ArticlePublic health challenges2026
Health Under Haze: Symptom Burden Among Adult Outpatients During the 2024-2025 Winter Smog Season in Lahore, Pakistan.
Article in Public health challenges, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Severe urban air pollution is a major public health challenge in many low- and middle-income countries. Lahore experiences recurrent winter smog episodes with pollution levels far exceeding international guidelines, but hospital-based evidence on associated symptom burden remains limited. Methods: We conducted a cross-sectional study of 400 adult outpatients attending a tertiary hospital in Lahore between October 2024 and January 2025, during a period of sustained severe air pollution. A structured questionnaire collected data on demographic characteristics, behavioural factors, occupational exposure proxies, medical history and respiratory and non-respiratory symptoms. Symptom burden was analysed using descriptive statistics and multivariable regression models, including an exploratory composite vulnerability index. City-level air quality index (AQI), PM Results: In this health-seeking outpatient sample, 98% of participants reported at least one symptom. The most common complaints were shortness of breath (74%), eye irritation (56%), cough (53%) and sore throat (50%). PM Conclusion: During Lahore's 2024-2025 winter smog season, adult outpatients reported substantial multisystem symptom burden. These findings support strengthened environmental control measures and public health responses in heavily polluted urban settings.
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