital admissions for pneumonia and other cardiovascular conditions. Children are particularly at risk due to their smaller lungs and faster breathing rates.

Air pollution is often referred to as a 'silent killer' because of its gradual and widespread impact on health. According to the World Health Organisation (WHO), air pollution is one of the leading causes of death worldwide. In the Western Pacific Region, it is estimated to be responsible for approximately 2.2 million deaths each year, with more than 60,000 deaths in Việt Nam alone—outnumbering traffic accident fatalities, which claim about 11,000 lives annually.

In 2023, air pollution in Việt Nam reached alarming levels. According to IQAir, Hà Nội's PM2.5 concentration averaged 43.7 μg/m³, often classified as unhealthy or very unhealthy and ranked as the eighth most polluted city in the world (New Delhi, India, the most with 92.7 μg/m³). HCMC had an average of 21.8 μg/m³ and was often classified as unhealthy for sensitive groups.

The economic burden of air pollution in Vietnam is substantial. It is estimated that air pollution costs the country between five and seven per cent of its GDP, or US$11-16 billion annually. This includes treatment costs, lost labour due to illness and the economic impact of premature deaths.

The main contributors to air pollution include, coal power plants providing nearly half of the country’s electricity and emitting large quantities of harmful pollutants. Traffic emissions with an increasing number of combustion-engine vehicles worsen urban air quality. Industrial emissions, which release particulate matter and harmful gasses. Agricultural and waste burning, which adds to the pollution and releases toxic gases. In addition to health risks, air pollution also contributes to global warming, which is particularly threatening to Việt Nam as the Mekong Delta, home to 19 million people, could be submerged in the next 30 years due to rising sea levels.

To improve air quality, investments could be made in clean energy including solar, wind and other renewable sources. Electric vehicles could be promoted through tax incentives and restrictions on fossil fuel-powered vehicles. Emissions regulations could be strengthened. Enforcing stricter standards for industries, transportation, and waste management would help reduce pollutants. Rubbish burning could be banned and agricultural burning restricted.

The COVID-19 pandemic demonstrated how quickly air quality can improve when human activity is reduced. During lockdowns, satellite images showed clearer skies and lower pollution levels in cities worldwide. This proves that with concerted effort, air pollution can be reduced, even in the short term.

On an individual level, there are steps you can take to protect yourself from air pollution: Use air purifiers to reduce indoor exposure to harmful particles. Wear protective masks (though they may not filter all pollutants). Limit outdoor activities on days with high AQI levels.

Advocate for cleaner air by supporting policies that promote clean energy and sustainable practices. Family Medical Practice 

*Dr Mattias Larsson is a paediatric doctor at Family Medical Practice and associate professor at Karolinska Institute and has a long experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Việt Nam. He is fluent in English, Swedish, Vietnamese, German and speaks some Spanish.

Family Medical Practice - FMP Healthcare Group operates medical centres in major cities including HCM City, Hà Nội and Đà Nẵng, offering consultations with international doctors, check-up centres and emergency ambulance services. In HCM City, they have clinics in Districts 1, 2 and 7, along with the Care1 - Executive Health Check-Up Centre and internationally accredited *9999 emergency ambulance services.