Grappling with a state of cyclical pollutant smoke

FOR weeks throughout August and September, the haze became part of daily life in Sarawak.

The smoke has changed how people move about, exercise, work and plan outdoor activities, while raising concerns about the health of children, older people and those with existing respiratory or cardiovascular conditions.

Sarawak experienced its first significant wave of transboundary haze in mid-August, as dry El Niño conditions and peatland and forest fires in neighbouring Kalimantan, Indonesia, contributed to deteriorating air quality.

Between Aug 19 and 21, areas including Serian and Kuching recorded unhealthy and very unhealthy Air Pollutant Index (API) readings.

The situation became more serious in early September, when air quality in Serian reached hazardous levels. An emergency was declared in the district on Sept 4 after API readings went above 400, with some areas recording readings close to 518.

The emergency was lifted on Sept 7 as air quality improved, but the haze has not disappeared completely.

Air quality has continued to fluctuate with changes in regional winds and intermittent rain, with areas including Serian and Samarahan experiencing occasional spikes in unhealthy API readings.

For people living through the haze, however, the issue is not simply about the number shown on an API reading.

It is about whether children can play outside, whether outdoor workers can continue their routines safely and whether people with breathing problems can get through the day without worsening symptoms.

A regional problem

From an academic perspective, lecturer in international relations at Universitas Andalas, Indonesia, Rifki Dermawan said addressing recurring transboundary haze required stronger commitment from individual countries, particularly to existing regional agreements.

Dermawan

He said ASEAN’s principles, including non-interference and reliance on consultation and consensus, could limit the organisation’s ability to compel member states to take action.

Rather than relying solely on ASEAN to push countries to act, he said stronger commitment from each member state to implement the ASEAN Agreement on Transboundary Haze Pollution (AATHP) is needed.

“In my view, this commitment to the regional agreement is missing from Indonesian President Prabowo Subianto’s approach toward the environmental problem,” he told Sarawak Tribune in a written reply.

Dermawan noted that representatives from Indonesia’s Ministry of Foreign Affairs had maintained that the country remained committed to the AATHP, but said he had not seen an official statement from Prabowo addressing the haze specifically in a regional context.

He also pointed to Indonesia’s recent acceptance of assistance from Malaysia to help deal with widespread fires as a possible opening for greater bilateral cooperation.

However, he said cooperation should go beyond responding to fires once they had already spread.

“Coordination on preventive action is much more needed to stop the recurring fires,” he said.

Dermawan said the region already had mechanisms for sharing information and monitoring hotspots, with data from the ASEAN Specialised Meteorological Centre (ASMC) helping identify potential fire locations.

The bigger challenge, he said, is what happens after hotspots are identified.

For Indonesia, stronger law enforcement is important in preventing fires from recurring, including meaningful sanctions against companies found responsible for causing fires, he said.

At the same time, he acknowledged that the causes of forest fires in Sumatra and Borneo are complex, involving different actors and interests.

This makes haze a problem that cannot easily be addressed by one country or one agency alone.

Malaysia and Sarawak also stepped up measures on the ground as the haze persisted. The National Haze Action Plan has been activated alongside closer monitoring of air quality, hotspots and health impacts, while the State Disaster Management Committee (SDMC) has coordinated state-level measures, including cloud-seeding operations.

In August, Malaysia called for stronger ASEAN preparedness through hotspot surveillance, open-burning enforcement and firefighting readiness.

Sarawak also engaged the federal government to raise the transboundary haze issue with Indonesia through ASEAN channels, while cloud seeding was carried out in early September to help improve conditions and replenish water catchments.

At the federal level, the Ministry of Health activated a National Haze Operations Room and continued monitoring haze-related illnesses through 78 sentinel health facilities, while ensuring the preparedness of healthcare facilities and medical supplies.

Malaysia has also offered Indonesia assistance, including aerial firefighting assets, as part of efforts to address the fires contributing to transboundary haze.

What the haze does to our health

While the regional response may take time, the health effects of haze are already being felt.

Consultant respiratory physician at Sunway Medical Centre, Dr Syed Ajmal Syed Ali, said the main health concern during a haze episode is exposure to fine particulate matter, particularly PM2.5.

Dr Syed

These tiny particles can travel deep into the lungs and, in some cases, enter the bloodstream.

In the short term, exposure can cause irritation of the eyes, nose and throat, as well as coughing, phlegm, wheezing, chest discomfort and shortness of breath.

For people with asthma, chronic obstructive pulmonary disease (COPD) and other respiratory conditions, haze can worsen existing symptoms and may result in a greater need for medication or medical attention.

Senior lecturer in public health at Taylor’s University Dr Sapna Shridhar Patil said the effects extended beyond respiratory health.

“Recurring haze is more than a seasonal inconvenience. It is a significant public health concern, particularly for vulnerable populations,” she said.

She explained that PM2.5 could penetrate deep into the lungs and enter the bloodstream, potentially triggering respiratory symptoms while increasing the risk of asthma exacerbations, respiratory infections and declining lung function.

Fine particulate pollution can also contribute to systemic inflammation and place additional strain on the heart and blood vessels.

“Haze should therefore not be viewed solely as a respiratory issue, but as a broader public health concern that can affect multiple body systems,” she said.

Children are particularly vulnerable because their lungs are still developing and they inhale more air relative to their body weight.

Older adults may have reduced physiological reserve and are more likely to live with chronic conditions that make them susceptible to air pollution.

Pregnant women and people with conditions such as asthma, COPD, cardiovascular disease and diabetes also require greater caution.

Outdoor workers and people who exercise outdoors for prolonged periods may face higher exposure simply because of the amount of time they spend breathing polluted air.

Beyond the API reading

One challenge during prolonged haze is that air quality does not remain at a single level.

Dr Sapna said short-term exposure could cause immediate symptoms such as eye irritation, coughing and difficulty breathing, while repeated exposure over weeks or months increased a person’s cumulative exposure to air pollution.

Dr Sapna

This means a temporary improvement in the API does not necessarily mean the risk has disappeared.

“The potential impact of air pollution depends not only on its concentration, but also on the duration and frequency of exposure,” she said.

Dr Syed similarly noted that the health impact depended not only on how visible the haze was, but also on pollutant concentrations and the length of exposure.

Parents, schools and caregivers should therefore consider both air quality readings and individual symptoms.

Persistent coughing, wheezing, shortness of breath, chest tightness, unusual fatigue, headaches, dizziness or difficulty carrying out ordinary physical activity can indicate a reaction to poor air quality.

For those with asthma, an increased need for prescribed inhalers or worsening allergy symptoms may also signal deteriorating conditions.

Dr Sapna advised that medical attention should be sought promptly if someone develops significant breathing difficulties, chest pain, bluish discoloration around the lips or fingertips, confusion, severe wheezing or symptoms that do not improve with prescribed medication.

Protecting children beyond the physical symptoms

The effects on children, however, may not always be visible.

Dr Sapna said growing research suggested air pollution could be associated with changes in cognitive performance, attention, concentration and learning outcomes, although researchers were continuing to examine the mechanisms and extent of these effects.

There are also indirect consequences when haze persists.

Schools may suspend outdoor activities, cancel field trips, close temporarily or move to alternative learning arrangements. Such disruptions can affect educational routines and learning opportunities, particularly for children who benefit from structured environments and social interaction.

Prolonged periods indoors and cancelled outdoor or social activities may also contribute to boredom, isolation, stress or anxiety for some children.

Reduced opportunities for physical activity and social interaction, coupled with increased screen time, can further disrupt children’s daily routines.

For children with chronic health conditions, concerns about worsening symptoms may create additional emotional stress.

Dr Sapna said families already facing economic or health challenges could experience further burdens during a prolonged haze.

“The public health response should therefore encompass not only physical protection from pollution but also measures that support children’s educational continuity and their psychosocial well-being,” she said.

These less visible effects reinforce the need to look beyond API readings when considering the impact of a prolonged haze on children.

Haze blankets Serian’s highway. Photo: Ghazali Bujang

A mask helps, but it is not everything

For those who have to go outdoors, wearing a properly fitted particulate respirator can help reduce exposure to fine particles.

Dr Syed said N95 respirators, or equivalents such as KN95 masks, provided substantially better protection against fine particles than surgical or cloth masks.

Dr Sapna also stressed that proper fit was particularly important for children, as gaps around the nose and sides of the face could reduce effectiveness.

But even an N95 does not completely eliminate exposure.

When haze levels are high, people should reduce the amount of time spent outdoors and avoid strenuous exercise.

Vulnerable individuals should pay particular attention to local API and PM2.5 readings when deciding whether to go outside.

For people with asthma, COPD or other chronic respiratory conditions, prescribed medication should be continued and kept readily available.

Staying indoors during hazy conditions does not mean stopping treatment.

When heat and haze come together

The situation can become more uncomfortable when the haze arrives alongside hotter and drier weather.

El Niño can contribute to hotter and drier conditions, helping vegetation and peat fires spread and persist, potentially increasing smoke and particulate pollution.

At the same time, high temperatures bring their own risks, including heat stress and dehydration.

Dr Syed advised people to pay attention to both heat and air quality, stay hydrated, reduce strenuous outdoor activity and seek cooler, cleaner indoor environments when conditions deteriorate.

Keeping the air cleaner at home

For families trying to get through the prolonged haze, many protective measures are simple.

Checking API and PM2.5 levels regularly can help people decide when to rem